02090020 (2) CUPERTINO
:..;;BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMTTNO.
228.00 RIDGEWAY DR �/�]} '` 14,yLodt 02090020
'- - 1.7 1 LL ( e'!' (,�
APPLICATIONTOB DA
bR 12IDGE OF CUPERTINO HOA Y '0P- 09/ 042002
PP SANITARY- ,. ml..lO A may ' �.,..,r SANITARY NO. CONTROL NO.
OOP -ARCHITECT/ENGINEF.R: ,� A BUILDING PERMIT INFO
,.
"-� BLDG ELECT PLUMB MECH
,! LICENSED CONTRACT'OR'S DECLARATION -
OZ;: it hereby annthat Iamlicensed under provisions ofChapter 9am
amen<mg J06Description.
. tn
� with Section 7")of Division 3 of the Business and Professions Code,ed my license REROOF �p
�yf is in roll lass rid /� /—
ti tt0.'u License Class
7 Lic.N sfJ
3,a Date Comm<tarAT 1 't
u O:g pC cl'undeistdnd'mY Plans s„a be useHECT'Sd vpubl�CLAR
e r<coNs JUN 1 O ZOO
t6!6 O:O Licen;cd Professional ,OWNER
:1 n e BUILDER m the ATION BUILDING ,m I hereby.(Seco that I s exempt from the Contractors C License law for the $17 9 4 9
rollout g ' omit t 10315 Business andmpe vee de Professions Cade Any city structure F❑ wh ch 9 permit sac ass-a hca mprove,demolish.or repine any stmewrc - - _• - _ _ _ -
3$ pd s s ante,al q rc th ppl c.m far mch permnto fleas gned statemem- -.
a Valuation
. . sees ...
Nal h{ li n dpuizuhnl!vdu'brvw'ons of Ne Convacmis License low(CM1upmr9 e-.. ,`1 i ,3 ,Ar.ITh r•I`.A�I-A� 111' 11 r
(co m<n mg thskRo ]0(10)ofhe basiion c far
in. Business and ProfessionsCosts) jT k.1�_, is i!'�1 ±? .
of Seethe ii exempt tinny applicant
p li and she hash for the Aliged exnnptiod.Any wpualty
of not mom
vanydreddamforapermit suhjccss the opPlicanno.civil penvlty
;arna�mare man five hundred dollars.coal. 3 0 roAPN WRAkE ,, : Occupancy Type
°Pas owner of the prnpeny,or my employees with wages as their sole compensation, 307 INSULATION
-will'do'the work:and the vmnure T not intended of offered for sale(Sec.-spurt- 6 O l — ROOF TEFF IQI>g'�'Inspections''- ' 'I '1”•'"
Bus ness and Profesdav Cade The Conac
vmr w s License ladocs not apply to an
ownerdi
of property Who builds or improves income and who does such work himself 602 - ROOF PLYWOOD NAIL
or emed h h sale.awn employees.Prov did rhos such uenient mems ere oat mmnde l or
.___ .._ _ sees.. rtes_..--
.- +alfawbnthu:howuilderthe llhiam(ertmpmofcausi;tldhdidnotWildor 603 — ROOF-'BATTENS- ...';iiv .�,.:-__._.._.. _ _ _ _..,.____._..
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completion,the osdnef Weer will hasx the bueden of proving shin he did not build or
isnPrnve roe liarjiose ar sine): 604 - ROOF IN-PROGRESS
--=_ --.._,..•,.__.amexc._ivelyc
°I,as owner of the propenY•aur exclusively comractin8 with licensed contractors to
coiisaucfthe prosect(sec.1614,Business and ed,who fif Codm The improve,
tmircu, o a,. _ Ll
License Law,docs not apply mra owner of property who builds or improves thereon, '
;. ._and'who.ro Livens.for.such.Pmje<s;ff 1 a-comtacme(." lieensed.pursuant.to die....__.-......_._......_.__.-_........___....__.._�,..._._._._:�__.CertLam......
F. Concon ace's ipt unde Law., n i'q>' r A•:b. 't s i?', V
r!� ❑lames<m tuVder Ser B&P C for this mason IO's .-'-""'!iLiJ;
., .l!.. sees, .,.. .. .. i v. . . ,.
Ower^..:. ,' .r ., .: 'Datil,see s.. nr _
WOR',.KER'S COMPENSATION DECLARATION
.:.�.:... .. .. .... .. .- -
Ihereby affirmunder pe miry ofPerjury)oric{orthefollowingdeciantions: -
-� ° 1 have and'will maintain a Cenificamof'Conuni to self-insure for Workers
Compensation, as;provided for by Section 3700 of the Labor Code, for the
``tt�fit ima m of the work(a' mch this pe t ed ,
lz have n d ill mmpt m Worke s Coupe t o In' m e a ed by Section -
B]LYt f ih I:dur Cal f theperformance f the A f which this permit is
1 iced My W k f n 1 s me P
cyuszo
`a�aERTIFICATI NOF %EMPTIOI FROM.WORKERS' "y.�y• _ '• (U -
COMPENSATION INSURANCE { - _
n •' ., ..,. ,._ �_. ..I..:_— _ , —_ (ICCq
(Th amo need not he warp cied f the permit is for one hundred dollars r i;v` .
($100)or less b
nfpdh tin m<pef,m-cum of the work for which the permit sissued,i .� - _ w`` L `.:,G •.• .— _•u
shall not mploy'ady,permn m any mann r;m as m become subject to the Workers '
Co pe'm much laws or Cel rami Dam,
-APpldunt
_. sees
ANF;If.
INUI PCH TOctto the Workes Compemaking this Cmtincae nl Exemption,de,you
youshould
.
Secure lubjeni slit worker'sComas.1 this provisionsllfthe Lanor Code,you must
O forth th mply with such prot ions m this pe n shall h correct rooked.
. .�
vi 'CONSTRUCTTON LENDING AGENCY
� � >S I hertbY R' that the s ' amnion IeM g g my for she pert mi tt i .s i .
bf(he ark f h<h sh s pe t v i ed(s c 309] C C 7 !
."0. z
9 I ceniry thin 1 have rcaJ ih s application and stmt thdi @c shove mrortwtion is
w E. boirecr 1 g e 1,comply oh ell c'sy and iy,u J ounce v d i sermitring
upon
t.,) IOW Id ge wnion,and hertby.aura z prtseniativa of th ctyt ter upon
r� the boa em gned p pony f .peer on puryox _
;,rys (W) gems.ive mdemntfyand Acep hand.vttie Oryof Cup nnovInst
ti halo t a dgmenu.coca and ape us h¢h may any y geins,saitl
U z Cityy a quartile ofthe g-n ng s
(Y,I
• MUMC
CANT.UNDER WILL Oh1PLK ALLN�r V-y(R'
oltce RFcc ............. .......... Issued by; Dale
1.1.i:ii WHAZARDOUMAT1ERIALS DISCLOSURE llsheappl¢a to fumrelutldmgopist=orhandle
hvudotsmat ZooAppinVctor-'&gam -
Gore Re-roofs
Type Of ROOF •• z.- - -�- . ..as defined by theC pen oo Municipal Cade Chapin 9 13 and theHealth and Safety _ iv IJ - .__ _ - \r.'
Cod sea n853 soli illi!; , fiu�y , I : 1.�. ss ..• ei Aox 'QiOt V T5 .i3 IAKu ' f 'I
.All roofs,shall be ms ectad rior.to.an roofin material,being.installed,._---------
W Ilth pplcat --
or future W ldingrecupx r me equipmentordevices which If a roof is installed without first obtaining an inspection I agree.to'reniove
1 emit hazvdous air conmmmams as defined by the Bay Are.Air Quality Management
District _ �N all new materials for inspection. Applicant understands and will comply with
°Ye\ i " all non- omt so are ulztiodk_ .
cc 1 have a dthe hazard a immedid regm in-nts under Chapm'fi 93 of the ,
California Healthy otsurafety CMe aveSluc sn Liner
tic end 55341 ndemand thin -
-",ifshe building does nowurtemly have a renan4 thdt t s my rc pan ib l ty to notify the -
oce amtoft„ re e mtM tp poor isssa«of rificmof -
Gera y 7
�f ���__ Signature of plicant _ ,- Date
_.
s u
oond1frr mcaM1Lim agent Date All roof coverings to be Class,"B"or better
,
-OFFICE_
Building Division '
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CI F= (408)777-3333
CUPEkTINO
Building Department
Subject: Reroofing policy for the City of Cupertino.
1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards
and manufactures specifications on reroofing..
2. .New roof coverings shall not be applied without first obtaining all inspection
'and written approval from the building inspector.A final inspection and
approval shall be obtained from the building inspector when the reroofing is
completed.
3. All roofs shall be inspected prior to any roofing installation
4. To receive a final sign off from the City the following steps are required.
1) Preinspection and/or tear off approval.
2) In progress inspection approvaL
3) Final inspection approval-
a)
pprovala) Spark arrester installation
5. If plywood is installed,a plywood nail inspection is required.
6. Any roofing which is applied without first obtaining an inspection,will
require the removal of all new material down to the sheathing so that the
proper City inspection can be performed.
IMPORTANT:
1. Flat roofs must have a minimum of U"per foot slope and demonstrate that
there is no ponding.
2. An I.C.B.O.report is required to be on the job site at the time of inspection
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name: .�
Address: b
1
Reroofing Company Name:
Applicants Signature: Date: q o Z-
Joe Antonucci
(Chief Building Official)
6/25/01