06040065 CITY OF CUPERTINO x. '�a'd•A '*:^ ' ` ' " �`"' #" ''�' '
BUILDING DIVISION PERMIT s 'ONIt,A.C,TnR,�INFQ,,RMA,TI,�,EN
BUILDING ADDRESS: FRANKLIN' S ROOFING SERVICE PBRMITNO06040065
20874 GREENT.RAP DR
OWNER'S NAME: PERMIT LSSUE OAYE
Ad k KANYU CAO 950 S
ONE: SANITARY NO. CONTROL NO.
(408) 371-9495
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMS
MECH
O
±oC LICENSED CONTRACTORS DECLARATION lob DBSC
1 kmby af0nn that 1 am licensed under pmvidms of Chapter 9(commencing
with Section 7000)of Division 3 of the Bummus,and Profeaions Code.and my license is
infutameenderfea /y REMOVE THE EXISTING .SHAK ARCH COM
Z License Claa ly—� Itt
Dam Contractor LASS A
ARCHITECTS DECLARATION pp
I 1 understand my plans shall k used u public records MAY �2006
5 C� Licensed Prufestiooel
�q OWNER-BUILDER DECLARATION ��'
i�f 1 krtby affirm Not I am exempt form the Commences License Law for um
yp o following moan. emit 703 L5.Budnas and .-mall Code:Any city or minty
d9 which im iseaapumil recrnss the plic.Wprove,dearriti ore asigned
ig ed tuement
NG
_Zj, Prior msl lensed momaixii ent
tto resW,the nt ofor schpermilunense La cufummcm 0000
(catkin kensit pSeoantm uta of Diatom ofofmc Biacmntexts¢Itaw(aaptn9 Sq.Ft. Floor Area Valuatfj5
(comet.ingexempt
pth Section7")Adfla Division3 of Arc Budnw andon.Anyvi Code)tion of
the be b exempt Wemfrom and tk bub far Ne alleged exemption.Any violation of
Section 7031.5 by airy appllcun for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
out mom Wan five hundred douses($500). 32630169 . 00
❑L u owrcr of dle import a my maploym with"tow theirsole mmpeadon,
will do the it and Netwnum is tmtinunded orarteed mraele(Sm.7044,Budaaa Required Inspections
And Pmfudans Cade:The CommbcmYs License Law dam ret apply m e ns an owner of q P
property who buildsorimpmw thereon,andwho doessuch work liberation or Nmagh his
own employoa,provided that each improvements art notmuMed or offered(orale B.
hinumm.the Wilding ar Impromi bald within ale year a(coopla im,We ower
Wilder will have cele burden of proving Out W did not Wild or improve for pumoae of
sale.).
❑1,as owner of the pmpeny,am exclusively conaseting with licensed mnaaean m
mrutorct the project(Sec.7044.Businea and Prorealau Critic)The Contsanofa U.
came,Law does not apply an an owner of pmpeny wW builds or improves themon.and.
who eenlans for such projects wild a mnaacust licensed pmsunt to dm Cance iabea
Lkense law,
❑lameaemptunder Sea ,Bk PCfa Niamuon
Owom Dau
WORKERS COMPENSATION DECLARATION
41 0 1 hereby Most under peaalty of perjury one of tin follewing dedantions:
1 Nm and will maintain aCeniOau nicerenl m self-Insure fur Workrl Compcn-
udon,As provided for by Smtion 3700 of W Lalar Code,for the performance of W
wart for which Ws permit is iaued.
❑I have and will maintain WmAeYs Compensation Insunna,As enquired by Section `
3700 of the labor Cride,for the performance of the wart for which this permit Is issued.
My Workefa CompemWot twe Whim am,"and policy number am:
Carriv: n-) No.��n6rr3Iff�.
CERTIFICA •OF MEMMON FROM WORKERS'
COMPENSATION INSURANCE
y
(This senior need out becompleleu If the permit Is forme hundmd dollen($100)
,it leas.)
I certify that In the put...ce of the work for which this Permit is heated.I"I nm
employ any person in any manes As m became subject to the Workers'Compensation
Laws of California.Due
Applicant
NOTICE TO APPLICANT:IL alter making this Ceninam of Exemption,you should
become subject m the Waheh Compensation provisions of the labor Codc,you most
.J O forthwith comply with such provisions or this permit shall be dcamed revoked.
.zvCONSTRUCTION LENDING AGENCY
F" I hussy Ahem bun them is.mnstnctia lending agency for the perfomum.of
ft wit for which this permit is issued ISm.3D97,Civ.C.) '
W
Lc dice,Name
fL,z Lcndert Md.
U0 1 certify thin I have mad Ws appliest.A aha Mule Wu We AWve micamalmn ts
correct I agree to"no", city a
veldt all city eounlY mdinaw.'ea and fele Man miming in
ting
OU building construction,and hereby auturine opraniAdvu of this city mo enter upon the
W shave-o mumed properly for inspection Purposes
(We)aS.,to ave,indemnify and keep harmlw the City of Cupertino against
raj) liabilities,judgments.costs and wscriu which may In any way acrncAgahm said City
U 7 in emaryumm of Wetanning of Nb permit y
Fry APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date //Z—d C
SOURCE E TIONS.
Re-roofs
Sigatme of*pficessarCompaupt Dale
HAZAA60US MATERIALS DISCLOSUREType of Roof
Willthe appliam or(uric Wilding mcupatamre or handle haxsNaus ma nal
As dented by the Cupenio t Municipal Code.Chapter 9.12.and the Health ad Safety
Cat,Seem.25532(4)? . �/ All roofs shall be inspected prior to any roofing material being installed.
❑Yes IANa 41
Will Ile applicant at future Wilding camp m sea equipment a dcvias which If a roof is installed without first obtaining an inspection,I agree to remove
emit huimmus air contaminants as Junod by the Bay Area Air Quallty Management all new materials for inspection.
District? 1
❑Yes 9 Nu;
I ham mad the him Ntwanwerialsmquimmenuunucr Chapav6.95afthe Calif.- v
ni,Hul"Safey Coda Sued=25505,25533m 25534.ImWerwndthmlfNe Wilding
dao neA currendy have a mean,that 11 b Y ribility m mof Y W Occup nt or the
myuimmc sew is uatbr�mmprio u a racenfaworyMparcy. Signatu ofAppli nt Date,
s T� . 4-1a'�h All roof coverings to be Class"B"or better
Owner mat 'rotiagent Date
f Community Development
10300 Torte Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
WUPEkTINO
Building Department
JOB ADDRESS: PERMIT #
� �*elc,� pGa ("ad406s`
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR: FAX # 3`1l - a a 4
I am not using any subcontractors: -/a
Si ature Date
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
• Linoleum/ Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
caner/959� actor Signature Date
U6-:1U%U3 Ub:dd U4U67 73333 ui'f (.:liPERTINC) lo 003"(11.13
4 Community Development Department
Building Division
• i.. City of Cupertino
10300 Torre Avenue
Telephone: (408)7'77-3228
CITY OF Fax: (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 manufacturers specifications on re-roofing.
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 re-roofing
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) Pre-inspection and/or tear off approval.
2) In-progress inspection approval.
3) Final inspection approval.
a) 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 a proper City inspection can be performed.
IMPORTANT:
1. Flat roofs must have a minimum,of 1/4 " 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 on inspection.
I understand.and will comply with the above stated policy on re-roofing,
Homeowner's Name: u Q X1 1 e. An
Job Site Address: _�OR`1Qc Gf'P AIQOJM bL
Roofing Company Name:
• A plicant's/Signature: Ml a C. Date:
lA.+�xt
Greg eel
Building Official
Revised 1/30/03
CITY OF CUPERTINO
46m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32630169 . 00
DATE ISSUED. . . . . . . : 04/12/2006
RECEIPT # • • • • . • • . . : 33955
REFERENCE ID # . . . : 06040065
SITE ADDRESS . . . . . : 20874 GREENLEAF DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : KANYU CAO
ADDRESS . . . . . . . . . ..:
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : KIM JOHNSON
CONTRACTOR . . . . . . . : FRANKLIN H DEATS LIC # 23154
COMPANY . . . . . . . . . . : FRANKLIN' S ROOFING SERVICE
ADDRESS . . . . . . . . . . : 950 S MCGLINCEY LANE
CITY/STATE/ZIP . . . : CAMPBELL, CA 95008-5414
TELEPHONE . . . . . . . . : (408) 371-9495
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 9, 000 . 00 158 . 76 0 . 00 158 . 76 0 . 00
BSEISMICRE VALUATION 9, 000 . 00 0 . 90 0 . 00 0 . 90 0 . 00
---------- -=-------- ---------- ----------
TOTAL PERMIT 159 . 66 0 . 00 159 . 66 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 159 . 66 10877
TOTAL RECEIPT 159 . 66
•
CITY OF CUPERTINO 06o�001o5
REROOF
CUP P.TINO , PERMIT APPLICATION FORM
• T
Date:
:3P,u -30 - I V?
4
............. .. .
Owruer's Narn�-..:
Phone #: License#:
Contact: Pi Cupertino Business License
fCaok n r 3 qS:_ A3 4 4-
Type of Roof Covering:
Existing: Proposed:
D Built-Up Roof El Built-up roof
0 Asphalt Shingles 0 Asphalt Shingles
0 Wood Shakes D Wood Shakes
Q Wood Shingles 0 Wood Shingles
ED Other(Specify) 11 Other(Specify)
Number of existing coverings -:t El Provide I.C.B4O,Report# U L�
0 To be Removed Z Provide Mfg. Installation Specs,• .
,I Have Read, Understand an11cy-.- - —
Description:
��e d Will Comply With CuCupertino's Tear Off Poll
es r
Job Description: C
1RP iba
.............. �Movc�_
Residential Z Coll u I lcjLi"hW ❑
Fire Zone: Yes El No 71 Confirmed with Planning Dept, if
there are any restrictions: LJ
Cost of Project: T e of Construction: Occupancy group:
%0 00
Qty. if
FeelD Fee Description Fee Group
BPERNdFEE Bid- Permit Fees
BUILDING
BFNERGY Energy BUILDING
BSEISMICRE Seismic Fee Res—_
BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
• 7--
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