03100135 ICITY OF CUPERTINO '��"^`° s?"
t nulLorrvc ulvlslory PERMIT CONTRACR INPMATION ;_,
5UTLDINGADDRESS: FRANKLIN' S ROOFING SERVIC PERMITNO.03100135
OWNER'S NAME: 950 S MCGLINCEY LANE. PERMIT ISSUE DATE
NE' (408) 371-9495 SANITARY N . CONTROLNO.
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MEC"
0 � 0
100 LICENSED CONTRACTOR'S DECLARATION Job Description
i U F 1 hereby firm that 1 am licensed under provisions of Chapter 9(commencing P
` with i{cg yZ Section]0fDivixion3of du➢us✓i
�to+r ad Professions Codc,and my iccu is
n0glgaLt.LiceneClassolo
REROOF
Dam Cntrac
3q�q ARCIfII Wiese a TION
i g 1 understand my plans shell M mud a public reenrm
IdD /
Licensed Psufcasinno l /
''I OWNER BUILDER DECLARATION
I<X 1 hereby affirm that 1 em exempt from the Cmuso rs License Law far the
❑O following mason.(Section 7031.5,Business and Professions Code:Any city or county O
$ which requires a Permit to construct,alter,improve,demolish,or repair any nructum
.ai prior to its issuance;also mquims the applicant for such Permit to file a signed statement
f G that he is licensed pursuantmthe Provisions Ofthe Cantmcmr'sLicense Law(Chapter 9 Sq. Ft. Floor Area Value'
$ (commencing with Section of Division 3 of the B Ostrom and Professions Cook)or
— Nat he is exempt thmefmm and the basis for the alleged exemption.Any violation of
Section?931.5 by any applicant for•permit subjects the applicant to a civil penalty of APN Number Occupancy Type
nm more Nan five hundred della,,(S500).
I,as owner of the property,or my employee with wages as their sole compensation,
will do the work.and Ne stmnum is not inlemcd or offered for aale(See.7014,Business - Required Inspections
and Professions Code:The Coingerm's License Law does not apply m C an owner of q P
property who builds or improves thereon,and who dos such work himself or through his
own employees,provided that such Improvements tie not intended coffered for sale.If,
however.the building or improvement is sold within one year of completion,the owner.
builder will hove the burden of proving that he did not build or improve for purpose of
sale.).
❑1,as Owner of the property,am exclusively contracting with licensed contractors to
construct the pmjcct(Sec.7 W,Business and Professions Cods:)The Contractor's Li.
ceme law does not apply to an owner of propeny who builds or improves thereon,and
who commcte for such projects with a contractor(s)licensed pursuant to the Contractor',
License Law.
❑I an exempt under Sao ,B It P C for this mason
Owner Data
70311WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty Of perjury one of the following decluniom, ,
1 have and will maintain a Ccni ficote of Consent m self-irmot for Worker'sCompen-
W"
on,u provided for by Section 37M of the labor Code,for the performance Of he
k for which thi,permit is issued.
I have and will maintain Workers Compensation Insurance,u mquiud by Semon
of the labor Code,for Ne performance of the work for which this permit is issued.
Wnrkcr'a CnmpemetinnJr,mmrce carticr endP numbcnm'cII�CERTIFIGTE OF EKEMPf1Oy OMM WM
COMPENSATION INSURANCE
(This section need not M completed if the permit Is fororc hundred dollms(5100)
o,Ices.)
1 cattily that in the performance Of the work for which this Permit is issued.I shall net
employ any person inany manner an as les become object to the Wmkei COmpensatinit
Laws of California.Date
Applicant
NOTICE TO APPLICANT:IL after making this CeniReate of Exemption,you should
become subject to the Worker'a Compensation provisions of the Labor Cook,you..at
Oforthwi tit comply with such provisions or this permil shall he doomed mvnked.
�2 CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for the perfurmeme,of
:d 7 the.,it for which this permit is issued(Sec.3097,Civ,C.)
4 QLmdch Name
jz Lmik,,S Address
J Q I ttniry that I have read this application and sem that the above infmmuien is
y P correct.l ague to comply with all city and county ordinances and slue law,milling to -
�U building construction,and hereby authorise upresenhadws of Nia city to enter upon the
Na above-mentioned property for inspection purposes
(We)agree to save,indemnify cad keep harmless the City of Copcdim against
'r N liabilities,judgments,costs and expenses which may in any wry accrue against said City
J7 in consequence Of the gram ng of this Permit. 4Q;6.•77 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE R ULATIO S.
Re-roofs
HAZARDOUS
urc of APPIicaDau
HAZARDOUS MATER cuponiDISCLOSURE Type of Roof
Will the applicant or mfuture building Occupant atmu or handle haemtrtrndSafety material
u defined by the Cupertino Municipal�,Chapter 9.11,and the HpIN and Salary
Cnde.Section u5axa)1 ,,��f[[���� All roofs shall be inspected prior to any roofing material being installed.
❑Yea *u
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
it Wa> dram air conitmimms u donned by the Bay Arta Air Quality Management all new materials for inspection.
tabrin7
h Yes
I hove mad the hmeNt smamrials mquirements under Chapter6.95 ofthe Calif.,.
ria Health k Safmy Codc,Sections 25505,25533 um 75539,I mu nuM Natifthc building 4 „� -o3
does not corrently have a mmnt.Nm h is my responsibility m no'fy the mcupent of the
requirements whichmust bc`mc�on'onniuuance Of a CeNficaae cupan y, Ig
gnature of Applicant ate
��/'a7 -
o cr a,aolocim<d agent Dam All roof coverings to be Class"B"or better
UB U;113 01) 44 'U4U67t 5:j333 C1'1 (.?EiCTINU [�]UO3i 1)U3
Community Development Department
Building Division
f:y City of Cupertino.
' 10300 Torre Avenue
Telephone: (408)777-3228
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.
I_
IMPORTANT:
1. Flat roofs must have a n%4-dmum 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: Adam Chan
fob Site Address: 10 14 4 Miner Place, Cupertino 95014
Roofing Company Nam Franklin' s Roo Service
Service
A plicant'sSignature
:
lA
Greg teen
Building Official
Revised 1/30/03
CITE' OF CUPERTINO D3 � o a 13J
. a REROOF
CUPEP,TINO PERMIT APPLICATION FORM
' AP ,i M� Date: _l
I hui�ding P.�dre;-r<;: .
10144 Miner Place, Cupertino 95014
--........... ..... ...__:._... ....._...._. .. .
0wm r s Narnl-: Phone#:
Adam Chan ( 408 ) 255-0825
Conrractor: Phone#: License#:
Franklin' s Roofing Service ( 408 ) 371 -9495 352164
Contact: Phone#: Cupertino Business License#:
Frank Deats or Kim Johnson ( 408) 371 -9495 23154
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof Q Built-Up roof
❑ Asphalt Shinglcs ❑ Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
Q Wood Shinglcs ❑ Wood Shingles �LIORI L� atY�n {�
M 'Other(Specify) Tile 3 C*er(Specify) Lightweight Tile
Number of existing coverings 1 t$ Provide I.C.B.O.Report# 2 6 5 6
N To be Removed ❑ Provide Mfg. Installation Specs.
• T Ha ` Readderstand and Wil] Comply With Cu ertino's Tear Off Policy:
De•criptign:
JRemove the isting tile, Apply plywood, Install a new Monier Tile Roof
Coll lillercial 17
ne: Yes 0 No ® Confirmed with Planning Dept, if
- there are, restrictions: LJ
Cost of Project: Type of Construction:—� pccu an gr up:
15 000 .00 Reroof F
Qty iif
-
A c ble. Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEI'SMICOM Seismic Commercial BUILDING
BPLANCHK J Plan Check Fee BUILDING
BUSLIC Business License BUILDING