03070047 CITY OF CUPERTINO i` =' a`
BUILDING DIVISION PERMITCONTRACTOR,4INFORM- ATION
BUILDING ADDRESS: FRANKLIN' S ROOFING SERVICE PERMIT NO'03070047
OWNER'S NAME: 950 S MCGLINCEY LANE PERMITLSUEDATE
ONE: SANITARY NO. CONTROLNO.
(408) 371-9495
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
l� o
�Op LICENSED CONTRACTOR'S DECLARATION
e 1 hereby affirm that I am licensed undo,,,,(NNf pmvisio a of Chapter 9(commencing Job Description
with Section] ggnf Division3of NC Boa .PdPndossbxrACade,andmyliccnseia
mmur c Jcffcd. % ✓ 3 / REROOF
> Liccnu Lic.X
C for 1 't p ']
' � a y ARCHITECI'S4 ION jUI_ 1 H LOO)
1 undcuunJ my plans shall be stud uhlie rtenrde
>�V
e u. Licensed Professional
OatIam exempt
DECLARATION BUILDING
IA I k'e.r Nk G
<o 1 hereby.(Sero that 1 1. exempt from On Contractor's Co License Low for the 67�1/ g.1J 51'i'LA
p o following rculun.(Secdut ](131.3.Business and improve.
da ora Code:Any city or county
3$0. which rtyuisaae.alsore ennstrvn,ober.itrar sudemolish, fie repair g any strucmm
-mi but heor its iensedp rcoart to the ibe isionant for suchremitLicense Lawned(Chapter
££ 0 (comms cttnwJPuection7 h)ofDivinvnfthe ftheBuslacts and
laonsCoOer9 Sq. Ft. Floor Area Valuation
e�S (cat keit xempwith herefon]000)of Divixion3 ofthefirmness Andon.Anynvi Crude)ser
that he is exempt therefrom and tbe breis for the alleged exemption.Any vlolathn of 35914019 . 00
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not more Nan Eve hundred dollen(1300).
❑1,as owner of she progeny,or my employees with wages u their sole compenutlon,
will do the work.and the sourclum is not intended or ofremd for tale(Sec.]BN.Busies. — FKAME Raired Inspections
and Professions Code:The Canonical Lltttue Law does not apply w an owner or p
progeny who builds or improves dmrcon,and who doe.such work himselforthrough his 307 - INSULATION ON -
ownemployees,provided that such improvements ase not intended or offered formic.It. 601 — ROOF TEAR OFF
however,be building or improvement is sold within one year of completion.the owner•
Wilder will Iran the burden of proving Nat he did not build or improve for purpose of 602 - ROOF PLYWOOD NAIL
RiI`')' 603 - ROOF BATTENS
❑1,as owner of ct progeny,,Business and convecting with licensed common m
cameadoes the noapplyoanownofproprty who Wigs or
Thew Romer.
604 - ROOF IN-PROGRESS
cove law does not apply to an owner of progeny who sed p or improves Contra,rod,
who mntnN for such projects with a contncmr(s)licensed pursuant to he Conuealul
License Law.
❑I am exempt under Sec. .B&P C for this rcmnn
Owner Data
Adkk WORKER'S COMPENSATION DECLARATION
1 hereby arfrm under penally of perjury one of the fallowing declarations:
1 haw and will m.I..n A Certificate of Consent to self-Insure for Worker's Compere
ration,as provided for by Section 3]11(1 of the labor Code,for the performance of the
work for which this permit is issued.
ISF)have and will maintain Worker's Compensation Insurance,u required by Section
37or Ne Labor Cade,for the performance of she work for which this permit is found.
MyWorkel CnmPenmdon Imm!nce Ire'r and Policy number art:
CA Pal icy N ..
ChR I IFICATE OF EKEM Pr10N FRQ WORKERS'
COMPENSATION INSURANCE
ffhls section head not be completed if Ne permit is for one hundred dollars(5100)
or Ices.)
1 certify that in the performance of the work for which this Permit is issued,1 shall not
employ any person in any munerAn mho become subject to IN Workeri Compensation
Law.of California.out
Applicant
NOTICE TO APPLICANT:If.after making this Certificate of Exemption,you should
become subject m the Worker's Compensation provisions of the Labor Code,you most
.JO fmOwith comply with Rich mvisions or unit Permit 0,11 he decreed revoked.
zCONSTRUCTION LENDING AGENCY
E" ^ Ihereby An.2t Nem its construction lending agency for she performance or
61i 7 Oc work for which this permit I.issued(See.309],Civ.C.)
QLender's Name s
7 z Lender's Address
V Q 1 certify Nat 1 have read this application and cute Nat the above information is
a. (✓ contact.I agree to comply with all city and county luminances and sum laws relating to
C.) building construction,and hereby authori.e mpsesentaiiws of Ni.city be enter upon the
W ahrvcmentioned property,for inspection purposes.
(We)agree I..ave,indemnify and keep harmlos the City of Cupenino against
I,,,, liabilities.judgments,costs and expenses which may in Any way Accrue agamanoCityS
in
f to anting of this ntra . at
C) ^ APPLICA`nc`oNDERSTANDS AND WALL C PLY WITH ALL NON-POINT Issued by: Mca D.
SOUR E ULATION
y' Re-roofs
nation or ApplicanvContncmr Dale
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Ne applicant m future building mcupam store nr handle hamrdous material
m Oennctl by the Cupertino Municipal Code,ChoPter 9.13,and the Health and Solely
Cone,QYAa 23532(.)? No All roofs shall be inspected prior to any roofing material being installed.
Wilt the applicant or future building occupant use equipment oa devices which If a roof is installed without first obtaining an inspection,I agree to remove
it havasdous air contaminants m dopned by the Bay Arca Air Quality Management all new materials for inspection.
I
,
E]Yet ANo
Ihave&Safet the handout 23505.2553ls 3mmo 5534,1under Charter
nsuind 95 ofde CalifonAt.
do Hen Safety Code.Secdons255115,2553)ud2553toy un notif, ecebrout etron,of the �wD o3
Joelyynccot curerQY have s tenant Nat is ie my res:am 10,.11
m of
Ibe mcupml of the D
reR �m enma.t m riarmiva mm�eg�nerra _pax 2 SI nature of Applicant Date
L L0
. eraraamad.naasehlI� All roof coverings to be Class "B" or better_
UUi all%1,1:} "1 .11 `-11M�'i'i 3333 (.il'1' t.:C.l'll�l'1AU 14]UU:S:bl13
Community Development Department
Building Division
City of Cupertino
� 10300 Torre Avenue
Telephone: (408) 777-3M
CITY OF Fax: (408) 777-3333
CUPEi�TINO -
Building Department
Subject: Re-roofing policy far 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: Glenn Ventura
Job Site Address: 10326 Westacres Drive
Roofing Company N _e) Pranklin''s 2of+ ng Seryine
A plicant s Signator y�/�4.�n �uc�C� �\ Date:
`N�WDL-X1
Greg teel
Building Official
Revised 1/30/03
CITY OF CUPERTINO
REROOF 3 7 "
CUPERTINO PERMIT APPLICATION FORM
APN 0 ate:
Buil �� Tt
---- ------ ......
Ing Adr res,,:
10326 Westacres Drive
Owner's Nata,,: Phone
Glenn Ventura 996-3006
Phone #: License#:
Franklin' s Roofing Service 371 -949 --a52164 C-3c)
Contact: Phone#: Cupertino Business License
..Franklin Deats 371 -9495 23154
Type of Roof Covering:
Existing: Proposed:
0 Built-Up Roof El Built-up roof
0 Asphalt Shingles IX Asphalt Shingles
R Wood Shakes 0 Wood Shakes
❑ Wood Shingles El Wood Shingles
0 Other(Specify) Q Other(Specify)
Number of existing coverings 1 13 Provide I.C.B.O.Report#
M To be Removed X3 Provide Mfgr.Installation Specs.UL790
• I Have Read, Understand and Will Comply With CupeiTino's Tear Off Policy.,
Job Description;
Reroof of residence
Residential Commercial rl
Fire Zone: El1
N!��G� Conti clwith Planning Dept, if
the;Zare eanyir�stricbons: 6
Cost of Oject: Type of Con , -cup up:
11 000 . 00 f'-7 Ll
Reroof Single Family
Qty. if
Applidb'jr,- Fee ID Fee Description Fee Group
BPERMFEE Bldg Pen-nit Fees BUILDING
BENFRGY Energy BUILDING
BSEISMTCRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
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