03120009 (2) crry or• curFirrwo „` ro roes a Y=
aU1LDINo DIVISION PERMIT CONTRACTOR INFORMATION s
BUILDING ADDRESS: FRANKLIN ' S ROOFING SERVICE PERMIT NOQ3120009
7639 ERIN WY
ER'S NA
YM1tE:E:NPERMIT ISSUE DATE
OKE ANCY K TRUSTEE 950 S MCGLINCEY LANE 12 02 2003
PHONE: SANITARY NO. CONTROL NO.
(408) 371-9495
ARCHITEC-UENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
:oa LICENSED CONTRACTOR'S DECLARATION
I Mreby affirm that I am licensed under provisions of Chapter 9(commencing lob Description
IiG esu with Section 7000).f Division 31filre Bus od Professions Cade.and my license is
.>. inmure erfey G( REMOVE EXISTING/INSTALL PLY OVER SPACE SHEATH
si;a Dale ueenLCorer INSTALL LIFETIME CERTAINTEED TRI-LAMINATE COMP
I F at d or
ARCIIITECI'S E ATION SHINGLESf y;L I and�y pbmn ,hall he used a public rcenrds
JadU
o t7, Licensed Professional
g OWNER-BUILDER DECLARATION
ya E 1 hereby of Brm that I am exempt from Ne Contractors License Law for the
00 following reason.(Section 7031.5,Business and Pmfeamon,Code:Any city or county
m which requires a Permit to construct,a1¢r,improve,demolish,or repairanystructure
primmos issuance,also requires the applicant forsuch Permit o rile a signed statement
;s< that he is licensed pursuant It)the provisions Of the Contractor's License Lrw(Chapter 9 Sq. Ft. Floor Area Valuation
E- (commencing with Section 70(Xg,d`Division3nfthc B a,ocsx and Prufcssinns Code)Or
that he is exempt thcrefrum and 0e basis for the allegedcscmptmit.Any violation of $9500
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of ane ApN Number Occupancy
not more Nan five hundred dollars($500). P Y Type
❑ I,as owner of the pret or my employees with wages M Noir sole compensation.
will do the work,and the structure is not intended or offered for sale(See.7044,Business 35920021 . 00
and Professions Code:The Contractor's License law doe,not apply to an owner of Required Inspections
property who builds or improves Hereon.and who does such work himself or tamugh his
own employees,provided that such improvements arc nut mended or offered for xalc.If.
however,the building or improvement is sold wiNin one year of completion,the owner
builder will have doe burden of proving Nat he did not Wild or improve fur pm,ase of
sale.).
1,as owner of me property,am exclusively contracting with licensed Carnal to
onswel the project(Sec.7044,Business and Professions Cade:)The Contractor's Li-
rise law docs not apply to an owner of property who Wilds or improves Reason.and
who contracts for such projects with a contiamor(sl licensed pursuant o to,Conamemes
01 w DEC 2 9 2003
❑Ivo Lac pt antler Scc. ,Bh PCiu
WORKER'S COMPENSATION DEC TION BUILDING1 hereby aff him under penalty of perjury one of the fallowing declarations:
❑1 hats and will maintain a Cenifeam of Consenuo sef-insure for Wortrr's Com ven-
sation,as provided for by Section 3700 of Ne Labor Code,for We perfarmance of hbe
work for which this perrnit is issued.
I have and will maintain Worker's Compensation Insurance,as"ivied by Section
37W of Nc labor Code.for the pmformance of the work for which this permit is issued.
My Wmj, x rdr]or an and�cynumber am: q
Ca 'cr. / GTWF/!.a'I_�pyli a.:OO o I Q M f-
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
phis section need not recombined Rik permit is forone hundred dollars($100)
or mss.)
1«oify that in the performance Of the work for whim(his permit is issued.I shall not
employ any person in any manner so m tar become subject to the Workers Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:If,at making this Ccmficate of Exemption,you should
become subject to the Worker's Camille osution provisions of the labor Code,you mush
aZ forthwith comply with such provisions or this permit shall W deemed revoked.
zCONSTRUCTION LENDING AGENCY
1 family affirm that Ban,is a construction lending agency for the performance of
2' me work for which this permit is issued(See.3097,Civ,C.)
].1 Q Under's Name
IIL Under's Address
J I certify tut 1 have read this application and sure Nn this,above infmollown is
torten.I agree 10 Comply with all city and county Collimates and sole laws mlaling to
.7. Uj abovengConstruction.tioneand hereby auNorimrposesenutirss of this city memo upon the
above-mentioned property for inspection purposes.
FI, (We)agree tu save,indemnify and keep harmless the City of Cupcnsts against
rq in
equnce of the Costs and expenses which may in any way Accrue against said Cdy
U z A APPLICANT
of UNDERSTANDS
granting of this permit. (/j
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOU ER(:GULATIO s.
.O Re-roofs
Signature of AppllcanUCahnnetor Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Ne applicant or future building occupant solid at handle hommous material
as dcrined by the Cupenine Municipal Code.Chapter 9.11,and the Health and Safety
Sceumt0YCs zss3z(a)^ WN. All roofs shall be inspected prior to any roofing material being installed.
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
mit havardous air contaminants m defined by the Bay Area Air Quality Management all new materials for inspection.
District?
C3Yes 'VNo
Ihave mailthe
. ims6.95 of he l
nixHealth65afly Code S.mou25505.25533and
25534.1tadennanedlhaif did holding
dotsaraIcuncmly have a tenant.that it is myresponsibility to soory
ILe rccupanl of the
mgair ent.whieh eat t nortniss ttOraceni0h:amoraenpane. I
Signature ofApplicant Date
URbsoc,or amhmi,cdClient Dale2 O All roof coverings to be Class"B"or better
CITY OF CUPERTINO
ILlCn 1 of 1 PERMIT RECEIPT OPERATOR: suem
COPY # 3
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35920021.00
DATE ISSUED. . . . . . . : 12/03/2003
RECEIPT #. . . . . . . . . : 23940
REFERENCE ID # . . . : 03120009
SITE ADDRESS . . . . . : 7639 ERIN WY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : BOOKE NANCY K TRUSTEE
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4342
RECEIVED FROM . . . . : FRANKLINS ROOFING
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 10, 000.00 157.00 0.00 157. 00 0.00
BSEISMICRE VALUATION 10, 000.00 1.00 0.00 1.00 0.00
TOTAL PERMIT 158. 00 0.00 158.00 0.00
METHOD OF PAYMENT AMOUNT NUMBER
____________ __________________
CHECK 158.00 9471
TOTAL RECEIPT 158 .00
•
Community Development Department
Building Division
City of Cupertino 10300 Torre Avenue
Telephone: (408) 777-3228
CITY OF Fax: (408) 777-3333
CUPEkTINO
Building Department
Subject: Re-roofing 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 Na� AQA CV 400XC
i
Job Site Address 7 ? PA.L/J't /
Roofing Company Name:/ 16 J" i /CrN�/�irt.di
A plicant'ss Signature: �ae7n, M i Date:)
Greg teel
Building Official
Revised 1/30/03
Printed an Recycled Paper
CITY OF CUPERTINO 0312000q
REROOF
OCUPEkTINO PERMIT APPLICATION FORM
APN ii Date:
11 -25-2003
7639 Erin Way, Cupertino
Owner's Nazn : Phone #-.
Nancy Booke 253-6221
Contractor Phone #: License#:
Franklin ' s Roofing Service ( 408 ) 371 -94955 C-39 352164
Contact: Phone #: Cupertino Business License #:
Frank Deats or Kim Johnson ( 408) 371 -9495 23154
Type of Roof Covering:
Existing: Proposed:
* Built-Up Roof Cl Built-up roof
* Asphalt Shingles E Asphalt Shingles CertainTeed Tri-Laminal e
M Wood Shakes L3 Wood Shakes
Q Wood Shingles D Wood Shingles
0 Other(Specify) 0 Other(Specify)
Number of existing coverings 1 C) Provide I.C.B.O.Report# 2656
20 To be Removed Q Provide MfgT. Installation Specs. 5 5/8 exposur(
1 Have Read, Understand and Will Comply With Cupertino's Tear Off Policy:
Job Description: Remove the existing shakes, install plywood over the spaced
sheathing, Install Lifetime CertainTeed Tri-Laminate Composition Shingles
..
0S....1�tl
Fire Zone: El No Confirmed with Planning Dy, if
there are any restrictions:
C'At of Project Type of Constructioa— Occupancy group:
T'9, 500. 00 ) Reroof Single Family
Qty. if
Appli$QrFee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENFRGY Energy BUILDING
L2 BSEISMfCRE Seismic Fee Res BUILDING
BSETSMICOM Seismic Corarnercial BUILDING
BPLANCHK Plan Check Fee BUILDING
DING
BUSLIC i Business License BUILDING