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09050150 CITY OF CUPERTINO BUILDING DIVi51ON PERMIT bwo MON ' BUILDING ADDRESS: PERMIT NO. 1497 JADES TOWN DR FRANKLIN' S R00FING SERVICE 09090150 OWNER'S NAME: PERMrf ISSUE DATE LONE: �ANMWWO. CONTROL NO. T (408) 31-9495 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH � 0 0 u0p LICENSED CONTRACTOR'S DECLARATION Job Description WC 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing z m with Section 7000)of Division 3 of the Business and Professions Code.and my license is '`4y in full force and effect, �i RE—RF FMV EXTNG RF & INSTL NEW 30YR COMP RF CLS A License Cl s �-�3� Lic.N S `I F o Date ^240 Contractor 2 8 S Q ARCHITECTS DECLA ATION I understand my plans shall be used as public records X96 C W Licensed Professional n rn OWNER-BUILDER DECLARATION 1 hcrehy aITrm that 1 am exempt from the Contractor's License Law for the p 00 following reason.(Section 7031.5,Business and Professions Code:Any city or county t which requires a permit to construct.alter,improve,demolish,or repair any structure y Z prior to its issuance,also requires the applicant for such permit to flit a signed statement E=0 that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft. Floor Area Valuation y(-$ (commencing with Section 70D0)of Division 3 of the Business and Professions Code)or 9 O O 0 that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not more than five hundred dollars(5500). 3 6 610 0 0. 0 0 ❑I,as owner of the property,or my employers with wages as their sole compensation, will do the work.and the structure is not intended or offered for sale(Sec.7044,Business ns Required Inspections and Professions Code:The Contractor's License Law docs not apply to an owner of 9 P property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). O I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contactor(s)licensed pursuant to the Contractor's License Law. ❑I am exempt under Sec. B&P C for this reason OwnerDate WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a Certificate of Consent to self-insure for Workees Compen- .tion,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Workees Compensation Insurance carrier and Policy number am: Carrier. 5tA)I9_ V-H r d PolicyNo.: 00 J IA3 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (chis section need not be completed it the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued,1 shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must ,J O forthwith comply with such provisions or this permit shall be deemed revoked. z. CONSTRUCTION LENDING AGENCY (~i ter I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec.3097,Civ.C.) WCL 0 Lender's Name r3 Z Lender's Address U O 1 certify that I have read this application and state that the above information is LL" correct I agree to comply with all city and county ordinances and state laws relating to Vbuilding construction,and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against rFt C+4) liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. ►+ APPLICANT UNDERSTANEA AND WILL COMPLY WITH ALL NON-POINT Issued b): Date 'L f SO RS�C REgquuLA �'``^��' S1-11e!160F) Re-roofs Signature of Applicant/Contractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. C]Yes 4 No WIf a roof s installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which ill hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. ,strict? ❑Yes ]No I have read the hazardous materials requirements under Chapter 6.95 of the Califor- u nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building docs not currently have a tenant,that it is my responsibility to notify the occupant of the require n m priortoissuance ofaCertificateofOccupancy. re ofAppli Date O ncrorauthori agent Dam All roof coverings to be Class'W'or better CITY OF CUPERTINO (L REROOF CITYCUPEk�TINO PERMIT APPLICATION APN#% v v Date: Building Address: _. Owner's Name: B 1'0 k l Q_y Phone#: HOA: Yes ❑ No If yes,provide letter from HOA 4442` 16-3 q Contractor: �z *1�w)'S P i i Phone#: :3 7 j _q�GS S _�v c q � ..M,L 6 �► �C�y 4N "-� �,c.�Yv� ���� Fax#: - 1— 3 y 4 Cupertino Business License#: , Contractor License#: 3 ! 59-- 3 5 Q 1 Type of F:oof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles id Asphalt Shingles X Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report# �P To be Removed ❑ Provide Mfgr. Installation Specs. 3 Job Description: "-\0 VC,—, _ Lj,lam �ax 1 _�_1 , � ,}� SiCA l I ck n�?_ L0 - ,y (- (� rnj)�-' �k n Residential EV os c3 P'y w o od Commercial ❑ Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist& attach it to the application or if there are any restrictions: ❑ applicable,include in plan set& the sheet index. Valuation: I Have Read,Understand and Will Comply witt. Cupertino's Tear-Off Policy: V Ll ature Revised 02/05/09 CITY OF CUPERTINO ,a ' R.EIRDOF CUPEkT1NO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commissio:i Fee 1BSEISMICO Seismic Commercial B 2 ,r 1RER00FRES Re-roof Residential B 1SFDWLROOF / 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commissio:l Fee 1BSEISMICRE Seismic Re;>idential B 1 REROOFMRES Re-roof ML lti-Family B 1MFDWLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commissio a Fee 1BSEISMICRE Seismic Re3idential B 1BUSLIC Business License B Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 Fax: (408)777-3333 Building Department Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must al;ree to comply with 2007 IBC Standards and manufacturers specifications on re-roofing.All roofs are Class "A"per Cupertino municipal code 16.04.080. 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 nzAl inspection is required. 6. Any roofing which is applied witho u t first obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of$176.18. The re-inspection fee must be paid before another inspection cim be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of'n "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: a'^d Q►� c y Job Site Address: 1 l-7 JAv",eS To a-N 'Dy Roofing Company Name: Fra`^ k I''%-� Applicant's Signature: — Date: t ko°-1 Greg Casteel Building Official Revised 07/30/08 Community Development 10300 Torre Avenue a=, � Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 "UPERTINO Building Department JOB ADDRESS: PERMIT # G 1 y 617 .Saves Q s (a ,.�:�. �D r F7 U -5 u I � c OWNER'S NAME: W&V% � k PHONE # L4410 -l tQ 3 9 GENERAL CONTRACTOR: V-0 FAX # -7► - gay 7 I am not using any subcontractors: i;-j 2&rZWe) Signature Date Please check applicable subcontractors and com-:)lete 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 Owner/Contractor Signature Date