06030096 CITY OF CUPERTINO 5
-ONT7_
BUILDING DIVISION PERMIT
BUILDING ADDRESS: Kvur.LNU PEMMO 0603009�__
7624 ERIN WY
OWNERS NAME: PERMIT ISSILTE DATE
LARRY LYNCH 15230 CLYDELLE AVENUE .03/20/2006
NE: SANITARY NO. CONTROL NO.
(408) 626-9320
ARCHITEZVENGINEER: BUILDING PIERMITINFD
BLW LUMB MECH
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LICENSED CONTRACTOR'S DECLARATION
I Imedn'affrom de,I gre jumuma under pmvW=of Chamor 9(commencing Job Description
wl
�LhScclhan.70(*)Mf � B mus dprof Woucle y license is REROOF—REMOVE (E) LAYE HAKE/INSTALL NEW
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Lic...Cl LIC.# 1/2 ' CDY 30LB FELT A
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ARCIH, CrS D R NAM
I unde nd my plans OAR W�imed zi��V* Ed�. LK;
2006 M Licensed Professional OWNER-BUILDER DECLARATION
NI hereby afrim that I am exempt room the Contractors License Law for the
z a following news,(Somon 70313,Business and Professions Code:My city or county
;ij9 which requires a Permit to construct,altar,improve,derntifish.or repair any structure Ila r%kk A^
r� that he is licensed pursuant to the provisions of the Conuramor's Uccrcm Law(Chapter 9 Sq.Ft.Floor Area
z poor W its issuance,also requires ft applicaral for such permit to file fis.b...
M 2 a
X (commencing with Section 7000)of Division 3 of the,Business aM Proicssims Code)or
Vast he is exempt thentfrom and the basis for Ban alleged exemption.Any violation of
Sectiort 7031.5 by any applicant for a permit ubjects&W applicstat to a civil Penalty of Occupancy rl�pe
.or...Van live method dollars($500). 3 0 0
C3 1.as...of the Property,Vr M'mn'lam..fth walso,.mou,sole compemlsti.e.
will do due work.and donmal..I ..t intended or offered far sale(Sm.70,1,1.Business
and Profession.Code:The Contracters Limmse Law does not apply to an owner of Required Inspections
property who buildco imparwass Lhowen,and who doessuchwerk khoodfor through his
man employ=,provided that such improvements art notintanded araflcm�for sale.If.
torwaver.the Wilding or impeavement is old within cove ear ofcamidetion.ths owner.
builder will have the burden of moving that he did net Wild a Improve forr purpose of
sal..)�
[:1 1.a owner of the property,am exclusively commming with limaxond comoutoo,In
construct the project(Set.7044,Business and ponfusions Cmm:)71m Contractor's Li.
cause Law does not apply w in maner of property wba builds or Winnows thereon.and
who conturacts,for such projects with a conurecuu(s)licensed pursuant so the Comraclues
License Law.
0 l4treserePtUmbeTSM. ..B&PCfart1d3M1x0R
owner Dam
WORKER'S COMPENSTnON—DECLARATION
I hereby aftlem under penalty of pujany,onse offt following declarmhour.
401 Ithovea.d.01amimud C�rmofC�.1m.if-i..mfmWorkcesCmpem-
eado..as provided for thyn4mlon 37M of tax,Labor Code.fur ft Performance of ft
work for which this Permit I.Wool.
0 1 have,and will maintain Warluo's Compensation Insurance.as requirm!by Section
37W offt LadmaCede,for the Performance of Ote wants for which this permit is i!W.
My Worices Compensation Insurance carries and Policy number.:
Carrier: Policy No.:C�-71— innf
RnFICATE EXEMPTIONFROMWORKERY
COMPENSATION INSURANCE
(This section naml am becomplemol Ban,permit is forone,hundooldollars($100)
Im)
I carfify that In t1W performance or ft work for which this permit is Issumd,I shall not
employ any person In any matter sa,as m become subject to thatWorkereCompeat
Laws fC.Iff..i.Dow
Applicant
NOTICE TO APPLICANT.If,after Making this Certificate of Exemption,you should!
became subject W the Workers Compenstion pecyl,ims of the Labor Code,you mum
z forthonch comply with each provisions or this permit shall W daemon revoked.
z 0
..by...CONSM CTION LENDING AGENCY
east ft.II a construction lending agency for ft perfermanoo of
dic week for which this poor,,i.lissued(Sm.3097,Cm C.)
Lmlaes Name
::1 z Leader's Addross
1 cenify in&,I haw tend this application and soon that the stow information is
correct-I agree to comply with all city and county andirtsocas and soon laws misting to
0 U building construction.and hereby authorize mpausentadws ofthis city to enmV upon be
hm.nomfiarsed preNucy for inspection purposes.
— (We)Agree to Mon.indemnify and locp harmless the City of Cupertino&pins,
'US 1.abfl W mus'4 AM consensus which may in any way We=&ZIJ.L SAXI City
d"'w"'
is mj'I"�-a-�f% . f h i
Apg;q�' c froomf- I Is COMPLY WITH A�L NON-POINT Issued by: Date
aq. &.
E S N914
R Re-roofs G7
Tg.seumc(ApplicaustACO Date
— =MATERIALS DISCLG�R'E Type of Roof
HAZX
som
Mlift�ppli.i.fut.b.ildi.goccupntstomor dle hwazdous mamrsd
a deffrom by ft Cupertino Munic pa Code.Chapmr 9.12.and the Health and Safety
Conn.Section 25532(4)? All roofs shall be inspected prior to any roofing material being installed.
0Ym 170 If a roof is installed without first obtaining an inspection,I agree to remove
Will the applicant or fuWm building occupant me,equipment or devices which
It hauzolous air canumni -d by ft Bay Area Air Qualfty Management all new materials for inspection.
'no
0yus :��N
I haw resel the Wardaus saaImialsoxforamentsunderompmr6,95 ofthe CAlifer.
.4FIenthWielyCom,5�Ng5Q 25533.d25534.lodc��ifftbuildi�l
X-1,1d uma=�Mvc.'u " 'I, ithility W notily ft occ.part or the
exere ,,
1 b !Lin anct; 'C=Oc o(, Signature of Applicant Date
VP ;r2-.) All roof coverings to be Class"B" or better
.net ar au1W,Izcax9ma� 1J.m I
CITY OF .CUPERTINO
I of I PERMIT RECEIPT OPERATOR: suem
COPY # 2
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . 35921018.00
DATE ISSUED. . . . . . . 03/20/2006
RECEIPT #. . . . . . . . . 33634
REFERENCE ID # 06030096
SITE ADDRESS . . . . . 7624 ERIN WY
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . LARRY LYNCH
ADDRESS . . . . . . . . . . 149 VIA DE TESOROS
CITY/STATE/ZTP . . . LOS GATOS CA, CA 95032
RECEIVED FROM . . . . RE ROOFING
CONTRACTOR . . . . . . . PROCTOR, PAUL LIC # 20615
COMPANY . . . . . . . . . . R E ROOFING & CONSTRUCTION INC
ADDRESS . . . . . . . . . . 15230 CLYDELLE AVENUE
CITY/STATE/ZIP . . . SAN JOSE, CA 95124
TELEPHONE . . . . . . . . (408) 626-9320
WE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS. REC NEW BAL
------ ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 11, 000.00 180.36 0.00 180.36 0.00
BSEISMICRE VALUATION 11, 000.00 1.10 0.00 1.10 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 181.46 0.00 181.46 0.00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 181.46 9872
TOTAL RECEIPT 181.46
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
Fax(408)777-3333
UPEkTINO Building Department
JOB ADDRESS: �,2 e,�)� PERMIT #
WK� 0� -63 ()0910
OWNER'S NANIE: , L-AFM L-�4 QC* PHONE # G 2-6- 9-3 2--D
.GENERAL CONTRACTOR: FAX #
CON 5T-P),LC4-f*N I(\(C
I am not using any sub�(4ttractor
S1 ture Date
�s, .-n a -s-an complete the following information:
Please check applicable su. c - li a rs.1-complel
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &r 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
Community Development Department
Building Division
City of Cupertino
M 10300 Torre Avenue
IAIW,
Telephone: (408)777-3228
CITY Of Fax: (408)777-3333
CUPEkTINO
Building Depaxtment
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuanc�,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 inspecti'on and
approval shall be,obtained from the building inspector when the re-rocifing
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 teai 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 roofir�g 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.
7; NOTE: if youcall 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 insRection can be sch�duled.
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:
job Site Address: 2 L+ \A/
Roofing,Company_�Ilme: loo I N 4— -!5- Ovi
-2
t's Sign re. Date: —>I 2-0 10 6
Applican" tu
Greg Castedl
Building Official
Revised 11/2/04
Printed on Recycled Paper
CITY OF CUPERTINO
REROOF
CITY OF PERMIT APPLICATION
UPEkTINO FORM Oe��,3 00
APN# 2s�, C;Z/ 0 Date�. *010(0
Building Address:
q62-q C/�, �j WM
Owner's Name: Phone#:
Con tactor: LAW L-�106� Phon 40k- J Iq - �0�
License#:
'�Ox I 91�2-0 —
Contact: Phone#: Cupertino Business License#:
2-0 (1
Type of Roof Covering:
Z
),eF
e
J,or
Existing:
U Built-Up Roof Q Built-Up roof
El .Asphalt Shingles Asphalt Shingles
Wood Shakes XC3 Wood Shakes
Wood Shingles 0 Wood Shingles
0 Other(Specify) Lj Other(Specify)
Number of existing coverings 13 Provide I.C.B.O.Report#
EI To be Removed 0 Provide Mfgr. Installation Specs.
C, A�S
A& I Have Read,Understand and Will Comply With Cupertino's Tear Off Policy: Pr .
Job Description: ?,,CHJW C�kwwq I L�� y- woLA) S-R,%< kN5-rA-LL, 114 1 Ew I I-z C I)y
3-u it WIM �T hSTUA111 CURL ` 1,lf-E70AC
Residenti 9i� Conurnercial rl
FireZone: YesE] N Confirmed with Planning D t. if
CA there are any restrictions:
Cost of ProjecN. Type of Construction: Occupancy group:
YZ,3
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
S SMI Seismic Commercial BUILDING
B PL C
PLANCHK Plan Check Fee BUILDING
B B SLIC
USLIC Business License BUILDING