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08100176 CITY OF CUPERTINO BUILDING DIVISION PERMITC�NTRACTORINFURMA.TION - BUILDING ADDRESS: PERMIT NO. 10114 E STATES DR K H ROOFING OWNER'S NAME: PERMIT ISSUE DATE O. CONTROL NO. (408)293-2754 ARCHRECffENGINEER: BURRING PERMIT INFO 'BLDG ELECT PLUMB MECH O 300 LICENSED CONTRACTOR'S DECLARATION O O O se I hereby affirm that I not licensed under pmvitimu Of Chapre 9(tammeMng Job Description Z� with Section 7")OfDiviuOn 3 of0e Business and Professions Code,and�fxenm is mBrmee and arc �' RE-RF T/0 WDSHK BLD DECK BY 1/2 OSB PLYWD LNDMARK mg Dam ossa Contractor� 30YRS CLS A 26SQ ARCHECTS DECLARATION n I undmsrand my plants Nall W used u public men"I'm K H ROOFING RENEWED BSL g H Licc.d Professional - OWNER•BUILDER DECLARATION i f i hereby.'m that T am exempt from the Cona m's License Law for the COO fallowing reason.(Section 1031.5.Business and Professions Cade:Any city or county which requires•Permit to conmnet alcor.improve,demolish,a¢Pon any swctum prior to its issuance.also require the applicant for such permit o file a sigrxd nammcm < this he is licensed purmanl to the promtiom of the,ConmetWes Liman aw(Clupmr 9 Sq.Ft.Floor Area Valuation E $ (commencing with Section 70001 of Division 3 of the Buwrcss and Professions Cods)or r3— that M k.,tNmefmm and Oe bask for the alleged exemption lol Any vation of 97000 Section 70313 by story applicant for a Permit subjects the app0unt N a civil perWt),Of APN Number Occupancy e al nmore than fin hundred dollen($300). P y •T7y P ❑Luawrcraltlie propmty,err my wployces with wagnas Net,role mmprsssation, 36907036 . 00 will drfmaimseande: heCmeknet Nmnaede Law tlfarsokpply no an Busituv and Profession Cade:The Conhmwrs ammo law dao oat apply lf rt awn of Required Inspections propertywho builds pmiimproveen imp andwhu arcssuchendhimselredthrough his own employees.iprogdedthatmch nt is semmuare net intendeduroRced for ewe.rr, however.the Wilding a Mprovemmn is colds,did ane year of impron for purpose pwnf Witter w10 have Ne WNan of proving that he did rot baled IX improve for puryom of sok.). , 0 L u own of the propmy.w eulusively conaacting MN Iicamrd conuastma Is covuue Ne project(See.701$4,easiness and Proressiom Cade:)The Coruscates Li. cove law does not apply to an owner of property who Wilds or improve Ihemen,W who contracts far such projects with a conuaete(w licensed punuam to the Com acture Licelve Law. ❑lamesemptunderSee .B&PCre Nkmsmn Owner Dau WORKER'S COMPENSATION DECLARATION I hereby aRm under penally of perjury arc of Om following doemrauons: 1 hew and will maintain a Cenmm ifimm OfCoent self-iwlm for Wmtrrs Camper tion,as provided for by Section PITO of the Labor Code,for the performance of the work far which this permit is earned. 1 haw and will maintain Workers Compensation I...as required by Section 37W of tic labor Cade.for f performance of the work for which Nis permit is issued. My Workers Campevutirc mess.carrier and Policy number art: Cartier. <-./ 7 - F(l2/' Policy No.: 3 003 2I CERTIFl FTION MOM WORKERS COMPENSATION INSURANCE 01hissmlm sena action completed Uthe permit is forarc hunNeddoOan(SIM) or lou) I crosaifv than in the perfmmanm of the work for which Nis permit k issued.I shall not employ any person in any manrcrm as m become subject to the Worked Compemxtion Laws of California.Dam Applicant NOTICE TO APPLICANT:If.after making this CeniRum of Exemption,you should become subject an the Worteri Compensation provisions of the labor Cede,you must .J z forthwith comply with much previed.or Nis permit Nall x deemed malted. Z CONSTRUCTION LENDING AGENCY E+ v(�-r Ihereby.1r.dust ft.k a comuuctim kndingagmrcy,far teperfartnen¢of fx the writ for which this percut is issued(Sec.3097,Civ.C.) Q Landers Name z (enters Address U Q 1 certify that 1 haw mad Ibis application and sum Nu the aWw information is - D. F ceomt 1 agree to comply with all city and county ordinances snd sum laws renting to .0Wilding construction,and hereby aurhorice mPnenuve m uof this city enter upon the ;t.La construction,aWn-mentioned Propcny for inspection purposes (We)agree to am,indemnify and keep harmless the City of Cupertino agaim, liabilities,judgments.caw and expense which may in any way accrue against mid City U Z in cmonegvnt.Of the i.d.g of this permit ^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS, to 'zg'D Re-roofs Signature of ApplimnUContractser Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof .WIO tic appliant IX future Wilting ocmpanlnorc or handle haaardov material as de0ned by the Cupertino Municipal Comic.Chapter 9.1;and the Health and Safety Code,CY25332(a)7 . dNo All roofs shall be inspected prior to any roofing material being installed. Will tic applicant or future Wilding Occupant use equipment of dcv ccs which If a roof is installed without first obtaining an inspection,I agree to remove it haraoMv air comerisunu u definnd by tic Bay Arca Air Quality Management all new materials for inspection. sat aT �t ❑its LIN. 1 haw read the heardms materials requirement,under C)upmr 6.95 of the Califor- niaHealN&Way Cade.Smiw 255M.M533 and 25534.I understand Nat ifte building doe net cmmndy M moan.them it is my respomih0ity m notify the occupant Of the rcquhcmc chh vl xmel prior m issuance or a ccrufxam of Occupancy. a /0 ,ZJ ' Signature of Applicant Date Owner ormthor edagent DnmAll roof coverings to be Class'n"or better CITY OF CUPERTINO • 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 36907036 . 00 DATE ISSUED. . . . . . . : 10/28/2008 RECEIPT #. . . . . . . . . : BS000006479 REFERENCE ID # . . . : 08100176 SITE ADDRESS . . . . . : 10114 E ESTATES DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : RAJ & SMITA LIMAYE ADDRESS . . . . . . . . . . : 10114 E ESTATES DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : KHANH CONTRACTOR . . . . . . . : KHANH TRAN LIC # 26971 COMPANY . . . . . . . . . . : K H ROOFING ADDRESS . . . . . . . . . . : 1556 LITTLE ORCHARD ST. CITY/STATE/ZIP . . . : SAN JOSE, CA 95110 TELEPHONE . . . . . . . . : (408) 293-2754 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ------- ------- --- - ---------- 1BSEISMICR VALUATION 7, 000 . 00 0 . 70 0 . 00 0 . 70 0 . 00 1REROOFRES SQ FEET 26 .00 338 . 00 0 . 00 338 . 00 0 . 00 ---------- ---------- --- ---------- TOTAL PERMIT 338 . 70 0 . 00 338 . 70 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- -- ------------ -------------------- CREDIT CARD 338 .70 MC ------------ TOTAL RECEIPT 338 .70 VOICE ID DESCRIPTION VOICE ID DESCRIPTION - ------------------------ -------- --------------- ------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF • 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 agree 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 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. 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 can be scheduled. 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: ( /�Gf V �ZCJ /e Job Site Address: 10 I Roofing Company Name: lA- • Applicant's Signature: Date: /Q _M Or Greg Casteel Building Official Revised 07/30/08 CITY OF CUPERTINO di REROOF OCUPEkTINO PERMIT APPLICATION APN # Date:D �� c� Date: LO _ 2 k- OP Building Address: /v /)4 ,r-- to Z-er 06- cy e2-tI7rc7 Owner's Name: > Phone #: Contractor. % Phone #: q vd- - 1C /l Gc n �_ lY�/� Fax #: Cupertino Business License #: Contractor License Type of Roof Covering: Existing: Proposed:. a Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Asphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other,(Specify) Number of existing coverings ❑ Provide I.C.B.O. Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: J el�z2 o�p wo /1,/f � � I'-61 GSC . �y � � aA' t z /as��j �w' r-e rav0� 2vy�-i — Gf crr � o� V Residential 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: 7OO O r"? I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 6/16/08 CITY OF CUPERTINO ,gs REROOF CUPERTINO FEE SCHEDULE • Number of Fee ID Fee Description Fee Permit Type Squares Group 1RER00FC0M Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 2 G 1REROOFRES Re-roof Residential B 1SFDWLROOF / 1BSEISMICRE Seismic Residential B IREROOFMRES Re-roof Multi-Family B iMFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B Revised 6/16/08