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07060106 CITY OF CUPERTINO ��tt BUILDING DIVISION PERMIT 4 �����*' PERMIT NO. BUILD DD ESS: � � EPTEMBER DR T D ROOFING 07060106 PERMIT ISSUE DATE OWNER'S NAME: ASHOK KUMAR 675 TULLY RD 06/13/2007 SANITARY NO. CONTROL NO. NE: (408) 89 -8872 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH p p LICENSED CONTRACTOR'S DECLARATION Job Description 'm P 1 hercb affirm that I am licensed under provisions of Chapter 9(commencing 'UF y EROOF—F-EMOVE WOOD SHAKE, INSTALL 50 YR PRESIDENT Z� with Section 7000)of DivisionJ�i¢e�usirucss and Profe 'u ode.and my license is e o. in full force an e ; z LicenscC S Lic.M 30 LB FELT 20 SQUARES. pato Contractor Laa A CHITECI'S DECLARATI N i a a I understand my plans shall be used as public me r s )yU U.yLicensed Professional a OWNER-BUILDER DECLARATION 3< I hereby affirm that 1 am exempt from the Contractor's License Law for the p o following reason.(Section 703 1.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure ti prior to its issuance,also requires the applicant for such permit to rile a signed statemrnt Valuation z r Ft.Floor Area $7000 that he is licensed pursuant to the provisions of Contractor's License Law(Chapter 9 �] F (commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he is exempt therefrom and the basis for the alleged exemption.Any violation of Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 36215024.:tl t Number not more than five hundred dollars(5500). ❑I,as owner of the property,or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of 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 sate.). ❑1,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 Taw does not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law. ❑1 am exempt under Sec B dt P C for this mason Owner Date WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations ❑1 have and will maintain a Certificate of Consent to self-insure for Workers Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the rw for which this permit is issued. I have and will maintain Workers Compensation Insurance,as required by Section of the Labor Code,for the performance of the work for which this permit is My Workers mpen ation inti carver d Policy number Cj Cartier. L obey No.: CERTIFICATE UF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if 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.I 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 Oforthwith comply with such provisions or this permit shall be deemed revoked. z " CONSTRUCTION LENDING AGENCY (� 1 hereby affirm that there is a construction lending agency for the performance of a.> the work for which this permit is issued(See.3097,Civ.C.) w Q Lenders Name Lc z ndeesAddress U O 1 certify that I have read this application and state that the above information is L>.► correct.I agree to comply with all city and county ordinances and state laws relating to Ubuilding construction,and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. GL (We)agree to save,indemnify and keep harmless the City of Cupertino against H Co,) liabilities,judgments,costs an 'expenses which may in any way accrue against said City ,) V z in consequence of the g i of this permit. Date APPLICANT U E DS WIL PLY WITH ALL ON-POINT Issued by: SOURCE REGU A n / ' �O Re-roofs Signature of ontractor Date Type of R sof HAZARDOUS MAT ER1A1S CLOSURE yl) Will the applicant or future building occupants or handle hazardous material as defined by the Cupertino al Code,Chap .12,and the Health and Safety Code,Section 25532(7)? All roofs:hall be inspected prior to any roofing material being installed. Cl Yes No If a roof i:.installed without first obtaining an inspection,I agree to remove Will the applicant or future 'Iding occupant use equipment or devices which emit hazardous air contamin do tncd by the Bay Arca Air Quality Management all new materials for inspection. District? ❑Yes ❑ o I have mai then rdous materials requirements under Chapter 6.95 of the Califor- nia Health&S cry Sections 25505,25533 and 25534.1 undcrstan that iC building does.not cu tly vc IC that it is my responsibility to motif the oceu t of the requrements hi m mel p to issuance of a Cerirt�e n Signature of Applicant Date �j All roof coverings to be Class 'B or better Owner or authorixcd agent pato CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: suew COPY # 1 Sec: Twp: Rng: Sub: Blk Lot: APN . . . . . . . . : 362:_5024 . 00 DATE ISSUED. . . . . . . : 06/:_3/2007 RECEIPT #. . . . • • • . . : BS000001646 REFERENCE ID # . . . : 07060106 SITE ADDRESS . . . . . : 998 SEPTEMBER DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUP:ERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ASHOK KUMAR ADDRESS . . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4141 RECEIVED FROM ASHDK KUMAR CONTRACTOR LESLIE HOANG LIC # 23155 COMPANY T D ROOFING ADDRESS 675 TULLY RD CITY/STATE/ZIP SAN JOSE, CA 95111 TELEPHONE (408) 892-8872 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ---------- ---- BPERMFEE VALUATION 7, 000 .00 137.16 0 .00 137 .16 0. 00 BSEISMICRE VALUATION 7, 000 .00 0 .70 0. 00 0 . 70 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 137. 86 0 . 00 137 .86 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- ------- CREDIT CARD 137.86 VISA --------------- TOTAL RECEIPT 137. 86 CITY OF C'UPERTINO REROOF CUPERTINO PERMIT APPLICATION FORM r-Build;ing N Date:ddress: II� S C Owner's Name: Phone Contractor: icense#: S C) 1 r 120 � j� c Contact: Cupertino Business License#: f ype of Roof Covering: Existing: Proposed: ❑ Built-Up Roof QBuilt-Up roof L Asphalt Shingles X Asphalt Shingles LJWood Shakes Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O.Report# XTo be Removed ❑ Provide Mfgr.Installation Specs. I Have Read,Understand and Will Comply With Cu iertino's Tear Off Policy: Job Description: [ e S C,,' �; `'C Jc LAG-u�l S�1c. Residential VQ Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Det. if there are any restrictions: LJ Cost of Project: 1 Type of Construction: Occupancy group: Qty. if Applicable Fee ID Fee Description Fee Group TBPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING 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 1997 UBC Standards and manufacturers specifications on re- oofing. 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 irspection 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 t to job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: A L g.)_,,-,\ Job Site Address: �� J i> gin'► < �' Roofing Company Name: T/ c0 C) i Z Applicant's Signature: Date: �^ I C ' Greg Casteel Building Official 111 11/2/04 Community Development w:. 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY Of Fax(408)777-3333 -.UPEkTINO Buildin De artment JOB PERMIT MIT # cr � � CY,, 6c<- A 070 0100 Ir OWNER'S NAME: A j 1io Lk--,-)>�X PHONE # �{v GENERAL CONTRACTOR L1 C FAX # I am not using any subcontractors: Signature � Date Please check applicable subcontractors and complete the followin 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