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12050144 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6386 BLACKWOOD DR CONTRACTOR:CD ROOFING PERMIT NO: 12050144 OWNER'SNANIE: RAYCIIIANG 2909 WILBUR AVE DATE ISSUED:05/18/2012 OWNER'S PHONE: 4088912808 SAN JOSE,CA 95127 PHONE NO:(408)898-6605 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COIh1ERC1AL License Class Lie.q �7 '�:( Y RE-ROOF 24 SQ COMP TO COMP,CLASS A Commclor C7�' Date R r"— I hereby affirm that 1 am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for whichthis perrihil is issued. Sq.FI Floor Area: Valuation:$8000 1 have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:36917048.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I cenil'y that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above keep harmless property for inspection purposes. (We)agree g save 180 DAY. 'I OM LAST CALLED INSP CTTN. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additional,the applicant understands and will comply Issued by: 7t. Date: C1 with all non-point source relions Cupertino Municipal Code,Section —, RF.-ROOFS: Signature Date ) Z All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. /- ❑ OWNER-BUILDER DECLARATION K- � 7_ l I hereby affirm that I em exempt from the Contractor's License Lew for one of Signature of Applicane Date S' the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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(Sea7044, Business&Professions Code) I,as owner of the property,not exclusively contracting with licensed contractors to HAZARDOUS MATERIAI S DISCLOSURE construct the project(Sec.7044,Business&Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534, 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(x)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should t use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for whichthis permit is issued. will maintain compliance with the Cupertino llfonicipal Code,Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,2 3. 534, Section 3700 of the Labor Code,for tie performance of the work for which this Owner or authorized agent: % Date: _ (4^ permit is issued. I 1 certify that in the performance of the work for which this permit is issued,I shall not employ any person inany manner so as to become subject to the Worker's Compensation laws of Cal ifomo. If,after making this cenificate of exemption,I CONSTRUCTION LENDING.AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize reprcwntitives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilites,judgments, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code;Section Licensed Professional 9.18. Signature Date REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE• CUPERTINO.CA 95014-3255 CUPERTINO (408)777-3228-FAX(408)777-3333-buildinaCa)cuoenino.ore PROJECTADDRESS [ I - APNa OWNER NAME -•l ^ P NEE-MAIL (J Vd b STREET ADDRESS CITY.STATE ZIP FAX CONTRACTOR NAME LICE SE NUMBER LICENSE TYPE BUS.LIC.a _ vl S �7' COMPANYNAME !—J N E-MAIL FAX STREET ADDR ESS / L 1--1i ✓ I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2010 California Codes. 2. An inspection request can be scheduled up to the day before the inspection date. Please call (408)777- 3228 from 7:30 - 3:30pm (Mon-Thurs) or 7:30 - 2:30pm (Friday) to schedule the next day inspection. For Tear-Off and Nailing Inspections, you must also call on the day of the inspection only after that phase of the work is completed. The building inspector will be available within one hour. Progress and Final Inspections will be given a two hour window. 3. Tear-Off Inspection is required. Any and all dry-rotted wood shall be replaced prior to this inspection. Unless new plywood roof sheathing is proposed throughout, all the nails/fasteners shall be either completely knocked-down or removed prior to this inspection. 4. If plywood is installed, a plywood Nailing Inspection is required. 5. Roofing shall not be applied without first obtaining all prior inspection and written approvals from the building inspector. Any roofing which is applied without first obtaining an approved inspection will require the removal of all new material down to the sheathing so a proper inspection can be performed. 6. Progress Inspection is required when approximately 50% of roof covering is installed. 7. A Final Inspection and approval shall be obtained from the building inspector when the re-roofing is completed. To receive a final sign-off, the following items will be verified: a. Flat roofs shall have a minimum of'/." per foot of slope and demonstrate there is no ponding. b. Listings from approved testing agencies for all pre-manufactured products used shall be available on-site to review at the time of the inspection. c. Proper spark arrestor installation, vents painted, gutter/downspouts installed, debris removed. 8. NOTE: If you call for a tear-off or plywood nailing inspection and the work is not complete, you will be charged a re-inspection fee of$126.00. The re-inspection fee shall be paid before another inspection can be scheduled. By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the property owner's behalf. I understand and agree to comply with the re-roof policy stated above. I also understand that smoke detectors and carbon monoxide detectors nstalled in accordance with Sections 8314 and R315 of the 2010 California Residential Code. Signature of Applicant/Agent: - Date: ReruolPolicr 201Ldocrrriwd0211hNI Building Department City Of Cupertino 10300 Torre Avenue Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR /SUBCONTRACTOR LIST JOB ADDRESS: (� PERMIT# OWNER'S NAME: PHONE # G}'L '�Do GENERAL CONTRACTOR. BUSINESS LICENSE # ADDRESS: CITY/ZIPCODE: ��� -7- *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONP TO VE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. 1 am not using any subcontractors. ature Date Please check applicable subcontractors and complete 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 Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Shect Metal Sheet Rock Tile X:;��, �/I-I-Z-2, Z Owner/Contr ct nature Date CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36917048.00 DATE ISSUED. . . . . . . : 05/18/2012 RECEIPT #. . . . . . . . . : BS000016854 REFERENCE ID # . . . : 12050144 SITE ADDRESS . . . . . : 6386 BLACKWOOD DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : RAY CHIANG ADDRESS . . . . . . . . . . : 6386 BLACKWOOD DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : CD ROOFING CONTRACTOR . . . . . . . : CHARLIE DUONG LIC # 28245 COMPANY . . . . . . . . . . : CD ROOFING ADDRESS . . . . . . . . . . : 2909 WILBUR AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95127 TELEPHONE . . . . . . . . : (408) 898-6605 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 8, 000 .00 1 . 00 0. 00 1 . 00 0. 00 1BSEISMICR VALUATION 8, 000 .00 0. 80 0. 00 0 .80 0. 00 1REROOFRES SQ FEET 24 .00 336. 00 0. 00 336 .00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 337. 80 0 .00 337.80 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 337.80 visa --------------- TOTAL RECEIPT 337.80 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -- -------- ---------------------------- 309 EXTERIOR LATH 311 SCRATCH COAT 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildinGncuoertino.om 12, O H PROJECT ADDRESS' g APNI LrJ08 . OWNER NA P�°cNE�; I E-MAIL o - STREET.ADDRESS CRY, STATE,ZIP FAX CONTACT NAME ` \ PHQ{f jS E-MAIL ) , /�/V S DRESS ( nn CITY,STATE, ZIP FAX _ Z (7 ❑ OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT COM14\CrOR ❑CONTRACTOR AGENT ❑ ARCHRECI ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAh1ELICENSENUMBER LICENSETYPE BUS.LIGq 1 � Ul 3 COMPANYN.AME E-MAIL FAX ©e v� STREET ADDRE� CrTY,STATE.ZIP ^ - Z PHONE a ARCHITECT/ENGINEER NAME LICENSE NUMBER `C. BUS.LIC.0 COMPANY NAME E-MAIL FAX STREET.ADDRESS CRY,STATE,ZIP PHONE USE OF SFD or Duplex ❑ Multl-Family._ _ROOF AREA: VALUATION, STRUCTURE. ❑ Commercial - 2 3 S C�OC� EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY( REMOVE REPLACE s IF NO, PLYWOOD ❑ w- ❑ PLYWD ❑ OSB PITCH: ROOF 13t INLAYER 13 1/&-- 1 TYPE13 COX '12 CLASS PROPOSEDROOFTYPE: ❑BUILT-UPROOF ❑.ASPHALT SHINGLES C3 WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT DESCRIPTION OF WORK: By my'signature below,l certify to each of the following: 1 am the property owner orauthorized agent to act on the property behalf. 1 have read This application and the information I have provided is wiry r Description of Work and verify it is accurate. I agree ro compl-v with all applicable local ordinances and slate laws relating to buildin - un. 10 orize rep nmtives ofCupenino to enter the above-identified property for inspection purposes. Signature of Applicant/AgenC r Dale: SUPPLEMENTAL INFORM QUWED OFFICE USE ONLY _ If building is associated with a Home Owner's Associadon,provide letter 1XIN CHECK TYPE ROUTING SLIP Of approval from HOA. OYER-THE-COUNTER ❑ BUILDING PLAN REVIEW' _Provide Planning approval to verify if there any restrictions. EXPRESS ❑ PLANNINr,PLAN REVIEW Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD - ❑ FIRE DEPT Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER: ReraofApp 2011.doc revised 03'16/11