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11080225I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 848 ALDERBROOK LN I CONTRACTOR: T D ROOFING I PERMIT NO: 11080225 1 OWNER'S NAME: TOOHEY JACK P AND BETTY J 1 675 TULLY RD I DATE ISSUED: 08/31/2011 1 ("i'NER'S PHONE: LICENSED CONTRACTOR'S DECLARATION License Class i.. .-� � Lic. # � Contractor dAl?17 Date 3 1 I I hereby affirm that I am licensed n r the provisions of Chapter 9 (commencing with Section 7000) o vision 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 which this permit is issued. I 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 permit is issued. APPLICANT CERTIFICATION 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 representatives 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 liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point so ce re lations per the Cupertino Municipal Code, Section 9.18. Signature Date / OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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 which this permit is issued. I 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 permit is issued. 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 Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 representatives 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 liabilities, judgments, and expenses which may accrue against said City in consequence of the ng of this permit. Additionally, the applicant understands and will comply w.Ln all non -point sour e regul bons per the Cupertino Municipal Code, Section 9.18. Signature Date 31 �) SAN JOSE, CA 95111 PHONE NO: (408)892 -8872 BUILDING PERMIT INFO: BLDG r ELECT PLUMB I- MECH F RESIDENTIAL COMMERCIAL f— JOB DESCRIPTION: SF REROOF, 21 SQ, REMOVE COMP, INSTALL COMP, NO NEW PLYWOOD, 30# FELT, EXISTING SHEATHING STAYS Sq. Ft Floor Area: I Valuation: $9000 APN Number: 36917024.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by:��' Date: -S/ - RE- ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an i p, I agree to remove all new materials for inspection. Signature of Applicant: Date: 3/ ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: Date: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION 1 understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT Sec: Twp: Rng: Sub: Elk: Lot: APN ........: 36917024.00 DATE ISSUED.......: 08/31/2011 RECEIPT #.........: BS000014629 REFERENCE ID # ...: 11080225 SITE ADDRESS .....: 848 ALDERBROOK LN SUBDIVISION ...... CITY .............. CUPERTINO IMPACT AREA ...... OPERATOR: TraciC COPY # : 1 OWNER ............: TOOHEY JACK P AND BETTY J ADDRESS .......... CITY /STATE /ZIP ...: LOS ALTOS CA, 94022 -1616 RECEIVED FROM CONTRACTOR ... COMPANY ...... ADDRESS ...... CITY /STATE /ZIP TELEPHONE .... LESLIE HOANG LESLIE HOANG LIC # 23155 T D ROOFING 675 TULLY RD SAN JOSE, CA 95111 (408)892 -8872 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ---- - - - - -- ------- - - - - 1BCBSC VALUATION -- ---- - - - - -- 9,000.00 ---- - - - - -- 1.00 ---- - - - - -- 0.00 ---- - - - - -- 1.00 ---- - - - - -- 0.00 1BSEISMICR VALUATION 9,000.00 0.90 0.00 0.90 0.00 1REROOFRES SQ FEET 21.00 294.00 0.00 294.00 0.00 TOTAL PERMIT ---- - - - - -- 295.90 ---- - - - - -- 0.00 ---- - - - - -- 295.90 ---- - - - - -- 0.00 METHOD OF PAYMENT --------------- -- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 295.90 --------------- 295.90 VOICE ID DESCRIPTION -- - - - - -- ---------------------- - - - - -- 309 EXTERIOR LATH 601 ROOF TEAR OFF REFERENCE NUMBER --------------- - - - -- Visa 031908 VOICE ID DESCRIPTION -- - - - - -- ---------------------- - - - - -- 311 SCRATCH COAT 602 ROOF PLYWOOD NAIL 604 ROOF IN- PROGRESS 605 FINAL REROOF WE CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION vo FEE ID ROOF AREA s.f. 1 REROOFFRES 2,100 NUIE. These tees are based on the nreltminary information available and are onlv an estimate. Contact the Dent for addn'l into. FEE ITEMS (F�e Resolution I1 -053 I. f. '- 1.- %1) FEE QTY /FEE MISC ITEMS Permit Fee: $294.00 Work Without Permit? 0 Yes (D No $0.00 i Strong Motion Fee: IBSEISMICR $0.90 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $295.90 $0.00 TOTAL FEE: $295.90 Revised: 07/04/2011 ADDRESS: 848 alderbrook In. DATE: 08/31/2011 REVIEWED BY: bob s. APN: BP #: - VALUATION: 1$9,000 'PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY SFD or Duplex USE: PENTAMATION 1 SFDWLROOF PERMIT TYPE: WORK remove shake install comp shingles. SCOPE FEE ID ROOF AREA s.f. 1 REROOFFRES 2,100 NUIE. These tees are based on the nreltminary information available and are onlv an estimate. Contact the Dent for addn'l into. FEE ITEMS (F�e Resolution I1 -053 I. f. '- 1.- %1) FEE QTY /FEE MISC ITEMS Permit Fee: $294.00 Work Without Permit? 0 Yes (D No $0.00 i Strong Motion Fee: IBSEISMICR $0.90 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $295.90 $0.00 TOTAL FEE: $295.90 Revised: 07/04/2011 CUPERTINO REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • buildingacupertino.org PROJECT ADDRESS �) J `� , l: L C APN # ! v � NAME �Ca I PHONE E-MAIL 1`.Z \`G , \ ` S IET RESS � h -L LN FAX „ � cl er vz� v (A APPLIC `qJ.g� 1 C , ` C PHO E -MAIL 5 ADDRESS l `� Crjy, STATE,G FAX J C` )n ❑ OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT X CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHI78CT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE %- � + , LICENSE 9 BUS. LIC. # 1� COMPANY NAME E -MAIL FAX STR ADDRF$,S ! i-1 l 1 y 2 C� SC t'A P'S HONE 4-13 ('T C\ _1 9 O ,S ARCHITECT/FNGIAIEER NAME LICENSE NUMBER BUS. LIC. # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi- Family ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial �\ EXISTING ROOF TYPE: ❑ BUILT -UP ROOF ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE /REPLACE YES IF NO, PLYWOOD El w, ❑ PLYWD CI OSB PITCH: ROOF 11 No # LAYERS: THICKNESS: 11 5/e" TYPE: ❑ CDX :12 CLASS: A PROPOSED ROOF TYPE: ❑ BUILT -UP ROOF ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT # DESCRIPTION OF WORK t! 'z�v 3 <i.) r {" "'A NX —i ;Yl By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provid ect I have read the Description of Work and verify it is accurate. I agree to co ply with all applicable local ordinances and state laws relating to buildin�` n. I a f�o rize representatives of Cupertino tc enter the above -ide 'fled prop rt. for inspection purposes. Signature ofApplicant/Agent Date: SUPPLEMENTAL INFORMATION REQ� =- -- =�* E ms ' _ = _� � Ifbullding is associated with a Home Owners Association, provide letter _ _R90911 — _ z _ of approval from HOA. Provide Planning approval to verify if there any restrictions. Provide copy of Manufacturer's Installation Specifications. �� '�Krovide Cupertino's Policy. �� Tom` - ��i -'3i'' ` �� .� �'1Yrl"`•c_ -�� 4 �az-�c f`c �ToTl signed copy of Tear -Off ReroofApp_2011.doc revised 03102111 CUPERTINO 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 (408) 777 -3228 •FAX (408) 777 -3333 • building (&-cupertino.org PROJECT ADDRESS C� `' O i hG� t� 1 c�R" APN # OWWtRJ4AME „ � � cis—m3, ` NX d PHONE E -MAIL STREE , DDRU S /� (� p CI TATE, ZIP L FAX CONTRACTOR NAME �� v1 \ LICE IYl1MB� C 1 LICEN T]PE�.� BUS. LIC. # COMPANY NAME E -MAIL FAX STRZ ADD S -i ` �C, C, STiT`E, ZIP S PHONE I UNDERSTAND AND AGREE TO THE FOLLOWING: 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 1/" 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 t comply with the re -roof policy stated above. I also understand that smoke detectors and carbon monoxide dete o Ire required to be installed in accordance with Sections R314 and 8315 of the 2010 California Residential Code. Signature of Applicant /Agent: Date: S 3 I if RemofPolicv 2011.doc revised 02116111 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014 -3255 Telephone: 408 - 777 -3228 Fax: 408 - 777 -3333 JOB ADDRESS: A � a e�- v. PERMIT # J 2 OWNER'S NAME: A PHONE # GENERAL CONTRACTOR: T n BUSINESS LICENSE # ADDRESS: C; ' '- 1�( I r,-,k CITY /ZIPCODE: SC-111 ESL *Our municipal code regtAres 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 S B TRACTORS HAVE OBTAINED A CITY OF .CUPER INO BUSINESS LICENSE. S /-S t 1 t I am not using any subcontractors: Sig to Date Please check applicable subcontractors and complete lowing information: Owner / Contractor Signature Date 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 Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date