11010027 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7529 BARNHART PL CONTRACTOR:CD ROOFING PERMIT NO: 11010027
OWNER'S NAME: ANGIE TAO 2909 WILBUR AVE DATE ISSUED:01/04/2011
l'' rER'S PHONE: 4088338622 SAN JOSE,CA 95127 PHONE NO:(408)898-6605
CY LICENSED CONTRACTOR'S DECLARATIONr r
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.# ��2 (—
MECH RESIDENTIAL COMMERCIAL
Contractor. Date
I hereby affirm that I am licensed and ovisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OFF WOOD SHAKES INSTALL
(commencing with Section 7000)of Division 3 of the Business&Professions COMPOSITION
Code and that my license is in full force and effect. 50 YRS CLASS A 32SQ
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 f
Section 3700 of the Labor Code,for the performance of the work for ich t s Sq.Ft Floor Area: Valuation:$10500
permit is issued.
APPLICANT CERTIFICATION APN Number:36616073.00 Occupancy Type:
I certify that I have read this application and state that the above info on 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 PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additional) ,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source re ti s per the Cu mo Municipal Code,Section
9.18.
SignatureDate Issued byse' f% ��---� Date:� � l
OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed without first obtaining an inspecti I a ree to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signature of Applicant: Date: I
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penalty of perjury one of the following three
declarations: HAZARDOUS MATERIALS DISCLOSURE
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 I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material.
Additionally,should I use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534.
Compensation laws of California. If,after making this certificate of exemption,I 01
become subject to the Worker's Compensation provisions of the Labor Code,I must Owner or authoriz
forthwith comply with such provisions or this permit shall be deemed revoked. Date:
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's
correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
r -,and expenses which may accrue against said City in consequence of the
ng of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
w..a all non-point source regulations per the Cupertino Municipal Code,Section
9.18. I understand my plans shall be used as public records.
Signature Date Licensed Professional
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: 7<r2 .4 12 T PERMIT# 0� 2
OWNER'S NAME: 4 C -nc_ c-) PHONE� d 15-
GENERAL
SGENERAL CONTRACTOR: r- CS> t t0 C BUSINESS LICENSE#
ADDRESS: ` 9 �Z &'A CITY/ZIPCODE: Z
*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 SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature 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
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333•building(d)cupertino.org
PROJECT ADDRESS APN#
S /
OWNA 1,3E ` J b �^ 1� E-MAIL
STREET AD+DRESS CITY, STATE,ZIP FAX
1-► a
CONTRACTOR NAME LICEMS NUMBER LICENSE TYPE BUS.LIC.#
COMPANY NAME E- AIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
I UNDERSTAND AND AGREE TO THE FOLLOWING:
I. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code.
2. You must schedule all needed inspections a minimum of one day before the requested inspection date.
Please schedule inspections online or call (408)777-3228 between 7:30-3:30 (Mon-Fri).
3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof is torn off and all
the nails/fasteners have been removed. Any and all dry-rotted wood shall be replaced prior to this
inspection. A building inspector will be available within one hour.
There are special hours for this service: 7:30 — 10:30am and 1:00— 3:30pm (Mon—Thurs);
7:30 — 10:30am and 1:00—2:30pm (Friday).
4. If plywood is installed, a plywood nailing inspection is required.
5. In-Progress roof inspection is required. Call for an in-progress roof inspection to verify building is
weather tight after installation of approximately 25% of the roofing material.
6. New roof coverings shall not be applied without first obtaining all inspections 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.
7. A final inspection and approval shall be obtained from the building inspector when the re-roofing is
complete. To receive a final sign-off, the following items will be verified:
a. Flat roofs shall have a minimum of 1/4"per foot of slope and must 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.
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 f i s true: I am the property owner or authorized agent to act
on the property owner's behalf. I unde nd a o com ly with the re-roof policy stated above. /
Signature of Applicant/Agent: Date:
ReroofPolicy_201 0.doc revised 05/17/10
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36616073 .00
DATE ISSUED. . . . . . . : 01/04/2011
RECEIPT #. . . . . . . . . : BS000012397
REFERENCE ID # . . . : 11010027
SITE ADDRESS . . . . . : 7529 BARNHART PL
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER ANGIE TAO
ADDRESS . . . . . . . . . . : 7529 BARNHART PL
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : CHARLIE DUONG
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 10, 500. 00 1 . 00 0 . 00 1. 00 0 . 00
1BSEISMICR VALUATION 10, 500. 00 1.05 0. 00 1. 05 0 .00
1REROOFRES SQ FEET 32 . 00 416 .00 0 .00 416 . 00 0 .00
---------- ---------- ---------- ----------
TOTAL PERMIT 418 . 05 0 . 00 418. 05 0 .00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 418 . 05 VISA
---------------
TOTAL RECEIPT 418 .05
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
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 7529 barnhart pl. DATE: 01/04/2011 REVIEWED BY: bobs.
APN: BP#: *VALUATION: 1$10,500
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLR00F
USE: PERMIT TYPE:
WORK
SCOPE
FEE ID ROOF AREA
s.f.
1REROOFFRES 3,200
lcch, P/Ort 'hc:'C_r'k r t'';i rz J'!( t x_Ilf"A I.l 1,1417 C.hCk
t'j ft72 3. Po-,il Fcc Int:rmit t`'V,
0,dwr f c h. Inn. Oihi,i.P irnh In'l,
L] I
fn,p. kc(' l'.'imb hixp. F"c, f Irc_Inch. Fc:c:
NOTE: Thesefees are based on the preliminary in ormation available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 09-051 Ef. '/1.-7D1 FEE QTY/FEE MISC ITEMS
Plan C'hecl, Fee.
suppl. PC:'Fee
T 'A
Plzrrrtf�.:_tleclr. '7;lec:plan (Jleck:
Permit Fee: $416.00
Suppl. Irtsp Fee
F'larrnf�.,`1lec7i. "Tlee Unit Fee:
1'lttrtzfi. ;I t 1cc 1'crrmit Fecr:
onsliwctton 7'a '
"Icoustic al 1ie1°ielt"FCC.'
Work Without Permit? 0 Yes (F) No $0.00
I'lcatrrtitt«f c'E': :
7 -a cel Z)ot rrirrc ottutirin t`c c.4:
I
Strong?Motion Fee: 1BSEISMICR $1.05 Select an Administrative Item
Bldy,Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $418.05 $0.00 TOTAL FEE: $418.05
Revised: 12/07/2010
CITY OF 1 I VA 0�\ a
CITY OF CUPERTINO[a V
REROOF
CUPERTINO PERMIT APPLICATION
APN # G � i � a� Date: � .
l _
If residential, is house an Eichler? Yes ❑ No If yes, needs planning approval.
Building Address:
Owner's Name: V Phone #: 1 f� 61 C T f�
HOA: Yes ❑ No If yes, provide letter from HOA
Contractor: Phone #:
66 a
�i 0 ockD v Fax#:
upertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles g d
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.C.E.S. Report
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
'Pe�_{20 �f 1 X02 /
-1 OS( cb S C yrs 3 2
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:
I Have Read, Understand Will Com ly with Cupertino's Tear-Off Policy:
% -
C.