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10040109 CITY OF CUPERTINO BUILDING PERMIT PERMIT NO: 10040109 7 FBUILDINGCONTRACTOR:T D ROOFING ADDRESS: 7531 NEWCASTLE DR DATE ISSUED:04/16/2010 675 TULLY RDWNER'S NAME: TRI TRAN PHONE NO:(408)892-8872 SAN JOSE,CA 95111 -YWNER'S PHONE: 4082557881 JOB DESCRIPTION: RESIDENTI COMMERCIAL r_1 LICENSED CONTRACTOR'S DECLARATION RE-ROOF REMOVE 2 LAYER WOOD INSTALL 30#FELT License Class C `� Lic.# 9,4 S � � AND 7; Date `� f `� PRESIDENTIAL C Contractor LASS A 25 SQUARES I hereby affirm that I am licensed er 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 Sq.Ft Floor Area: Valuation:$10500 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by Occupancy Type: Section 3700 of the Labor Code,for the performance of the work for which this APN Number:36617069.00 Type- permit is issued. APPLICANT CERTIFICATION ation is I certify that I have read this application and state thadinancet the s and stave te laws relating PERMIT 1g DAySIOF PPERMIT ISOSUANCE OR correct.I agree to comply with all city and county or WIT to building construction,and hereby authorize representatives of this city to enter 180 DAYS FROM LAST CALLED INSPECTION. property for inspection purposes. (We)agree to save upon the above mentioned _ indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Issued Date: granting of this permit. Additionally,the applicant understands and will comply with all non-point seurge egulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: 1! Date (J All roofs shall be inspected prior to any roofing material being installed.If a roof is Signature 4 installed without first obtainin ani spection,I agree to remove all new materials for inspection. 0 OWNER BUILDER DECLARATION Date: ' Signature of Applicant: i � I hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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) HAZARDOUS MATERIALS DISCLOSURE 1,as owner of the property,am exclusively contracting with licensed contractors to I have read the hazardous materials requirements under Chapter 6.95 of the construct the project(Sec.7044,Business&Professions Code). California Health&Safety Code,Sections 25505,25533,and 25534. 1 will I hereby affirm under penalty of perjury one of the following three Health maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the &Safety Code,Section 25532(a)should Itoreor handhhazardous declarations: ch emit hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's air contaminants as defined by the BayuAreaent or devices Air Quality Management District I Compensation,as provided for by Section 3700 of the Labor Code,for the will maintain compliance with the u er no Municipal Code,Chapter 9.12 and performance of the work for which this permit is Insurance,as provided for by the Health&Safety Code,Sectioq ,25/J533,and 25534. 1 have and will maintain Worker's Compensation which this gent: w Date. Section 3700 of the Labor Code,for the performance of the work forOwner or authorized a permit is issued. I certify that in the performance of the work for which this permit is issued,I shall CONSTRUCTION LENDING AGENCY 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 work's for which this permit is issued(Sec.3097,Civ C.) become subject to the Worker's Compensation provisions I hereby a ons of the Labor Code,I must affirm that there is a construction lending agency for the performance o forthwith comply with such provisions or this permit shall be deemed revoked. 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 representatives of this city to enter ARCHITECT'S DECLARATION non the above mentioned property for inspection purposes.(We)agree to save lemnify and keep harmless the City of Cupertino against liabilities,judgments, y plans shall be used as public records. costs,and expenses which may accrue against said City in consequence of the I understand m p granting of this permit.Additionally,the applicant understands and will comply with all non points rce re ulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Date `{ � Signature Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 CUPERTINO CONTRACTOR/ SUBCONTRACTOR LIST PERMIT# (.�a Ol JOB ADDRESS: 1 3 f W Q -1-5j OWNER'S NAME: �. �"e'.» PHONE# `I GENERAL CONTRAC OR i Rov Y1 BUSINESS LICENSE# _ � : ` CITY/ZIPCODE: ADDRESS1) *Our municipal code req res all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECRSION(S) WILL BE HAVE OBTAINED AHCITY OF CUPERTINO UNTIL THE GENERAL CONTRACTOR AND ALL ONTRACTO BUSINESS LICENSE. y t �p I am not using any subcontractors: Sign 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 Date Owner/Contractor Signature CITY OF CUPERTINO PERMIT RECEIPT OPERATOR: SylviaM 3 ITEMS OF 6 COPY # = 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 36617069 . 00 DATE ISSUED. . . . . . . 04/16/20107 RECEIPT #. . . . . . . . . REFERENCE ID # 10040109 SITE ADDRESS 7531 NEWCASTLE DR SUBDIVISION • • • . . . : CUPERTINO CITY . . . . . . . . . . . . IMPACT AREA . . . . . . OWNER TRI TRAM ADDRESS 7531 NEW CASTLE DR CITY/STATE/ZIP CUPERTINO, CA 95014 RECEIVED FROM LESLIE HOANG CONTRACTOR . . . . . . . : LESLIE HOANG LIC # 23155 COMPANY T D ROOFING ADDRESS 675 TULLY RD CITY/STATE/ZIP . . . : SAN p8)OS2, 88A2 95111 TELEPHONE . . . . . . . . : FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC _NEW-BAL - --------- 0 . 00 1 . 00 0 . 00 10, 500 .00 1. 00 0 . 00 1BSEISMICR VALUATION 10, 500 .00 1BCBSC VALUATION 1.10 0 .00 1 .10 1REROOFRES SQ FEET 25 .00 325 . -- 0 .00 325 . 00 ---- 0_00 ---------- ---------- TOTAL PERMIT 327 .10 0 .00 327 .10 0 . 00 REFERENCE NUMBER AMOUNT METHOD OF PAYMENT -------------------- ------------ CREDIT CARD 588 . 90 visa --------------- TOTAL RECEIPT 588 . 90 ON VOICE ID DESCRIPTION VOICE ID DESCRIPTI ---------------------------- 602 ROOF PLYWOOD NAIL 601 ROOF TEAR OFF 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CITY OF CUPERTINO :01REROOF CUPERTINO PERMIT APPLICATION APN# Date: LA 1 co �� O (� �► b c.Q 1-� Building A dress: Owner's Name-'� Phone #: , I zL�� HOA: Yes ❑ NoVff es, rovide letter from HOAContractor: Phone #:(ZJOn 4�s ) S y �l o h`( V 5 Fax#: Cupertino Business License #: Contractor License #: S14 >Cl Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles � Wood Shakes o Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) 'Other (Specify) � trb Number of existing coverings ❑ Provide I.C.C.E.S. Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. rJobDescription: L �v- r��o� _ re5� Residenti 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, Un r t d and Will Comply with Cupertino's Tear-Off Policy: f Signature Revised 02/05/09 CITY OF CITY OF CUPERTINO Is REROOF cuPeRTINo FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Group Squares IREROOFCOM Re-roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee IBSEISMICO Seismic Commercial B 1RER00FRES Re-roof Residential B 1SFDWLR00F 1BCBSC Cal Bldg Standards g ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B IREROOFMRES Re-roof Multi-Family B 1MFDWLROOF IBCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee IBSEISMICRE Seismic Residential B IBUSLIC Business License B 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•building(pDcupertlno.org APN# PROJECT ADDIS C�� F t vlJ P NE �� `� , EMAIL OWNEB.�AM& � '`V� C(C7� a STATE,ZIP(' CA FAX STREET ADDRESS (� e il a� LICENSE NUMBER^ LICEI�E TY) BUS.LIC# rCONTRACTORNAMK 8 (.t ((�-I FAX i::: E-MAIL PANY NAME /� J I / PHONE STREETAD n Q i Iain STATE Z c ' l Gj /1 1 o� l I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. An inspection request shall be scheduled the day before the inspection date. Please call (408)777- 3228 between 7:30 - 3:30pm (Mon-Fri) to schedule the next day inspection. 3. After the roof is torn off and the nails/fasteners have been removed and all the dry-rotted wood has been replaced, you must call for a roof inspection. A building inspector will be available with one hour. There are special hours for the 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. New roof coverings shall not be applied without first obtaining all 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. 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 item will be verified: a. Flat roofs shall have a minimum of J/" per foot of slope and demonstrate there is no ponding. b. A listing from an approved testing agency shall be available on-site to review at the time of the inspection. c. Proper spark arrestor installation. 7. NOTE: If you call for a plywood nailing inspection and the job is not ready, you will be charged to a re- inspection fee of$126.00. The re-inspection fee shall be paid before another inspection can be scheduled. `y my signature below, I certify to ea the following: I am the property owner or authorized agent to act on the property owner's behalf. I and and a to comply with the re-roof policy stateda ove �© Date Signature of Applicant/Agent: ReroofPolicy_2010.doc revised 04/14/10