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10010009 CUPERTINO BUILDING PERMIT 9 CITY OF PERMIT NO:1001000 CONTRACTOR:CONRAD ROOFING BUILDING ADDRESS: 7449 ROLLINGDELL DR SERVICE DATE ISSUED:01/04/2010 332 PHELAN AVE "NER'S NAME: TANG STEPHEN N PHONE NO:(408)294-7615 } SAN JOSE,CA 95112 NER'S PHONE: 4084016922 PLUMB BUILDING PERMIT INFO: BLDG ELECT LICENSED CONTRACTOR'S DECLARATION COMMERCIAL f 13 �3� Lic.# L-� MECH RESIDENTIAL License Class 1�y�-� o Date ( DESCRIPTION:RE-ROOF TEAR-OFF 2 LAYERS OF COMP.INSTALL 30L Contractor JOB I hereby affirm that I am licensed under the provisions of Chapter 9 FELT&CLASS A 40YR COMP 22SQUARES commencing with Section 7000)of Division 3 of the Business&Professions ( Code and that my license is in full force and effect. I herebyaffirm under penalty of perjury one of the following two declarations: insure for I have and will maintain a certificate of consent to self-Labor Code,for the Compensation,as provided for by Section 3700 of the Valuation:$8400 performance of the work for which this pe� atirmit is issued. e,as provided for by Sq.Ft Floor Area: 1 have and will maintain Worker's Comp ction 3700 of the Labor Code,for the performance of the work for which this 2007.00 Occupancy Type: Se APN Number:3593 permit is issued. APPLICANT CERTIFICATION ove ation is I certifythat I have read this application and state thats and ate laws relating IS NOT STARTED with all city and county ordinance correct.I agree to comply representatives of this city to enter PERMIT EXPIRES IF WO ISSUANCE OR to building construction,and hereby authorizep purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISS upon the above mentioned property for inspection purp judgments, armless the City of Cupertino against liabilities,judge FROM LAST CALLED INSPECTIO . indemnify and keep h in consequence of 180 DAYS and expenses which may accrue against said City costs, applicant understands and will comply granting of this permit. Additionally,the app `„��--v ,�'--- Date: with all non-point source regulations per the Cupertino Municipal Code,Section Issued bey`_ 9.18. l ,,(� !f� Date 1 � nature RE-ROOFS: DECLARATION roofs shall be inspected prior to any roofing material being installed. all new materials is 0 OWNER-BUILDER DEC All ntractor's License Law for one of installed without first obtaining an inspection,I agree to re I hereby affirm that I am exempt from the Co inspection. I the following two reasons: � Date: baso caner of the property,or my employees with wages as their sole compensation, Signature of Applicant: X2�will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I as owner of the property,am exclusively contracting withdlicensed contractors to construct the project(Sec.7044,Business&Professions Co ) I hereby affirm under penalty of perjury on e of the following three HAZARDOUS MATERIALS DISCLOSURE 95 of the Worker's I have read the hazardous materials requirements ns 25505 25533,andapter 25534. I will maintain declarations: Code,Sect I have and will maintain a Certificate of Consent to self-insure or California Health&Safety Chapter 9.12 and the Health& Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code, Safety Code,Section 25532(a)should I store or handle hazardous material. Comp Sa ty performance of the work for which this permit is issued. provided for by Quality Management District I will sation Insurance,as p Additionally,should I use equipment or devices es whish emit hazardous air I have and will maintain Workers Compen contaminants as defined by the Bay Area A Q 00 of the Labor Code,for the performance of the work for which this 4. 7 maintain compliance with the Cupertino Municipal 53 e,Chapter 9.12 and the Section 3 permit is issued. which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 2 1 certify that in the performance of the work t°become subject to the Worker's to an person in any mann Own r t` o ed Date: not employ Y of Compensation laws of California. If,after making this certi f��ne Labor Codeol must p provisions o become subject to the Worker's Compensation p ENDING AGENCY forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION Lfor the erformance of work' I hereby affirm that there is a construction 3097,CndC)agency p APPLICANT CERTIFICATION for which this permit is issued(S certify that I have read this application and state that the above information is I c fy 1 with all city and county ordinances and state laws relating Lender's Name correct.1 agree to comply Lender's Address to building construction,and hereby authorize representatives of this city o°ave r for inspection purposes.(We)agree �the above mentioned property ments, Minify and keep harmless the City of Cupertino againstliabilities, of the ARCHITECT'S DECLARATION Lgr�anting ,and expenses which may accrue against said n' and will lans shall be used as public records. of this permit.Additionally,the applicant undoer�,sltandlpa Code,Section I understand my pall non-point source regulations per the Cupertin Licensed Professional J �1,Date1ature CITY OF CUPERTINO PERMIT RECEIPT OPERATOR: patg 3 ITEMS OF 3 COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 35932007 . 00 DATE ISSUED. • • • • " 01/04/2010BS000009482 RECEIPT #• • " " • ; 10010009 REFERENCE ID # SITE ADDRESS 7449 ROLLINGDELL DR SUBDIVISION : : : : : : : CITY . . • CUPERTINO IMPACT AREA . • . . . . . OWNER TANG STEPHEN N ADDRESS . . . . . . . . . . : 7449 ROLLINGDECLA D95014-5812 CITY/STATE/ZIP . • - ADD ; CjJpERTINO CA, REC EIVED FROM CONRAD ROOFING SVL KEITH CARNAHAN IC # 22297 ; CONTRACTOR CONRAD ROOFING SERVICE COMPANY • " ' . . . 332 PHELAN AVE ADDRESS . • . . . . .. ; SAN JOSE, CA 95112 CITY/STATE/ZIP • ' ' ; (408) 294-7615 TELEPHONE . • • THIS REC NEW BAL QUANTITY AMOUNT'--- _pD_TO_--- ---------- ---------- FEE ID UNIT -__----- ------- 1.00 0 . 00 _ ____ ------------- -- 1 . 00 0 .00 0 .00 VALUATION 8,400 .00 0 . 00 0 . 90 1BCBSC 8,400 .00 0 . 90 286 . 00 0.00 1BSEISMICR VALUATION 286 . 00 0 . 00 ------ ---------- FEET 22 .00 ___------ ---- 1REROOFRES SQ ---------- - 287 . 90 0 . 00 287 . 90 0 .00 TOTAL PERMIT : COUNT REFERENCE_NUMBER-- METHOD OF PAYMENT -----____ _-__- ----------------- ------ 287 . 90 #12850 CHECK _______________ 287 .90 TOTAL RECEIPT VOICE ID DESCRIPTION ------- VOICE ID DESCRIPTION -------- -_------ --------------------- -------------------- ----------------- ___ ---------------- - 602 ROOF PLYWOOD NAIL 601 ROOF TEAR OFF 605 FINAL REROOF 604 ROOF IN-PROGRESS CITY OF CUPERTINO REROOF alo PES IT APPLICATION E�T CUP Date: C' Building Address: -7 H I �``� �` ��� , Phone 4 Owner's N ame: S4-c per^ 7�r"-5 Yes No If es rovPhone#.ide letter from HOA „L� , -74 is A: ❑ [�' . Contractor. C--o r-<� '�'� Fax#: 1-76 L �-' Contractor License #: Cupertino Business License #: Z.Z.2..`l-7 5--L Type of Roof Covering: Proposed: Existing: ❑ Built-Up roof ❑ Built-Up Roof sre'asphalt Shingles v�Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) ❑ Provide I.C.C.E•S• Report# �— Specs Number of existing coverings ❑ Provide Mfgr. Installation Sp cam To be Removed Job Description: 0 2 Commercial Residential Dept. if • he Confirmed with Planning p • e com Tete relevant portion of are an restrictions: ❑ Green Building: Pleas p •t to the application or if there y Green Building Checklist & attach i • include in plan set & the sheet index. a licable, enc i Valuation: is g,4 pc) d Understand and Will Comply with Cupertino's Tear-Off Policy: I Have Rea , Signature Revised 02/05/09 CITY OF CUPERTINO REROOF CUPE�TiNo FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICO Seismic Commercial B 1RER00FRES Re-roof Residential B 1SFDWLR00F 'Z2 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B 1 REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 Fax: (408)777-3333 BuildingDepartment Subject: Re-roofing p Y • fin olic for the City of Cupertino ce you must a, Prior to permit issuance.,y agree to comply with 2007 IBC Standards 1 and manufacturers specifications on re-roofing.All roofs are Class A per Cupertino municipal code 16.04.080. all inspection coverings shall not b and written approval applied without first obtaining P d 2• New roofg from the building inspector. A final inspection an hall be obtained from the building inspector when the re-roofing approval s 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. inspection is required. 5. If plywood is installed, a plywood nail insp q inspection, An roofing which is applied without first obta' " g ansheathing, 6. Y re uire the removal of all new material down to the well q so aP P ro er City inspection can be performed. 7. NOTE: y job not read you call for a plywood nail inspection and the o — y., . If g must you will be charged a re-inspection fee of$176.18. The re-inspection fee ti" aid before another ins ection can be scheduled. IMPORTANT: 1, Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate that there is no ponding. ' re aired to be on the job site at the time on inspection. 2. An I.C.B.O.report is q ill complywith the above stated policy on re-roofing. I understand and w T4 Homeowner's Name: -- t �`- � �2.��l��•g X11 �n job Site e Address: C,0 vk.<,v Roofing Company Name: Date: Applicant's Signature: Greg Casteel Building official Revised 07/30/08 L INPUT - . M.Indoor Air Quality an Finishes 1.Use LowIND-VOC Paint 1 IAQ/Health pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes. 0 3.Use LowNo VOC Adhesives 3 IAQ/Health pts y=yes 0 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Health pts y=yes 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0 7.Seal all Exposed Particleboard or MDF 4 IAQ/Health. pts y=yes 0 B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0 10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0 N.Flooring 1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 Mftalth pts y=yes ° 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 f i � Total Points Available:1 1 1401 1301 57 � 0 0 0 Total Points Project Received: G:data/progs/greenbuildingguidelines/remodelers/greenpointsfinal2.12.04protected.xis Community Development 10300 Torre Avenue J;K Cupertino CA 95028 Telephone(408) 777-3228 w Fax(408)777-3333 CITY 0� SUPE TING , �. Dent Bui 1 dln artme PERMIT # � JOB ADDRESS. 991 ,Z2 PHONE # 4 OR'S NAME: K- .. T FAX# VVNE GENERAL CONTRACTO --10 of usin any subcontractors: Date I am n g Signature complete the f ollowin inf orma�On' applicable subcontractors and BUSINESS LICENSE # Please checkBUSINESS NAME SUB CONTI�CTOR 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 ja Date Owner/Contractor Signature