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10010161 CITY OF CUPERTINO BUILDING PERMIT CONTRACTOR:T D ROOFING PERMIT NO: 10010161 BUILDING ADDRESS: 10840 WUNDERLICH DR DATE ISSUED:01/28/2010 675 TULLY RD OWNER'S NAME: CHARLES CHU PHONE NO:(408)892-8872 SAN JOSE,CA 95111 ER'S PHONE: 4084721888 F LICENSED CONTRACTORS DECLARATION BUILDING PERMIT INFO: BLD G ELECT PLUMB License Class Lic.# MECH RESIDENTIAL COMMERCIAL Contractor Date JO c B DESCRIPTION:RE-ROOF REMV EXTNG TAR&GRVL FOR HOUSE(GARAG I hereby affirm that I am lie sed der the provisions of Chapter 9 EXL,UDED FRM JOB)TOP OFF W/PLYWD 2 LYRS OF FELT& (commencing with Section 7000)of Division and effect. the Business&Professions COMP SHNGLS.INSTALL 2 GUTTERS&4 DOWNSPOUTS APPRX Code and that my license is in full force I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of corse self-insuret to Labor Code,for Compensation,as provided for by Section 3700 of the performance of the work for which this permit is issued. provided for b I have and will maintain Worker's Compensation Insurance,asp y Valuation:$5300 Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: permit is issued. Occupancy Type: APPLICANT CERTIFICATION APN Number:37522011.00 I certify that I have read this application and state thadinances t the above information is correct.I agree to comply with all city and county or resentatives of this state city t s enterrelating ED to building construction,and hereby authorize p PERMIT EXPIRES IF WORK IS NOT START upon the above mentioned property for inspection purposes. (We)agree to save indemnifyand keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, applicant ll the a licant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section �� Date:/ 9.18. Issued by: Signature Date OWNER-BUILDER DECLARATION RE-ROOFS: If a the Contractor's License Law for one of All roofs shall be inspected prior to any roofing tto remove all erial being ned ew mate �alsof ifor I hereby affirm that I am exempt from installed without first obtaining an inspectionagree the following two reasons: I,as owner of the property,or my employees with wages as their sole compensation, inspection. work,and the structure is not intended or offered for sale(Sec.7044, � of A Date: will do the wo �ignature Applicant- Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 oft e Compensation,as provided for by Section 3700 of the 25533,and 25534. I will maintain California Health&Safety Code,Sections 25505Chapter 9.12 and the Health& performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code, provided for b Safety Code,Section Cupertino should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as p yAdditionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. Chapter 9.12 and the he performance of the work for which this permit is issued,I,shall maintain compliance with the 25505,25533,and 25534. I certify that m t not employ any person in any manner so as to become subject to the Workers Health&Sa ety Code, Compensation laws of California. If,after making this certificate of exemption,I O r ut zed become subject to the Worker's Compensation provisions of the Labor Code,I must Date: forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION information is I hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address minify and keep harmless the City of assaid itsjudgments, and expenses which may accrue against Cty in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply with all ye ce regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Signatu � Date Licensed Professional CITY OF CUPERTINO PERMIT RECEIPT OPERATOR: patg 3 ITEMS OF 3 COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 37522011.00 DATE ISSUED. . . . . . . : 01/28/2010 RECEIPT # . . . . . . . . . BS000009635 REFERENCE ID # 10010161 SITE ADDRESS 10840 WUNDERLICH DR SUBDIVISION . . . . ' CUPERTINO CITY . . . . . . . . . . . . . IMPACT AREA . . . . . . • OWNER . . . . . . . . . . . . : CHARLES CHU ADDRESS . . . . . . . . . . : 10840 WUNDERLICH DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : CHARLES CHU NTR.ACTOR . . . . . . . : LESLIE HOANG LIC # 23155 CO T D ROOFING COMPANY • " " ' 675 TULLY RD ADDRESS " ' SAN JOSE, CA 95111 CITY/STATE/ZIP • ' TELEPHONE . . • • • • • • (408) 892-8872 PD-TO-DT' THIS REC NEW BAL FEE ID UNIT QUANTITY _AMOUNT--- ---------- ---------- ---------- ------ -------- 0 .00 1 . 00 0.00 1BCBSC VALUATION , 0 . 00 -- 5300 .00 1. 00 0 . 60 0 . 0 0 .60 0 . 00 5, 300 .00 0 130 . 00 0 . 00 1BSEISMICR VALUATION 10 .00 130 . 00 ___ __________ 1REROOFRES SQ FEET __________ ---------- ------- 131.60 0 .00 131 .60 0 . 00 TOTAL PERMIT : PAYMENT AMOUNT' REFERENCE NUMBER METHOD OF P _______________ __ - ----------------- 131.60 CASH --------------- 131.60 TOTAL RECEIPT DESCRIPTION VOICE ID _____ VOICE ID DESCRIPTION ----_- _------- ----------------------- -------- ---------------------- 602 ROOF PLYWOOD NAIL 601 ROOF TEAR OFF 605 FINAL REROOF 604 ROOF IN-PROGRESS CITY OF CUPERTINO Cry I mui_N REROOF CUPERTINO PERMIT APPLICATION X7PN # � Date: J�� 1a, '� � I, c�L) �:fig...................... ........................... Building Address: �o D W U N � zC-� J: i fie/ G � I � c� Phone# Owner's Name: C H �rRL�S CH U HOA: Yes ❑ No If yes, provide letter from HOA 7—�D �iL� Phone#:Contractor: �� Fax Cupertino Business License #: Contractor License #:i?q Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof o W Asphalt Shingles Asphalt Shingles a Wood Shakes Ll Wood Shakes o Wood Shingles ❑ Wood Shingles � Other (Specify) �an- � u Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report# ❑ Provide Mfgr. Installation Specs. o To be Removed Job Description: Residential Commercial Green Building: Please complete relevant portion of the Confirmed with Planni Dept. if Green Building Checklist & attach it to the application or if there are any restriction applicable, include in plan set & the sheet index. Valuation: '9300 I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09 CITY OF CUPERTINO �� - REROOF C1 6F FEE SCHEDULE CUPEI�TINO Number of Fee ID __J__Fe7e 'D escription 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 1REROOFRES Re-roof Residential B 1SFDWLR00F //n 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 _ _j IBSEISMICRE 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 Building Department Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must agree to comply with 2007 IBC Standards and manufacturers specifications on re-roofing.All roofs are Class A per Cupertino municipal code 16.04.080. 2. New roof coverings shall not be applied without first obtaining all inspection and written approval from the building inspector. A final inspection and approval shall be obtained from the building inspector when the re-roofing 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. 5. If plywood is installed,a plywood nail inspection is required. 6. Any roofing which is applied without first obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of$176.18. The re-inspection fee must be paid before another inspection can be scheduled. IMPORTANT: of 1 1. Flat roofs must have a minimum /4 " per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O. report is required to be on the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: C P C- r ' L c L Address: 0 0 w R cl Job Site A Roofing Company Name. /GF A 1 „ r• Applicant's Signature: Date. Greg Casteel Building Official Revised 07/30/08 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF` Fax(408)777-3333 -%UPEkTINO Building Depart ent P 4 JOB ADDRESS: Q L) E ,LG . PERMIT # �l� - .N I� Gq�Eo- 1+ '04:9 0/ OWNER' NAME: C HAkL-F-5 C PHONE # - OOT . GENERAL CONTRACTOR: FAX # U 0 I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the followin information: F-a SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # 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 ` an d Owner/Contractor Signature Date