10110029 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 6435 BOLLINGER RD CONTRACTOR:TRAN ROOFING& PERMIT NO: 10110029
LANDSCAPING
(...NER'S NAME: PRINCE WONG 531 MEKLER CT DATE ISSUED: 11/04/2010
(. AER'S PHONE: 4083907108 SAN JOSE,CA 95111 PHONE NO:(408)892-3215
❑ LICENSED CONTRACTOR'S DE/CLARATION_ BUILDING PERMIT INFO: BLDG r ELECT r PLUMB
License Class _ Li .# 7 F/ MECH RESIDENTIAL COMMERCIAL
Contractor Date
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:6435-6437 BOLLINGER RD(DUPLEX)-RE-ROOF TEAR OFF
(commencing with Section 7000)of Division 3 of the Business&Professions WOODSHAKE BUILD DECK BY 1/2"OSB PLYWOOD REROOF BY
Code and that my license is in full force and effect. 30 YEARS LANDMARK COMP CLASS A 28SQ
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 Sq.Ft Floor Area: Valuation:$8000
permit is issued.
APPLICANT CERTIFICATION APN Number:36920030.00 Occupancy Type:
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 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. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulatio per the Cupertino Municipal Code,Section
9.18.
S��rature
/It �- Issued by: _ Date: ��• ��
CC��
� � � Date �,-
-r
❑ 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 inspection,I agree 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:
1,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:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
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. 1 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&SafetyCo e,Sections 25505,25533,and 25534.
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 Owner `d= d agent:
forthwith comply with such provisions or this permit shall be deemed revoked. Date:
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
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
V, the above mentioned property for inspection purposes.(We)agree to save
reify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. 1 understand my plans shall be used as public records.
Signature Date Licensed Professional
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(a)cupertino.orp
PROJECTADDRESS /_ /�1 j/ .- APN#
OWNER NAME l' /J/7 W V 7 PHONE E-MAIL
STREET ADDRESS / CITY, STATE,ZIP FAX
CONTRACTOR NAMEA� LIC SE N�I,1MBEi LIC SE_TYPE BUS.LIC.#COMPANY NAME '��/'�/ /')��/ •` E-MAIL FAX
STREET ADDRESS ((/ �1�1 /-� 4�+ CITY,STATE,ZIP r�-Lye e7 PHONE /C,)X �i�3�
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. 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 follo ing;s true: I am the property owner or authorized agent to act
on the property owner's behalf. I un to a 'ee to comply with the re-roof policy stated above.
Signature of Applicant/Agent: Date: _ _y)0 _
ReroofPolicy_2010.doc revised 05/17/10
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
CUPERTINO Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: Cr ? - i�� �'�' �' c PERMIT#
OWNER'S NAME: PHONE#
GENERAL CONTRACTOR: 4 li- —711�---� BUSINESS LICENSE#
ADDRESS: CITY/ZIPCODE:
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY IN ECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBC NT n ORS 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
10CI � v2�,
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: U b�A(I Q:OATE: REVIEWED BY:
APN: BP#: *VALUATION: 1$8,000
q*PERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY 07 l i. PENTAMATION
USE: SFD or Duplex PERMIT TYPE: 1 SFDWLROOF
WORK
SCOPE
FEE ID ROOF AREA
s.f.
1REROOFFRES 2,800
Ch, n, 1
af�c1? T'f�Pn C'.reck r'/��l>�_1�crii� ta�<�"L Alf""',r<_ ifsa C`r�rc
F�,r'1. 1"'rnfa F0", ���1un�1 r�rtr;t l'i'e°. I�;f�r t'c'w)il 1"I"c:
tali, / ,ft f,";'-'> ki,( !'?Sj:!.
hl.v" 1"11C. Itas'f! PL"),
NOTE: Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addh 7 in o.
FEE ITEMS,(Fee Resohatioli 09-051 Elf. 7'T,.I()) FEE QTY/FEE MISC ITEMS
Plan C'hec'k Fee:
S?1p1,1. PC1,(A'
phlnah.'.11cIf. 11c c P/01? 01C,A":
Permit Fee: $364.00
Saallh/. hl'�p Fee
F-1
.1couslical" !�'cviuw VC(",
C'oT?sJl'llt'Ft >t7 lCl,i
Work Without Permit? 0 Yes E) No $0.00
1'lcanlfir 'z f'cc;
I
1-1-kilcl 0c1t_ifnicniol1t�o
Strong Motion Fee: IBSEISMICR $0.80 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $365.80 $0.00 TOTAL FEE: $365.80
Revised: 10/17/2010
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36920030 . 00
DATE ISSUED. . . . . . . : 11/04/2010
RECEIPT #. . . . . . . . • : BS000011921
REFERENCE ID # . . . : 10110029
SITE ADDRESS . . . . . : 6435 BOLLINGER RD
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : PRINCE WONG
ADDRESS . . . . . . . . . . : 6435 BOLLINGER RD
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : KHANH CONG TRAN
CONTRACTOR . . . . . . . : KHANH TRAN LIC # 32053
COMPANY . . . . . . . . . . : TRAN ROOFING & LANDSCAPING
ADDRESS . . . . . . . . . . : 531 MEKLER CT
CITY/STATE/ZIP . . . : SAN JOSE, CA 95111
TELEPHONE . . . . . . . . : (408) 892-3215
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 8, 000 . 00 1. 00 0 .00 1. 00 0 . 00
1BSEISMICR VALUATION 8, 000 . 00 0 .80 0 .00 0 .80 0 . 00
1REROOFRES SQ FEET 28. 00 364 .00 0.00 364 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 365.80 0. 00 365. 80 0 .00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 365.80 VISA
---------------
TOTAL RECEIPT 365 .80
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 C) c)
CITY OF CUPERTINO
10 1 REROOF
CUPERTINO PERMIT APPLICATION
APN# � r � 4 � Date: /0
Building Address:
0
Owner's Name: Phone #:
Z
HOA: Yes El / No If Yes, provide letter from HOA
Contractor: Phone #:
4
Fax#:
Cupertino Business License #: () Contractor License #:
6-3
Type of Roof Covering:
Existing: Proposed:
• Built-Up Roof u Built-Up roof
• Asphalt Shingles A! ' Asphalt Shingles
X Wood Shakes o Wood Shakes
• Wood Shingles o Wood Shingles
• Other (Specify) o Other (Specify)
Number of existing coverings .1 u Provide I.C.C.E.S. Report
o To be Removed o Provide Mfgr. Installation Specs.
Job Description:
<
Residential Commercial
Green Building: Please complete relevant portion of the Conr,,.rmed with-Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: El
applicable, include in plan set & the sheet index.
Valuation:
I Have Read, Understand and,Will_C//Omply with Cupertino's Tear-Off Policy:
Signature
Revised 02/05/09
M.lndODr Air Quality and Finishes
�• 1 IAQ/Health pts y--yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y--yes 0
4.doLM*v=moo= 3IAQ/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
T:sew4w M 4 IAQ/Health. pts y=yes D
B.Use FSC Certified Materials for Interior Finish 4 Resource pts y--yes D
9.Use Fnger-Jointed or Recycled-Content Trim 1 Resource pts y--yesD
10.Install Whole House Vacuum System 3 IAQ/Health pts y—yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Fooring 8 Resource pts y--yes 0
y8 ]ooririg dais 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 IAQ/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y--yes 0
5.Install Recycled Content Carpet with Low VOCs 4 Resource pts y--yes 0
! ! 1
Total Points Available: L_1401 1301 57
Total Points Project Received: 01 0 0
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