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08010081 CITY OF CUPERTINO wa�s �«wt=+$, ' kl ?Y6=says fr'� '' BUILDING,DIVISIOPI PERMIT CUNTRACTC3R INFURMAT ON ; aAx ar.$'1'a s`u ,aPrA' :PS,yiCye«}w a3.ce'n[4'e}+zP" 1717 NO. BUILG1NB'ff'%ARNHART CT TNT ROOFING CO PEa 08010081 OW NER'SNAME:: li PERbfff ISSUE DATE MOHAN 1610 BLOSSOM HILL RD STE 6C 01/14/2008 `NE SANITARY NO. CONTROL NO. ARCHRECT/ENGINEER: BUILDING PERMIT INFO RE—ROOF, RMV TAR&GRVL & INST aDG E ECT PLUMB MECH Sop LICENSED CONTRACLOR'S DECLARATION IOU Description Mrd 1 hmby alBnn WI I w Ileved under Drovidons of Chapter 9(comms"Ing p with Section 7o(0)of Division 3 of Ne Business and Procssum Codemil my became is n o min full forte end eff 17 Z j$Z Li he Clw 1 Lin CC Dam Conuach. ARCHnECrS DECLARATION 1 undemlanJ my Plans shall he used u public records aIsd Licensed ProllsommJ y OWNER-asempt frm DECLARATION gm 1 hereby.(Sac that 1 I.S.uempt from the Cssiom Coca: :A License Law for the p O following mason.(Section 7M LBudness and improve, Cade:Any pry st county which regdses n Permit ro construct,alter, t for demolish,or mash almeturo that heor its also Rquima the apPheNf for eachContractor's L censele a signed(Ch p eel 51thathcislieeawitpSection ewanlmodeprovisionofNeheBusiinessaJcemoLaw(Chapmr9 Sq.Ft.Floor Area Valuation �g $ (co M 3 co ervin Secfrom and the Division r of the Business and Preon.My vi Code)or S�— Nat he ts aamnPl therefrom end tfr buff for the alleged assumption.MY violation of Section 7031.7 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy not oan fl.hundred dollars(M), p y Type more N ❑I,u owner of the pmpmy,m my employee with wags u Heir wk eompenudon, will do the wart and dmsuumum i.neHnmnded m effeeed rorsste(Sec.70".Buaineu and Professions Coon:The ConuYtar'a Liam Law doe act apply Y an owner of Required Inspections property who builds or important theroon,and who does such wart himself m Nmugh his awaemploymal.provided that such improvements art am intended"offered for als.it. however,Ne building or Improvement is Yid within am year of Ymple ton.the owner. builder wW have the buNcn of proving that k did rot build or Improve for purpose of ante.). 1,as owner of the property,am eaciuively canuuning with licensed comacmn 0 mm act the project(Sec.7014,Business and Rafestimes Code:)The Cneuatema's U. cew Law does am apply te Y owner orproperty,who builds or improves,thereon.and who contracts for such projects with a conuvetar(s)licensed pursuant N due Contrsomes Liceme Law. [3I w eaemptundee See. ,B h PC for N4 muon Owner Date WORKER'S COMPENSATTON DECLARATION I hereby affirm under pendty of perjury oro of the following declwtions: M. ad will maintain•CardOots of Consent an Ylfdnsure for wob sCompete n.Y provided fm by Section 37M of the Latter Code,for the performulY of the work for which this permit is issued ❑1 have and will maintain Worker's Compensation Insurance,an required by Section 37M M the fab"Cade,fer the pelfmmYce of the wart for which Nu permit is Wised My Warker'aC m iy9/p�psur/ay/��aam�ennd Polity Cart W: - PON No.: WI�Llb Z CERTIFICATEOF SAMONIINN FROM WORKERS' COMPENSATON INSURANCE CDtusce dm nand Ytbe completed i(tthe permit is far em hundred submit($I0(l) or ex) I certify that in the performance of the work for which thin permit is Whand,l shill no employ any person in my manner an an m become subject to tiro Workeri Compensation Laws of California.Dam Applicant NOnCE 70 APPLICANT:IL after making this Certinem of Exemption.you should become subject m the Workers Compensation previsions of the Labor Code you a= .,O forthwith comply with such provisions or this permit shall he dmmar ed mked. ,z., CONSTRUCTION LENDING AGENCY [+� I hereby affirm Nal there is a construction landing agency for the performance of C the work for which this permit I.Wood(Sec.3097,Civ.C.) 0 Lender's Name Qd Z) z lender's Address U O 1 con ly that 1 have mad this application and+tate that the above information is (y colrtm.l agree Y comply mth all City and county oNinarcu Yd!tate lava miming m .O building construction.and hereby authorise rtpmnnuaive of this city to enter upon the LQ ahoce-mentannd property fur Inspection purposes 0. (We)agree to Yw,indemnify and keep harmless the City of Commode.agaimu o-n rrA liabilities,judgments,coats and expelaea which may in my way eccom against addCity V 7 in co of doe gnnung of Nu permit �7 APP A ERSfANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date Ar ndrr- R S. Re-roofs Sigmturt of Applient/Conuaumr Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupsenutom or handle hazardous mamrid as dcnned by the Cupertino Municipal Code.Cbapmr 9,13.and the Health and Safety Cade,S: zss3:(a)7 All roofs shall be inspected prior to any roofing material being installed. [:]Y. sum the applicant or f tv building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,.1 agree to remove huardnns air conuminmts u defend by the Bay Arta Air Quality Management all new materials for inspection. cG ❑Yee "ET1. . Ihrvemadthehs.Soca mamriabmquirtmnets 4,I Chspmn that Wattling / .:Has u FkalNkSefcry Code,Savons7550s.2S337 arW23dJ4.l undmtsnd that lrtM hdming /` (Lj dem note by haw a Imuat,Nm It u my .. Ytify Nc t.f Ne —� mqut his he mato".' , ofacmnneateor y�aO Signature of Applicant Date / All roof coverings to be Class "B"or better Owner nauNmr<d agent Dom' aum-, CITY OF CUPERTINO REROOF ®CUPERTINO PERMIT APPLICATION APN # 3 75 ��. (� C� Date: Building Address: O 7 Q Owner's N e: Phone #: c�h/fi Contractor: Phone #: Z 77-0�8w r ao/cl� Fax #: Z-69 zJ U 3 Cupertino Business Licens #: Contractor Lice se #: Type of Roof Covering: Existing: Proposed: Built-Up Roof !Built-Up roof ❑ sphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles a Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O. Report # ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: ac�ve Residential Commercial Fire Zone: Yes No ❑ Confirmed with Planning Dept. if there are any restrictions: ❑ Valuation: �4—v I Have Read, U erstan nd Will Comply with Cupertino's Tear-Off Policy: Si atur CITY OF CUPERTINO Son REROOF �CUPEI�TINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1RER00FC0M Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 1RER00FRES Re-roof Residential B 1SFDWLROOF 1BSEISMICRE Seismic Residential B 1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 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 Building Department Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards and manufacturers specifications on re-roofing. 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: 1. Flat roofs must have a minimum of 1/4" 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 eith the above stated policy on re-roofing. Homeowner's Name: / �L) _ Job Site Address: �7�� Roofing Company Name: Zoo JJ Applicant's Signatu ate: __/7Z • Greg Casteel Building Official Revised 11/2/04 e 1 CITY OF CUPERTINO • 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: , APN 37537027 . 00 DATE ISSUED. . . . . . . : 01/14/2008 RECEIPT #. . . . . . . . . : BS000003686 REFERENCE ID # . . . : 08010081 SITE ADDRESS . . . . . : 10550 BARNHART CT SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : MOHAN ADDRESS . . . . . . . . . . : 10550 BARNHART CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : MICHAEL D WILLIAMS CONTRACTOR . . . . . . . : WILLIAM TYLER LIC # 22988 COMPANY . . . . . . . . . . : TNT ROOFING CO ADDRESS . . . . . . . . . . : 1610 BLOSSOM HILL RD STE 6C CITY/STATE/ZIP . . : SAN JOSE, CA 95124 TELEPHONE . . . . . . . . : (408) 277-0800 • FEE ID UNIT QUANTITY. AMOUNT. .. PD-TO-DT THIS REC NEW BAL --------- ------------- ------ --- --------- ---------- -------- ---------- 1BSEISMICR VALUATION 6, 825 . 00 0.70 0. 00 0 .70 0. 00 1REROOFRES SQ FEET 20. 00 260. 00 0. 00 260. 00 0. 00 BUSLIC FLAT RATE 1. 00 110. 00 0. 00 110. 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 370 .70 0. 00 370.70 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 370.70 VISA --------------- TOTAL RECEIPT 370.70 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS 605 FINAL REROOF • x Community Development 10300 Torte Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 �CUPEkTINO Building Department JOB ADDRESS: PERMIT # 0"5'S NAME: PHONE # z GENERAL CONTRACTOR: FAX # Zf4=, • - c-J7/3 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 Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date