08080109 CITY OF CUPERTINO -
BUILDINGDIVISION PERMIT J a NTRACTORI�IFORMATIQN
BUILDING ADDRESS: PERMIT NO.
1.0396 AVENIDA LN TBD — TO BE DETERMINED 08080109
OWNER'S NAME: PERMIT ISSUE DATE
liskIt0W HOWARD B AND HELEN H 08/15/2008
NE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
RE—RF T/0 SHKS& INSTL 1/2 BLDG ELECT PLUMB MECH
0 0 0 0
�Oci LICENSED CONTRACTOR'S DECLARATION esB
,,,-,JOU Description
uC IwrobY&(firm that l am licensed under provision of Chapmr 9(comelcming ^-•^—^-^-^- ^- p
ZW with Section7IXl0)ofly ivision 3afdm Busiae..and Prof swn and my livens is
<< in full force aM eRc
j�� License os � Lie.• '
r O Dau Conti DEC,ttaay�� ARCHITECTS EC,
i e< 1 uM..d my plans l W wed n Mbl' recarda
JyU
k y Licensed Professional
1 OWNER-BUILDER DECLARATION
I I hereby&Trm that I sec exempt from the Contractor's License Law for f
OO following reason.(Section 71131.5,Business and Profession Code:Any city or County
I3 V which equirn a Permit in cmmoreL alms,improve,demolish,m repair my snetum
ZZV priorm an
its issuance.also rocuirn the applicant for such permit m rise signed statement
< thatWulicensJ pursumtlO dee proviilov oftW Conuacmh lxene Law(Chapur9 Sq. Ft. Floor Area Valuation
iO (Commencing with Section 7000)of Div¢ion 3 of the Busincesmd Profussun Code)w
y`<$ that he Is exempt timmfromd dee bamis for use alleged exemption.Any violation of
Section 7031.5 by any applicant for a Form,subjects the applicmno a civil penalty of APN Number Occupancy Type
not mom man r1w hundred dollars($SBS. Pane Y YP
I, minerof dee tapevy,remYemployees wise mgrudee"vele Compmrudon,
will doo the work,and dee theme Is net intended w sawoffereddos Out apply in
m Butlmv
and property
Professions Cade:The Conuacmr'i License Law dear set apply lf,t awn of Required Inspections
pme cm wW Wildswimprowsth unon,v r wM10 are not
himsrdfor Wougn his
own employees,provided prsuchimprowmmtsartnot ear of
for aler..
huilder CanWildingth6mimprovementusoldwithinon year or improve
dee owner
builder will have dee burden of proving that W did not Wim w improve for purpose of
ars.).
❑1,as own of dee property,w acluovely contracting wide licensed Conuacmes to
cmuteuct dee project(Sec.7044.Business and Prok sssian Cade)The Cm=Mes Li- .
cense Law don not apply W an Owner of PrOPWY who Wilda or improves memon.and
who contracts for such projens wise aconuam cats)licensed puma,to the Contractor's
Lint.Law.
❑I sen exemptunder See .B A P C for this macre
Owner Dam
WORKER'S COMPENSATION DECLARATION
1 hereby y aunder pn faunally of perjury oof the following declantionc
I haw and will maintain a Cenifieam of Consent to self-insure for Wmrscfs Compen.
sation,as provided for by Section 3700 of the I mor Cod,fm dee performance of the
wart for which this permit is issued.
❑1 have and will maintain Worker's Compensation Insurance,as required by section
3700 of the Labor Code,for the performer ofine work fwwbich this permit is issued. '
My Wor n mdon Imm�nce carrier and Policy number w: _
Cartier. POliry NO.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
ribissectimt reed not W compered if the permit is foronce hundred dollar(SIM)
or less)
1 certify that in the performance of the work for which this permit u issued.l shall Int
employ any person in my beemer m as an beCome subject m the Workers'Comperwtion
Laws Of California.Dau
Applicant
NOTICE TO APPLICANT.If,after making this Certificate of Exemption,you should
become subject to the Workers Compewdon provision of the Labor Code.you most
.J O foMwim comply with such Provision w this permit shall W domed reversed.
z '-' CONSTRUCTION LENDING AGENCY
[-t I for by which
ised(Secti3097,Cng agency for Nc pmfwmar of
eL> tie want ran which m,permit,issued(Sec.J0S7,Civ.C.)
0 lender's Native:
D z Undoes Address
U O 1 certify that I haw mad this application and sum dead the above information is
Is. E coned I agree te Comply wise all City and county oNin.and mute laws relating m
C) SV-: building conswction,and hereby aumoion apteunutiws of this city to cnur upon me
Fmove-mentioned property for inspection purposes a. (We)agree to saw,indemnify and kecp harmless tiro City of Cupertino agsint
CA liabilitica.Judgmcnu.cosu and expr.,..which may in mywayacerm againtsaid City
U,z in STANDS A
of DERnabong of ts permit.
ND WILL COMPLY WITH ALL NON-POINT Issued by: Date �-�S"-fl✓�
SOURCE ONS. /y
Signet App icmUConuazmr D Re-roofs —�_
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will tie applianr m future Wilding occupant von or hand a nanrdan material
as defused by me Cupertino Municipal Code.Chapter 9.12,and the Health and Safely
Cade,Section 255J2(a)? All roofs shall be inspected prior to any roofing material being installed.
Will mea Applicant or future Wilding emu nt care If a roof is installed without first obtainingan inspection,I agree to remove
pp g pa ea Air equipment P g
I ha'rallon air conuminnts as OcOncd by dee Bay Area Air Quality Management all new materials for inspection.
Wert
❑Yu t�
I have mad dee harardrm etwom,requiremmtsmukr Cnapmr6.95ofthe Califor- - ^ -
nuHalm&Safely Cudc.Secdon255U5.25533md25M.lummend matifde Wilding
Z
not dy haw a um 0 ype a5y Iticn term W met poormiuuvuxofa Cmtifrsmof Occu ncy. Signaft a ofApplicant Date
rawhmi.edagent m' I All roof coverings to be Class'W or better
CITY OF CUPERTINO
• 3 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . 1 . : 34245035 . 00
DATE ISSUED. . . . . . . : 08/15/2008
RECEIPT # . . . . . . . . . : BS000005801
REFERENCE ID # . . . : 08080109
SITE ADDRESS . . . . . : 10396 AVENIDA IN
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . .. LOW HOWARD B AND HELEN H
ADDRESS . . . . . . . . . . : 10396 AVENIDA LN
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-3947
RECEIVED FROM . . . . : ANTHONY RAINIERI
CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096
COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . .
TELEPHONE . . . . . . . . :
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--------- - ----- ------- --- ----
1.13SEISMICR VALUATION 25, 000 . 00 2 . 50 0 . 00 2 . 50 0 . 00
113USLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 0 . 00
IREROOFRES SQ FEET 58 . 00 754 . 00 0 . 00 754 . 00 0 . 00
---------- ---------- --------- ----------
TOTAL PERMIT 866 . 50 0 . 00 866 . 50 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
- -------------------------- -------- ------------- ---------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
a CITY OF IIPERTIN of O h( U l
REROOF
CUPERTINO PERMIT APPLICATION
APN # L/�L/ J Date:
Building Addre�s03q
vi-I #,
Owner's Name: Phone #:
L , ?�� Z7
Contractor: n� Phone#: 2lr ySz/o
A I,\��y 2�1�, r7/ , 1�/ .
Fax#:
Cupertino Business License#: Contractor License#:
Gl3Cp /
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
• Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ 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: T/ �� S q I i v 3C' r T
cow sL, � I'e e ( r'
Residential Commercial
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist& attach it to the applicatiQllor if there are any restrictions: ❑
applicable, include in plan set& the sheet index.
Valuation:
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signa
Revised 6/16/08
CITY OF CUPERTINO
D' REROOF
CUPERIINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
S 1RER00FRES Re-roof Residential B 1SFDWLR00F
IBSEISMICRE Seismic Residential B
IREROOFMRES Re-roof Multi-Family B 1MFDWLROOF
• 1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08
•
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:
1. Flat roofs must have a minimum of 1/ "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: AUv�/arsV
Job Site Address:
Roofing Company Name: �.�{h do v IA w IL
• Applicant's Signature: a Date:9 i� 01f
Greg Casteel
Building Official
Revised 07/30/08
Community Development
I S 10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
`@kJPEkTINO
Building Department
All Cupertino building permits must meet certain conditions related to maintaining
environmental quality and public peace and safety. The two most common
conditions are described below.
STORMWATER POLLUTION CONTROL
State law requires that Cupertino, 12 other Silicon Valley cities, Santa Clara County and
the Santa Clara Valley Water District control stormwater pollution. Educating local
residents and businesses and enforcing stormwater pollution control laws are key parts
of the City's compliance efforts.
Stormwater pollution prevention: It's up to us
In northern Santa Clara Valley, storm drains flow directly to local creeks and San
Francisco Bay, with no treatment. Stormwater pollution is a serious problem for wildlife
dependent on our waterways, for people living near streams and baylands, and for the
local water supply. Common sources of stormwater pollution include:
Dripped oil, fuel, and antifreeze from vehicles and heavy equipment;
• Construction debris, including dirt, concrete and paint;
• • Landscaping runoff containing pesticides or weed killers; and
• Any material dumped or spilled into streets or storm drains
The property owner and the contractor share ultimate responsibility for activities
occurring at a construction site and will be held responsible for any environmental
damage caused by subcontractors or employees.
For more information on construction-related stormwater requirements, see the
Stormwater Quality Regulations section of the City of Cupertino web site at:
http://www.cui)ertino.org/city government/departments and offices/
environmental services
J
COMMUNITY NOISE CONTROL
The basic noise control requirements for construction sites are as follows:
Typical construction work hours are:
- Weekdays - 7 a.m. to 8 p.m.
- Weekends - 9 a.m. to 6 p.m.
• Construction other than street construction is prohibited on holidays.
Residential daytime noise levels from complaint site - 60 dBA
• Nonresidential daytime noise levels from complaint site - 65 dBA
For more information on noise control, please see Chapter 10.48 of the Cupertino
Municipal Code, which can be accessed at http //www amleaal com/cupertino ca/
•
Greg Casteel
Building Official
F-ryA Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
4FUPEI�TINO
Building Department
JOB ADDRESS: PERMIT6kq 9
OWNER'S NAME: PHONE # ,2Z U Yr
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
21 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