08060184 (2) CITY OF CUPERTINO
BUILDIN(gDIVI510N PERMIT CONTRAC�"TOI2 INI+'ORMATIONw.z
u.2.2s R L C-TO
BUIL811 DRESS: PERMIT NO.
.134 DERBYSHIRE DR T D ROOFING 08060184
OWNER'S NAME: PERMUT ISSUE DATE
XINMING ZHANG 675 TULLY RD 06/24/2008
ONE:
(408) 892-8872 SANITARY NO. CONTROL NO.
ARCHITECT/FNGINEER:
BUILDING PERMIT INFO
• BLDG ELECT PLUMB MECH
0 0 0 0
O p LICENSED CONTRACTOR'S DECLARATION
u F I hereby,affirm that I me licensed under provisions of Chapter 9(commencing Job Description
`.
^ wishSection?")ofDlrlsiun3o(theBusiness and Profassm
iaCade,and atBeenseis RE—RF RMV CMP INSTL CMP NO PLYWD 2�2'SQ CLS A
nN mon(arta anturee�j gy 1 f
Data Cl Lica
F ata¢ Contramm �A
ARCHfIECfS DECLARATION r v1
� < I undentanJ my plum dull W used v public rteaNa
yU
b Q Ufa Licensed Pmfcssi...I
w7m OWNER-BUILDER DECLARATION
2 F 1 hereby aRmr that I am exempt from the Coniractafs Lk,nm Law for the
-O O following mason.(Soudan?1131.5,Business ant Professions Code:Any city of county
$ which na uirm a permit to construct,slur.improve,demolish,ar mPan any Mae.
prim in its issuance.also,requires to applicant for such permit to file a signed women,
< wt he is licensed personal taweprovisions ardue canpaatm'SLucumLaw(L*amm9 Sq.Ft.Floor Areax� Valuation 0 (eommeming with Section 7000)of Division 3 aftM But.and Professions Code)or $6000
y $
than he is exempt ftmfmm and me basis for due alleged assumption.My violatlnn of
Section 703L3 by any applicant for.permit subjects thc applicant to a civil penalty ofNumber Occupancy
.at come man Rai hundred dollars(S50013 6 2 210 31 . Pane Y Type
do
he work.
die property,m mY a1 mumces wish wages t tale'(sole compensation,
will doltwork soda- ahumontisnots Laccod Law da .1Appec.I0a4,Business
Nd er ywho ni Cade:Talc mm dambYa ndwW Law wh Mt apply to rt OWner of Required Inspections
propertywhobuildssirimproves muton.andwho doesotO work himul!sir through his
monoemployees.provided Wtsuch improid wit erenot earofidmoloreddem,fornaletheow.lr.
unfromement proving soldwithinarcyearofcempktion,theowner-
builder will ham the burden of proving Wt W did riot build or imProm for PUTose of
sale.).
0 1,as owner of talo pmpeny,am exelnsimly contracting wish licensed contractors on
construct fee pmjem(Sec.70".Business and Professions Code)The Convacter's U.
commlaw dors not apply to an owner of property who Wilds or improv mem.n,and.
who contracts for such Projects with a contractor(s)licensed pursuant to the Contractor's
License,law.
0 lameximptunderSee .BkPCfmthismasan
Owner Data - -
WORKER'S COMPENSATION DECLARATION
1 hereby aRrm under penalty.(,do,ane of the following declarations:
1 ham and will maintain a Certificate.(Consent to self-insure fm WorkcesCompcn-
mism,as,provided far by Section 3700 of the IaWr Code,for the radmmance of the
wow for which this permit is issued+
nave and will maintain Worto(s Compensation Insurance,as required by Section
3700 of the Latter Code,fm the perrarmnnce of the wort for which this pcanit is issued.
My Warkees C.mpensadun to..carrier and Policy nberumam: _
Cartier. C.S I FPolicy No.
CETITE OFEKEMP ION : I SSC
FRO WORKERS'
COMPENSATION INSURANCE
(iris suction used not W complemd nth.permit Is forma,hundred dollars(SIM)
or leu)
I certify that in the Performance of the wort fm which this permit u issued.I shall am
employ anypersen in any mannerso u to bmome subject Or the Warners'Compensation
Laws of California.Date
Applicant
NOTICE TO APPIJCANT.1!.after making this Certifcam or Exemption,you should
become subjem in the Winter's Compensation provisions of tie Labor Cade,you most
.J O forthwith comply with such Provisions m this Permit shall be deemed remkcd.
tip" CONSTRUCTION LENDING AGENCY
ti
1 WmbY affirm that then is s econtraction(Sec.
0 lending ag,nq far the Performance of
f>: Lc wish for which his permit is issued(Sou.J09T,Civ,C.)
Gz landcr's Name
0 Z lrnder's Addross
U0 i cartifY that I lam mad this application and cern,tha the W.information u
lg. ^ cormtt 1 agree in comply with 01 city and county oNinances and sate Ian relating to
0 rV' building construction,and hereby aumarian rtpmsenadmS of this city to enter Open the
W whom-ro mfiabod pmpcny In,Inspection purposes.
Fy C (We)agree m save.indemnify and keep barmless the City of Cupertino against
vnh liabilities,judgmcnu.caw and e¢ensues which may in any way Accuse agunlmid City
U Z in eawq LOURNANDS
ofthisp mi Issuedby: Date j —'LAPPLICA AND WILL COMPLY WITH LL NO OINfRCE
b 1 o Re-roofs. y/
Signaure OfAirplicarOCuffiristor Dare /
HAZARDOUS MA ALS DISCLOSURE Type of Roof
Will the Applicant
ertino 0builds Immature 9.1 m handle Health esmamritl
az dented by tier Cupertino Mumps 1 ode. apter 9.13,and the Health and Safety .
Code,Section 35532(a)? C All roofs shall be inspected prior to any roofing material being installed.
0Yes JanP�
applicant of forum (ding aaupant tax equipment m devices which an inspection,If a roof is installed without first obtainingiection,I agree to remove
the
Will tW
it hvalloru air canumi Bued by Bay Area Air Quality Management all new materials for inspection.
cam0Yes /0 No
n
I have mad the hvallous materials mquimmenu under Chapter 6.95 of the Califor- /try
iia Hcal hS'n Cada Sccdom25505,2S533a M534.1un&c dthuif Wilding i /
Jars no e d hoc s unara.tha it u my reapmnalbility m n 'fy the ace set of the J�'t
require n oci met ri miss.amcan I"n cora Signature of Applicant Date
o All roo erin s to be Class'f{
Owner or authmved.gem r Date' g "or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36221031. 00
DATE ISSUED. . . . . . . : 06/24/2008
RECEIPT # . . . . . . . . . : BS000005209
REFERENCE ID # . . . : 08060184
SITE ADDRESS . . . . . : 1134 DERBYSHIRE DR
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER XINMING ZHANG
ADDRESS . . . . . . . . . . : 1134 DERBYSHIRE DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5072
RECEIVED FROM . . . . : LESLIE A HOANG
CONTRACTOR . . . . . . . : LESLIE HOANG LIC # 23155
COMPANY . . . . . . . . . . : T D ROOFING
ADDRESS 675 TULLY RD
CITY/STATE/ZIP . . . : SAN JOSE, CA 95111
TELEPHONE (4,08) 892-8872
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 6, 000 . 00 0 . 60 0 . 00 0 . 60 0 . 00
1REROOFRES SQ FEET 19 . 00 247 . 00 0 . 00 247 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 247 . 60 0 . 00 247 . 60 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 247 . 60 VISA
---------------
TOTAL RECEIPT 247 . 60
VOICE ID -- DESCRIPTION -- -- VOICE ID DESCRIPTION
-------- -------- -------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: pdtg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36221031 . 00
DATE ISSUED. . . . . . . : 06/24/2008
RECEIPT # . . . . . . . . . : BS000005207
REFERENCE ID # . . . : 08060184
SITE ADDRESS . . . . . : 1134 DERBYSHIRE DR
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER XINMING ZHANG
ADDRESS 1134 DERBYSHIRE DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5072
RECEIVED FROM . . . . : LESLIE' A HOANG
CONTRACTOR . . . . . . . : LESLIE.HOANG LIC # 23155
COMPANY . . . . . . . . . . : T D ROOFING
ADDRESS 675 TULLY RD
CITY/STATE/ZIP . . . : SAN JOSE, CA 95111
TELEPHONE (408) 892-8872
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 6, 000 . 00 0 . 60 0 . 00 0 . 60 0 . 00
1REROOFRES SQ FEET 22 . 00 286 . 00 0 . 00 286 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 286 . 60 0 . 00 286 . 60 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 286 . 60 VISA
---------------
TOTAL RECEIPT 286 . 60
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
ti
CITY OF CUPERTINO
oho (P 04y
REROOF
CITY 0
•CUPEkTINO PERMIT APPLICATION
APN #3 / U / Date:
Building Address-
it 3q
ddress:i13y r) evh
Owner's Name: Phone #:
C, V1 yJ�� X19 - 1c
Contractor: Phone #: G
i D IZ op �;�� y0S) 2-G 3 - 91 I
ax # yo o293 9 i
Cupertino Business License #: — Contractor License #:
/ � � 8y5Sq I
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
o Wood Shingles ❑ Wood Shingles
* Other (Specify) C,o ov /i' Other (Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report#
e\Q To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: l f I
AL2 -n l O v z ��1 f1 , 4 Yl S"1 C%_, ,
1110 W obcj -- V Iv C_1Y1,,4
Residential Xj I I Commercial ❑
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuation:
I Have Read, Un rst d and Will Comply with Cupertino's Tear-Off Policy:
Signature
. i
CITY OF CUPERTINO
tb a' REROOF
CITY Of
CUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
2� 1RER00FRES Re-roof Residential B 1SFDWLROOF
1BSEISMICRE Seismic Residential B
1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
IBUSLIC 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 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 with the above stated policy on re-roofing.
Homeowner's Name: Y'1 7n'1 ') 11 Z � Ci V1
Job Site Address: ( ( 3 `I e h y S i tr Q
Roofing Company Name:
Applicant's Signature: Date:_�Ij_q 0 d
• Greg Casteel
Building Official
Revised 11/2/04
Green Building Plan Check
Index of Green Building Points/Categories
A. Category Example of an Index or Table of Green Plan Sheet or Page Points
Building Points Categories that must be
shown and referenced on the Project
Plans See below
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 2 points
11. Permeable Paving, Note L-1 2 points
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 points
D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, detail S-2 2 points
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 2 points
F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 points
5. Tankless W.H., (Note/Spec.) A-2 2 points
11. A 2500 Gal. Tank, (Note/Spec L-1 10 points
G. ,Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point
3. Ener y Star Refrigerator, (Note/Spec. A-3 12int
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 40 points
•
•
Plan Review Process Work Book Page-12-Revised 3/25/08
Green Points Rating System for Remodeling Projects
Due to the diversity of remodeling project types,assigning a'total points'value to a project to be considered environmentally friendly is
not feasible. However,25 measures have been highlighted to signify that every effort should be made to incorporate them into your •
projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with
ease of implementation and relative low cost. These measures can be used as a starting point for'greening'your project.
INPUT Resources Energy IAO[Heafth
A.Site
1.Recycle Job Site Construction&Demolition Waste'
65%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts 0
2.Salvage Reusable Building Materials 4 Resource pts y--yes 0
3.Remodel for Mixed Use,Adaptive Reuse,and
Historic Preservation 4 Resource pts y=yes 0
4,Protect Native Soil 2 Resource pts y=yes 0
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y=yes 0
6.Implement Construction Site Stormwaler Practices 2 Resource pts y=yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 0
8.Design Resource-Efficient Landscapes and Gardens 4 Resource pts y=yes 0
9.Reuse MaterialsfUse Recycled Content Materials
for Landscape Areas 2 Resource pts y=yes , 0
10.Install High-Efficiency Irrigation Systems 2 Resource pts y--yes 0
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes 0
1
EMO
B.Foundation
1.Incorporate Recycled Flyash in Concrete
25%Recycled Flyash=2 points;Add 1 point for every 10% •
increase of flyash,up to 5 points up to 5 Resource pts 0
2.Use Recycled Content Aggregate 2 Resource pts y=yes 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yesF 0
1 1 1
C.Structural Frame
1.Substitute Solid Sewn Lumber'with Engineered Lumber 3 Resource pts y--yes 0
2.Use FSC Certified Wood for framing
(For every 10%of FSC lumber used=2 points,up to 10) up to 10 Resource pts. 0
3.Use Wood I-Joists for Floors and Ceilings 2 Resource pts y=yes 0
4.Use Web Floor Trusses 2 Resource pts y--yes 0
5.Design Energy Heels on Trusses 6'or more 2 Energy pts y=yes 0
6.Use Finger-Jointed Studs for Vertical Applications 2 Resource pts y=yes 0
7.Use Engineered Studs for Vertical Applications 2 Resource pts y=yes 0
8.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0
9.Use Structural Insulated Panels(SIPs)
a.Floors 3 Energy pts y=yes 0
b.Wall 3 Energy pts y=yes 0
c.Roof 3 Energy pts y=yes 0
10.Apply Advanced Framing Techniques 4 Resource pts y=yes 0
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes 0
12.Use OSB
a.Subfloors 1 Resource pt y=yes 0
b.Sheathing 1 Resource pt y=yes 0 •
INPUT Resources E ..9V lAQ1H,,ItF
windows
1.Install Energy-Efficient Windows
• a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 2 Energy pts y=yes 0
c.Low.Conductivity Frames 2 Energy pts y=yes 0
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0
1 1 1
J.Heating Ventilation and Air Conditioning
1.Use Duct Mastic on All Duct Joints 2 Energy pts y=yes 0
2.Install Ductwork within Conditioned Space 3 Energy pts y=yes 0
3.Vent Range Hood to the Outside 1 IAQ/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 0
5.Install Solar Attic Fan 2 Energy pts y=yes 0
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts y=yes 0
6.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes 0
b.Water Heaters 3 IAQ/Health pts y=yes 0
9.Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wall Heat Pumps 3 Energy pts y=yes 0
10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts Y--yes 0
11.Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes 0
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes 0
13.Retrofit Wood Burning Fireplaces
• a.Install EPA certified wood stovesfnsens 1 IAQ/Health pt y--yes 0
b. Install/Replace Dampers 1 Energy pt y--yes 0
c.Install Airtight Doors 1 Energy pt y=yes 0
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes 0
15.Install High Efficiency Filter 41AQ/Health pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yes p
1 1 1
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pts Y--yes 0
2.Install Solar Water Heating System 10 Energy pts y--yes0
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes 0
4.Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=16 points) Up to 16 Energy pts 0
6.Select Safe and Durable Roofing Materials 1 Resource pt y=yes 0
7.Install Radiant Barrier 3 Energy pts y--yes0
L.Natural Heating and Cooling 1 1 1
1.Incorporate Passive Solar Heating 5 Energy pts y=yes 0
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes p
3.Plant Deciduous Treason the West and South Sides 3 Energy pts Y--yesp
1 1 1
•
i
Community Development
10300 Torre Avenue
r Cupertino CA 95014
Telephone(408)777-3228
CITY Of Fax(408)777-3333
�UPEI�TINO
ByRding Department
JOBADDRESS: i r e I r k PERMIT #
OWNER'S NAME: m '� Il -0-11 Cttn Q PHONE `t 219 - I i `o f
GENERAL CONTRACTOR: T It 21o FAX # ( 40 g" .7-93 - q1
I am not using any subcontractors:
Signa Date
Please check applicable subcontractors and complete the o owin 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