08070118 (2) CITY OF CUPERTINO +
BUILDING'DIVISION' PERMIT CONTR'ACnTORI1�ik,O,RMA�,I(7N,
PERMff NO.
BmLpIyG,/.jjO IANTA TERESA DR SHELTON ROOFING 08070118
OWNERS ICNA`1MLE: PERMIT MUE DATE
IEPRA_I:M GIDEON B AND BINA B 1988 LEGHORN ST 07/16/2008
Ne SANITARY NO, CONTROL NO.
ARCHIEC(ENGINEER: BUILDING PERMIT INFO
RE-RF T/0 EXTNG WDSHK RF; BLDG ELECT PLUMB MECH
0 0 0 0
08 OZ LICENSED CONTRACTOR'S DECLARATION JobDescription
U C 1 thereby Africa,that 1 un li¢iued under pmvWons of Chapter 9(commencing ^^'^ ^^^ ^^^^ ^'
,u with Section7000)ofDhbom,3ofd¢Burineavb Pnfcsnum Code.and my lketucu
n in full farce and c(fam.
License Class — 3 4Lle,te9�
n F Dam Comrano_
ARCHITECTS DECLARATION
DECLAR TION
? U 1 understand my plans shad used an public racards
M
9w[; Licensed Pmfcsciooal
3 OWNER-BUILDER DECLARATION
<E I hereby affirm that 1 am exempt from the Comnmoes Lkenm Law for tW
o o following mason.(Section 7031.5,Business and Professions Cade:My city or manly
e$(L which requires a permit to cmuvucr.aha,improve,dcmolissh,or repair any structure
^I< prior at its issuance.also rtquims the applicant for such Permit to file a signed smcon",
ym' dustW4limnedpurcuanttotWprovisionsoftheComrmtor3Licenselaw(Otaper9 Sq.FCFloor Area Valuation
yF� (eommenring with Swtion70W)of Division3oflW BYsnGV and Pofrrdom Code)w
'59 Nat an u eumpt therefrom and the basis far the alleged exemption.Any violation of
Section IDMS by any applicant fora permit subjects due applicant to a civil penalty of APN Number Occupancy
nut moa thio firs hundred dollars(SKID). P Y Type
0 Lasowner of die pmpmty,a my employees with wanesa theb solecompamedon,
will do the work and on,strucnm 0 not intended or ofrsed far sale(Sm.70na,Business
And Pmrasiana Cade:The ConuacmYa L^•d law does ml apply As An owner of Required Inspections
property who builds w impnevcs dtmeon.and who dos inch work him self or through his
Own employes,provided that such improvements Are,an,intended oroRmal fwaale lL
however,the building or improvement is cold within ma year acomplmion.dm owner.
builder HO have the Wrdsr of proving that K did an,wild w improve for purpose of
ale.). ..
1.as owner of the propeny am exclum,mly contracting with licensed contractors to
Construct the project(Sec.7044.Business and Profealon Code:)M Comracmr's U. .
«nse Law does not Apply to an A.of property who builds or improves thmew,and,
who contracts for such prejecu with a conarmfor(s)licensed partners to the Carwwtors
License Law.
❑Iancamoptunder See .B&Pcfwdtisreama
Owner Dam
WORKERS COMPENSATION DECLARATION
1 Wreby affirm under pmadly of Perjtuy,am of the fallowing declarations:
1 have And will maintain A Ccrtib[Ae of Consent to self-imure for Worme.Compen-
union,as provided for by Section 37M of the labor Code,for the performance of IW
work for which this permit is Wood.
ve and will maintain Worker's Compensation Lrwrana.As Mquirtd by Seedon
3700of the labor Cade.1.tW performAnw of the work for which this permit is issued.
My Workers Compensation htmrarce carrier and Policy number Art:
Cartier.i :t]?6j!ElyA10 Poli"No.: S7/-0010176/
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE .
(This rection wed not he com plc rad if de permit infatuate hundred dollars($100)
w less)
I certify that in the performance of the work for which this permit is laved.l shall nal
employ anypermn in any maim rm a m become subject to Irk Worked Companalon
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If,afar making this Ccrtificae of Exemption,you should
become subject As the Workers,Compensation provisions of the labor Coda,you muse
,J Q forthwith comply with men provisions or Nu permit shall W deemed revoked.
z CONSTRUCTION LENDING AGENCY u
[—i IWreby Mfirm this dere is A construction landingagmay for the perfwmance of
fL' Use work for which thiu Permit is issued(Sec.3097.Civ.C.)
QLender's Nuns
z L<ndce,Adams
U O 1 certify that 1 have MW this applicuion and Aum dual the above information I, _ -
Iy !' conot.l agree to comply with All city and county asome laws aha slaws relating to
.O building conmvction,ad hereby AmWriM MPM3aMmVc$of this city to onmr upon the
r IA shove-mentioned property far inspection purposes.
(~ G (We)agree to an,indemnify and keep harmless the City of Cupertino against
en inconseajuagmenh,emu and alibis
pormi[hmryN ay way awmm Against said City
U z Aconsequence of due granting of this permit. �7 /
APPLIC UNDERSTANDS AND WILL COMPLY WITN ALL NON-POINT Issued by: Date
SOUR R UTATfgr+s.
Y-_t 71 01 Ad ,e �!� 0 P Re-roofs
Signwurt of A,fipn onuector Data
H ARDOUS MA DISCLOSURE Type of Roof
Will the ApplipntorfuturtbujldingoccpenLsmm mhandlc haallous mAmrial
as defined by the Cupertino Mu "I Code,Chapmr 9.13,and the Health and Safety
Code,Section 255334)? All roofs shall be inspected prior to any roofing material being installed.
DY No
Will the applicat or mare Wilding occupant um equlpmmt or devices which If a roof is installed without first obtaining an inspection,I agree to remove
u biramous air contaminants as defined by the Bay AMA Air Dually Management all new materials for inspection.
District?
❑Ya `/T—jN/o
I have Mad Oe haxa,2 m'mrula Mqui oomms under Chapur 15,95 of dm Califw-
nielieal &Safety Gatic,Rc.=25YJS.25533.d25534.lundemmdU if Nc Wilding �
dors at dandy ham•AnenL the u my r.ponsihllhy to notify the occupenl of die j�JvJ
Mq which muse mem ' ran umofa Ccrolksw of Ocsupuuy.
Signature of Applicant Date
Owner ar Aaduarir ag[n r DAM All roof coverings to be Class'RW'or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: alk: Lot:.
APN . . . . . . . . : 35615006 . 00
DATE ISSUED. . . . . . . : 07/16/2008
RECEIPT # . . . . . . . . . : BS000005487
REFERENCE ID # . . . : 08070118
SITE ADDRESS . . . . . : 10891 SANTA TERESA DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : EFRAIM GIDEON B AND BINA B
ADDRESS . . . . . . . . . . : 10891 SANTA TERESA DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4724
RECEIVED FROM . . . . : EDWARD A GREGORY
CONTRACTOR . . . . . . . : WRAY, RICHARD LIC # 20755
COMPANY SHELTON ROOFING
ADDRESS 1988 LEGHORN ST
CITY/STATE/ZIP . . . : MOUNTAIN VIEW, CA 94043
TELEPHONE . . . . . . . . : (650) 961-7699
• FEE ID UNIT QUANTITY AMOUNT. PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 12, 617 . 00 1 .30 0 . 00 1 . 30 0 . 00
1REROOFRES SQ FEET 32 . 00 416 . 00 0 . 00 416 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 417 .30 0 . 00 417 . 30 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 417 . 30 MC
---------------
TOTAL RECEIPT 417 . 30
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
CITY OF CUPERTINO
REROOF
P CUPEROTINO PERMIT APPLICATION
APN # .35-�p Date:
Building Address:
0 O A Sz t, ri 7_Ares -R �r
Owner's Name: Phone #:
j ;t45 6So - 3Z 3 - ZrVZr
Contractor: 54e,14— ��o aaj c Phone #: (�so- 96/-76 9 9
Fax #: 6 v- 96(- sob r
Cupertino Business License #: Contractor License #:
�Q<
Type of Roof Covering:
Existing: Proposed:
a Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles > Asphalt Shingles 30y`
Wood Shakes ❑ Wood Shakes
a Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings / ❑ Provide LC.B.O. Report # / 3 9 [SE
To be Removed ❑ Provide Mfgr. Installation Specs.
Cl9 rr
Job Description:
ff e1.;s4i4j <'w{ /0y
30 3Cyr 00,V
3z s9s
Residential 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: ❑
a licable include in plan set & the sheet index. - ^�-
Valuation:
I/ Ae
Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
l,/,�/4 L AXI i m y
Signature
CITY OF CUPERTINO
� REROOF
CUPEkTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMIC0 Seismic Commercial B
1RER00FRES Re-roof Residential B 1SFDWLR00F
32
I 1BSEISMICRE Seismic Residential B
1RER00FMRES 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 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: R 2.1 e _rt q i
Job Site Address: Sq t,4,. / ee-r e S 2 �r•.
Roofing Company Name: S ¢ F �o ��g C.
Applicant's Signature: Date:
/ 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
a-
r r
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 72points
11. Permeable Paving, Note L-1 C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 5. Use Truss with heels, (detail) S-2 6. B. OSB Sheathin detail S-2
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. Energy Star Refrigerator, (Note/Spec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS1 40 points
/ Q p v R Aal-e M�
< 69 7� dc, � s %ese -D,.
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 M011-leafth
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 Stormwater 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 Materials/Use 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 D
1 1 1
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=yes 0
1 1 1
C.Structural Frame
1.Substitute Solid Sawn 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 pis 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 •
114PUT Resources Energy IAO/Heafth
• L 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 IAO/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 IAO/Health pts y--yes 0
b.Water Heaters 31A0/Health pts y--yes 0
9.Replace Wall-Mounted Electric and Gas Healers 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 9D%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes D
13.Retrofit Wood Burning Fireplaces
. a.Install EPA certified wood stovesfinserts 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 0
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 pis y=yes 0
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=yes p
1 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes p
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes p
3.Plant Deciduous Trees on the West and South Sides 3 Energy pis y=yes p
1 1
•
Community Development
✓ 10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408) 777-3333
*�UPEkJINO
Building De artment
JOB ADDRESS: PERMIT #
Q ?9(
OWNER'SNAME: PHONE # 6a-t9 -3Z3-Zb ?_P
GENERAL CONTRACTOR $ , o s •q FAX # (oov- 9 6!- s0 b p
I am not using any subcontractors: -7!6-O e
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
76p a�
Owner/Contractor SieatulVe Date