08070137 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT ��.CpONT=RACTCTR�.I. MATIOI�F'
BUILDING ADDRESS: PERMrr NO.
2072.4 SUNRISE DR ARMSTRONG INSTALLATION 08070137
OWNER'S NAME: PERMrr SUE DATE
LANTZ ROWENA 4575 SAN PABLO AVE 07/18/2008
NE: (510) 777-1234 SANr17ARY NO. CONTROL NO.
ARCHrTEC rlENGINEER: BUILDING PERMU INFO
'BLDGELECT PLUMB MECH
o p LICENSED CONTRACTOR'S DECLARATION O O O
I bomby aRrm that I ern Ilecoml under provisions of Chapter 9(commencing lob Description
-" wlthsecdon7m)OfDivuion3of Busirm mdPons Coe.aomyliccmcis RE—RF T/0 EXTNG WDSHK RF& INSTL CLSA 166 GAF
_ N mfullforce rt -, ♦W �S\ 40YR
4
J ? UeenseClus Is.I •1�
k, Dam ARCHRB(TrSDECURATION CMPSHNG NEW SHETHNG RDWD CLS A
WI understand my plans YW l be hand u public ReoNs
g w UUUt; Licensed Professional
OWNER-BUILDER DECLARATION
ji x i hereby affirm Nal 1 am exempt from the Conu mors Ucenre Law for the
Z p o following won(Section 7M 1.5,Buausss and Prof.atiom Codc:Any city m County
IRE! which requires a permit to com act,almr,improve,demolish,nr repair my somctum
_Z< prior to its Women.also requires the applicant forwch permit to db a signed statement
9ss� that he is licensed pumont a the provisions,of We Commeter's Ucman Ua(LTapter 9 Sq.Ft. Floor Area Valuation
FJFg (commencingwithSection700D)ofDivision3oftheBusinessandProfessinnsCodc)or $10000
R its,W u exempt IMRfrom and the bus,for the alleged exempdon Any violation of
Section 7031.5 by arty applicant for a permit subjew ten applicant m a civil penalty Of ppppmy�Number O
out mom then rove hmmdRd dollars(SYM 35910031 .'ff Occupancy P Y T YPe
I,u owner of the property,or my employee with wages as their to compensation,
will do the work,and the s.semen is not intended of offcro for sale(Sec.7044,Busioeu
and Profeaions Coe:The GntraTor'.Nares Law dao nal appy to an owner of _ Required Inspections
property who Wilda onuproves thereon,and whodoessuchwork himselfortuough his
own employes,provided Nn such improvements me not intended arolrered for sale.If.
however.the building or improwment is mid within arc year of cmopiction.the owner.
builder will law tie When of proving that he did ml build or improve fm purpose of
sale.).
❑1,as owner of the property,w exclusively contracting with licensed conhanon in
canshecl the project(Sec.7044.Business ao Profwssions Codm)The Cmtractm's U. .
come law dean not apply Or m owner of property who builds or imptores immon,and,
who contracts for such projects with aconhacler(s)licensed punanl m the COWMMOrS
I.icema law.
❑luneanmptuoersec. .B&pCftr Nis Ruga
Owner Dam
WORKER'S COMPENSATION DECLARATION
1 hereby.Qum under pemlty,of perjury ane of the following declvWom:
haw and will maintain a CerdDamn
te ofCoem self-insomm
uw for Werner.Cps
talon,as provides for by Section 3700 of the labm code.for the performance of the
wort for which this permit is ismed.
❑1 haw and will maintain Worimes Compensation Insurance,u Ryuited by Section
37M.1 On labor Code,for the pcdo..ofthe wort for which this permit is usual. '
My We Comp4uatm mnemes artier and Poiiryp1ht.ber am: L
Grser. O`�F.ftdh Polity No.:
V UV
CERTIFICATE OF EXEMMON FROM WORKERS'
COMPENSATION INSURANCE
(ThiaacNon need nothe completed If ton permil1.forme hundred doll.(SIw)
or loss.)
I cntify that in the performance,of the worn for which this permit is innocent.l shall not -
employ any person in my mannerm at to WCome subject to to Woracrs'Compensaton
laws of Califomia.Date
Applicant
NOTICE TO APPLICANT:IL alma malting Lau CeniEam of Exemption,you should
become subject 0 the Warners compensation provisions of the l er Code,you most
.J O foMwith comply with such provisions
or this ppmtil shill W downed revoked.
z N CONSTRUCDON LENDING AGENCY
[—t Ihereby affirm that them is a commusdon lendingagenry for the performance of
C
the work for which this permit Is usurd(Sec.3097•Civ.Q
STA Q Lender's Name
.ti. z t<oMs Address
U O 1 ratify thus 1 haw teal this application and sum dot The show information u
Lk. coowt.1 agree to comply win all city and aunty otdinaaa and sate saws Rating to
O Wilding conswnian,and hereby authodR repmxnutivesof this city to enmrupnn the
aWw-mentioned properly for inspection purposes
F pal, (We,).gra ro taw,hal m ify and keep humles the City of Culacow,ag final
t/) liabilitiou,judgments.coon sand upmaa which may in my way aneew against said City
fft
U? m co" pemtiL Issued by: Date
APPLIC ND TANDS AND LL MPLY NONPOINf /
Re-roofs
Signuum ofAppli uconuanor pram
HAZARDOUS MATERIALS DI, .SURE Type of Roof
Will the appliwh m future Wilding worpmts cam rehandle haandoces material
u defined by the Cupertino Municipal Coe.Chapter 9.12.and the HNth and Safety
Cote,Section 25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑You —)Tta
Win thea liaant or future Wilding ecu nt use If a roof is installed without first obtainingan inspection,I agree to remove
Pp g W equipment on devise which P g
I n 7,rdnae air<ananimnts n aenned by to Bay Area Air Oumy Mm.gwnem all new materials for inspection.
❑You o
I have real the hnaNwrmamriils Rquimmew under0,mn&95oftie Cilifar-
nu Health&Safe1YCodn Srconce, 5505.25533mul 25534.1 Coernntal dtmifthe Wikhag
dam nal caRnty mon is u my maponsihilhy m n y ten compent of the
RqutRmcnts t W Ppar inn. r cenfr p Signature of Applicant Date
LV])
owner n<
uth.rdi nt Dam' All roof coverings to be Class'na'or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35910031. 00
DATE ISSUED. . . . . . . : 07/18/2008
RECEIPT # . . . . . . . . . : BS000005512
REFERENCE ID # . . . : 08070137
SITE ADDRESS . . . . . : 20724 SUNRISE DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . .. LANTZ ROWENA
ADDRESS . . . . . . . . . . : 20724 SUNRISE DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2929
RECEIVED FROM . . . . : ARMSTRONG INSTALLAT
CONTRACTOR . . . . . . . : MITCH FINE LIC # 22581
COMPANY . . . : . . . . . . : ARMSTRONG INSTALLATION
ADDRESS . . . . . . . . . . : 4575 SAN PABLO AVE
CITY/STATE/ZIP . . . : EMERYVILLE, CA 94608
TELEPHONE . . . . . . . . : (510) 777-1234
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- --- - ---------- --------- ------ ----------
1BSEISMICR VALUATION 10, 000 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1REROOFRES SQ FEET 16 . 00 208. 00 0 . 00 208 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 209 . 00 0 . 00 209 . 00 0 . 00
METHOD OF 'PAYMENT AMOUNT REFERENCE NUMBER
--- --------------- --------------------
CHECK 209 . 00 #1129
---------------
TOTAL RECEIPT 209 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS . 605 FINAL REROOF
•
CITY OF CUPERTINO L) e0701 a-7
REROOF
• Y 0
CUPEkTINO PERMIT APPLICATION
APN # Date:
O v �.
e v 7117 �
Building Address:
Owner's Name: I Phone #:
Contractor: Phone #: J71-/;- j
n P--?v Fax #: 5 GSS-/9
Cupertino 4siness License #: Contractor License #:
- �v71
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles g6, Asphalt Shingles
.5t, Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
• ❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings Z ❑ Provide I.C.B.O. Report# h-j
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
; t� CUaP S��, �, y/en /
qe,� S l�
y�e lnrcJ S�e
Residen 'al 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:
U tic c,
1 Have Read Understand and Will Comp with Cupertino's Tear-Off Policy:
_ - 4;0 .
Signature
CITY OF CUPERTINO
i
��� REROOF
CITY OF
CUPEkTINO 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 1SFDWLR00F
1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family . B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08
I
Community Development Department
f
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 ori the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name:�/ p u wf k n L M,� Z
Job Site Address: 7111/ f w✓1 r+f[ �/
Roofing Company Name: �/� iS ./oYt �y S-X ,� l
Applicant's Signature: Date: 7 / , v�
• 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
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 1-Joist, (See Spec.) S-2
5. Use Truss with heels, (detail) S-2
6. B. OSB Sheathing, 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. Tarikless 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 oint
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 A.Srte 0 -
fth
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 Stonnwater 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 0
I 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
F;
C.Structural Frame
1.Substitute Solid Sawn Lumber with Engineered Lumber 3 Resource pts y--yes 0
2.Use FSC Certified Wood for iraming
(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
B.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 •
NPUT Resources Energy 1A011-leafth
indows
1.Install Energy-Efficient Windows
• a.Double-Paned 1 Energy pt y=yes D
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 7 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 pis 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 stoves/inserts 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 pis y=yes 0
15.Install High Efficiency Filter 4 IAQ/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 p
2.Install Solar Water Heating System 10 Energy pts 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
f.
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 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes p
1 1 1
•
Community Development
4 10300 Torte Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
OCUPERTINO
Building Department
JOB ADDRESS: PERMIT #
OWNER'S NAME: PHONE # y _j,
GENERAL CONTRACTOR: FAX #5 I 0- 6 - /
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 Si ature Date