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11020020 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19682 AMHERST DR CONTRACTOR:JIM KRAUSE ROOFING PERMIT NO: 11020020 OWNER'S NAME: BEAN ROBIN C AND KINNEAR RAYMO 2310 DIANA AVE DATE ISSUED:02/07/2011 r--""ER'S PHONE: 4084462920 MORGAN HILL,CA 95037 PHONE NO:(408)779-0704 LICENSED CONTRACTOR'S DECLARATIONF BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class 4f 3 Lic.# 55 `f 3 5 MECH F RESIDENTIAL F COMMERCIAL� Contractor.J I M K,-t� 4wr"Y Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OFF EXISTING SHAKE.NO RESHEET, (commencing with Section 7000)of Division 3 of the Business&Professions INSTALL MINERAL SURFACED CAP SHEET,30LB FELT,"B" HEAVY SHAKES.CLASS A,29SQARES Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$22000 permit is issued. APPLICANT CERTIFICATION APN Number:31628018.00 Occupancy Type: I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS F OM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. .L/� Issued by: � - 7- it Date: Signature Date / C 6WNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVER&�TOCLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE I have and will maintain a Certificate of Consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must Owner or authorize gent: forthwith comply with such provisions or this permit shall be deemed revoked. Date: Z. 7 APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address co- ^nd expenses which may accrue against said City in consequence of the g ;of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION w..1.-, non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31628018 . 00 DATE ISSUED. . . . . . . : 02/07/2011 RECEIPT # . . . . . . . . . BS000012653 REFERENCE ID # . . . : 11020020 SITE ADDRESS . . . . . : 19682 AMHERST DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER BEAN ROBIN C AND KINNEAR RAYMO ADDRESS 19682 AMHERST DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-2408 RECEIVED FROM . . . . : JEFF RAINEY CONTRACTOR KRAUSE, JIM LIC # 21415 COMPANY JIM KRAUSE ROOFING ADDRESS 2310 DIANA AVE CITY/STATE/ZIP . . . : MORGAN HILL, CA 95037 TELEPHONE (408) 779-0704 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ----------- ---------- ----- 1BCBSC VALUATION 22, 000 . 00 1. 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 22, 000 .00 2 .20 0 . 00 2 .20 0 . 00 1REROOFRES SQ FEET 29 . 00 377 . 00 0 .00 377 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 380 .20 0 .00 380 .20 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 380 .20 MC --------------- TOTAL RECEIPT 380 .20 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 309 EXTERIOR LATH 311 SCRATCH COAT 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 19682 AMHERST DR DATE: REVIEWED BY: APN: BP#: "VALUATION: 1$22,000 -� *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION 1SFDWLR00F USE: PERMIT TYPE: WORK REROOF 29SQ SCOPE FEE ID ROOF AREA s.f. 1REROOFFRES 2,900 LJ I NOTE. Thesefees are based on the preliminary in ormation available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS (Fee Resolution 09-051 Eff. 7/1/10) FEE QTY/FEE MISC ITEMS Ph{17:71;, 11cd F i Ic' feta:-7ti Permit Fee: $377.00 f'Tz,rr��a.-aly°cdt. "I•�(e. �err f°c>�.. Work Without Permit? 0 Yes G No $0.00 T A 1'(iutltl`ttE' f'c't' : Strong Motion Fee: 1BSEISMICR $2.20 Select an Administrative Item B1dwStds Commission Fee: IBCBSC $1.00 1 SUBTOTALS: $380.20 $0.00 TOTAL FEE: $380.20 Revised: 01/15/2011 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: !�YWZ A r✓1 E Z Z PERMIT# l D OWNER'S NAME: IRo&,j 13 L--,J PHONE# qO9 �Z 9LO GENERAL CONTRACTOR: j Klp-/ro5C j cxp ,r jj- BUSINESS LICENSE# ADDRESS: 'z3;0 Di ,J i CITY/ZIPCODE: MM-GA-J H IL-L-0 75037 *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: S' Date Please check applicable subcontractors and omplete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum /Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting /Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•build ing(d)cugertino.org PROJECT ADDRESSI�/ �Z 14* H M L•,T I -1 AP IV# OWNER NAME 51 PHONE 1 / ��� E-MAIL (G STREET ADDRESS --^^ CITY, STATE,ZIP* FAX 116 Q Z 7„ �L� l /\ CU t7 I J C I ©i CONTRACTOR NA (� �' 1 LICENSE NUMB R c L ICENSE BUS.LIC.# 7 Afe S 7' NAME E-MAIL F AX STREET ADDRESS CITY,STATE,ZIPPHONE 2 O t AJ A /)\1 yMoft 6 AAl i-VIL-L c'503 7 -log,2.q 5 -q Z-4 5� I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimum of one day before the requested inspection date. Please schedule inspections online or call (408)777-3228 between 7:30-3:30 (Mon-Fri). 3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof is torn off and all the nails/fasteners have been removed. Any and all dry-rotted wood shall be replaced prior to this inspection. A building inspector will be available within one hour. There are special hours for this service: 7:30 — 10:30am and 1:00— 3:30pm(Mon—Thurs); 7:30 — 10:30am and 1:00—2:30pm (Friday). 4. If plywood is installed, a plywood nailing inspection is required. 5. In-Progress roof inspection is required. Call for an in-progress roof inspection to verify building is weather tight after installation of approximately 25% of the roofing material. 6. New roof coverings shall not be applied without first obtaining all inspections and written approvals from the building inspector. Any roofing which is applied without first obtaining an approved inspection will require the removal of all new material down to the sheathing so a proper inspection can be performed. 7. A final inspection and approval shall be obtained from the building inspector when the re-roofing is complete. To receive a final sign-off, the following items will be verified: a. Flat roofs shall have a minimum of 1/4"per foot of slope and must demonstrate there is no ponding. b. Listings from approved testing agencies for all pre-manufactured products used shall be available on-site to review at the time of the inspection. c. Proper spark arrestor installation. 8. NOTE: If you call for a tear-off or plywood nailing inspection and the work is not complete, you will be charged a re-inspection fee of$126.00. The re-inspection fee shall be paid before another inspection can be scheduled. By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the property owner's behalf. I under d and agree to com 1 e re-roof policy stated above. Signature of Applicant/Agent: Date: ReroofPolicy_2010.doc revised 05/17/10 INPUT Resources Energy IAQ/Health M.In oor Ir ua ity an inis es 1.Use Low/No-VOC Paint 1 IAO/Health pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 3.Use Low/No VOC Adhesives 3 IAO/Health pts y=yes 0 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Health pts y=yes 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0 7.Seal all Exposed Particleboard or MDF 4 IAQ/Health pts y=yes 0 8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0 10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0 1 1 1 N,Flooring 1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 1 1 I Total Pointsvalla le: 1 1401 130 57 Total Points Project Received:1 1 01 01 0 --/ 7 /1 1> G:data/props/greenbuildingguidelinestremodelers/greenpointsfinal2.12.04protected.xls (D2, ZcJ CITY Of CITY OF CUPERTINO REROOF CUPER -INS, PERMIT APPLICATION APN 25i (4) (, Date: -7 Building Address: a Owner's Name: �_03 oJ �>o w Phone #: HOA: Yes ❑ No © If Yes, provide letter from HOA 409 06- 292-0 Contractor: Phone#: 408-295-4244 JIM KRAUSE ROOFING Fax#: 408-779-8807 Cupertino Business License #: Contractor License #: 554351 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof o Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles * Wood Shakes >( Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) o Other(Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report # To be Removed o Provide Mfgr. Installation Specs. Job Description: -fe?-f _ cr-F ERI 5-r,AJ3 S rf mac-, O rif-S Rtz-E"T , 1.j 5 -V-LL- �►-s s A) '2-Cl 5q C JA1Zf3. 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: ❑ applicable, include in plan set & the sheet index. Valuation: 1 t I Have Read, Understand and W' Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09