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07050109 77777777777777. CITE'OF CUPERTINO ATI BUILDING DIVISION PERMIT � • � W .... BUILD N 1�ESS: PERMIT NO. � U TILSON AVE RESPONSIBLE ROOFING INC 07050109 OWNER'S NAME. PERMIT ISSUE DATE KYRIE, DOMINIQUE 2882 SPRING ST 05/14/2007 INE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO TEAR OFF EXISTING AND BLDG ELECT PLUMB MECH D D O O p 0O LICENSED CONTRACTOR'S DECLARATION ob escrlption iv P I hereby affirm that I am licensed under provisions of Chapter 9(commencing - U w with Section 7000)of Division 3 of the Business and Professions Code,and my license is t<o in full force and effect Ln License Class Lic.# p Date L.!ri—A.!2 Contractor F —��AREHI9ECT5 DECLARATION i a a 1 understand my plans shall be used as public records )yU U.y Licensed Professional H OWNER-BUILDER DECLARATION > I hereby affirm that I am exempt from the Contractor's License Law for the a o following reason.(Section 7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure Z} prior to its issuance,also requires the applicant for such permit to rile a signed statement Valuation that he is licensed pursuant to the provisions of the Contractor's license Law(Chapter 9 3q.Ft.Floor Area e.i- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not more than five hundred dollars(5500). 0 I,as owner of the property.or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law does not apply w an owner of p property who builds or improves thereon,and who does such work himself or through his awn employees,provided that such improvements ate not intended or offered for sale.If, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). 0 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business and Professions Code:)The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon,and. who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. 0 I am exempt under Sec B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: L]1 have and will maintain a Certificate of Consent to self-insure for Worker's Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 0 1 have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the labor Code,for the performance of the work for which this permit is issued. My Worker's Compensation Insurance carrier and Policy number arc: Q Sri 7'�' Policy No.:�o 0 �� ✓ Carrier. CERTIFICATE OF EXEMPTION FROM wo RKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less) I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must Oforthwith comply with such provisions or this permit shall be deemed revoked. Z " CONSTRUCTION LENDING AGENCY (~-r CA 1 hereby affirm that there is a construction lending agency for the performancv of (x> the work for which this permit is issued(See.3097.Civ.C.) W Q Lender's Name Z Lender's Address V I certify that 1 have read this application and slate that the above information is rr correct.I agree to comply with all city and county ordinances and state laws relating to Ubuilding construction.and hereby authorise p sentatives of this city to enter upon the <ZWi above-mentioned property for inspection pure sea. (We)agree to save,indemnify and cep harmless the City of Cupertino against In liabilities,judgments,costs and expenses/which may in any way accrue against said City U Z in consequence oC Ole grantin C this permit. APPLICANT UNDERST AND WILL COMPLY WITH ALL NON-POINT Issued by Date SOURCE REGULATI Re-roofs Signature ofkppli on Date Type of Roof H OUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs ;hall be inspected prior to any roofing material being installed. ❑Yes If a roof i;installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. District? 0 Yes 0 No 1 have read the hazardous ma requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 5.25533 and 25534.1 understand that if the building docs not currently ha ten at it is my responsibility to notify the occupant of the requirements whit u prior to issuance of a Certificate of Occupancy. Signature of Applicant Date All roof coverings to be Class"B"or better Owner or aur c t Date CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: bethe COPY # 1 Sec: Twp: Rng: Sub: B11: Lot: APN . . . . . . . . : 37E,16046 . 00 DATE ISSUED. . . . . . . : 05/14/2007 RECEIPT #. . . . . . . . . : BS000001302 REFERENCE ID # . - - : 07050109 SITE ADDRESS . . . . . : 18650 TILSON AVE SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER KYI'IE, DOMINIQUE ADDRESS . . . . . . . . . . : 18£ 50 TILSON AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : REC:EIPT INTERFACE CONTRACTOR . . . . . . . : ELMORE, PAUL M. LIC # 105 COMPANY RESPONSIBLE ROOFING INC ADDRESS . . . . . . . . . . : 2802 SPRING ST CITY/STATE/ZIP . . . : REDWOOD CITY, CA 94063 TELEPHONE . . . . . . . . : (6SO) 969-6151 FEE ID UNIT QUANTITY IMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- -- -------- ---------- ---------- ---------- BPERMFEE VALUATION 15, 620.00 234 .36 0 . 00 234 .36 0. 00 BSEISMICRE VALUATION 15, 620.00 1 .60 0 . 00 1 .60 0. 00 -- -------- ---------- ---------- ---------- TOTAL PERMIT 235 . 96 0 . 00 235 . 96 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER -----------2----- --------------- -------------------- CHECK 235. 96 11723 --------------- TOTAL RECEIPT 235 . 96 CITY OF CUPERTINO REP.00F ':UPEkTINO PERMIT APPLICATION FORM 0705010 APN# Date: Building Address �<?no 1—h opt 4vel. Owner's Name: hon #: G)M/ 4,r v& Y) e � oe Co ractor: PhoneLicense #: Conta PhCupertino Business License#: TT�, 'L' Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ¢P-Other(Specify) ey K 0 9--'-Other(Specify) Fo Q Y L J L7 11 Number of existing coveringsy — ❑ Provide I.C.B.O.Report# &"'To be Removed ❑ Provide Mfgr.Installation Specs. T Have Read, Understand and)Xig Comply With Cupf; 'no's Tear ff Policy: Job Descript n: J i?Gty �if O S PAX i l ✓t 7� �(� Residential Commercial Fire Zone: Yes ❑ No [3"' Confirmed with Planning Det. if there are any restrictions. LI Cost of Project: Type of Construct: Occupancy group: � e7-YO 9 -� Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE —Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE S-ismic Fee Res BUILDING BSEISMICOM S--ismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING Community Development Department Building Division City of Cupertino .•r..--• 10300 Torre Avenue Telephone: (408)777-3228 CITY OF �,,,.,.��� Fax: (408)777-3333 CUPBuilding 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 r(-roofing. 2. New roof coverings shall not be applied without first obtaining all inspection and written approval from the buildir g 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 Citi,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 mz.terial down to the sheathing, so a proper City inspection can be performed. 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 or.the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: QW i V�2; C WC, J l �'S� -'1sc�n ob Site Address: � ye, Roofing Company Name: Re-5 to O K-1 I&OA Y1 fiLC A plicant's Signature: A Date: Greg Q4AeeI Building Official Revi Sed 1/30/03 Printed.m Recycled Paper y . Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 Ci "'OF Fax(408)777-3333 `'UPEI�TINO Building Department JOB ADDRESS: PERMIT # /B ,0V W Tecls,,. ��� n �5 ola OWNER'S NAME: Y PHONE # - p GENERAL CONTRACTOR: FAX # 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 Signature Date � U'I �... . 707 ICB0 Evaluation Service, Inc. • j AsuhsidiarycorWratiOn ofIhe In:crnational Conference of Building O fie als Report No.4630 EVALUATION REPORT January, 1993 copyright 0 19931000 Evaluation Service,Inc. FilingCate9ary:ROOF COVERING AND ROOF OECK CONSTRIICTION—Roof Covering (202) PERIIMX 108)3pdF1NG SYSTEMS roof covering is removed to the substrate,the foam plastic is installed as sot forth in paragraphs 11.8 and II-C.The roofing systems maybe installed RESIN TECHNOLOGY COMPANY over built-up,Composition,or asphalt-single roof coverings recognized 2270 CASWE HARBOR PLACE by the code. OKTARIO.CALIFORNIA 01761 Prior to roaming,rhe surfacemust be prepared to assure adequate ad- 1.subject:Permax 108 Roofing Systems. heslon.All tools rock,cementitious coatings,peeling paint,dirt and ds- It.Descriplloc A.Goneral:The Resin Technology Corporation's Pei- hris must he romaved by branming,power vacuuming or wire brushing. max 108 Rooting Systems consist otspray-appiied foam plastic:and cin,- Dlisters In the existing roofing larger than 6 inches irl diametor must be tomeric coaling.The foams are classified as RT 2030-2.5 and RT 2030-3 removed from the roof.Blisters in the exlsting rooting less than 6 inches polyurethane foams.Tho coating systems are labeled as Ncrrrrax 108 grc y in diameter are to be slit and nailed with l Anch roofing nails. base coat and Permax 108 whitetop coat.Foam thickness,densit-n cue- Curled asphalt shingles must be either removed or nalled to the deck. ing information and roof-covering classiflcatian for the various Systems All prajectionsthrough the roof deckmust be sealed with roof mastic.Par- are in Tables NoS.Iand li.Typical roof penetration and tlashiuy detaiis arc ticutar care IS to no exercised to seal under all roof-mounted equipment in Figure No.1. with cold-process asphaltic products and to prevent roof depressions B.Deck Preparation:Float surfaces must be fro of gre�na., oil, dirt, when it is not feasibi3 to spray foam.The surface Is then primed with a sediment and moisture.All surfaces, not covered with tabm, must to chlorinated rubber ptimer at a rate of 200 square feet per gallon and al- masked off or afherwlse protected from ovempray.All parapets,ci irlel s lowed to cure a minimum of one hour prior to foam application. Spray and valleys must be flashed in accordance with the code.Where precaA applications are subject to the same conditions as iisted in paragraph 11-C. concrete planks are encountered,all joints must be taped with 1111114111,,n On flat surfaces.the foam may be built up 10 provide a slope to assure ade- 2-inch-wide roofing tape identified as OT-100. quate drainage provided the maximum thicknesses noted in Table No. I New plywood decks must be primed with a neoprene primer.New con- are not exceeded. crele decks must bo allowed to cure at least 21 days prior to airplicatic n F.ldentlfiealian:All material drums and containers are identified by the of foam,The surface is then pruned with a catalyzed urethan,primer. manufacturer's name and address, product designation,the evaluation mew metal decks are primed with a two-cr7mponent wash pruner.Gals report number, shelf life, and an Underwriters Laboratnries Inc, label in end or sldelap5 must be sealed with an approved sealant. noted as(f1-?0185,f311f-345}. Where wood decks are permitted,the deck may be covered with a vap it [it.Evidence Submitted:Reports of tests in accordance with U,B_C. harrier in accordance with manufacturer's specifications and Wall the all- Standards Nos. 17-4 (Part 11), 32-7, 42-1 and Acceptance Criteria for proval of the building otflciaL Membrane Roof Covering Systems,dated July,1992. C.Fbarn PlastleApplieattnn:The foam isspray applied to the prepared 1992 Supplement to the U.B.C.:This report is unaffected by the supple- submrale in minimum 111lrklch4hick poses to thicknesses noted in Tau le irent. No.1.Wind velocity=mat exceed 12 miles per hour during application. Findings Application shall not proceed if the ambient temperature Is secs than 4U'F, or it the substrate temperature is less than 50°F The foam canilot ye IV.Findings:That the fllesia Technology Company PUMAK 108 R88111- applied over wet substrates or if rain or inclement weather is iiftmincrrt. Ing systems described in this report comply with 1991 Voilmrm Build- Thefown i5appuedIn aone-to-onsratio with equipment capableof uw(i r- ing Cpdr:,seblerA to the followiep conditions: ing each component within plus or minus 2 percent of the design rat o. 1. All system Components aro prepared and applied by trained per- 11 the loam application Isterminated beforethe Ileal thickness is wiaine d, sonnel approved by ltesitl Technology Company. additional foam may be applied within 24 hours, provided the exis►i 19 foam is primed with a ca[aly�d urethane primer and a minimum of 2. The roof-covering system is applied is accordance with this re- t!�-inch foam is applied in a single pass.The foam must be lr re of bu ml s, part and meautacturrrt"s iastrncuons. pin holes anddo ges.Arty of these irregularities must 4" enated, 3. Where moderate or heavy foot IrafflC occurs such;}s for maiMe- D.Csatinp ppUcatleri:The E ng is applied in two coals contra nonce of equfpmerd,the roof system mull be adequately pro- ing calor at a rate of 3 gallor>S 00suarefeet-The coati�ig cannot be !ectad to prevent rupture ar wtHirirp of surtace. applied it MM fogorincleatentherisimminentorittemperature te- A. Whereplymedshealhing.installed Inaccardancewith Section low freezing are anliCOP d within 24 hours of coating application. 1713 of the code, or noncombustible cemealiNous substrates E.Existing Roots:The roofing system may be installed ovar existing are provided.a thermal harrier is npt required. roofs•provided the substrate is as required for the system. Pin uxisti fig 5. installation:addressed in this report are limited to areas with roof covering can remain In place but must be inspected as set forth in a maximum basic wind speed of 8o mph,Exposure B,on reals Chapter 32 of the Uniform Building Code Appendix.Where the existing not exceeding 40 feet above grade. Rw/reaaen tdperYs of D� �wr 1 errr(c�!Nr_,ars;srurd.rj).re(y la p ruvide itrfunnafion la Ctaa A mernhens of ICBU,attr+u„a!ke cvde apnK whidl the reporr is barer.Rvehmd en mparo ere aorty be tanwwed es nprrseatrrr};arsthrr ice orarry urheratlribarer 0Wspw4fte&a) eddresrrdnorasasi adericeueterreronown- dellen fair art Q/0-sakka meapt. Mi repart is bend rrpon iedepirmkRt testi or other technical dura.tetA+nij ved by the app[icnar.Tkc fCBU 6v4ruurian Srerrit r,enc.,hChglCQt sraffbar r,rvlewedy]" trslresYlrs aNI/er otbtrdefa,bat dors not Pasini recd facrmer tri mal a r,.t indepeodanr vorrloadion.There is me warf'aaty hYWHO TS vaLmatilm Sefl*E,lac,exPrers ut'hnp/iad,alta emy"Finding"orodwrmwdsr lie the reixrrt oras ru.ut y ion Ward c u rend by I&repvr�This rfrrclrtlenerineLtdta,Pat rr riot tiaalr4d to,artrtharrte8irity. Page 1 of 3 ZO' d SOO' Ohl 61 : 6 q6, 80 uni'