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09010017 CITY OF CUPERTINO BUILDING DIVISION PERMIT ic �? `RATQIZ�� RkI�kfi BUILDING ADDRESS: PERMIT NO. 7635 HOLLANDERRY PL DADDARIO ROOFING 09010017 OWNER'S NAME: PERMIT ISSUEDATE TONE: A A CONTROL NO. nTMr)-rn (831) 476-9109 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH a 0 0 a O p LICENSED CONTRACTOR'S DECLARATION m I hereby affirm that I am licensed under provisions of Chapter 9(commencing Job Description 2, with Section 7000)of Division 3 of the Business and Professions Code,and my license is !<o in full force and effect. RE—RF T/O COMP & INSTL 30# FLT PAPER 50. YR COMP E-0 Date Contractor G et Contr ��;) CLS A 25 SQ; HAS SOLID PLYWOOD ALREADY E-0 p Datc Contractor ARCHrmL-rS DECLARATION a U 1 understand my plans shall be used as public records O y Licensed Professional n rn OWNER-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the is O 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 n z prior to its issuance,also requires the applicant for such permit to file a signed statement F=`e that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation Y t- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or all that he is exempt therefrom and the basis for the alleged exemption.Any violation of $7850 Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not more than rive hundred dollars($500). 36226068. 00 ❑1,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 and Professions Code:The Contractor's License Law does not apply to an owner of Required Inspections property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are 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.). [11.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. ❑1 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: I have and will maintain a Certificate of Consent to self-insure for Worker's Compen- -don,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 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 Polity number are: Carrier.-S4f-,Yom! /-w—Q Policy No.:6Cd"29—hd l5'i CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or Icss.) I certify that in the performance of the work for which this permit is issued,1 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 Workers Compensation provisions of the Labor Code,you must Oforthwith comply with such provisions or this permit shall be deemed revoked. z"'' CONSTRUCTION LENDING AGENCY F-t►�.. I hereby affirm that there is a construction lending agency for the performance of IY. the work for which this permit is issued(Sec.3097,Civ.C.) Wil,0 Lendcrs Name ] Lenders Address U O 1 certify that I have read this application and state that the above information is LL►" correct.I agree to comply with all city and county ordinances and stale laws relating to 0 V building construction,and hereby authorize representatives of this city to enter upon the Uabove-mentioned property for inspection purposes (We)agree to save,indemnify and keep harmless the City of Cupertino against co) liabilities,judgments,costs and expenses which may in any way accrue against said City V Z in consequence of the granting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date _ -el-- SOURCE REGULATIONS. — g2� Re-roofs a of App' t/ ony o Date HAZA bOUS MATERIALS DISCLOSURE Type of Roof 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 shall be inspected prior to any roofing material being installed. ❑Yes Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove ,it hazardous air contaminantsas defined the Bay Area Air Quality Management all new materials for inspection. strict? ❑Yes contaminants; 1 have mad the hazardous materials requiremcns under Chapter 6.95 of the Califor- nia Hcalth&Safcty Code,Sections 25505.25533 and 75534.I understand that if the building docs not currently have a tenant.that it is my responsibility to notify the occupant of the requiremcn hick must be mel pri to issuance of a Certificate of occupancy. Signature of Applicant Date or aulhoriz ge d Date All roof coverings to be Class'n"or better CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . . 36226068 . 00 DATE ISSUED. . . . . . . : 01/06/2009 RECEIPT # . . . . . . . . . . BS000006910 REFERENCE ID # . . . : 09010017 SITE ADDRESS . . . . . : 7635 HOLLANDERRY PL SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : JANNING ROBERT J JR AND PATRIC ADDRESS . . . . . . . . . . : 7635 HOLLANDERRY PL CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5070 RECEIVED FROM . . . . : DADDARIO ROOFING CONTRACTOR . . . . . . . : EDGAR MONTOYA LIC # 26245 COMPANY . . . . . . . . . . : DADDARIO ROOFING ADDRESS . . . . . . . . . . : 1734 WILLA WAY CITY/STATE/ZIP . . . : SANTA CRUZ, CA 95062 TELEPHONE . . . . . . . . . (831) 476-9109 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 7, 850 . 00 0 . 80 0 . 00 0 . 80 0 . 00 1REROOFRES SQ FEET 25 . 00 325 . 00 0 . 00 325 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 325 . 80 0 . 00 325 . 80 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 325 . 80 #22301 --------------- TOTAL RECEIPT 325 . 80 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF Community Development {A 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 -'UPEkTIN0 Building Department JOB ADDRESS: PERMIT # 0q a I Oot -7 OWNER'S NAME: _ PHONE # 0=j j e- GENERAL CONTRACTO a, ,�k;-v v FAX # I am not using any subcontractors: ign a 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 Ow r/C tractor Signature Date CITY OF CUPERTINO REROOF ,0F CUPEI�TINO PERMIT APPLICATION APN # Date: 762)5 A0 Ito-" 46 06 — o Building Address: 13016 ► Q Owner's Name: Phone #: ►�� 6 io Contractor: Phone #: Fax#: Cupertino Business License #: Contractor License #: v? Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof Asphalt Shingles A-lk-sphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O. Report# ❑ To be Removed ❑ Provide Mfg. Installation Specs. Job Description: , -7 o,� 05 TC) vee ResidentialCo ercial ❑ c t( �Q��VX 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: ,7D I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature 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 2007 IBC Standards and manufacturers specifications on re-roofing.All roofs are Class "A"per Cupertino municipal code 16.04.080. 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/ "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: So 6 o,�A ?04! ! Job Site Address: '7�,3 5c1-4- Roofing Company Name:KDa JA 0,V';Z> VZdclr,i.�q Applicant's Signature: _ 4XDate: Greg Casteel Building Official Revised 07/30/08 r M. ndoor Air Quality and Fints es 1.Use Low/No-VOC Paint 1 IAQ/Health pts y=yes p 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes p 3.Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes p 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 p 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes p 7.Seal all fxposed Particleboard or MDF 4 IAQ/Health, pts y=yes p 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 p 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 p 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes p 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y—yes p 1 1 1 Total Points Available: 1401_ 130 57 Total Points Project Received: �0 0 00 0 G:data/progs/greenbuilc ingguideli nes/remodelers/greenpointsfinal2.12.04protected.xls