09010109 CITY OF CUPERTINO
BUILDING DIVISION PERMIT
BUILDING ADDRESS: PERMrr NO.
18856 HUNTER WAY --GUTTER WORKS INC ngoi ni ng
OWNER'S NAME: PERMIT ISSUE DATE
)4JANISHA CONTROL NO.
510) 887-6964
ARCHMCTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
90p LICENSED CONTRACTOR'S DECLARATION Job Description
U I hereby affirm that I am licensed under provisions of Chapter 9(commencing
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with Sector 7000)of Division 3 of the Business and Professions Code.and my license is
e=y in fullforeeanaA
E-RF RNV EXT TAAR&GRVL ON STEEP SLOPE AREAS&
j ? License ClassLic.tDateConlracto INSTL COMP SHNGLS ON EXTNG SOLID DECK, 28SQ
h ARCHITECTS DECLARIAMON
I understand my plans shall be used as public records
�qU
Zu,in Licensed Professional
Z
y� OWNER-BUILDER DECLARATION
i I hereby affirm that 1 am exempt from the Contractor's License Law for the
Loo following reason.(Section 7031.5,Business and Professions Code:Any city or county
K m which requires a permit to construct.alter,improve,demolish,or repair any structure
y Z} prior to its issuance,also requires the applicant for such permit to file a signed statement
=G that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation
yF- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or
y that he is exempt therefrom and the basis for the alleged exemption.Any violation of 812000
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). 37535063 . 01
❑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 Required Inspections
and Professions Code:The Contractor's License Law does not apply to an owner of P
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.).
❑I.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 docs 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-
.son,as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑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 Irurrance carrier and Policy number are:
Carrier. 170M Fw'&,4 Policy No.: 06155-13 7
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section recd 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
,J Z forthwith comply with such provisions or this permit shall be deemed revoked.
Z O CONSTRUCTION LENDING AGENCY
[~.h►N. 1 hereby affirm that there is a construction lending agency for the performance of
the work for which this permit is issued(Sec.3097,Civ.C.)
aA Lenders Name
Z Lender's Address
U Q I certify that I have read this application and state that the above information is
IL►" correct 1 agree to comply with all city and county ordinances and state laws relating to
0 U building construction.and hereby authorise representatives of this city to enter upon the
W above-mentioned property for inspection purposes
LL (We)agree to save,indemnify and keep harmless the City of Cupertino against
1.m cA liabilities,judgments,costs and expenses which may in any way accrue against said City
V Z in consequence of the granting of this permit.
N
ERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: DateTIONS.
LG Re-roofs ,
S' p ontractor Dire
HAZARDOUS 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
hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
strict?
❑Yes Nu
1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- 112
/
Ing Health Cade,Sections 25505.25533 and 25534.1 understand that if the buildin ! 16 a
acs not cu nd have a tenant,that it is my responsibility to notify the occupant of the
hch must be met prior to issuance of a Cc ificyc of cAupancy. at r plicant Date
ncr a razed agent
� Date All roof coverings to be Class" '`or better
CITY OF CUPERTINO
4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 37535063 . 01
DATE ISSUED. . . . . . . : 01/26/2009
RECEIPT #. . . . . . . . . BS000007040
REFERENCE ID # . . . : 09010109
SITE ADDRESS . . . . . : 18856 HUNTER WAY
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER MANISH PANJIAR
ADDRESS . . . . . . . . . . : 18856 HUNTER WAY
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : GUTTER WORKS, INC.
CONTRACTOR . . . . . . . : MICHAEL A FAZIO LIC # 27531
COMPANY GUTTER WORKS INC
ADDRESS . . . . . . . . . . : 22434 THUNAERBIRA PL
CITY/STATE/ZIP . . . : HAYWARD, CA 94545
TELEPHONE . . . . . . . . : (510) 887-6964
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 12, 000 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1BSEISMICR VALUATION 12, 000 . 00 1 .20 0 . 00 1 .20 0 .00
1BUSLIC FLAT RATE 1 . 00 114 . 00 0 . 00 114 . 00 0 .00
1REROOFRES SQ FEET 28 . 00 364 . 00 0 . 00 364 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 480 .20 0 . 00 480 .20 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 480 .20 #2715
---------------
TOTAL RECEIPT 480 .20
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
Community Development
• a^'yam;
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
171UPEkTINO
Building Department
JOB ADDRESS: legS6 AN11X- wAY PERMIT #
Q
O R'S N 4,gis4 ,4oqPHONE # Sip W7-6
GENERAL CONTRACTOR: FAX # Sep fl7—3f
I am not using any subcontra ors• / 0
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
_ Z � 4
e /Contractor Signature Date
CITY OF CUPERTINO Oct 01
REROOF
CUPEkTINO PERMIT APPLICATION
APN # Date: I b 6/0 1
Building Address: ��
Owner's Name: Phone #:
Contractor: Phone Phone #:(5',0)
6WE Fax#: —
Cupertino Business Lic se #: Contractor License #:
S.3bSYI!
Type of Roof Covering:
Existing: Proposed:
Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) Other (Specify) vrd ��
Number of existing coverings ❑ Provide I.C.B.O. Report# d
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: �Cfdvt� �SfN' t 4wp/ ov
AW jf CX
-� ✓ w�/r AA/ . .rs7.4 N si
ResidentialCommercial ❑
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: _
ll,ca0
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Si atur
Revised 01/07/09
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: Nd-All S N &0.9,
Job Site Address: �SQ�
Roofing Company Name:
IF
Applicant's Signa e: Date:
Greg Casteel
Building Official
Revised 07/30/08
ndoor Air duality and Finishes
1.Use Low%-VOC Paint - 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0
3.Use LowlNo VOC Adhesives 3 IAQ/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 Paftleboard 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 B 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 d
Total Points Available: 1401 130 57
Mi
"
Total Points Project Received: , r-01 0 0
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