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09030115 CITY OF CUPERTINO PERMIT BUILDING DI,vISION PL PERMIT NO. BUILDING ADDRESS: 10882 WILKINSON AVE JIM KRAJSE R00 PERMIT ISSUE DATE OWNER'S NAME: g AgU 2009 CONTROL NO. -'TONE: (408) 779-0704 BUILDING P£RMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH u O p LICENSED CONTRACTOR'S DECLARATION Job Description U1 hereby affirm that I am licensed under provisions of Chapter 9(commencing Z with Section 70(X0)of Division 3 of the Business and professions Code,and my license is RE—RF T/O EXT wD S HK 1 LYR RE S HE ET 7/16 0 S B 3 0 LB FLT n H in full fore and cft C / jvnz License Class 3 Lic.N ' S PRES TL CMPSHING CLS A 31SQ t-in Date 1- `/ Contractor ARCHITECTS DECLARATION 4�< I understand my plans shall be used as public records 15yU Oy Licensed Professional rn OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for the in O following reason.(Section 7031.5,Business and Professions Code:Any city or county K which requires a permit to construct,alter,improve,demolish,or repair any structure y >. prior to its issuance•also requires the applicant for such permit to file a signed statement Ft.Floor Area Valuation Z £=G that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq >t F$ (commencing with Section 7000)of Division 3 of the Business and Professions Codc)or $21700 y .. that he is exempt therefrom and the basis for the alleged exemption.Any violation of APN Number Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(6500)• 3 5 613 0 E 0 . 00 ❑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 to an owner of 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.). ❑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. C]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: I have and will maintain a Certificate of Consent to self-insure for Workers Compcn- �on,as provided for by Section 3700 of the Labor Code,for the performance of the work Cor 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 Workeees Compensation Insurance carrier and Policy number arc: Z Yz J Carrier. �TAr .Col)6 PolicyNo.:72 l3 —60 1 CERTIFICATE F 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.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 CONSTRUCTION LENDING AGENCY [.�hN+ I hereby affirm that there is a construction lending agency for the performance of a 5 the work for which this permit is issued(Sec.3097,Civ.C.) W Q lenders Name 0 Lenders Address I certify that I have ad this application and state that the above information is LUL 0 correct.I agree to comply with all city and county ordinances and state laws relating to 0 building construction,and hereby authorize representatives of this city to enter upon the UWabove-mentioned property for inspection purposes Ia. (We)agree to save,indemnify and keep harmless the City of Cupertino against „Fh l) liabilities,judgments,costs and expenses which may in any way scenic against said City �T y U Z in consequence of the granting of this permit. Date `� / APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued b`r: SOURCE REGULATI S. 9-2-7-J 1 Re-roofs - SignatureoCAppicant/Contrac Dare T of Roof HAZARDOUS MA ERIALS DISCLOSURE Type 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 roofi shall be inspected prior to any roofing material being installed. ❑Yes /106 If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which t hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. Act? ❑yes o 1 have read the It materials requirements under Chapter 6.95 of the Cali(or- nia Health&Safety Code,Sections 25505.25533 and 25534.I understand that if the building docs currently have a terhan4 that it is my respohhsihility to notify the occupant of the re _ cnts which Must be met prior to issuance of a Ccnificate of Occupancy. S Ignatur%of Applicant Date All roof coverings to be Class I. or better Owner or authorize nt Date CITY OF CUPERTINO REROOF CUPEkTINO PERMIT APPLICATION APN # Date: Building Address: 4 y /D 8 ,z f,�" lI 4,5�fc `� Owner's Name: Phone #: Contractor: Phone #: yo S'- 2 Fax #: 779�- Cupertino Business License M Contractor License #: v7 / ` , J 55- 9/33-/ Type of 1Zoof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles X Asphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O. Report# �C To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: 71>, .r g 13 4i S14 k t / L yy e., V-4 Sollo 4Z14 TL 0 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 inclex. Valuation:P/7 OL) I Have Read, Understand and Will Comply witti Cupertino's Tear-Off Policy: Signature Revised 6/16/08 CITY OF ('UPERTINO *OF REROOF CUPEkTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 1RER00FRES Re-roof Residential B 1SFDWLR00F J 1BSEISMICRE Seismic Residential B 1REROOFMRES Re-roof Mu"ti-Family B 1MFDWLROOF 1 BSEISMICRE Seismic Residential B 1 BUSLIC Business License B 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 agi ee 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 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 ar y 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 fe,� 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 or.the job site at the time on inspection. I understand and will comply with the abo-ve//stated policy on re-roofing. Homeowner's Name: L 4' G4 Job Site Address: j Roofing Company Name: J Applicant's Signature: Date: 2C S Greg Casteel Building Official Revh ed 07/30/08 Green Buillding 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 mutt be shown and referenced on the Proj:ct Plans See below B. Site 9. Install H.E. Irrigation, (details/spe.-)' L-1 2 points 11. Permeable Paving, Note L-1 2 points C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 points D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 points 5. Use Truss with heels, (detail) S-2 2 points 6. B. OSB Sheathing, detail S-2 2 points E. Ext. Finish 1. Composite Decking, (Note/Spec.i A-3 2 points 4. B. Fiber Cement Siding, (Note/Spec. A-4 2 points F. Plumbing 1. Insulate all H.W. pipes, (Note/Sp,:c.) P-1 2:points ts 5. Tankless W.H., (Note/Spec.) A-2 2 11. A 2500 Gal.Tank, Note/S ec L-1 1ts 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/,pec.) A-3 1Lint P. Other 1. List Green Features on Plans A-1 1 point ; TOTAL POINTSr 1 40 points z M Plan Review Process Work Book Page-12-Revised 3/250 8 l Kilt&>_t Au-e_ �- e for Remodeling Projects Green Points Rating System o g 1 Due to the diversity of remodeling project types,assigning au 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 cE.n be used as a starting point for"greening"your project. INPUT Resources Energy AO A.Site 65%=I pct 76= 2 points 80%=4 points up to 4 Resource pts 0 2.Salvage Reusable�Bu�ng 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 Stormwater Practices 2 Resource pts y=yes 0 7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 0 6.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 ■ t 1 1 B.Foundation 1.Incorporate Recycled Flyash in Concrete e 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 Resource pts y=yes 0 3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes 0 ■ 1 1 1 C.Structural Frame r 1.Substitute Sid Sawn Lumber with Engineered Lumber 3 Resource pts y=yes 0 2.Use FSC Certified Wood for framing (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 8.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 1 1 ! M.Indoor Air Quality and Finishes 1,Use LowlNo-VOC Pain IAQ/Health pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes IAQ/Health pts y=yes. 0 3.Use LowMo VOC Adhesives IAQ/Health pts y=yes 0 4.Use Salvaged Materials for Interior Finishes :;Resource pts y=yes 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 6IAQ/Health pts y=yes 0 6.Use Exterior Grade Plywood for Interior Uses IAQ/Health pts y=yes 0 7.Seal all Exposed P,arfioleboaid of MDF 4 IAQ/Health pts y=yes 01 B.Use FSC Certified Materials for Interior Finish f Resource pts y=yes 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 1 0 N.Flooring 1.Select FSC Certified Wood Flooring E Resource pts y=yes 0 2.Use Rapidly Renewable Flooring Materials I Resource pts y=yes 0 3.Use Recycled Content Ceramic Tiles I Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl i IAQ/Health pts y=yes 5.Use Exposed Concrete as Finished Floor Resource pts y=yes 6.Install Recycled Content Carpet with Low VOCs Resource pts y=yes Total Points Available: 1 1401 130 57 Total Points Project Received:1 1 0 T 0 r� G:datalprogslgre+nbuildingguidelines/remodelers/greenpointslinal2.12.D4protected.xls � 9 j ;. Community Development 10300 Torre Avenue It Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 CUPEKTINO Building Department JOB ADDRESS: l f PERMIT #/0 e92- _ Ale- o 7 OWNER'S NAME: ee-- PHONE # &61 6S7% Z GENERAL CONTRACTOR: t,t 4 FAX # _ _ JO PC); I am not using any subcontractors. a j-zx� CignaturW 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 i A Septic Tank Sheet Metal Sheet Rock Tile "4 - r QI Owner Contra or Si e Date