09060127 CITY OF CUPERTINO
BUILDING DIVISION PERMIT NF6
BUILDING ADDRESS: PERMIT NO.
' S R00FING4 09060127
PERMIT ISSUE DATE
OWNER'S NAME:
---
A O. 0 9 CONTROL NO.
408 251 -3565
BUILDING PERMIT INFO
ARCHITECT/ENGINEER:
BLDG ELECT PLUMB MECH
a0p LICENSED CONTRACTOR'S DECLARATION fob Description
i1U(= I hereby affirm that I am licensed under provisions of Chapter 9(commencing
_Z S with Section 7000)of Division 3 of the Business and ofessums Code,and my license is
7=y L�.in full force and effect./.'-1 A t d 1 RE—RF TSO SHKS INSTL 3 0. LB FLT NEW GAF GRAND
v�Z License Class C�✓ / CANYON
n F
DateCoCon
tj ARCHITECTS DECLA A N
-CJ I understand my plans shall be used as public records COMP CL!; A 2 0 S Q
rJ
�y
U.y Licensed Professional
0 OWNER-BUILDER DECLARATION
Gn
I hereby affirm that 1 am exempt from the Contractor's License Law for the
r p O following mason.(Section 7031.5,Business and Professions Code:Any city or county
K m 9 which requires a permit to construct.alter,improve,demolish,or repair any structure
't Z prior to its issuance.also requires the applicant for such permit to file a signed statement
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
$9000
y .. 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). 3 6 6 5 4 11 1) . 0 Q
❑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 ns Required Inspections
and Professions Code:The Contractor's License Law does not apply to an owner of q 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.).
❑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 contractors)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
IpEieby affirm under penalty of perjury one of the following declarations:
,7�fiave and will maintain a Certificate of Consent to self-insure for Worker's Compen-
.,ation,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 pensatian Insurance ca 'per and Policy number arc:
Carrier f�� Policy No.l2061
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars($100)
or Iess)
I cerifv 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 Worker's Compensation provisions of the Labor Code,you must
O forthwith comply with such provisions or this permit shall be deemed revoked.
Z" CONSTRUCTION LENDING AGENCY
[~-r dam" I 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.)
ALender's Name
Lender's Address
Z
U 0 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 state laws relating to
0 building construction.and hemby authorize representatives of this city w enter upon the
U above-mentioned property for inspection purposes.
>4 Wt.1. (We)agree to save,indemnify and keep harmless the City of Cupertino against
p..4to) liabilities,judgments,toss and expenses which may in any way scenic against said City �J
U Z in consequence of the granting of this permit. Date !�,`_—
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by i'
SOURCE REGULATIONS.
Re-roofs
rgnatu of Applicant/Conuictor E52te T of R oof
HAZARDOUS MATERIALS DISCLOSURE Type
Will the applicant or future building occupant store or handle hazardous material
az defined by the Cupertino Munici '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.
❑Yea o
Will the applicant or future build' g occupant use equipment or devices which
If a roof is installed without first obtaining an inspection,I agree to remove
nit hazardous air contaminants ncd by enc Bay Area Air Quality Management all new rr aterials for inspection.
district?
❑Yes u
1 have read the hazardous materials requirements under Chapter 6.95 of the Califor-
nia Health&Safety Code,Sections 25505.25533 and 25534.1 understand that if the building
docs not cturcn y have a tenant that itis my responsibility to notify the Occup t of the
be met prior to issuance of a Certificate of cupan D SlgnatuT Date
JJ All roof coverings to be Class'R.'or better
Own cr authorized agent Date
V 0(41 -�
CITY OF CUPERTINO
RE ROOF
CUPEkTINO PERMIT APPLICATION
APN # Date:
Building Address: II(A] �I i nC4
Owner's Name: ; +
#: �—
CFax #:
Cupertino Business License #: Contractor License #:
436 q-5 6o
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ ilt-Up roof
halt Shingles Asphalt Shingles
❑ sp g Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
N}tuber of existing coverings ❑ Provide I.C.C.E.S. Report#
C To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: e g r o -f�- S h C L k�S ]�-ri S f-A I :3c - Fe
I
Kk w GAF C o w`P . 2� S
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: -
q oba o
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signatur
Revised 02/05/09
CITY OF CUPERTINO
REI OOF
CUPEkTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Cor,,unercial B 1COMMLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICO Seismic Commercial B
n 1REROOFRES Re-roof Residential B 1SFDWLR00F
' 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
r 1BSEISMICRE Seismic Re:;idential B
1 REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Residential B
1BUSLIC Business Lizense B
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 ri!-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 mz.terial 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 fe4? of$176.18. The re-inspection fee must
be paid before another inspection cast 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 on re-roofing.
Homeowner's Name:
Job Site Address: C �o cv -
Roofing Company Name: Ys
Applic C -Date:
Greg Casteel
Building Official
Revised 07/30/08
M.Indoor Air Quality and Finishes
1.Use Lo"o-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 Low/No 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
0
7.Seal all EM)osed R�irticleboaid or MOF 4 IAQ/Health. pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes
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 I I0
. 1 ! 1
N.Flooring
1.Select FSC Certified Wood Flooring it 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 l Resource pts y=yes 0
Total Points Available: 1 1401 1301 57
Total Points Pro'ect Received: 01 5F___51
G:datalprogslgre mbuildingg' neshemodelerslgreenpointsfinal2.12.04protected.xls
Seven Springs Owners Association
Application For Approval of Architectural Change/Addition
CA rEGORY C
Category C- Modifications that are exterior moditicati,)ns with no changes to the original building structure or floor
plan.All roofing,siding,or window material change,a exterior paint color change,or addition of a roof attic fan, fall
into this category.
Date 5 / 27 /2009
To: Architectural Control Committee
Subject: Request for Approval of Proposed Change
PLEASE PRINT THE 'OLLOWING INFORMATION
Name:
Work P lone:
Description of Proposed Change:
1) Paint Color Change:
New Exterior Siding Color(please pick one color comt ination from approved paint list):
Combination# 41 keystone km186 bravado km160 diamond white ow224-1
2) Roofing Material Change(please check one choi:e)
a. Lightweight Concrete Tile from MonierLifetile-style"Cedarlite 5780",color "Muirwood"
b. GAF Laminated Fiberglass Asphalt-style"Grand Canyon",color"Mission Brown" X
c. GAF Laminated Fiberglass Asphalt-style"Grand Canyon",color""Stonewood"
d. Decra Stone Coated Steel Rood System-style"De(ra Shake",color"Shadowood"
e. Class"A" Fire Retardant Rooting System using pressured treated cedar wood shingles with fire retardant fiberglass
cap sheet underlay.Need to have a City of Cuperti io Permit accompanying this application for all wood shingle
roofs.
3) Siding Material Change(Please check one choic )
New Siding Material : Hardiplank Select Cedarmill Hardiplank Smooth Finish Which sides are
you are changing material(front, back, left or right?)
4) Window Material and Design change
(Please check this box): Milgard Vinyl Windows-style '`l uscany",color White
5) Adding a roof attic fan or Tubular Skylight
Please attach information regarding the proposed chanf e.Application must include dimension,color of the proposed fan
and its location on the roof. Please include detailed dr,wings,specifications,and product brochures if available.
Homeowner's Signature: ,,
ARCHITECTURAL CONTROL COMMITTEE/BOARD ACTION
Approved >_ Approved Pending __
Denied Denied Pending
Architectural Control Committee/Board Comments:
Architectural Control Coin mittee/Board Signaturo-_