09060059 CITY OF CUPERTINO
WG
BUILDING DIVISION PERMIT
� �
PERMIT NO.
BUILDING ADDRESS:
11707 PALM SPRING 2T CAST1111- 2 ZOQEIIIG_ nc)06n0,;c)
PERMTf ISSUE DATE
'VNER'S NAME:
A CONTROL NO.
PHO
408 251-3565
BUILDING PERMIT INFO
ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH
u p O LICENSED CONTRACTOR'S DECLARATION Job Description
V
(= I hereby affirm that I am licensed under provisions of Chapter 9(commencing
with Section 70(X0)of Division 3 of thc Business and Professions Code,and my license is
Z< in full force ande[Cec RE-ROOF T/O (E) WOOD SHAKES. INSTALL 30LB FELT,
j Z License Clan t - Lle•# y�
F p Dam Contractor
GRAND CANYON COMP-18 SQUARES.
ARCHITECTS DECLARATION
1 understand my plans shall be used as public records
3 U
Citn Licensed Pmfcssional
N..1 OWNER-BUILDER DECLARATION
I hereby alTirm that I am exempt from the Contractor's License Law for the
COO following reason.(Section 7031.5,Business and Professions Code:Any city or county
C
m rE which requires a permit to construct,alter,improve,demolish,or repair any structure
w prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation
zthat he is licensed pursuant to the provisions of the Contractor's Incense Law(Chapter 9 Sq.Ft.Floor Area
X F- (commencing with Section 7000)of Division 3 of the Business and Professions CadC)or
y that he is exempt therefrom and the basis for the alleged exemption.Any violation of Occupancy Type
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number
not more than five hundred dollars($500). 36654111 . 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(See.7044,Business Required Inspections
and Professions Code:The Contractor's License Law docs 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 U.
cease Law does not apply to an owner of property who builds or improves thereon,and
who contracts for such projects with a cortuactor(s)licensed pursuant m the Contractor's
License Law.
❑I am exempt under Sec B&P C for this mason
,mer 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 WorkeesCompen-
sation,as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
00have 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 Workees Compensation Insurance carrier and Policy number are:
Carrier. - L V—U"Id Policy No.: 123 0 O D p L9 q
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Chis section need not be completed if the permit is for one hundred dollars($100)
or less.)
I certify Nat 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 2 forthwith comply with such provisions or this permit shall be deemed revoked.
Z O CONSTRUCTION LENDING AGENCY
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.)
a Q Lender's Name
Lender's Address
V 0 1 certify that I have read this application and state that the above information is
LL E* correct.I agree to comply with all city and county ordinances and state laws relating to
0U building construction,and hereby authorize 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
H,t to liabilities,judgments,costs and expenses which may in any way accrue against said City
V Z in consequence of the granting of this permit. Date
014 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued b3
SOURCE REG LATIONS.
-�� `� Re-roofs
SignattiWol'Applicant/Contractor Dale T of I:oof
HAZARDOUS MATERIALS 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
-,dc,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
❑Yes (J No
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
emit hazardous air contaminants as defined by the Bay Area Air Quality Managemcm all new r iaterials for inspection.
District? ,/
❑Yes C7 No
1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- `� ^ 1 2
nia Health&Safcty Codc,Sections 25505.25533 and 25534.1 understand that if the building V T
does not currently have a tenant.that it is my responsibility to notify the occupant of the 'gyp
regaire�cots�h�ch must be, t prior to issuance of a certificate of Occupancy. Si
cg ;of Applicant Date
C- V 1 d All roof coverings to be Class' ``or better
Owql,or authorized agent Dare
CITY OF CUPERTINO
RE ROOF
CUPEkTINO PERMIT APPLICATION
APN # ✓ / _ / Date:
Building Address:
HOA: Yes [�] No ❑ If es rovide leiter from HOA �(
1v Fax #:
Cupertino Business License #: Contra or License #:
1.30�57Z
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ wilt-Up roof
❑ Asphalt Shingles Asphalt Shingles
V Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.C.E.S. Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: ` cap—
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:
Revised 02/05/09
CITY OF C UPERTINO
REROOF
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
1RER00FRES Re-roof ReE idential B 1SFDWLR00F
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
/ 1BSEISMICRE Seismic Residential B
1REROOFMRES Re-roof Multi-Family B 1MFDWLR00F
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Residential B
1BUSLIC Business License 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 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 appL ed without first obtaining all inspection
and written approval from the buildilg inspector. A final inspection and
approval shall be obtained from the t uilding 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 Ci,y,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 na:l 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 ca:1 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.
At
Homeowner's Name:
Job Site Address: � U ' C_1 1\,!'
Roofing Company Name: � � I t�� , !
Applicant's SiC Date:
Greg Casteel
Building Official
Revised 07/30/08
M.Indoor Air Qualfty and Finishes
1.Use LoWND-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 Looft 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
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes
7.Seal all Exposed Pa Wsboaml or ACDF 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 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 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 1
1 1 1
Total Points Available: 1401 1301 57
Total Points Project Received: 01 01 0
G:data/progs/gre:nb ' ngguidelines/remodelers/greenpointsfinal2.12.04protected.xis
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COMNN;E M MANAGF.M NT SERVICES,INCORPORATED
hno9,20M
Okay Moandea
11707 Palm Sprung Ct
CWu*w,CA 95014-5142 µ
Rc: S n=Springs Hamcowmrs Amociatiaa
1 E 707 Palm Spring Coart
- Y)ear I�attu�wners:
Ficlowd you wM find at copy of y=ArcWt=bx a Apphcatioa for tlra ro-roa teg of yoor homey wi&the
aw,aW fim the Board of DmoCbrk as wcH as any reshieflons or coaditians toed the BOW rimed
Y- � to appy you you w a iDtallirrg The G" Lamu�vd F-bc S%" Asphalt—
at*"XwwI CaMW,dolor-hfission Nrwe'.
pl=w Jeep m mind that any daviabm fwm your approved application will require you to resubM your
applicafm for=view.. if you u ff= an-uoappmv ed matcwWyou will be nqu iced to ftwovo and replace
the matwal wig an approved sdbcbca.
The approval of your progoWs ardvla t W cOP40MAW wO the Sam Spngp O wwo' Assodebm's I
onuRplex dcm not camst tx w or imply, that the Aidmww r+1 Committee an&or the Anoaiatm Bwd of
Dir+ectocs dcn your project as nwew*City of G Vomw/Cvunty of Satan Clara codas. Mw appavml is
&w omtbagal Mm y(s and )br yew cwtw bw(s) ebM=ft tltc r *umd. cwsft=Uon permits and i
medWg all code:etluir ,if any.
V you have any quesdow,ploaae don't bc%W to toconaame. �
swc"*,
c omnuutit�r Maaagomeau€t ,Inc.
z
L uis H rWia, Senior Association Msaager
S wen Springs Hormeowrness Association {
LHA=r
C(;: Board ofMvchm
1936 DrV Creels Road, Suite 203 Campbell CA•9 5008,3631 R voice (408) 655-1977■fax (408) 559-1970