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09060056 CITY OF CUPERTINO BUILDING DIVISION PERMIT fi� Itt� o I� BUILDING ADDRESS: PERMIT NO. 20840 PEPPER WESTERN OWNER'S NAME: FERMrr ISSUE DATE iO : A CONTROL NO. 831) 273-1837 ABUILDING PERMIT INFO RCHITECT/ENGINEER: BLDG ELECT PLUMB MECH 0 u p p LICENSED CONTRACTOR'S DECLARATION Job Description m I hereby affirm that I am licensed under provisions of Chapter 9(commencing Z with Section 7000)of Division 3 of the Business and Professions Code,and my license is ' in full force andeffec / ,. RE-RF T i0 2LYRS OF WOOD RFNG INSTL BATTERSYS &40# j r�Z License Class —Lic•*—iIME +�O Date 1.rh��# Contractor FLT INS'[L MTAL TILE LIGHTWEIGHT CLS A 28SQ & 1 ARCHITECTS DEC A 1 understand my plans shall be used as public records SUNTUNN.�',L DyU U.HLicensed Professional O.0 OWNER-BUILDER DECLARATION F 1 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'.0! which requires a permit to construct.alter,improve,demolish,or repair any structure yZ� prior to its issuance,also requires the applicant for such permit to Glc a signed statement E_ that he is licensed pursuant to tic 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 S17500 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(tom)- 3591300L . 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 Required Inspections and Professions Code:The Contractor's License Law docs 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 docs not apply to an owner of property who builds or improves themon,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 Compcn- .on,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 Worket's Compensation Insurance carrier and Policy number am: CarrierPolity No/�L�� CER Fl TE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need 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 Workces Compensation provisions of the Labor Codc,you must Oforthwith comply with such provisions or this permit shall be deemed revoked. Z"" CONSTRUCTION LENDING AGENCY [~i.�.r 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.) Ow.h Q Lender's Name r7 z Lender's Address IJ 1 certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to Vbuilding convection,and hereby authorize representatives of this city to enter upon the t7W.h above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. -- APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date �'u Re-roofs r_W DSCLOSURE Dam Type of Roof OUS MAHAZ anShW ht or future buildit)f(ScApant.store or handle hazardous material as defined by the Cupertino Municipal c,Chapter 9.12,and the Health and Safety Code,Section 25532(x)? )CN All roofs shall be inspected prior to any roofing material being installed. ❑YesIf a roof is installed without first obtaining an inspection,I agree to remove Will the applicant outure building occupant use equipment or devices which -iit hazardous air contaminants as defined by the Bay Area Air Quality Management all new IT aterials for inspection. Strict? ❑Yes o have read the hazT�usaterials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code, 5505,25533 and 25534.1 understand that if thc building docs not currently have a tenant,that it is my responsibility to notify the occupant of the CITY OF CUPERTINO IKREROOF CUPEkT1NO PERMIT APPLICATION APN # Date: Building Address: /� �/- zJ Contractor: Phone #: yve Z 405 ti Fax #: 'Yu ,9 /-4-33 Cupertino Business License #: Contractor License #: G-;z Type of hoof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles Wood Shakes ❑ Wood Shakes -Wood Shingles ❑ Wood Shingles ❑ Other (Specify) )a-- Other (Specify) 0 Number of existing coverings Z- ❑ Provide I.C.C.E.S. Report 4-- To be Removed ❑ Provide Mfgr. Installation Specs. l Job Description: ir 4f d& b z, t� , .., r�•/f .�e A! Lit 7LI/Ic— /.15 Z �� ilOfS � Ute' S'4NTKi✓�{/ � �ji,p /Nf'��-t �. 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: El applicable, include in plan set & the sheet index. Valuation: 7, I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: S Revised 02/05/09 CITY OF CUPERTINO a_ -- RERDOF CUPEkTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1RER06FC MM Re-roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICO Seismic Commercial B 2 C 1REROOFRES Re-roof Residential B 1SFDWLROOF 1BCBSC Cal Bldg Stindards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B 1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commissio 1 Fee 1BSEISMICRE Seismic Re3idential B 1BUSLIC Business L:cense 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 r,�-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 b-. lding 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 nai 1 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 pei formed. 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/ "per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O.report is required to be ort the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: job Site Address: 2 O f 40 Veal �{- Roofing Company Name: W-es4t rrj P—isof—i, S_.s-e,,--S Applicant's Signatur : Date: �J Greg Casteel Building Official Revi:;ed 07/30/08 Green Points Rating System for Remodeling Projects Due to the diversity of remodeling project types,assigning a"toti,Ll points"value to a project to be considered environmentally friendly is not feasible.However,25 measures have been highlighted to sicinify that every effort should be made to incorporate them into your projects. These items have been chosen based upon their impart on the environment and the health of the home in coordination with ease of implementation and relative low cost. These measures i:an be used as a starting point for"greening"your project. INPUT Resluces Energy .! A.Site li' 96=1 poi 73°l6 ;? M% 4points up to 4 Resource pts 0 r 2.Salvage# t> e 1g tertals 3 Resource pts y--yes 0 3.Remodel for Mixed Use,Adaptive Reuse,and Historic Preservation 3 Resource pts y=yes D 4.Protect Native Soil ?Resource pts y=yes 0 5.Minimize Disruption of Existing Plants&Trees I Resource pt y=yes 0 6.Implement Construction Site Stormwater Practices 2 Resource pts y=yes 0 7.Protect Water Quality with Landscape Design ?Resource pts y=yes 0 B.Design resource-Efficient Landscapes and Gardens 1 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 s y=yes 0 11.Provide for On Site Water Catchment/Retention s y=yes 0 Eii 1 1 1 B.Foundation 1.Incorporate Recycled Flyash in Concrete 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 2 Resource pts y=yes 0 3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes 1 0 C.Structural Frame 1. EnglmeredUmber 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 B.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.SheaMing 1 Resource pt y=yes 0 i 1 1 M.Indoorit Quality and Finishes 1.Use Low/No-VOC Pair 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 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 7.Seal all wed P,ardalaboaatd 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 1 1 10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0 1 i i 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 i Total Points Available: 1401 130 57 Total Points Project Received:1 01 01 0 17 G:datalprogslgre anbuilcfingguidelines/ramodelers/greenpointsfiinal2.12.D4protected.xls Community Development S 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 rUPEkTINO Buildin De artment JOB ADDRESS: PERMIT # OWNER'S NAME. GENERAL CONTRACTOR/ >< y%y FAX # & -73 I am not using any subcontractors: G-*-m f Si;natue7e Date Please check applicable subcontractors and com Meteollowin information: SUBCONTRACTOR BUSINESAME 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 Own r ntractor Signature Date