09100024 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10268 CRESTON DR CONTRACTOR:LOS GATOS ROOFING PERMIT NO:09100024
OWNER'S NAME: CHAMBERLAIN STEPHEN P O BOX 1726 DATE ISSUED: 10/05/2009
ER'S PHONE: 4087393040 LOS GATOS,CA 95031 PHONE NO:(408)298-9399
LICENSED CONTRACTOR'S DECLARATION
/ BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.# 3,
MECH RESIDENTIAL COMMERCIAL
Contractor Date
I hereby affirm that I am licensed under the provisions of hapter 9 JOB DESCRIPTION:RE-ROOF REMOVE EXISTING CEMWOOD
(commencing with Section 7000)of Division 3 of the Business&Professions ROOFING INSTALL
Code and that my license is in full force and effect. CLASS A 40 SQ 7/16"OSB ASPHALT SHINGLES
1 hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,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 provided for by Sq.Ft Floor Area: Valuation:$13116
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued.
APN Number:32637038.00 Occupancy Type:
APPLICANT CERTIFICATION
I 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 building construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the 180 D S FROM L T CALLED INSPECTION.
granting of this permit. Additionally,the applicant understands and will comply
with all non-pom ource regulations per the Cupertino Municipal Code,Section r
9.18. Issued by: 0 Date:
Signature Date
CI OWNER-BUILDER DECLARATION RE-ROOFS:
All roofs shall be inspected prior to any roofing material being installed.If a roof is
1 hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtai an inspection,I agree to remove all new materials for
the following two reasons: inspection.
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, Sin re f plicant: - Date:
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penalty of perjury one of the following three
HAZARDOUS MATERIALS DISCLOSURE
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued,I shall Health& afety Code,Sections 25505,25533,and 25534.
not employ any person in any manner so as to become subject to the Worker's ;
Compensation laws of California. If,after making this certificate of exemption,I Own ed agent: t� �n
become subject to the Worker's Compensation provisions of the Labor Code,I must Date: i v
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's
I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.)
correct.1 agree to comply with all city and county ordinances and state laws relating Lender's Name
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address
i nify and keep harmless the City of Cupertino against liabilities,judgments,
c and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.18.
Licensed Professional
Signature Date
CITY OF CUPERTINO
3 ITEMS OF 18 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32637038 . 00
DATE ISSUED. . . . . . . : 10/05/2009
RECEIPT #. . . . . . . . . BS000008829
REFERENCE ID # . . . : 09100024
SITE ADDRESS . . . . . : 10268 CRESTON DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . . CUPERTINO
IMPACT AREA . . . . . .
OWNER CHAMBERLAIN STEPHEN
ADDRESS . . . . . . . . . . : 10268 CRESTON DR
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-1014
RECEIVED FROM . . . . : LOS GATOS ROOFING
CONTRACTOR . . . . . . . : RANDY BROWN LIC # 23481
COMPANY . . . . . . . . . . : LOS GATOS ROOFING
ADDRESS . . . . . . . . . . : P O BOX 1726
CITY/STATE/ZIP . . . : LOS GATOS, CA 95031
TELEPHONE . . . . . . . . : (408) 298-9399
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 13, 116 . 00 1. 00 0 .00 1. 00 0 . 00
1BSEISMICR VALUATION 13, 116 . 00 1.40 0. 00 1.40 0 . 00
1REROOFRES SQ FEET 40. 00 520 . 00 0. 00 520 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 522 .40 0. 00 522 .40 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
CITY OF CUPERTINO
ocJ
I.am U
REROOF
CUPER�TINO PERMIT APPLICATION
APN # —,7_ 0 Date:
J,26:;,-3 le:?_1112 ylr"9
Building Address:
16-2-& &
Owner's Name: Phone #:
6�e_)4�g4
Contractor: Phone #: OS' c�2 ,,5; J
/ f Fax#:
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles �Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles /� � l ❑ Wood Shingles
Other (Specify) (fin?00 0 Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O. eport#
To be Removed Provident fgr. Installation Specs.
s.
Job Des ription;
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:
131160- v d
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
CITY OF CUPERTINO
REROOF
CUPEkTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B ICOMMLROOF
1BSEISMICO Seismic Commercial B
1RER00FRES ' Re-roof Residential B ISFDWLROOF
1BSEISMICRE Seismic Residential B
1REROOFMRES Re-roof Multi-Family B IMFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC 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 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$176.18. The re-inspection fee must
be paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/ "per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comp y with the above stated policy on re-roofing.
Homeowner's Name: 1
Job Site Address: 16 2-67 C �
o
Roofing Company Name:
Applicant's Signature: D te: 6)
Greg Casteel
Building Official
Revised 07/30/08
Green Points Rating System for Remodeling Projects
Due to the diversity of remodeling project types, assigning a"total points"value to a project to be considered environmentally friendly is
not feasible.However,25 measures have been highlighted to signify that every effort should be made to incorporate them into your
projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with
ease of implementation and relative low cost. These measures can be used as a starting point for"greening"your project.
INPUT ResDurces Energy AO
A.Site
1.Recycle Job She ConOnmtion$DemoFdion Waste
65%=1 pant~75%= 2 points;80%=4 points up to 4 Resource pts 0
2.Salvage Reusable Building 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
B.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 D
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes 0
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 10
1 1 !
C.Structural Frame
1.Substitute Solid 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 1-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 D
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.Sheathing 1 Resource pt y=yes 0
! ! 1
Community Development
10300 Torre Avenue
:� - Cupertino CA 95014
Telephone(408) 777-3228
CITY U Fax(408) 777-3333
CUPERTINO
Building Depa- Ament
JOB ADDRESS: PERMIT
OWNER'S NAME: PHONE 1 !� �
GENERAL CONTRAC OR - i FAX r ',� V,y Cis
I am not using any subcontractors:
Sib afore D to
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSINESS NAME I BUSINESS LICENSE ,'
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum/ Wood
Glass/ Glazing
Heating
Insulation
Landscaping
Lathing I
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
(..Sheet Rock
Tile
Owner on actor Signature Date