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09100140I CITY OF CUPERTINO BUILDING PERMIT I IBUILDING ADDRESS: 10190 YOSHINO PL I CONTRACTOR: KEVIN SULLIVAN OFING I PERMIT NO: 09100140 I C- NER'S NAME: EDDY YAN V vv NER'S PHONE: 4083651190 CL LIC'E2NS�ED CONTRACTOR'S License Class c//� Lic. # CSCi� Contractor Date D �Lii I hereby affirm that I am lic sed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I 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. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 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 upon the 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 accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. S: ztur d ' 2Z Ky v I ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 1 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. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 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 Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, 1 must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is correct. 1 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 I he above mentioned property for inspection purposes. (We) agree to save i, nify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 1696 VALLEY OAKS DR GILROY, CA 95020 DATE ISSUED: 10/22/2009 PHONE NO: (408)842-1057 BUILDING PERMIT INFO: BLDG F ELECT f- PLUMB I- MECH f- RESIDENTIAL T- COMMERCIAL r - JOB DESCRIPTION: RE -ROOF REMOVE EXISTING WOOD SHAKE, INSTALL NEW 72LB CAPSHEET ROOFING & 30LB FELT & CLASS B HEAVY SHAKES FOR A CLASS A SYSTEM 25SQ Sq. Ft Floor Area: I Valuation: $16000 APN Number: 37503013.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued-Ifyc Datea��2 RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: ate: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. OwnerqX rt riz nt: Date: ZZ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional 3 ITEMS OF 3 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 37503013.00 DATE ISSUED.......: 10/22/2009 RECEIPT #.........: BS000009003 REFERENCE ID # ...: 09100140 SITE ADDRESS .....: 10190 YOSHINO PL SUBDIVISION ...... CITY CUPERTINO IMPACT AREA ...... OPERATOR: patg COPY # : 1 OWNER EDDY YAN ADDRESS 10190 YOSHINO PL CITY/STATE/ZIP ...: CUPERTINO CA, CA 95014-3435 RECEIVED FROM ....: KEVIN E SULLIVAN CONTRACTOR .......: KEVIN E. SULLIVAN LIC # 23810 COMPANY KEVIN SULLIVAN ROOFING ADDRESS 1696 VALLEY OAKS DR CITY/STATE/ZIP ...: GILROY, CA 95020 TELEPHONE (408)842-1057 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC ---------- NEW BAL ---------- ----------------------- 1BCBSC VALUATION ---------- 16,000.00 ---------- 1.00 ---------- 0.00 1.00 0.00 1BSEISMICR VALUATION 16,000.00 1.60 0.00 1.60 0.00 1REROOFRES SQ FEET 25.00 325.00 0.00 ---------- 325.00 ---------- 0.00 ---------- TOTAL PERMIT ---------- 327.60 0.00 327.60 0.00 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT AMOUNT --------------- 327.60 --------------- 327.60 VOICE ID DESCRIPTION -------- ---------------------------- 601 ROOF TEAR OFF REFERENCE NUMBER -------------------- MC VOICE ID DESCRIPTION -------- ---------------------------- 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF CITY OF CUPERTINO CITY OF CUPERTINO REROOF PERMIT APPLICATION ol (J 61 4 6 APN #� �� ] � Date: , � � Kff Building Address: C>c`o Owner's Name: Phone #: &c6�*-36 HOA: Yes No ❑ If yes, provide letter from HOA Contractor: /t Phone It: ax #: - 6e Cupertino Business License #: -- Contrac or License #: Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof • halt Shingles ❑phalt Shingles U1400d Shakes u --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: /2-6vL NJ- _. C -y_. SZ- ,-- 4�V-pp .5 ��(G&1 i,, 5 �,�u-�- /v'�= `72-1.b. L,.t� .a -U �►, ?" .� �:, � Residential Commercial El 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: I Have Read, U Signature and Will Comply with Cupertino's Tear -Off Policy: Revised 02/05/09 C CITY OF CUPERTINO a(ft REROOF CUPERTINO FEE SCHEDULE ber of ares j Fee ID Fee Description Fee Group Permit Type 1RER00FC0M Re -roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICO Seismic Commercial B 1REROOFRESC Re -roof Residential B 1SFDWLR00F 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICRE Seismic Residential B 1 REROOFMRES Re -roof Multi -Family B 1MFDWLROOF 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 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 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 comply with the above stated policy on re -roofing. Homeowner's Name: Le A-0 Job Site Address: [ O l.cl. J -(o S or'I ,J u r L , Roofing Company Name: Applicant's Signature: Greg Casteel Building Official Revised 07/30/08 1. Use Low/No-VOC Paint 1 IAC?/Health pts y --yes 2. Use Low VOC, Neater -Based Wood Finishes 2 IAO/Health pts y=yas 3. Use LDw)No VOC Adhesives 3 IADJHealth pts y=yes 4. Use Salvaged Materials for Interior Finishes 3 Resource pts y --yes 5. Use Engineered Sheet Goods with no added Ursa 5 IAQ/Hsalth pts y=yes Formaldehyde 61AD]Health pts y=yes S. Use Exterior Grade Plywood for lnterlDr Uses 1 IA4/Health pts y --yes 7. Seal pl�iolebo�rd or hblF _ 4 IAOIHsalth pts y-��es B. Use FSC Certified Materials for Interior Finish 4 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 N. Flooring 1. Select FSC Certified Wood Flooring B Resource pts y=yes 2. Use Rapidly Renewawe Flooring Materials 4 Resource pts y=yes 3. Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 4. Install Natural Linoleum in Place of Vinyl 5 IAQ/Hsalth pts y=yes 5. Use Exposed Concrete as Finished Floor 4 Resource pts y=yes S. Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes Total Points Available: Total Points Project Received: 140 130 57 01 0 0 C:datalprogslg buildingguidelinesl2modelerslgreenpointsfinal212D4pro d.xls CITY OF .'UPEI�TINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: O q -r, t%b3 J " PERMIT # r 09J 0 1 `t 0 OWNER'S NAME: ftme PHONE # �w GENERAL CONTRACTOR: FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: Owner ontract ignature DV -1 ate 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 Septic Tank Sheet Metal Sheet Rock Tile Owner ontract ignature DV -1 ate