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09080323 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10800 W ESTATES DR CONTRACTOR:THD AT-HOME SERVICES, PERMIT NO:09080323 INC. ( """ER'S NAME: LOHLOH FRANK T 2690 CUMBERLAND PKWY STE 300 DATE ISSUED:08/24/2009 O...rER'S PHONE: 4082554511 ATLANTA,GA 30339-3913 PHONE NO:(510)731-1004 ❑ LICENSED CONTRACTOR'S DECLARATION 2 License Class_ Lic.# 0-2-- f BUILDING PERMIT INFO: BLDG F ELECT f PLUMB ��U f Contractor % ate Z MECH f— RESIDENTIAL f— COMMERCIAL I hereby affirm that I am licensed under the provisio s of Chapter 9 JOB DESCRIPTION:RE-ROOF T/O WOOD SHINGLS ROOF&INSTALL (commencing with Section 7000)of Division 3 of the Business&Professions GRAND SEQ Code and that my license is in full force and effect. COMP CLS A 24 SQ I hereby affirm under penalty of perjury one of the following two 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 Sq.Ft Floor Area: Valuation:$16000 permit is issued. APPLICANT CERTIFICATION APN Number:36922030.00 Occupancy Type: 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 enter PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree too 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 granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point sou regulations per the Cupertino MunicipalCo e,Section 9.18. Issued byr� Date: Si-- tune "� Date ' C ❑ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of f,ll roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: i:mstalled without first obtaining an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, r'inspection. will do the work,and the structure is not intended or offered for saleSec.7044, ( Signature of Applicant: Date: Business&Professions Code) I,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 1 hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE I have and will maintain a Certificate of Consent to self-insure for Worker's 1 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 &Lfety Code,Section 25532(a)should I store or handle hazardous material. Section?700 of the Labor Code,for the performance of the work for which this A iditionally,should I use equipment or devices which emit hazardous air pennit is issued. cc ntaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall in iintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person'in any manner so as to become subject to the Worker's H alth&Safety Code,Sections 25505,25533,and 25534. �J Compensation laws of California. If,after making this certificate of exemption,I Owner become subject to the Worker's Compensation provisions of the Labor Code,I must Date: forthwith comply with such provisions or this permit shall be deemed revoked. _ T CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I h--reby 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. I 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 u ;e above mentioned property for inspection purposes.(We)agree to save Leader's Address ii., ;ify 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 ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO REROOF CITY Of CUPEkTiNO PERMIT APPLICATION APN # O v O Date: Building Addres� D Owner's Name: > / Phone #: HOA: Yes ❑ No If es—provide letter from HOA Contractor: �� .�/ Phone #: e in Fax #: G Cu p rt o Business License #: ,/ Contractor Li ense OZ-- / Type of hoof Covering: Existing: Proposed: �❑ Built-Up Roof ❑ B114'-It-Up roof a6/""sphalt Shingles LAsphalt Shingles ❑ Wood Shakes ❑ Wood Shakes 0d Shingles c3 Wood Shingles ci Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report # ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: CJd� S C4 Residential 5�4,ommerci�al:g 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 Ian set & the sheet index. Valuation: I Have Read, Und r tand and Wi om ly with Cupertino's Tear-Off Policy: Signature Revised 02/05/09 CITY OF CUPERTINO /1f REIZOOF CUPEkT1NO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1 BCBSC Cal Bldg S'andards B ALL PERMIT TYPES Commissicn Fee 1BSEISMICO Seismic Ccmmercial B 1RER00FRES Re-roof Re,;idential B 1SFDWLR00F 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commissiu-1 Fee f 1BSEISMICRE Seismic Residential B 1 REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B 1 BUSLIC 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 a1y 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 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 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 abov a stated policy on r -ro in . / L Homeowner's Name: Job Site Address: logo T Roofing Company Name: JL0 Applicant's Signature: Date: Z Y Greg Casteel / Building Official Revise 107/30/08 INPUT Resources Energy 1ADrHeafth M.Indoor Air Quality and Finishes 1.Use LowMo-VOC Paint 1 IAQ/Health pts y=yes p 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes p 3.Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes p 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 p 6.Use Exterior Grade Plywoodfor Interior Uses 1 IAQ/Health pts y=yes p 7.Sea]all Exposed Particleboard or MDF 4 IAQ/Health. pts y=yes 0 S.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes p 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes p 10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes p ' i N.Flooring i i 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 p 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes p 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 ! i 011 Total Points Available: 140 130 57 Total Points Project Received: 01 01 0 G:data/progs/grei nbuildingguidelines/remodelers/greenpointsfinal212.D4protected.xls Community Development 10300 Torre Avenue baw, Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 ,;M TINO Building Department JOB AD R PERMIT # i� 0-32—3 O ,�Oa"!f�� /;k- - OWNER'S NAME: PHONE # - 7 GENERAL CONTRACTOR: ,� �1 FAX # I am not using any subcontractors: ignature Da(e Please check applicable subcontractors and complete the following information: 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 kU Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date