09080128 ' CITY OF CUPERTIN O BUILDING PERMIT
BUILDING ADDRESS: 10858 E ESTATES DR CONTRACTOR:CUPERTINO ROOF,INC PERMIT NO:09080128
OWNER'S NAME: BLASQUEZ-GUERRA SHAREN ET AL
1052 KELLY DR DATE ISSUED:08/14/2009
n�NER'S PHONE: 4082211108
iAN JOSE,CA 95129 PHONE NO:(408)973-9427
L, LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT r— PLUMB
License Class Lic.# MECH RESIDENTIAL COMMERCIAL
Contractor �f y +—A v 12Date T"_j
JOB DESCRIPTION:RE-ROOF TEAR OFF SHAKES INSTALL 1/2
1 hereby affirm that I am licensed undeIt
provisions of Chapter 9 RADIAN BARRIER
(commencing with Section 7000)of Division 3 of the Business&Professions INSTALL 30# FELT 40 YR SHINGLE CLS A 23SQ
Code and that my license is in full force and effect.
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:$9000
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. APN Number:36922004.00 Occupancy Type:
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 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 DAYS FROM LAST CALLED INSPECTION.
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Date:
9.18. 1 S_,,,,,, _' Issued by.--c
Signature 1... //,, Date T)� � l r -ZVf
[ OWNER-BUILDER DECLARATION
RE-ROOFS:
All roofs shall be inspected prior to any roofing material being installed.If a roof is
I hereby affirm that 1 am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for
the following two reasons: inspection.
I,as owner of the property,or my employees with wages as their sole compensation, Date:
will do the work,and the structure is not intended or offered for sale(Sec.7044, Signature of Applicant Q�t >>
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
construct the project(Sec.7044,Business&Professions Code).
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
compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
performance of the work for which this permit is issued.
Safety Code,Section use eq should 1 store handle hazardous material.
I have and will maintain Worker's Compensation Insurance,as provided for by I
Additionally,should use equipment or devices which emit hazardous air
Section 3700 of the Labor Code,for the performance of the work for which this 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&Safety 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 flo er r authorized agent: 1—1 4-0,�
become subject to the Worker's Compensation provisions of the Labor Code,I muss
Date:
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 relatinl, 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
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
co Ind expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION
gi, ,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__
Community Development
10300 Torre Avenue
Cupertino CA 95014
Oka
Telephone(408)777-3228
Fax(408)777-3333
CITY OF
"'UPEkTINO
Buildirt De artment
JOB ADDRESS- PERMIT #
OWNER'S
PHONE # ,
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors: Date
Signature
Please check applicable subcontractors and complete the folloin '1'fB
SUBCONTRACTOR BUSIN ESS NAMEUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
JElectrical
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
Date
owner/Contractor Signature
eyow
��U
CITY OF C UPERTINO
REROOF
CUP TY OF O PERMIT APPLICATION
! O
APN=-, ✓� ,f�� £� Date:Ol V
Building Address: q G S+-qf s
Owner's Name:
pY) QV (z Phone #:
221 -�6gZ
HOA: Yes ❑ No ❑ If es, provide lever from HOA
Phone #: .1 3 �� Z
Contractor: _cf
� p Fax #: � � 2-
Contractor License #:
Cupertino Business License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up RoofEl Built-Up roof
❑ Asphalt Shingles _ `m Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify)
Li Other (Specify)
Number of existing coverings 7-5 ❑ Provide I.C.C.E.S. Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: of a,�-� S�.a� n 5 t 1 1 2 1 Q�� !3 -X--
Commercial
Res'
• Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building. P ❑
Green Building Checklist & attach it to the :application or if there are any restrictions:
applicable, include in plan set & the sheet index.
Valuation: 9 OUl7 �C/
I Have Read, Understand and Will Comply wi':h Cupertino's Tear-Off Policy:
J
Tature
Revised 02/05/09
a�Tt _..
CITY OF CUPERTINO
REROOF
'OF FEE SCHEDULE
CUPEI�TINO
N
umber of Fee ID Fee Description Fee Permit Type
Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICO Seismic Commercial B
1REROOFRES Re-roofRes.dential B 1SFDWLROOF
Z_
r! 1BCBSC Cal Bldg Stmdards B ALL PERMIT TYPES
Commissior,Fee
1BSEISMICRE Seismic Residential B
1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commissio:i Fee
1BSEISMICRE Seismic Residential B
B
1BUSLIC Business License
Community Development Department
Building Division
City of Cupertino
10300 Tone 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 applie d 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 Cit,,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 e of$176.18. e a re-inspection fee must
be Raid before another inspection can be schedul
IMPORTANT:
1. Flat roofs must have a minimum of liE "per foot slope and demonstrate
that there is no ponding.
be on the job site at the time on inspection.
2. An I.C.B.O.report is required to
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: ''
r D % s uu X54+ s
Job Site Address: l
Roofing Company
Applicant's Signature:
Date:
Greg Casteel
Building Official
Re fised 07/30/08
INPUT Resources EnLrgy IAD,Health
M.Indoor Air ua ity and Finishes 0
1.Use Leval 10-VM Pot 1 AQ/Health pts y=yes
0
2.Use Low VOC,Water-Based Wood Finishes 2 AQ/Health pts y=yes 0
3.Use Lowfi*VOC Adhesives 3 AQ/Health pts y=yes
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes
0
5.Use Engineered Sheet Goods with no added Urea 6 IAQ/Health is es 0
Formaldehyde p Y_y 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes7. 0
Seal allFxposa paaW@boardor�F 41AQ/Health. pts y=yes
B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 00
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
01
N.Flooring
B Resource pts y=yes 0
1.Select FSC Certified Wood Flooring 0
2 Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes
4 Resource is es 0
3,Use Recycled Content Ceramic Tiles p Y=y 0
4.Install Natural Linoleum in Place of Vinyl IAQ/Health pts y=yes
4 Resource is es 0
5.Use Exposed Concrete as Finished Floor P Y=y 0
6.Install Recycled Content Carpet with Low VOCs 2 Resource pts y=yes
Total Points Available: —1401 130 57
01 0
Total Points Project Received:
0
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