09080314CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10310 STERN AVE
O �.R'S NAME: CONRAD CHAN
O'er 4FR'S PHONE: 4083936994
CY LICENSED CONTRACTOR'S
_ C ONTRACTTOR''SDECLARATION
License Class C_+57 Lic. # YON? I (
Contractor /4/. , 4 Date / O p
1 hereby affirm that I am icensed 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.
I APPLICANT CERTIFICATION
t I certif}- 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
i� to building construction, and hereby authorize representatives of this city to enter
p upon the above mentioned property for inspection purposes. (We) agree to save
indernnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
j granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
IS, 'ure s Date 6 f
❑ OWNER- BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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 (See. 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).
1 hereby affirm under penalty of perjury one of the following three
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.
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, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. l 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
he above mentioned property for inspection purposes. (We) agree to save
..mify 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.
CONTRACTOR: KEVIN SULLIVAN PERMIT NO: 09080314
ROOFING
1696 VALLEY OAKS DR DATE ISSUED: 08/24/2009
GILROY, CA 95020 PHONE NO: (408)842 -1057
BUILDING PERMIT INFO: BLDG F_ ELECT I— PLUMB
MECH r RESIDENTIAL r COMMERCIAL f—
JOB DESCRIPTION: RE -ROOF REMV EXISTING ROOFING, INSTALL 2
LAYERS OF
15LB ASTM FELT AND 30YR ASPHALT COMPOSITION
SHINGLS(2:12) AND TPO MEMBRANE ROOF ON LOW- SLOPED
Sq. Ft Floor Area:
APN Number: 37514033.00
Valuation: $9000
Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Date:
Lt ->,
RE- ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, 1 agree to remove all new materials for
inspection. 101,
Signatur of Applicant!�Ld. to
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. I 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.
agent:
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.
Signature Date I Licensed Professional
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 agi ee 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 buildirg 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 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 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 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: (1-11W KV 0
Job Site Address: to-W s�� °'�'
Roofing Company Name:
Applicant's Signature:
a «.
Greg Casteel
Building Official
Revh:ed 07/30/08
N. Flooring
1. Select FSC Certified Wood Flooring
8 Resource pts
y =yes
1. Use LowMo-VOC Paint
1 IAQ/Health pts
y--yes
2. Use Low VOC, Water -Based Wood Finishes
2 IAQ/Health pts
y =yes
3. Use Low/No VOC Adhesives
3 IAQ/Health pts
y =yes
4. Use Salvaged Materials for Interior Finishes
3 Resource pts
y =yes
5. Use Engineered Sheet Goods with no added Urea
4 Resource pts
y =yes
Formaldehyde
61AQ/Health pts
y =yes
6. Use Exterior Grade Plywoodfor Interior Uses
1 IAQ/Health pts
y =yes
7. Seal all Exposed Particleboard or MDF
4 IAQ/Health. pts
y =yes
B. Use FSC Certified Materials for Interior Finish
Resource pts
y =yes
9. Use Finger- Jointed or Recycled- Content Trim
Resource pts
y =yes
10. Install Whole House Vacuum System
3 IAQ/Health pts
y =yes
N. Flooring
1. Select FSC Certified Wood Flooring
8 Resource pts
y =yes
2. Use Rapidly Renewable 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 /Health pts
y =yes
5. Use Exposed Concrete as Finished Floor
4 Resource pts
y =yes
6. Install Recycled Content Carpet with Low VOCs
4 Resource pts
y =yes
Total Points Available:
Totai Points Project Received:
140 1301 57
0 0 0
JZ..f-67
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CITY OF
CUPEkTINO
CITY OF CUPERTINO
RF:ROOF
PERMIT APPLICATION
Cyo�C�31(_l
APN # -7 �' q0 3 U
Date:
Building Address:
t) a) 10 5-r v6
Owner's Name: e iv r� C
Phone #:
-
HOA: Yes F1 No If es provide lette r from HOA
Contractor:
Phone
Fax #:
Cupertino Business License #:
Contractor License #:
-37
903'715- e
Type of hoof Covering:
Existing: Proposed:
uilt -Up Roof ❑ BB ' -Up roof
• Asphalt Shingles z.-'Asphalt Shingles
• Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles -51,4 kz- 104-1-
❑ Other (Specify) /Other (Specify) 7'0 ew L ! :j aPF
Number of existing coverings ❑ Provide I.C.C.E.S. Report # 156c7"111)
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: �- vE �K=� S��sG / ' iniG /AJS74VL1 Z LAI TS OF
Z)
3
Residential Commercial ❑
Green Building: Please complete relevant po : -tion 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: q
I Have Read, Understan d Will Comply with Cupertino's Tear -Off Policy:
Signature
Revised 02/05/09
CITY OF C UPERTINO
an, REROOF
CUPEkTINO FEE SCHEDULE
Number of
Squares
Fee ID
Fee Descri]:)tion
Fee
Group
Permit Type
1REROOFCOM
Re -roof Corunercial
B
1COMMLROOF
1BCBSC
Cal Bldg Standards
Commission Fee
B
ALL PERMIT TYPES
1BSEISMICO
Seismic Commercial
B
1REROOFRES
Re -roof ReEidential
B
1SFDWLR00F
1BCBSC
Cal Bldg Standards
Commission Fee
B
ALL PERMIT TYPES
/
1BSEISMICRE
Seismic Residential
B
1REROOFMRES
Re -roof Multi - Family
B
1MFDWLROOF
1BCBSC
Cal Bldg Standards
Commission Fee
B
ALL PERMIT TYPES
1BSEISMICRE
Seismic Re :;idential
B
1BUSLIC
Business License
B
CITY OF
kXPEkTINO
Community Develop.
10300 Torre Avenu,
Cupertino CA 95014
Telephone (408) 777 -3228
Fax (408) 777 -3333
Buildimmy Department
JOB ADDRESS: �, PERMIT # j- -0 6310 S �
OWNER'S NAME: PHONE # Z —( oS"'7
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors: d%
Signature Date
h k li ble subcontractors and com Mete the followinLr information:
Please c
ec a %-
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/ ontrac ignature Date