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09080035CITY OF CUPERTI: BUILDING ADDRESS: 19200 STEVENS CREEK BLVD r WNER'S NAME. CYPRESS BUILDING ASSOCIATES I OWNER'S PHONE: 6504248383 ❑ LICENSED CONTRACTOR'S DECLARATION License Cl t Lic. # 7 Contract Date '" ! — I hereby affirm that I am license 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. v0 BUILDING PERMIT CONTRACTOR: ALLIANCE PERMIT NO: 09080035 ROOFING 1250 CAMPBELL AVE DATE ISSUED: 08/07/2009 SAN JOSE, CA 95126 PHONE NO: (408)261 -2595 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 1 certify that 1 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. /�i ., Date�;%J) ❑ OWNER- BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for one if the following two reasons: 1, as owner of the property, or my employees with wages as their sole compensatic n, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors tc 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. 1 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 mr Lst forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION II 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 I'milding construction, and hereby authorize representatives of this city to enter ,,on 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. Signature_ _ Date F_ f F BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH f— RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: COMM. RE -ROOF BUILD UP ROOF TO SINGLE PLYWOOD CLASS A Sq. Ft Floor Area: I Valuation: $198000 APN Number: 37506005.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: r Date '=`-? 10 'y RE- ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtajx' g an inspection, 1 agree to remove all new materials for inspection. 77 „ n, Signature of Applic�l _ Date: Z attt , 2xf- 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, S ti s 25505, 25533, and 25534. Owner or authorized age Date:X- _; 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 OF CUPEkTINO CITY OF C'UPERTINO REROOF PERMIT AJPPLICATION ()QbgOCR35' APN # -75' 3 6� ao 5— Date: ? - 2�� � Building Address: c� / UC�cs- Cite fc O/✓d Owner's Name: Phone #: G e/-4 Contractor: / �) �1 i �v� ce-- Phone #: yo e_ 6 �_ ZS-VT 0-0 Fax #: D (f 26! Z S7 Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: Proposed: Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ®J�; Wood Shakes Wood Shakes ❑ Wood Shingles ❑ Wood Shingles � P 0 ❑ Other (Specify) Other (Specify) Number of existing coverings Provide I.C.B.O. Report # To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: � ,,- �; a (.` a` � " � /S z- Ur<D �b 3 , s uv C %5 5 s Residential ❑ Commercial � k 0,1 515 P -f lo'_ 1-2- Ci . 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: ov-o I Have Read, Understand and Will Comply with Cupertino's Tear -Off Policy: Signature Revised 6/16/08 CITY OF CUPERTINO REROOF FEE SCIH:EDULE Number of Squares Fee ID Fee Description Fee Group Permit Type 1REROOFCOM Re -roof Commercial B 1COMMLROOF � 1BSEISMICO Seismic Conunercial B 1RER00FRES Re -roof Residential B 1SFDWLR00F 1BSEISMICRE Seismic Re& fential B 1REROOFMRES Re -roof Multi- Family B 1MFDWLROOF 1 BSEISMICRE Seismic Res idential B 1BUSLIC Business License B Revised 6/16/08 Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408) 777-3228 M 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 appL.ed without first obtaining all inspection and written approval from the building inspector. A final inspection and approval shall be obtained from the t uilding 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 City, the following steps are required: 1) Pre - inspection and /or tear off apF roval. 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 nai. inspection and the job is not ready, you will be charged a re- inspection ff!e 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 liE " 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. r" Homeowner's Name: y s o r s Job Site Address: l 9 Z v0 e- v e^ S C;-ePi 1v d- Roofing Company Name: l i Q � c Applicant's Signature: Date: Greg Casteel Building Official Revised 07/30/08 0 _S 6� v Plan Review Process Work Book Page -12- Revised 3/25/( 8 Green Building Plan Check Index of Green Building Points /Categories A. Category Example of an Index or Table of G-een Plan Sheet or Page Points Building Points Categories that mu it be shown and referenced on the Pro. ect Plans See below 2 points B. Site 9. Install H.E. Irrigation, (details /spec)` L -1 11. Permeable Paving, Note L -1 2 points C. Foundation 1. Use 15 % Flyash Concrete, (note;) S -1 5 points D. Structural 3. Uses Wood k Joist, (See Spec.) S -2 2 points 5. Use Truss with heels, (detail) S -2 2 points 6. B. OSB Sheathing, detail S -2 2 points E. Ext. Finish 1. Composite Decking, (Note /Spec) A -3 2 points 4. B. Fiber Cement Siding, Note /Spec. A-4 2 points F. Plumbing 1. Insulate all H.W. pipes, (Note /Spec.) P -1 2 points 5. Tankless W.H., (Note /Spec.) 11. A 2500 Gal. Tank, (Note/Spec A -2 L -1 2 points 10 points G. Electrical 4. E. Ceiling Fans, (Note /Spec.) A -3 4 points H. Appliances 1. Energy Star Dishwasher, (Note /.3pec.) A-3 1 point 3. Energy Star Refrigerator, Note / 3 ec. A -3 1 point P. Other 1 1. List Green Features on Plans A -1 1 point TOTAL P13INTSI 1 40 points 0 _S 6� v Plan Review Process Work Book Page -12- Revised 3/25/( 8 1. Use LowiNto -VOC Pami . IAQ/Health pts y =yes 2. Use Low VOC, Water -Based Wood Finishes IAQ/Health pts y =yes 3. Use Low/No VOC Adhesives :i 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 Formaldehyde �31AQ/Health pts y =yes 6. Use Exterior Grade Plywood for Interior Uses I IAQ/Health pts y =yes 7. Seal all & xposed Particleboard Or MDF t IAQ/Health pts y =yes 8. 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 E Resource pts y =yes 0 2. Use Rapidly Renewable Flooring Materials 2 Resource pts y =yes 0 3. Use Recycled Content Ceramic Tiles I Resource pts y =yes 0 4. Install Natural Linoleum in Place of Vinyl 3 IAQ/Health pts y =yes 0 5. Use Exposed Concrete as Finished Floor Resource pts y =yes 0 6. Install Recycled Content Carpet with Low VOCs i Resource pts yges 0 . 1 kind Total Points Available: 1401 1301 57 Total Points Project Received: 01 01 0 G:datalprogslgreE nbuildingguidelines/ remode lers/ greenpointsnnal2 .12.D4protected.xls