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10110054 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22382 HOMESTEAD RD CONTRACTOR: PERMIT NO: 10110054 OWNER'S NAME: THOMAS E HARRINGTON TRUST DATE ISSUED: 11/09/2010 ER'S PHONE: 4083167299 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATIONr— r r BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class—_<--3, 'Lic.# 3 b r r _ MECH RESIDENTIAL COMMERCIAL Contractor/;f Date�� � ^/ d I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: HOMESTEAD CROSSING SHOPPING CENTER-END SPACE (commencing with Section 7000)of Division 3 of the Business&Professions OF Code and that my license is in full force and effect. SHOPPING CENTER-RE-ROOF,TEAR OFF TAR&GRAVEL 34SQ CLASS A INSTALL AN 80 MIL WHITE I B CPA PUC 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. Sq.Ft Floor Area: Valuation:$28000 APPLICANT CERTIFICATION C I certify that I have read this application and state that the above information is APN Number:32601018.22382 Occupancy Type: 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, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. Signa DateIssued �- Date: ❑ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS: the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant• _tT Date: construct the project(Sec.7044,Business&Professions Code). 7 I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. permit is issued. Additionally,should I use equipment or devices which emit hazardous air I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12,and the Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534. 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. O er r authorize agent: sit Dater l C7 APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of work's to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.) upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name mify and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the Lender's Address granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 22382 homestead TDATE: 11/09/2010 REVIEWED BY: APN: BP#: *VALUATION: 1$28,000 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY Commercial Building Y 1 7-A � ��,; 1 PENIA TYPE: 1COMMLROOF USE: WORK commercial tear off tar and gravel 43 squares class A SCOPE FEE ID ROOF AREA s.f. 1 REROOFCOM 3,400 ,I fc,h_ 1 ('!,,o k Li(}thr-r llcc•h. ITts',.r3 t) 1"',.rJ1f tt,; t)_'=:'r/t f .•.lig, NOTE: Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'1 info, FEE ITEMS (Fee Resohitiorr 09-051 Eff 7,%1%70) FEE QTY/FEE MISC ITEMS Plan ("he°ch 1 ec. .Sirp1d, PC.'/"Ce F 'A f'lrtnilt.%ll�n°/z.%I Icy:Plan C`Tic c k: Permit Fee: $348.00 Sup1V. Irish 1°C f'lttir7h.i_ll� .h.ilelcc: C 17it Fc,t%, 11crirril F,v: Consftwclion Ic:rtusticct/Rci^ici Work Without Permit? 0 Yes (F) No $0.00 Mannino FCC, , 7i irr>el C)oc�titrecrr[ftzfi��rt I c c,y: Strong;Motion Fee: IBSEISMICO $5.88 Select an Administrative Item Bld&Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: $355.88 $0.00 TOTAL FEE: $355.88 -- Revised: 11/08/2010 L M.Indoor Air Quality and Finishes 1 IAQ/Health pts y--yes p 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y--yes. 0 toVOID A 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 Plywood for Interior Uses 1 IAQ/Health pts y--yes 0 T,SOW ftPQWft-*WJPMdW 4 IAQ/Health. pts y=yes 0 B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y--yes D 10.Install Whole House Vacuum System 3 IAQ/Health pts y--yes 1, 0 1 1 1 N.Fiaoring 1.Select FSC Certified Wood Flooring 6 Resource pts y=yes 0 Jse -..y f3er1e1eJDnririgMabdals, 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 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 B.Install Recycled Content Carpet with Low VOCs 4 Resource pts y--yes0 1 1 1 Total Points Availa—ble: 1401 1301 57 Total Points Project Received: 01 0 Q G:datalprogsrgreenbuildngguidelines/remodelersJgreenpointsfina1212.D4proterted.xls CITY OF CUPERTINO 3 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 32601018 .22382 DATE ISSUED. . . . . . . : 11/09/2010 RECEIPT #. . . . . . . . . BS000011956 REFERENCE ID # . . . : 10110054 SITE ADDRESS . . . . . : 22382 HOMESTEAD RD SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER THOMAS E HARRINGTON TRUST ADDRESS . . . . . . . . . . : 22352 HOMESTEAD RD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : MIGUEL RODRIGUEZ CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096 COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 28, 000 . 00 2 . 00 0. 00 2 . 00 0.00 1BSEISMICO VALUATION 28, 000 . 00 5 . 88 0 . 00 5.88 0 .00 1REROOFCOM SQUARES 34 . 00 348 .00 0 .00 348 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 355.88 0. 00 355 . 88 0 .00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 309 EXTERIOR LATH 311 SCRATCH COAT 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•building(d)cupertino.org PROJECT ADDRESS t _3 60l APN# OWNER NAME r- (/ PHONE E-MAIL AWSTREET ADDRESS CITY, STATE,ZIP . FAX CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC.# yS-4.4 3C- COMPANY NAME E-MAIL FAX STREET ADDRESS/o/ CITY,STATE,ZIP PHONE R 6 a ,q,✓ 6-so 97, I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. There-roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimum of one day before the requested inspection date. Please schedule inspections online or call (408)777-3228 between 7:30-3:30 (Mon-Fri). 3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof is torn off and all the nails/fasteners have been removed. Any and all dry-rotted wood shall be replaced prior to this inspection. A building inspector will be available within one hour. There are special hours for this service: 7:30 — 10:30am and 1:00—3:30pm (Mon—Thurs); 7:30 — 10:30am and 1:00—2:30pm (Friday). 4. If plywood is installed, a plywood nailing inspection is required. 5. In-Progress roof inspection is required. Call for an in-progress roof inspection to verify building is weather tight after installation of approximately 25% of the roofing material. 6. New roof coverings shall not be applied without first obtaining all inspections and written approvals from the building inspector. Any roofing which is applied without first obtaining an approved inspection will require the removal of all new material down to the sheathing so a proper inspection can be performed. 7. A final inspection and approval shall be obtained from the building inspector when the re-roofing is complete. To receive a final sign-off, the following items will be verified: a. Flat roofs shall have a minimum of`/4" per foot of slope and must demonstrate there is no ponding. b. Listings from approved testing agencies for all pre-manufactured products used shall be available on-site to review at the time of the inspection. c. Proper spark arrestor installation. 8. NOTE: If you call for a tear-off or plywood nailing inspection and the work is not complete, you will be charged a re-inspection fee of$126.00. The re-inspection fee shall be paid before another inspection can be scheduled. By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the property owner's behalf. I understand and agree tg comply with the re-roof policy stated above. Signature of Applicant/Agen • Date: ReroofPolicy_2010.doc revised 05/17/10 CITY OF r CITY OF CUPERTINO .91 REROOF CUPERTINO PERMIT APPLICATION APN# II �i Date: Building Address: nL� b Phone #: Owner's Name: .TW"ss HOA: Yes ❑ No 2-1"-If yes, provide letter from HOA Contractor. resod y�j,�6- Phone #: �j 7a Fax#: Cupertino Business License #: Contractor License #: 3 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ,a' Other (Specify) ❑ Other(Specify) 3 Number of existing coverings �Z ❑ Provide I.C.C.E.S. Report# ,a-'To be Removed ❑ Provide Mfgr. Installation Specs. f� Job Description: �� -7',%f< ,� �"�'�d,�L ca acv f /4/.5 rey L- 4W Residential Commercial 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, Understand and Will Comply with Cupertino's Tear-Off Policy: r ' igna e Revised 02/05/09