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10090156 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10295 BYRNE AVE CONTRACTOR:T44)—T4)-B PERMIT NO: 10090156 j�FTFR t�,rn.TFn WNER'S NAME: DAVID MC LEROY Y� G DATE ISSUED:09/16/2010 OWNER'S PHONE: PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL License Class C l '? Lic.# 6 5[7 5 6 RE-ROOF 18 SQUARES TEAR OFF OLD ROOF,INSTALL f / RADIANT BARRIER OSB INSTALL BATTS AND&TILE Contractor S S /�no'F`ny Date `f(lG I hereby affirm that I am licensed 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. Sq.Ft Floor Area: Valuation:$3500 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 APN Number:35711019.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relatir g WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION. costs,and expenses which may accrue against said City in consequence of the /, indemnify and keep harmless the City of Cupertino against liabilities,judgments, /� granting of this permit. Additionally,the applicant understands and will comply Issued by: L Date: 6/, X/C,_�7 with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. l�d �6� RE-ROOFS: "+gnature � Date / All roofs shall be inspected prior to any roofing material being installed.If a roof is _ installed without first obtaining an inspection,I agree to remove all new materials for inspection. / f ❑ OWNER-BUILDER DECLARATION � Signature of Applicant: Date: (( 1 I hereby affirm that I am exempt from the Contractor's License Law for one A the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,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) I,as owner of the property,am exclusively contracting with licensed contractors tc HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent:<� —Date: ?/'11 40 (0 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I mL st I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 to building construction,and hereby authorize representatives of this city to enter hon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION ,demnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35711019. 00 DATE ISSUED. . . . . . . : 09/16/2010 RECEIPT #. . . . . . . . . : BE000011477 REFERENCE ID # . . . : 1C090156 SITE ADDRESS . . . . . : 1C295 BYRNE AVE SUBDIVISION . . . . . . CITY CLPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : DP.VID MC LEROY ADDRESS . . . . . . . . . . : 1C295 BYRNE AVE CITY/STATE/ZIP . . . : CLPERTINO, CA 95014 RECEIVED FROM . . . . : SE ROOFING CONTRACTOR . . . . . . . : TED - TO BE DETERMINED LIC # 00096 COMPANY . . . . . . . . . . : TED - TO BE DETERMINED ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . : FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- - --------- ---------- ---------- ---------- 1BCBSC VALUATION 3, 500 . 00 1 . 00 0 . 00 1 . 00 0. 00 1BSEISMICR VALUATION 3, 500 .00 0 .50 0 .00 0 . 50 0. 00 1REROOFRES SQ FEET 18 .00 234 . 00 0 .00 234 .00 0 . 00 - --------- ---------- ---------- ---------- TOTAL PERMIT 235 .50 0. 00 235 .50 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 235 .50 4434 --------------- TOTAL RECEIPT 235. 50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: Z7 F-,�e CL PERMIT# ° OWNER'S NAME: a-ve H1ct QrC 2e PHONE # GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working its the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTI:ACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: �(c 4 Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUS INE SS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/ Carpeting Linoleum/Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date CITY OF CUPERTINO FEE ESTIMATOR -BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: rdw APN: BP#: *VALUATION: 1$3,500 *PERMIT TYPE: Minor Building Permit PLE►N CHECK TYPE: Re-roof PRIMARY SFD or Duplex lex 1C11 � PENTAMATION USE: 11C)t�11 tr.I>_��: PERMIT TYPE: 1SFDWLROOF WORK SCOPE FEE ID ROOT'AREA .f. 1REROOFFRES 1,BOO lc'c;r flan Ch"(k Phtrnh. P1(;;I Chc(!, Flcc. t'hm C'hcc�k 1:14"ch, Fc,": P wz,. Perm b, lac°c {?t,rcf° llcrFi. In,v, 01/r c-r I glwnh/rtch. 01liei lnvj ticrh, [n,p F'V' Phrnrh. hop. I 17c,c.lniq'. 1"'v NOTE. Thesefees are based on the preliminary in ormation u vailable and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS.(Fee Resohitiorr 09-051 Eff 7j1i10) FEE QTY/FEE MISC ITEMS Plur� C'Irec�k�"c c': supe/. PC.'/,_C{ F71 F'lur�th.: 11cc°h. I Icc:Plau Check: Permit Fee: $234.00 .Supp/. Irish FA, ( 'rrrr FCC.' Plurrth.-;11cclt.:1'lc'c Permit C'c�ttstru<°hors 7�r:� F-1 "ICOu: tic(tl Rc ilc is k'ec Work Without Permit? Q Yes E) No $0.00 I'lcrrrrritt,�r 1'trc,,: Travel 0octrrrwalatioli tires': Strona,Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $235.50 $0.00 TOTAL FEE: $235.50 Revised: 9/14/2010 REROOF TEAR-OFF PO-ICY COMMUNITY DEVELOPMENT DEPAR rMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333• )uildinq(@cupertino.orq PROJECT ADDRESS q_5 xr-tf &VT APN# '-I I I „ � ) OWNER NAME e! PHO 4E �/J _7.r7 5, E-MAIL � fav t NtG STREET ADDRESS CITY, ST 4TE,ZIP C%4. a _q3 Ory FAX CONTRACTOR NAME J e ar f A9 LICENSE NUMBI R 6 5 17 C 1�j, LICENSE TYPE BUS.LIC.# z')c!/j 7 COMPANY NAME E-MAIL J > FAX STREET ADDRESS CITY,ST ATE,ZIP PHONE AA r` ze/ OZ7 K —30 -71 Za I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applica:)le 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 a id 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 1/4"per loot 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 inspecticn. c. Proper spark arrestor installation. 8. NOTE: If you call for a tear-off or plywood na ling inspection and the work is not complete, you will be charged a re-inspection fee of$126.00. The i-e-inspection fee shall be paid before another inspection can be scheduled. By my signing below, I certify each of the following i. true: I am the property owner or authorized agent to act on the property owner's behalf. I understand and agre: to comply with the re-roof policy stated above. Signature of Applicant/Agent: Date: Cf l/6 (Co ReroofPolicy_2010.doc revised 05/17/10 M.lndODr Air Quality and Finishes - 1 IAQ/Health pts yeses 0 2.Use Low VOC,Water-Based Wood Finishes. 2 IAQ/Health pts y--yes. 0 - 31AQ/Health pts yeses 0 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 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts yeses 0 4IAQ/Health pts y=yes 0 B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Fnger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0 10.Install Whole House Vacuum System 3 IAWealth pts y=yes 0 N.Flooring 1.Select FSC Certified Wood Flooring B Resource pts y=yes 0 laejfr?e>rvable7norm94 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 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 Total Points Available: 1 1401 130 57 Total Points Project Received: 01 01 0 G:data/progslgn enbwldngguideMestremodelara/greenpointsfinal212-MprIected.zls OF liCITY OF CXPERTINO REROOF CUPERTINO PERMIT APPLICATION APN # Date: q 111 /10 Building Address: 0Z rhe QUe Owner's Name: �Q„e �c�erP� Phone #: HOA: Yes ❑ No If Yes, provide letter from HOA (10b- 205- 7 77�_ Contractor: Phone #:KL,)5_3,9q_ 7a o -55 R o0 `h Fax#: Cupertino Business License #: Contractor License #: 23$7a 651756 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles o Asphalt Shingles 7 Wood Shakes -- ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles p� Other (Specify) e, 'K Other (Specify) m t?4� 7-#-/,r Number of existing coverings Provide I.C.C.E.S. Report# E 2 `-f 3 6 l To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: Fear Q`�'� ��� �6 a`F> ,Tn5N1( f td,'Cj +T Bgr, er 6-59 ICS Residential - Commercial Green Building: Please complete relevant por":ion of the Confirmed 1with 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: 35©a I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09