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10090023CITY OF CUPERT BUILDING ADDRESS: 7644 KIRWIN LN 'NER'S NAME: LIEHW WANG I OWNER'S PHONE: 4082536606 LICENSED CONTRACTOR'S DECLARATION License Class Lic.# �S b OL Contractor d D A'! -f 4 r SHS%, 5 Date �3 / O 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. INO BUILDING PERMIT I hereby affirm under penalty of perjury one of the following two declaratio as: 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 oe permit is issued. /A71APPLICANT CERTIFICATION 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 rela ing to building construction, and hereby authorize representatives of this city to ente 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. f rature Date I❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for or a of the following two reasons: I, as owner of the property, or my employees with wages as their sole compensa cion, 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 to construct the project (Sec.7044, Business & Professions Code). I 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 nust 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. I agree to comply with all city and county ordinances and state laws relating *„ building construction, and hereby authorize representatives of this city to ent--r m the above mentioned property for inspection purposes. (We) agree to save .aemnify and keep harmless the City of Cupertino against liabilities, judgmen s, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will compl, with all non -point source regulations per the Cupertino Municipal Code, Sectic n 9.18. Signature Date CONTRACTOR: THD AT-HOME SERVICES, INC. 2690 CUMBERLAND PKWY STE 300 ATLANTA, GA 30339-3913 PERMIT NO: 10090023 DATE ISSUED: 09/03/2010 PHONE NO: (510) 731-1004 JOB DESCRIPTION: RESIDENTIAL U COMMERCIAL RE -ROOF 32 SQUARES TEAR OFF EXISITNG WOOD SHAKE RESHEET W/ 7/16" OSB INSTALL PRESIDENTIAL ASPHALT SHINGLE CLAS A Sq. Ft Floor Area: I Valuation: $20292 APN Number: 35922073.00 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: Date: RE -ROOFS: 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. Signature of Applicant: Date: ALL ROO OV G �E 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 I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25505, 255339 and 25534./.G� Owner or authorized agent: ZD t : O 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 CITY OF CUPERTINO 3 ITEMS OF 3 PERM=T RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 3_'1922073.00 DATE ISSUED.......: 09/03/2010 RECEIPT #.........: B;S000011380 REFERENCE ID # ...: 10090023 SITE ADDRESS .....: 7644 KIRWIN LN SUBDIVISION ...... CITY .............. CUPERTINO IMPACT AREA ...... OWNER ............. LTEHW WANG ADDRESS ..........: 7644 KIRWIN LN CITY/STATE/ZIP ...: CUPERTINO CA, OPERATOR: SylviaM COPY # : 1 95014-4357 RECEIVED FROM .... CEFF RAINEY CONTRACTOR .......: FFANCES BLAKE LIC # 29818 COMPANY ..........: TF[D AT-HOME SERVICES, INC. ADDRESS ..........: 2C90 CUMBERLAND PKWY STE 300 CITY/STATE/ZIP ...: ATLANTA, GA 30339-3913 TELEPHONE ........: (510) 731-1004 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ----------------------- 1BCBSC VALUATION ---------- 20,292.00 ---------- 1.00 ---------- 0.00 ---------- 1.00 ---------- 0.00 1BSEISMICR VALUATION 20,292.00 2.10 0.00 2.10 0.00 1REROOFRES SQ FEET 32.00 416.00 0.00 416.00 0.00 TOTAL PERMIT ---------- 419.10 ---------- 0.00 ---------- 419.10 ---------- 0.00 METHOD OF PAYMENT ----------------- CHECK CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 119.10 300.00 --------------- 419.10 VOICE ID DESCRIPTION -------- ---------------------------- 601 ROOF TEAR OFF REFERENCE NUMBER -------------------- 320 VISA VOICE ID DESCRIPTION -------- ---------------------------- 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF 1. Use Low/No-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 Formaldehyde 61AQ/Health pts y=yes 6. Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 7. Seal all Exposed Particleboard or MDF 4 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 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 Total Points Available: 1 1401 130 57 Total Points Project Received:1 1 01 0 0 GAaWp sl 9nbuildingg delinest modelers/greenpointsfinal2.12.04protected.xls CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: 7644i -,j LA PERMIT # OWNER'S NAME: C_ i jE H J A,J (-, PHONE # 019 2-53-6-606 GENERAL CONTRACTOR: THP 4-T t4op4r,- BUSINESS LICENSE # ADDRESS: 2-45& jC--Z A L7, CITY/ZIPCODE: A-„) 91 "7 *Our municipal code requires all businesses working �n 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 SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. j4� q• I am not using any subcontractors: / /3 1,ignatu Date Please check applicable subcontr �ctors�accmldete the following information: /�Z'-b6er / Contractor Signature 7/3/io Date J SUBCONTRACTOR BUSIN ESS 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 /�Z'-b6er / Contractor Signature 7/3/io Date J CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION NOTE: These fees are based on the vreliminary information available and are only on eciimnio rnein,-i iho none fon —m.. q .*_r, FEE ITEMS (Fee Resolution 09-051 Elf.' 7;1./10) ADDRESS: DATE: REVIEWED BY: P/an C'hccA ['0': APN: BP#: 'VALUATION: 1$20,293 *PERMIT TYPE: Minor Building Permit PIAN CHECK TYPE: Re -roof PRIMARY SFD or Duplex USE: P 1017 11 hl �X�t� tt�E��. PENTAMATION PERMIT TYPE: 1SFDWLROOF WORK Permit Fee: SCOPE Sapp[ Fc -c NOTE: These fees are based on the vreliminary information available and are only on eciimnio rnein,-i iho none fon —m.. q .*_r, FEE ITEMS (Fee Resolution 09-051 Elf.' 7;1./10) �i,'C i7. t�i<tJt e hel'n 1>t -i`)iA 1'/t?it c_t3Cc MISC ITEMS P/an C'hccA ['0': F7, V.,", of tc�' ;tic � h. Ina7' 01i;c°r' Yr'rrrah Irs� � , CIt1,� !'<� i�zrt�.Lj 14("h Phio;h, it s/;. F"" I„ec M"o, Fco NOTE: These fees are based on the vreliminary information available and are only on eciimnio rnein,-i iho none fon —m.. q .*_r, FEE ITEMS (Fee Resolution 09-051 Elf.' 7;1./10) FEE QTY/FEE MISC ITEMS P/an C'hccA ['0': slfppl. PC 1'tv Plzrrral�.;.11ccJt.. F:lcc: P/uat 01cc:k. Permit Fee: $416.00 Sapp[ Fc -c P/tr111/3'_1 ech.I. nit F"c. Plt�nrh_::,llcrch. fs1<c F'el-mit FCC> F I ("onswilction TIx F-1 Work Without Permit? Q Yes E) No $ 3.00 _T 71-(wel 1)oc frrncrltution FcTS_ Strong Motion h'ee: IBSEISMICR $2.03 Select an Administrative Item Bldg; Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $41).03 $0.00 TOTAL FEE: $419.03 Revised: 9/01/2010 REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE • CUPERTIN J, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building0kupertino.org PROJECTADDRESS 7644 KIRWIN LANE APN# OWNERNAME LIEH WANG PH3NE408-253-6606 E-MAIL STREETADDRESS 7644 KIRWIN LANECITY,'. TATE, ZIP FAX CUPI'RTINO, CA 95014 CONTRACTOR NAME LICENSE NUM] SER LICENSE TYPE BUS. LIC. # 836021 C39 COMPANY NAME THD AT HOME SERVICES E-MAIL FAX 510-357-3750 STREET ADDRESS 2456 VERNA CT. CITY, S FATE, ZIP SAN LEANDRO, CA 94577 PHONE 510-887-4565 I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re -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 z nd 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 follow ing items will be verified: a. Flat roofs shall have a minimum of 1/4" per i bot 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 nal'ling 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 iE true: I am the property owner or authorized agent to act on the property owner's behalf. I derstand and agree; to comply with the re -roof policy stated above. Signature of Applicant/Agent: Date: 7 ReroofPolicy_201 0. doc revised 05/17110 iTYOf CITY OF CUPERTINO RI:ROOF CUPERTINO PERMIT APPLICATION /0090v";�3 APN # Q 22 0 -73 -03 Date: / Building Addres-sl: 7644 KIRWIN LANE Owner's Name: LIEH WANG Phone #: HOA: Yes No [ If yes, provide h4ter from HOA 408-253-6606 Phone #: 510-877-4550 Contractor: THD @ HOME SERVICES Fax#:510-357-3750 Cupertino Business License #: Contractor License #: 836021 Type of hoof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles 6 Asphalt Shingles ® Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report # ESR 1389 ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: REROOF - TEAR OFF EXISTING WOOD SHAKE. RESHEE" WITH 7/16" OSB. INSTALL PRESIDENTIAL ASPHALT SHINGLE CALSS A. 3 L 5q()Ae�L-c J Residential x❑ 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: $20,292.80 I Have Read, Understand and Will Comply with Cupertino's Tear -Off Policy: ............. . . . Signature Revised 02/05/09