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10070038CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10355 STERN AVE CONTRACTOR: ANTHONY RAINIERI ROOFING INC nWNER'S NAME: BILL VLAHOV 1655 FORMAN AVE _ AJNER'S PHONE: 4088633060 SAN JOSE, CA 95124 VLICENSED CONTRACTOR'S DECLARATION License Class _ Liic. # la -g7 l✓ Contractor Date I hereby aff 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. 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 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 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. l'b, Sienature Date / J ❑ OWNER -BUILDER DECLARATION I 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 (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 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. 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 w- -n the above mentioned property for inspection purposes. (We) agree to save mify and keep harmless the City of Cupertino against liabilities, judgments, cu. ,s, 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. Signatur4� Date --A PERMIT NO: 10070038 DATE ISSUED: 07/06/2010 PHONE NO: (408) 265-8010 BUILDING PERMIT INFO: BLDG r— ELECT r— PLUMB f— MECH I— RESIDENTIAL I— COMMERCIAL JOB DESCRIPTION: RE -ROOF T/O EXISTING TAR & GRAVEL ROOF. INSTALL NEW TAR & CAPSHEET CLASS A 20SQ Sq. Ft Floor Area: I Valuation: $7000 APN Number: 37510053.00 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 Applica .. a Date: 2141/,10 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 I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. O horized agent: 7Z&� Date: 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 Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional �� CITY OF CUPERTINO 1! FEE ESTIMATOR .- BUILDING DIVISION AInT) • Tboce inoc nra hncod nn rho nroliminary infarmatinn availahle and are only an estimate. Contact the Dept for addn'l into. FEE ITEMS (Fee Resolution 09-051 Ef: 7/1`09) ADDRESS: DATE: MISC ITEMS REVIEWED BY: APN: BP#: *VALUATION: Iso xPERMIT TYPE: Minor Building Permit PLiiN CHECK TYPE: Re -roof PRIMARY SFD or Duplex USE: TOTAL ROOF AREA: 2,000 S f APPLICATION TYPE: x W as O� 3� AInT) • Tboce inoc nra hncod nn rho nroliminary infarmatinn availahle and are only an estimate. Contact the Dept for addn'l into. FEE ITEMS (Fee Resolution 09-051 Ef: 7/1`09) FE; QTY/FEE MISC ITEMS Permit Fee: $260.00 F-1 Work Without Permit? Q Yes (F) No $0.00 Stron,�,y Motion Fee: 10.00 Select an Administrative Item E31d�_, Stds Commission Fee: 90.00 SUBTOTALS: $2E 0.00 $0.00 TOTAL FEE: $260.00 Revised: 6/30/2010 2 ITEMS OF 2 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 37510053.00 DATE ISSUED.......: 07/06/2010 RECEIPT #......... BS000010779 REFERENCE ID # ...: 10070038 SITE ADDRESS .....: 1C355 STERN AVE SUBDIVISION ...... CITY CL PERTINO IMPACT AREA ...... OWNER ............: BILL VLAHOV ADDRESS 1C355 STERN AVE CITY/STATE/ZIP ...: CLPERTINO, CA 95014 OPERATOR: patg COPY # : 1 RECEIVED FROM ....: A R ROOFING CONTRACTOR AI\THONY RAINIERI LIC # 30363 COMPANY ANTHONY RAINIERI ROOFING INC ADDRESS 1E55 FORMAN AVE CITY/STATE/ZIP ...: SIN JOSE, CA 95124 TELEPHONE (408) 265-8010 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC ---------- NEW BAL ---------- ----------------------- 1BCBSC VALUATION -------------------- 7,000.00 1.00 ---------- 0.00 1.00 0.00 1REROOFRES SQ FEET 20.00 260.00 0.00 260.00 ---------- 0.00 ---------- TOTAL PERMIT ---------- 261.00 ---------- 0.00 261.00 0.00 METHOD OF PAYMENT AMOUNT ----------------- --------------- CASH 261.00 --------------- TOTAL RECEIPT 261.00 VOICE ID DESCRIPTION -------- --------------------------- 601 ROOF TEAR OFF REFERENCE NUMBER -------------------- VOICE ID DESCRIPTION -------- ---------------------------- 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF CITY OF CUPERTINO CITY OF CXPERTINO RE]:_ZOOF PERMIT APPLICATION APN # _ Date. Building Address:. . Owner's Name: �t c % \ f o,l,� o✓ Phone #: HOA: Yes ❑ NoIf es, provide letter from HOA -k-& 3 - 3 L)6 o Contractor: Phone #: Yoh 4 v Fax #: �Oy 3 3 Cupertino Business License #: Contractor License #: 2Zt/ 7�7 Type of Roof Covering: Existing: Proposed: iK- Built -Up Roof -%e Built -Up roof ❑ Asphalt Shingles ❑ 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 # ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description:,V- lr C, _Z. Residential Commercial Green Building: Please complete relevant portion of the Con --firmed 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: o v 6 I Have Read, Understand and Will Comply with Cupertino's Tear -Off Policy: Signature Revised 02/05/09 'Uc -7 o,,i, � REROOF TEAR -OFF POLICY is 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(a-)cugertino.orq PROJECT ADDRESS S�� S� APN # OWNER NAME PHO 4E _30 / Jj E-MAIL LL Ut �� STREET ADDRESS { J ry t CIT ST NTE, P ^� ` -7 �` FAX CONTRACTOR ME LICENSE NUMB] R - LICE�ISF,-T sY BUS. LIC # p„ CO AN NAME E-MAIL FAX n a1 H a'4�t 1 �` � c STREET ADDRES � CITY ST. ATE, Z S r /'� w [` Jr j / i �/�' l ^L 7 Pli_ONE �` [I ^�K 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 miw mum 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 cz 11 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 availab e 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 inspc ction is required. 5. In -Progress roof inspection is required. Call -or 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 dove n to the sheathing so a proper inspection can be performed. 7. A final inspection and approval shall be obtaine i 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 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 o the follgwing is true: -,,I am the property owner or authorized agent to act on the property owner's behalf nd and a rc e to c___. omply with the re -roof policy stated above. Signature of Applicant/Agent: Date: ReroofPolicy_2010.doc revised 05/17/10 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 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 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: Total Points Project Received: ff, I 1 1401 1301 57 0 0 0 -7/"o' 61C0 G:data/progs/gr:enbuildinoguidelines/remodelers/greenpointsfinal2.12.D4protected.xis 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 Id PERMIT # C 70 BUSINESS NAME PHONE # t/ Qt L&J-40e U OWNER'S NAME: L L A w Cabinets & Millwork GENERAL CONTRACTOR: , i [. BUSINESS LICENSE # ADDRESS: -L)( CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to nave a k.ny vi <'Upui tuw UUCIIM�o ._�. •_��• NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL BCONTP ACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. -716110 I am not using any subcontractors: Si ;nature Date PlPace check annlicable subcontractors and complete the following information: Owner / Contractor Signature Date SUBCONTRACTOR BUSINESS 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