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10070099
CITY OF CUPERTI vO BUILDING PERMIT BUILDING ADDRESS: 10431 WESTACRES DR CONTRACTOR:THD AT-HOME SERVICES, PERMIT NO: 10070099 INC. 'VNER'S NAME: TSING JOHN Y AND MICHELLE L 2690 CUMBERLAND PKWY STE 300 DATE ISSUED:07/14/2010 vWNER'S PHONE: 4087654380 ATLANTA,GA 30339-3913 PHONE NO:(510)731-1004 ❑ LICENSED CONTRACTOR'S DECLARATIONF BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class L. l"j Lic.# -''J MECH RESIDENTIAL COMMERCIAL Contractov!��C-C.�L [^/d(,,''� Date ! ��/%(/ I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OFF&RESHEET&INSTALL TIMBERLINE (commencing with Section 7000)of Division 3 of the Business&Professions 30 Code and that my license is in full force and effect. YR COMP CLASS A 31 SQ 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 whit his Sq.Ft Floor Area: Valuation:$16220 permit is issued. APPLICANT CERTIFICATION APN Number:35914029.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. �� ^na Issued by. Date: cl ,(i Date ❑ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 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. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. 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 Owne r authorized agent: forthwith comply with such provisions or this permit shall be deemed revoked. �'% ��s�Z�i-� � Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name the above mentioned property for inspection purposes.(We)agree to save unify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 35914029 . 00 DATE ISSUED. . . . . . . : 07/14/2010 RECEIPT #. . . . . . . . . : BS000010865 REFERENCE ID # . . . : 10070099 SITE ADDRESS . . . . . : 10431 WESTACRES DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : TSING JOHN Y AND MICHELLE L ADDRESS . . . . . . . . . . : 10431 WESTACRRES DR CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-1658 RECEIVED FROM . . . . : PIT STOP PERMITS CONTRACTOR . . . . . . . : FRANCES BLAKE LIC # 29818 COMPANY . . . . . . . . . . : THD AT-HOME SERVICES, INC. ADDRESS . . . . . . . . . . : 2690 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 16, 220. 00 1. 00 0 .00 1 . 00 0 . 00 1REROOFRES SQ FEET 31. 00 403 . 00 0 . 00 403 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 404 .00 0. 00 404 . 00 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 404 .00 #1275 --------------- TOTAL RECEIPT 404 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: `VALUATION: 1$16,220 PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex TOTAL 3 100 S.f. APPLICATION USE: ROOF AREA: TYPE: xW p; a cc 3U F1 E ID 1 RERC,OFFRES NOTE. Thesefees are based on the preliminary information twilable and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS (Fee Resolution 09-051 Eff' 7'Ii09) FEE QTY/FEE MISC ITEMS Permit Fee: $402.00 Work Without Permit? Q Yes 0 No $0.00 Strom Motion Fee: IBSEISMICR $1.62 Select an Administrative Item Bld , Stds Commission Fee: IBCBSC $1.00 SUBTOTALS $405.621 $0.00 TOTAL FEE: $405.62 Revised: 6/30/2010 CITY OF CITY OF 4_UPERTINO REROOF CUPERTINO PERMIT APPLICATION APN#� �, � � ��: Date: Li Building Address: . Owner's Name: S Phone #: . HOA: Yes ❑ No ® If yes, provide let:er from HOA Contractor: Phone Fax#: Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ta, Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) W Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report# To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: ge _ � 2�� i' r �c �'"c`� fTiq'r' bet Residential - Commercial Green Building: Please complete relevant portion of the Cor rmed:nth-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 ,'.upertino's Tear-Off Policy: 'Sie Revised 02/05/09 M.lndoDr Air Quality and Finishes 1.Use 1br1PIo-V©C Nrd 1 IAQ/Health pts y--yes p 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes p 3.Use Loft VOC Adhesives 3 IAQ/Health pts Y--yes p 4.Use Salvaged Materials for Interior Finishes 3 Resource pts yeses 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Health pts y--yes D 6.Use Exterior Grade Plywood for interior Uses 1 IAQ/Health pts y--yes p 7 Seal all 4 Par and or WP 4 IAQ/Health pts y=yes p 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 0 10.Install Whole House Vacuum System 3 IAQ/Health pts y--yes p N.Flooring 1.Select FSC Certified Wood Flooring B Resource pts y=yes 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pts yryes D 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 yeses 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 Total Points Available: 1 1401 1301 57 Total Points Project Received: 01 01 Q Cfc-I& G:data/pmgs/gr:enbuBcOngodelines/remodelerslgreenpointsfinal212.D4protected.xls REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BU LDING OFFICIAL CUPERTINO 10300 TORRE AVENUE•CUPERTINC, CA 95014-3255 (408)777-3228•FAX(408)777-3333• ouildingCokupertino.org PROJECT ADDRESSAPN#pq 1 - f" OWNER NAME Ic PHO J �.�[ E-MAIL STREET ADDRESSCITY, ST ITE,ZIP 116 U L' FAX CONTRACTOR NA LICENSE NUMBI LICE E TYPE.(eQ BUS.LIC# COMPANY NAME y�. C E-MAIL FAX J ,�jl L STREET ADDRESS i CITY,ST,SE,ZIP PHON s v ��'III�JJ I UNDERSTAND AND A6REE 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 mini num 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 ca l for tear-off inspection after the roof is torn off and all the nails/fasteners have been removed. Any ar.d all dry-rotted wood shall be replaced prior to this inspection. A building inspector will be availably 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 5% 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 dowr 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 fc of of slope and must demonstrate there is no ponding. b. Listings from approved testing agencies for-11 pre-manufactured products used shall be available on-site to review at the time of the inspectior.. c. Proper spark arrestor installation. 8. NOTE: If you call for a tear-off or plywood nail ng inspection and the work is not complete, you will be charged a re-inspection fee of$126.00. The rF-inspection fee shall be paid before another inspection can be scheduled. By my signing below, I certify each of the following is -rue: I am the property owner or authorized agent to act on the property owner's behalf erstand and agree to com with the re-roof policy stated above. Signature of Applicant/Agent: Date: l ReroofPolicy_2010.doc revised 05117/10