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10070022 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1060 WEST HILL CT CONTRACTOR:SEARS HOME PERMIT NO: 10070022 IMPROVEMENT r"VNER'S NAME: HWALING LIAW 1024 FLORIDA CENTRAL PKWY DATE ISSUED:07/02/2010 %..rNER'S PHONE: 4084464670 LONGWOOD,FL 32750 PHONE NO:(925)245-2000 IKLICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB b, c36,G2G License Class N I i � Lic.# —2_ 3 /" MECH RESIDENTIAL COMMERCIAL Contractor Date 7/-Z OV 1 hereby aff t 1 am lic under the provisions of Chapter 9 JOB DESCRIPTION: REROOF TEAR OFF 1 LAYRER,RE-SHEET,INSTALL (commencing wr ecti 000)of Division 3 of the Business&Professions OWENS Code and that my license is in full force and effect. CORNIGN DURATION 30 CLASS A 49.SSQ 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 Sq.Ft Floor Area: Valuation:$22612 permit is issued. APPLICANT CERTIFICATION APN Number:36227042.00 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. Issued by Date: c:-nature ❑ 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 I,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, /Z/ Business&Professions Code) Signature of Applicant: Date: 7 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL R"CONGS TO BE CLASS"A"OR BETTER 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 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. 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 Owner or authorized agent: forthwith comply with such provisions or this permit shall be deemed revoked. 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.1 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 mify 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 er the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Date Z O Licensed Professional CITY OF CUPERTINO FEE ESTIMATOR.- BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: *VALUATION: Iso `PERMIT TYPE: Minor Building Permit PLE►N CHECK TYPE: Re-roof PRIMARY TOTAL JT1YPE: PPLICATION USE: SFD or Duplex ROOF ALEA: , S f �g w rx a o � 3 � FI E ID 1 RERC,OFFRES NOTE: Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 09-051 Fff.' 7,,1/09) FEE QTY/FEE MISC ITEMS Permit Fee: $593.00 t) Work Without Permit? Q Yes No $0.00 Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $10.00 SUBTOTALS: $59,13.00 $0.00 TOTAL FEE: $598.00 Revised: 6/30/2010 ( �3 QY7 CITY OF CITY OF CUPERTINO ELM RE ROOF CUPERTINO PERMIT APPLICATION APN #�_`!) / � � � �> Date: -7 /Z-//o Building Address: 1060 WEST HILL CT. Owner's Name: +� W/,r II j) L 1 A Phone #: HOA: Yes ❑ NO408-446-4670 © If es, provide lel ter from HOA Contractor: Phone #: 916-830-3423 SEARS HOME IMPROVEMENT Fax #: 407-551-3085 Cupertino Business License #: Contractor License #: 721379 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles Xj Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ® Other (Specify) COMPOSITION SHINGLE Number of existing coverings ❑ Provide I.C.C.E.S. Report # ® To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: Reroof - Tear off 1 LAYER/ Re-sheet/Install Owens Corning Duration 30 Class A. 49.5 squares. 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: ❑ j applicable, include in plan set & the sheet index. Valuation: $22 , 612 . 00 I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: 01 i Si e Revised 02/05/09 M. ndoor Air Quality and Finishes 1.Use Low/No-VOC Paint 1 IAQ/Health pts y--yes D 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y--yes 7 0 3.Use LowMo VOC Adhesives 3 IAQ/Health pts y=yes D 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes D 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 6IAQ/Health pts y=yes 0 0 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 0 8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes D 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 0 1 1 N.Flooring 1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0 2.Use Rapidly Renewable Flooring Materials 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 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes D Total Points Available: 1401 130 57 Total Points Project Received:1 01 01 0 G:data/progs/gre:nbuilc inoguidelines/remodelers/greenpointsfinal2.12.04protected. W-2- Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 is Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: + - (,. PERMIT# 0- C--' --) OWNER'S NAME: �,�;.- L PHONE # d `J 6- 6 -70 GENERAL CONTRACTOR: 5 t.4&,1 C 'rN j>�.i,/ BUSINESS LICENSE# ADDRESS: 1 Zc kz PA-56 . cCITY/ZI PCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY [NSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SU CONT ACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. /� I am not using any subcontractors: Sig re Date Please check applicable subcontra to mplete the following information: 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 / L) /Contor Signat Date