10060089 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10122 ADELHEID CT CONTRACTOR:KEVIN SULLIVAN PERMIT NO: 10060089
ROOFING
_)WNER'S NAME: BROOKS FISHER 1696 VALLEY OAKS DR DATE ISSUED:06/15/2010
OWNER'S PHONE: 6509445430 GILROY,CA 95020 PHONE NO:(408)842-1057
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIAL0
License Class Lic.# ,!S RE-ROOF REMOVE EXISTING SHAKE ROOF AND
I � REPLACE
Contractor AT- 7v/r✓ Date ��// //<�' WITH 38 CLASS A SHAKE SYSTEM,W/72 ILB CAPSHEET
I hereby affirm that I am licensed under the provisions of Chapter 9 UNDERLAYMENT SQUARES
(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 declaratior s:
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:$20000
1 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:35709025.00 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 relat ng 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.
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 Issued by: Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. I ��
C' / Date 7 any r ROOFS:
natur � All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection gree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION 61111-
Signature of Applicant Date:
I hereby affirm that I am exempt from the Contractor's License Law for on of �
the following two reasons: ALL ROOF'COVE GS TO BE CLASS"A"OR BETTER
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 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 05, 5533 d 25534. /
Ir
Section 3700 of the Labor Code,for the performance of the work for which this ���rr` , Date: G^ 1
Owner or authorized agent: __7 7 G
permit is issued. /
I certify that in the performance of the work for which this permit is issued,I shill
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 inust 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 relaing
to building construction,and hereby authorize representatives of this city to enter
n the above mentioned property for inspection purposes.(We)agree to save
mnify and keep harmless the City of Cupertino against liabilities,judgment;, ARCHITECT'S DECLARATION
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
C
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE •CUPERTINO, GA 95014-3255
(408)777-3228- FAX(408)777-3333-buildina(WcuDertino.ora.
PROJECT ADDRESS / APN`#/J
101/?1�/a cl I yf� C J/y'/ f D
OWNER NAME PHON( E-MAIL �-
J
STREET ADDRESS //��G)� r�l 1��e/L,� /^ � I CITY, STA TE,ZIP /%<�C FAX
CONTRACTOR NAME LICENSE NUMBE't` G LICENPE� i BUS.LIC.#
COMPANY NAME t ( G(!L c(%) E-MAIL / / FAX J��
fC /S
STREET ADDRESS / CITY,STATE,ZIP "' PHONE ^-
Y e L �
I UNDERSTAND AND A 3REE 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)-/77-3228 between 7:30-3:30 (Mon-Fri).
3. Tear-off roof inspection is required. Please cell 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
Iinspection. 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 insp ection 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 withot:t first obtaining all inspections and written approvals
from the building inspector. Any roofing whic l 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 obtain'-d 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 I/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 mailing inspection and the work is not complete, you will
be charged a re-inspection fee of$126.00. Th.- re-inspection fee shall be paid before another
inspection can be scheduled.
.t By my signing below, I certify each of the following; is true: I am the property owner or authorized agent to act
ra 'bn the property owner's be lf. understand and agree to comply with the re-roof policy stated above.
Signature of Applicant/Age � /' Date: f 15Z 1", "
/ ReroofPolicy-2010.doc revised 05117110
Ct7Y of
13 CITY OI' CUPERTINO
REROOF
CUPERTINO FEE SiCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BCBSC Cal Bldg; Standards B ALL PERMIT TYPES
Commission Fee
IBSEISMICO Seismic Commercial B
1REROOFRES Re-roof Residential B 1SFDWLROOF
3
1BCBSC Cal Bldg; Standards B ALL PERMIT TYPES
Commission Fee
O 1BSEISMICRE Seismic Residential B
IREROOFMRES Re-roof Vlulti-Family B 1MFDWLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commis;ion Fee
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
M.Indoor Air Quality an Finishes
1.Use Low/No-VOC Paint 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0
3.Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes 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 y=yes 0
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 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 0
1 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 0
Total Points Available: 1 1401 1301 571
Total Points Project Received: 1 01 01 01
f
G:datalpro ga/gi enbui/gguidelineslrem elersl greenpointsfinal2.12.o4protected.xis
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPART v1ENT• BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINQ 10300 TORRE AVENUE-CUPERTINO, 0A 95014-3255
(408)777-3228•FAX(408)777-3333-buildina()..cuoetno.ora
PROTECT ADDRESS `) � "N# L
OWNER NAME `D ��--// //`AI`1 T PHOP E� GJ E-MMAIL
STREET ADDRESS I/�� ) r11 e / /C.� C f I CITY, ST ATE,ZIP 0`01'f J `�C FAX
CONTRACTOR NAME `(/ C _ / (//h LICENSE NUMBER .__ LIKENS TYPE BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP / °'> _ PHONE
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 and 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 reauired.
5. In-Progress roof inspection is required. Cad 1 for an in-progress roof inspection to verify building is
weather tight after installation of approximate ly 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 d awn 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 f6t owing items will be verified:
a. Flat roofs shall have a minimum of%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 plywooc.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.
13y my signing below, I certify each of the following is true: I am the property owner or authorized agent to act
on the property owner's beh If understand and agree to comply with the re-roof policy stated above.
Signature of Applicant/Ager ,.�f/ % /��__ Date: ETC--
i / t
ReroofPolicy_2010.doc revised 05117110
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: 1 Z,� C PERMIT# 00(.o (X)A--e7
OWNER'S NAME: L r,�� S ����, PHONE# -541:�%
GENERAL CONTRACTOR: BUSINESS LICENSE #
ADDRESS:',`l rf CITY/ZIPCODE: C-���� 6-/i
'Our municipal code requires all businesses working in 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 SUAC TRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
/_S �-�
- Xgnature ate
Please check applicable subcontraictors comp fete 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
0 wYA r Contractor Signature Date
To The City of Cupertino:
I, Mike Ryan, am the Chairman of the Architecture Committee for the Meadows HOA. I am
writing to let you know that the Architecture Committee and the Board of the Meadows HOA
have approved a shake roof replacement for th--residence owned by Brooks and Kim Fisher at
10122 Adelheid Court in Cupertino. Please le: me know if you have any questions.