10060100 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 750 TIPTOE LN CONTRACTOR:QUALITY FIRST HOME PERMIT NO: 10060100
IMPROVEMENTS
f .' NER'S NAME: CHANG KUO-CHIN AND LIN SHOW-HOW 654E SUNRISE BLVD STE 202 DATE ISSUED:06/16/2010
OvvNER'S PHONE: 4085824708 CITRUS HEIGHTS,CA 95610 PHONE NO:(916)788-2921
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F ELECT F PLUMB r—
License Class 1 Lic.# �J 7 /
MECH r- RESIDENTIAL COMMERCIAL �
Contractor Date —
I hereby affirm that I am licensed under the provisions of Chapter 9 J03 DESCRIPTION:REMOVE SHAKE ROOF,REPLACE WITH 1/2 OSB
DE(KING,
(commencing with Section 7000)of Division 3 of the Business&Professions 30)EAR HD COMP ROOF SHINGLES,37 SF,CLASS A
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 fpr w ich this Sq.Ft Floor Area: Valuation:$15000
permit is issued.
APPLICANT CERTIFICATION AP Q Number:35928008.00 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-points rce regu ations per PeCupe unicipal Code,Section
9.18. 1
l(� Iss aed Date: /Q
S' ture ate
❑ 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 t any roofin materia mg inst led.If a roof is
the following two reasons: ins ailed without first obtaining nspection agr o remove new materials for
1,as owner of the property,or my employees with wages as their sole compensation, ins)ection.
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Sig nature of Applicant: ate:
1,as owner of the property,am exclusively contracting with licensed contractors to — I
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
i
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. 1 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&
Sa 5ety Code,Section 25532(x)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this Ac ditionally,should I use equipment or devices which emit hazardous air
permit is issued. co rtaminants 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 in:intain compliance witD 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, ections 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 vne r a agent:
ate:6✓
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is I h ereby 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 foi which this permit is issued(Sec.3097,Civ C.)
to hnilding construction,and hereby authorize representatives of this city to enter L<rider's Name
he above mentioned property for inspection purposes.(We)agree to save
ii.....nnify and keep harmless the City of Cupertino against liabilities,judgments, L4 rider'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. 11 nderstand my plans shall be used as public records.
Signature Date Licensed Professional
CITY OF CUPE,RTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: TraciC
COPY # : 1
Sec: Twp: Rng: Sub: Blk: Lost:
APN 35928008 .00
DATE ISSUED. . . . . . . : 06/16/2010
RECEIPT #. . . . . . . . . BSOOOOL0646
REFERENCE ID # 100601 )0
SITE ADDRESS 7503 TIPTOE LN
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER CHANG KUO-CHIN AND LIN SHOW-HO
ADDRESS 7503 TIPTOE LN
CITY/STATE/ZIP CUPERTINO, CA 95014
RECEIVED FROM QUALITY FIRST HOME
CONTRACTOR . . : GC ANLERSON LIC # 30398
COMPANY QUALITY FIRST HOME IMPROVEMENT
ADDRESS 6545 SUNRISE BLVD STE 202
CITY/STATE/ZIP CITRUS HEIGHTS, CA 95610
TELEPHONE (916) 788-2921
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC --NEW-BAL-
----
---------- -------------
----------
1BCBSC VALUATION 15, 000 .00 1.00 0. 00 1 .00 0 . 0
1BSEISMICR VALUATION 15, 000 .00 1.50 0.00 1 .50 0 . 00
1REROOFRES SQ FEET 37 .00 481.00 0.00 481 .00 -------
---- ------ ---------- ----------
TOTAL PERMIT : 483 .50 0 .00 483 .50 0. 00
METHOD OF PAYMENT AMOUNT----- REFERENCE NUMBER
_____ ---------- - -------------------
CHECK
483 .50 1764
---------------
TOTAL RECEIPT 483 .50
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
_ ------ ---------------------------
--
-- ----------
___
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
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: C7 �U� PERMIT# d 6 1
OWNER'S NAME: G G PHONE# '" �
GENERAL CONTRACTOR: U �' BUSINESS LICENSE#
ADDRESS: /�,el p. CITY/ZIPCODE: S6/D
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY SUBCONTRAC'�'ORS ION(S) WILL BE SCHEDULED
HAVE OBTAINED ACIY O
GUNTIL THE
ENERAL CONTRACTOR AND A CUPERTINO
BUSINESS LICENSE. /,::�'_f 4�'_lv
I am not using any subcontractors: _. Date
Signature
Please check applicable subcontractors and complete i he 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
Owner/Contractor Signature Date
CITY OF CUFERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 1503 tip toe lane D,�TE: 06/16/2010 REVIEWED BY: building
APN: BP#: "•, !' C' � r G (� *VALUATION: $15,000
`PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY TOTAL �=3,700 S.f. APPLICATIONUSE: SFD or Duplex ROOFAREA: TYPE:
x w
as
00
3 �
FEE ID
1 REROOFFF ES
P ,.-1
77
NOTE. These fees are based on the preliminary information avails ble and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 0I-051 F;f�' 7;'l%0.9) FEE QTY/FEE
MISC ITEMS
Permit Fee: $481.00 F- 1
f,
Work Without Permit? Q Yes (F) No $0.0C
Strom Motion Fee: IBSEISMICR $1.5(1 Select an Administrative Item _..-
Bld,T Stds Commission Fee: IBCBSC $1.0(1
SUBTOTALS: $483.51) $0.00 TOTAL FEE: $483.50
Revised: 5/2712010
CITY OF
CITY OF CUPERTINO
[0REROOF
CUPERTINO PERMIT APP]LJICATION
APN # Date:
Building Address
j5.3'
Owner's Name: C� { �f C tC Phone #:
vide letter from HOA
HOA: Yes F71 No If es, ro Phone #:
Contractor:
Fax#: fel�o
Cupertino Business License #: Contractor License #:
X375772
Type of Roof Covering:
Existing: :?roposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles � Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) o Other (Specify)
Number of existing coverings / ❑ Provide I.C.C.E.S. Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: _ wl*S-6 �t:7�(1410 2
3-7 jpj Lt_,ett;c
2)Oy
Residential Commercial
Green Building: Please complete relevant portio i of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the appItation or if there are any restrictions:
applicable, include in plan set & the sheet index.
Valuation:
I Have ead, Understa d and Will mp y with Cupertino's Tear-Off Policy:
Siature
Revised 02/05/09
CITY of
CITY OF CUPERTINO
REROOF
CUPE RT INO FEE SCHEDULE
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
1BSEISMICO Seismic Commercial B
✓� 1RER00FRES Re-roof Residential B 1SFDWLR00F
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Residential B
1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISN UCRE Seismic Res:dential B
1BUSLIC Business License B
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDHG OFFICIAL
10300 TORRE AVENUE•CUPERTINO, CP 95014-3255
CUPERTINO
(408)777-3228• FAX(408)777-3333•buikling(cDcupertino.org
PROJECT ADDRESS SC3 ''�� C �--/V ,• APN#
OWNER NAME �
G� 7
PH ��- ��� _� 0 E-MAIL
STREET ADDRE �3 CITY, '-IP FAX
f
COM -OR LICE _ LISEs BUS.LIC.rJ5
y�ni 7C-7
COMPANYEE E-MAIL #
FAX
STREET ADDRESS / �'�C Q f .S CITY/STA`T 1P j Q PHO��.y.>e G,�,�(/
��({ I UNDERSTAND AND AGREE TO THE FOLLOWING:
I. 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 ,Ill dry-rotted wood shall be replaced prior to this
inspection. A building inspector will be available w ithin 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 250//0 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 tc 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 foot of slope and must demonstrate there is no ponding.
b. Listings from approved testing agencies for all ire-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 ach of the following is tru--: I am the property owner or authorized agent to act
on the property owner's be al I u ders d and agree o c mply with the re-roof policy stated
labove.
Signature of Applicant/Agent: Date:
ReroofPolicy_201 0.doc revised 05/17/10
INPUT Resources Energy •L
Indoor Air Quality andtrashes
1.Use Low/No-VOC Paint 1 IMI Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAC,Health pts y=yes. 0
3.Use Low/No VOC Adhesives 3 M,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 6 IAQ Health pts y=yes 0
6.Use Exterior Grade Plywoodfor Interior Uses 1 IAQ'Health pts y=yes 0
7.Seal all Exposed Particleboard or MDF 4 IAC/Health pts y=yes 0
S.Use FSC Certified Materials for Interior Finish 4 Re.,ource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Re;source pts y=yes 0
10.Install Whole House Vacuum System 3 IAO /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 Res wrce pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Res)urce pts y--yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAC/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Res wrce pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
1 1 !
Total Points Available: 140 130 57
Total Points Project Received: 0 0 0
G:data/progs/greenbuilc noguidelines/remodelers/greenpointsfinal2.12.04protected.xls