Loading...
10040176 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22044 CREEKSIDE CT CONTRACTOR:SHADOWFAX ROOFING PERMIT NO: 10040176 ^WNER'S NAME: ROBERT MIDDLETON& MARY L 1366 SANTA FE DR DATE ISSUED:04/30/2010 _vVNER'S PHONE: 4082550620 SAN JOSE,CA 95118 PHONE NO:(408)265-2490 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL elZ 7 RE-ROOF REMOVE WOOD SHAKE,COVER STRUCTURE License Class C"3 Lic.# -- W/7/16 Contractor AOO& Datecid/1� OSB FELT NEW FLASHING AND NEW COMP CLASS A 35 I hereby affirm that I am licensed under the provision"Ch er 9 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 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. Sq.Ft Floor Area: Valuation:$18000 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 APN Number:32639042.00 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 relating 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, c�`�- costs,and expenses which may accrue against said City in consequence of the Issued by:, Date: granting of this permit. Additionally,the applicant understands and will comply , /`'^ with all non-p ' source regulatio per the Cupertino Municipal Code,Section 9.18. �i RE-ROOFS: '-ignatur Date C 3� p 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. ❑ OWNER-BUILDER DECLARATION Date: Signature of Applicant: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,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) HAZARDOUS MATERIALS DISCLOSURE I,as owner of the property,am exclusively contracting with licensed contractors to 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 C tin Mu ipal Code,Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Secti 505,2553 d 25 34. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: 3d?O 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 CONSTRUCTION LENDING AGENCY 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 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 relating to building construction,and hereby authorize representatives of this city to enter -ion the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION ,emnify and keep harmless the City of Cupertino against liabilities,judgments, posts,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. ,L--,oi Signature Date 3v REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT- 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-building(a�cugertino.org PROJECT ADDRESS ✓ APN N OWNER NAME PHO � ZE-MAIL 444W1r___ 6`1 STREET ADDRESS s • CITY, STATE,ZIP/f FAX CONTRACTOR NAM�A_A71 s LICE E NUMBER LICENSE TYPE BUS.LIC.N AX COMPANY NAME f� E-MAIL �d S STREET ADDRESS CITY TE,ZIP Vr & 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. An inspection request shall be scheduled the day before the inspection date. Please call (408)777- 3228 between 7:30 - 3:30pm (Mon-Fri) to schedule the next day inspection. 1. After the roof is torn off and the nails/fasteners have been removed and all the dry-rotted wood has been replaced, you must call for a roof inspection. A building inspector will be available with one hour. There are special hours for the 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. New roof coverings shall not be applied without first obtaining all inspection 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 to the sheathing so a proper inspection can be performed. 6. A final inspection and approval shall be obtained from the building inspector when the re-roofing is completed. To receive a final sign-off, the following item will be verified: a. Flat roofs shall have a minimum of 1/" per foot of slope and demonstrate there is no ponding. b. A listing from an approved testing agency shall be available on-site to review at the time of the . inspection. c. Proper spark arrestor installation. 7. NOTE: If you call for a plywood nailing inspection and the job is not ready, you will be charged to a re- inspection fee of$126.00. The re-inspection fee shall be paid before another inspection can be scheduled. y my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's beh understand gree to omply with the re-roof policy stated abov Signature of Applicant/Agen: �� Date: ! ReroofPolicy_2010.doc revised 04/14110 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 112 Telephone: 408-777-3228 C U P E RTI N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: O PERMIT# 42 OWNER'S NAME: PHONE# f —0 GENERAL CONTRACTOR: 5+r�� BUSINESS LICENSE# ADDRESS: 1,366 CITY/ZIPCODE: S/ g *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 SUB TRACTO HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Dat Please check applicable subcontractors and complete 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 oofing Septic Tank Sheet Metal Sheet Rock Tile 3rd mold Owner ontractor Signature Date CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 32639042 . 00 DATE ISSUED. . . . . . . : 04/30/2010 RECEIPT # . . . . . . . . . BS000010291 REFERENCE ID # 10040176 SITE ADDRESS 22044 CREEKSIDE CT SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER ROBERT MIDDLETON & MARY L ADDRESS 22044 CREEKSIDE CT CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1103 RECEIVED FROM JERRY SHAFFER CONTRACTOR JERRY SHAFFER LIC # 27342 COMPANY SHADOWFAX ROOFING ADDRESS 1366 SANTA FE DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95118 TELEPHONE (408) 265-2490 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ------- 1BCBSC VALUATION 18, 000 . 00 1. 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 18, 000 . 00 1 . 80 0 .00 1 . 80 0 . 00 1REROOFRES SQ FEET 35 .00 455 . 00 0 . 00 455 . 00 - ----0 . 00 ---------- ---------- ---------- TOTAL PERMIT 457 . 80 0 .00 457 . 80 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- ------------- CREDIT CARD 457 . 80 me --------------- TOTAL RECEIPT 457. 80 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- -- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF Green Building Plan Check Index of Green Building Points/Categories A. Category Example of an Index or Table of Green Plan Sheet or Page Points Building Points Categories that must be shown and referenced on the Project Plans See below WNr . _ r .. .tl. .. ... .. .. .. B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 2 points 11. Permeable Paving, Note L-1 2 points C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 points D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 points 5. Use Truss with heels, (detail) S-2 2 points 6. B. OSB Sheathing, detail S-2 2 points E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points 4. B. Fiber Cement Siding, (Note/Spec. A-4 2 points F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 points 5. Tankless W.H., (Note/Spec.) A-2 2 points 11. A 2500 Gal.Tank, (Note/Spec L-1 10 points G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 points H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point 3. Energy Star Refrigerator, (Note/Spec. A-3 1 oint P. Other 1. List Green Features on Plans A-1 1 point TOTAL POINTS1 40 points Plan Review Process Work Book Page-12-Revised 3/25/08 M.Indoor Air Quality and Finishes 1.Use Low/Na-V©C Paint 1 IAOJHealth pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAD/Health pts y=yes D 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 D 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 6IAOJHealth pts y=yes D 6.Use Exterior Grade PlytVood for Interior Uses 1 IAO/Health pts y=yes 0 7.Seal al Ei ad Patbialzard Qr MDF 4 IAQ/Healih pts y= es _- D 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 IAQ1Health pts y=yes 0 1 1 1 N.Flooring 1.Select FSC Certified Wood Fiooring 8 Resource pts y=yes 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 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 S.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 1 1 1 Total Points Available: 1401 130 57 Total Points Project Received: 01 01 0 G:data/progslgreenbuildingguidelines/ramodelerslgreenpointsfina1212.D4protected.xls CITY OF CITY OF CUPERTINO REROOF CUPERTINO PERMIT APPLICATION Date: APN# Building Address: 17740 Owner's Name: / / ��� Phone #: HOA: Yes ❑ No If es, provide letter from HOA Contractor: Phone #: Fax#: Cupertino Business License #: Contractor License #: y a Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles >< Asphalt Shingles X__ ood 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: 4,�ISG �o'�`� .�1�•.�r C'fr.�c, J�T/e:�c%lk�'G � ��b^a�S.� f c't� 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: applicable, include in plan set & the sheet index. Valuation: I Have Read, Unders and and Will Comply with Cupertino's Tear-Off Policy: Si 4ature Revised 02/05/09