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10030028 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21426 AMULET DR CONTRACTOR:R E ROOFING& PERMIT NO: 10030028 CONSTRUCTION INC ,WNER'S NAME: SUSAN S AND ROBERT E SLAVIK 15230 CLYDELLE AVE DATE ISSUED:03/03/2010 _ .VNER'S PHONE: 4087359720 SAN JOSE,CA 95032 PHONE NO:(408)626-9320 Fontrad;to CENSED CONTRACTOR'S 'D"ECLAR TION BUILDING PERMIT INFO: BLDG ELECT PLUMB - Lic.# + 2 ` MECH RESIDENTIAL COMMERCIAL Date I hereby affirm that am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF REMOVE EXISTING 1 LAYER OF SHAKE, INSTALL (commencing with Section 7000)of Division 3 of the Business&Professions NEW 1/2"CDX,30#FELT&LIFETIME COMP CLASS A Code and that my license is in full force and effect. 36SQ 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:$17000 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:32643015.00 Occupancy Type: 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the granting,of 's permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all nor ' t so egulations he Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION. ---._ SiQnatur ' Date t• Issued b Date: –�d o — ❑ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS: the following two reasons: All roofs hall-beiuspected prior to any roofing material being installed.If a roof is 1,as owner of the property,or my employees with wages as their sole compensation, inst d without first tainin an4 ction.L ree to remove all new materials for will do the work,and the structure is not intended or offered for sale(Sec.7044, ins ection. ( :, Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to Signa re of Applic t Date: construct the project(Sec.7044,Business&Professions Code). X �� ALL ROOF COVERINGS TO BE CLASS" "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 performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain 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. permit is issued. Additionally,should I use equipment or devices which emit hazardous air I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Compensation laws of California. If,after making this certificate of exemption,I Hgalth&Safe, Codes Se tions 25505,25533,and 25534. become subject to the Worker's Compensation provisions of the Labor Code,I rrufst t forthwith comply with such provisions or this permit shall be deemed revoked. ( Ow o rz a P Y P P Dater APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby a correct.I agree to comply with all city and county ordinances and state laws relating affirm that there is a construction lending agency for the performance of work's to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.) i,n the above mentioned property for inspection purposes.(We)agree to save Lender's Name nify and keep harmless the City of Cupertino against liabilities,judgments, d expenses which may accrue against said City in consequence of the Lender's Address jranting this permit.Additionally,the applicant understands and will comply with all no -point s(z ce regulations r the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION 9.18. (1. ��3 I understand my plans shall be used as public records. Si Date Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32643015 . 00 DATE ISSUED. . . . . . . : 03/03/2010 RECEIPT #. . . . . . . . . BS000009871 REFERENCE ID # . . . : 10030028 SITE ADDRESS 21426 AMULET DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER SUSAN S AND ROBERT E SLAVIK ADDRESS 21426 AMULET DR CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-1301 RECEIVED FROM . . . . : R E ROOFING & CONST CONTRACTOR PROCTOR, PAUL LIC # 20615 COMPANY . . . . . . . . . . : R E ROOFING & CONSTRUCTION INC ADDRESS 15230 CLYDELLE AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95032 TELEPHONE (408) 626-9320 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ----- 1BCBSC VALUATION 17, 000 . 00 1. 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 17, 000 .00 1 . 70 0 .00 1 . 70 0 . 00 1REROOFRES SQ FEET 36 . 00 468 . 00 0 . 00 468 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 470 .70 0 . 00 470 .70 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 470 . 70 #2124 --------------- TOTAL RECEIPT 470 . 70 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ----------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CUPERTINO REROOF CUPEkTINO PERMIT APPLICATION APN # Date: l 10 Building Address: ' /� M Lk uo' INZ � 1 Owner's Name: U 1,AV � K Phone #: HOA: Yes ❑ No If yes, provide letter from HOA �0 � -1 5�- 9 Contractor:. co�j Phone#qo�_ ( Zjo_ q j 2- Fax Fax #: qo j_ 6 Cupertino Business License #: 2u� / - Contractor License #: `? 7 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Asphalt Shingles Wood Shakes ❑ Wood Shakes Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report# i To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: a �T (u�- ac 0V Residential ommercial ❑ 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--IZeacT;-U dersta1 Compl ith Cupertino's Tear-Off Policy: Signa�txre Revised 02/05/09 CITY OF CUPERTINO ! `J REROOF CITY OF CUPERTINO 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 1 REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B 1 BUSLIC Business License B 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 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 point 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 Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 Fax: (408)777-3333 Building Department Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must agree to comply with 2007 IBC Standards and manufacturers specifications on re-roofing.All roofs are Class "A"per Cupertino municipal code 16.04.080. 2. New roof coverings shall not be applied without first obtaining all inspection and written approval from the building inspector. A final inspection and approval shall be obtained from the building inspector when the re-roofing is completed. 3. All roofs shall be inspected prior to any roofing installation. 4. To receive a final sign off from the City,the following steps are required: 1) Pre-inspection and/or tear off approval. 2) In-progress inspection approval. 3) Final inspection approval. a) Spark arrester installation. 5. If plywood is installed,a plywood nail inspection is required. 6. Any roofing which is applied without first obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of$176.18. The re-inspection fee must be paid before another inspection can be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of 1/ "per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O. report is required to be on the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: _5u G �L A V ( K Job Site Address: 2-1 +Z AM L� Lef , Roofing Company Mame: ` z -0►") Applicant's Signature: -i Date Greg Casteel Building Official Revised 07/30/08