10020109 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1161 S STELLING RD CONTRACTOR:QUALITY FIRST HOME PERMIT NO: 10020109
IMPROVEMENTS
OWNER'S NAME: WOODIE KERMIT D 6545 SUNRISE BLVD STE 202 DATE ISSUED:02/19/2010
JVNER'S PHONE: 4082526768 CITRUS HEIGHTS,CA 95610 PHONE NO:(916)788-2921
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL L1 COMMERCIAL
,� Lic.# R j57� RE-ROOF CLASS A 25 SQUARES REMOVE COMP AND
License Class �
REPLACE
Contractor Date `� '/'� /� WITH NEW 30YR COMP
1 hereby affirm that I am licensed under the provisions of Chapter 9
(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 declaration::
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:$15600
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:36222018.00 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 relatir g 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-lay, _ Date: [
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
i
RE-ROOFS:
Signature ."A_4�YIODate '� All roofs shall be inspected prior to any roofing material being installed.If a roof is
_ installed without first obtaini an inspection,I agree to remove all new materials for
inspection. , ')
❑ Date:
OWNER-BUILDER DECLARATION !`,
I hereby affirm that I am exempt from the Contractor's License Law for one ASignature of Applicant:4
the following two reasons: ALL RO COVERINGS TO BE CLA))-SS"A"OR BETTER
I,as owner of the property,or my employees with wages as their sole compensatic n,
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 tc 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 1
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,Section 5505,255,#3,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: - Date: _
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
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 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 relatii ig
to building construction,and hereby authorize representatives of this city to enter
,,non the above mentioned property for inspection purposes.(We)agree to save
'emnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION
..,sts,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-spurce regul 'ons per:the Cupertino Municipal Code,Section Licensed Professional
9.18. r j
'1 i
Signature,/'•" Date q- - O
Community Development
10300 Torre Avenue
is Cupertino CA 95014
Telephone(408)777-3228
,CITY OF Fax(408)777-3333
,UPEkTINO
Buildinjg De artment
JOB ADDRESS: .�� %o��! ERMIT #
R'S NAME: PHO # 24
GENERAL CONTRACTO ;,_T_L�� FAX#
I am not using any subcontractors: Zj,
Signature Date
Please check a licable subcontractors and co m lete 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
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36222018 . 00
DATE ISSUED. . . . . . . : 02/19/2010
RECEIPT #. . . . . . . . . : BE000009785
REFERENCE ID # . . . : 1CO20109
SITE ADDRESS . . . . . : 1161 S STELLING RD
SUBDIVISION . . . . . .
CITY CL PERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : WCODIE KERMIT D
ADDRESS . . . . . . . . . . : 1161 S STELLING RD
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5020
RECEIVED FROM . . . . : QLALITY FIRST HOME
CONTRACTOR . . . . . . . : GC ANDERSON LIC # 30398
COMPANY . . . . . . . . . . : QLALITY FIRST HOME IMPROVEMENT
ADDRESS . . . . . . . . . . : 6E45 SUNRISE BLVD STE 202
CITY/STATE/ZIP . . . : CITRUS HEIGHTS, CA 95610
TELEPHONE . . . . . . . . : (S16) 788-2921
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- - --------- ---------- ---------- ----------
1BCBSC VALUATION 15, 600 .00 1 . 00 0 .00 1. 00 0 . 00
1BSEISMICR VALUATION 15, 600 . 00 1 . 60 0 . 00 1 . 60 0. 00
1REROOFRES SQ FEET 25 . 00 325 . 00 0 . 00 325 . 00 0 . 00
- --------- ---------- ---------- ----------
TOTAL PERMIT 327. 60 0 . 00 327 . 60 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 327 . 60 1573
---------------
TOTAL RECEIPT 327. 60
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
I
CITY OF CUPERTINO
} , 4 RE ROOF
CUPEkT1NO PERMIT APPLICATION
i��'ZbID �
APN # `� J Dat
Buildi,�n ddress:
Owner's Name: Phone #:
2;y,fq✓i/ W(9010l �1_
HOA: Yes ❑ No�< If Yes, provide letter from HOA
Con actor: hone #:
lgwc/ :Ljp,,(oven" U1A7Fax #:
Cu ertino Bu iness License #: C ntractor License #:
—3-0 9 �7 lz=
Type of Ikoof 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#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
6j� f -A-
Job Description' '
e- c)FF cy-nd f&mocle
�� tarp fop la c C, w f �k "cc/ _50- y CcJ�y7 p
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:
/c
17 1
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
C ! .
S' a re �
Revised 02/05/09
CITY OF CUPERTINO
RER.00F
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
1REROOFRES Re-roof Residential B 1SFDWLR00F
I 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commissior; Fee
1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BCBSC Cal Bldg Stz.ndards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
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 appl ed without first obtaining all inspection
and written approval from the building inspector. A final inspection and
approval shall be obtained from the I uilding 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 Ci-y,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 na it inspection is required.
6. Any roofing which is applied withou: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: �L ,N
Job Site Address: / /��J
Roofing Company Name: . 1
,csv��
Applicant's Signature: Date: Ie?
Greg Casteel
Building Official
Revised 07/30/08
INPUT Resources .
M.Indoor Air Ouallity and Finishes
1.Use to~ P*t 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes i IAQ/Health pts y=yes 0
3.Use Lo0b,VOGAd)e*m 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 31AQ/Health pts y=yes 0
0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes
7.Seal All Cssdit idebaand.p rUDF 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 D
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0
N.Flooring
1.Select FSC Certified Wood Flooring E Resource pts y=yes 0
2.Use Ra*ty Renewable Flooring Materials 2 Resource pts y=yes 0
3.Use Recycled Content Ceramic Tiles z Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl i IAQ/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor Resource pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs Resource pts y=yes 0
Total Points Available: 1401 130 57
Total Points Project Received: 0 0 0
G:datalprogs/gree ibuildingguidelines/remodrs/greenpointsfinal2.12.D4proteoted.xls