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10010044 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10832 CARVER DR CONTRACTOR:CUPERTINO ROOF,INC PERMIT NO: 10010044 OWNER'S NAME: CHIN PAK 1052 KELLY DR DATE ISSUED:01/11/2010 iER'S PHONE: 4089960605 SAN JOSE,CA 95129 PHONE NO:(408)973-9427 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Cly C 3 4% Lic.# (=Qs� 431 MECH� RESIDENTIAL COMMERCIAL r Contractor ADate ) —11-0 I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OFF COMP INSTALL 30YEAR COMP 15 (commencing with Section 7000)of Division 3 of the Business&Professions POUND Code and that my license is in full force and effect. FELT 28SQ CLASS A 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:$7000 permit is issued. APPLICANT CERTIFICATION APN Number:37532002.00 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 alf^rion po urce regulations per the Cupertino Municipal Code,Section 9.18. � Issued by: c ., ��._ Dater---� ___[Signature Date + 1 ` �- 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 to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: ! I mate: I,as owner of the property,am exclusively contracting with licensed contractors to 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 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. I 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& 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. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants 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 maintain compliance with 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,Sections 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 Owe r utho ' ed agent: forthwith comply with such provisions or this permit shall be deemed revoked. Date: 0 CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby 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 for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save 'nnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address and expenses which may accrue against said City in consequence of the ...Ming of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all no Q- t source regulations per the Cupertino Municipal Code,Section 9.18. , I understand my plans shall be used as public records. Signature Date�'� 1 L Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 37532002 . 00 DATE ISSUED. . . . . . . : 01/11/2010 RECEIPT ## . . . . . . . . . : BS000009531 REFERENCE ID # . . . : 10010044 SITE ADDRESS . . . . . : 10832 CARVER DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER CHIN PAK ADDRESS . . . . . . . . . . : 10832 CARVER DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : DAVE SMITH CONTRACTOR . . . . . . . : DAVE SMITH LIC # 25701 COMPANY . . . . . . . . . . : CUPERTINO ROOF, INC ADDRESS . . . . . . . . . . : 1052 KELLY DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95129 TELEPHONE . . . . . . . . : (408) 973-9427 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 71000 . 00 1. 00 0 . 00 1 . 00 0. 00 1BSEISMICR VALUATION 7, 000 . 00 0 . 70 0 . 00 0 . 70 0 . 00 1REROOFRES SQ FEET 26 . 00 338 . 00 0 . 00 338 . 00 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT 339 . 70 0 . 00 339 . 70 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 339. 70 MC --------------- TOTAL RECEIPT 339 . 70 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF ' 1 aiA CITY OF CUPERTINO REROOF CUPSkTING PERMIT APPLICATION APN # -Y _ Date:?_5 2- J Building Address: 0 Q � �. Owner's Name: �� ' � Phone #: HOA: Yes ❑ - If yes, provide letter from HOA 9 9 Contractor: Phone #: 13 Fax #: Cupertino Business License #: Contractor License #: 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# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: � Q., &Q--1 C Residentia Commercial ❑ Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if J Green Building Checklist & attach it to the application or if there are any restrictions: El applicable, include in plan set & the sheet index. Valuation: `7 o o o I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09 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: Job Site Address: 7--- C V e Roofing ComP anY C L� � Applicant's Signature: ___...._, Date: Greg Casteel Building Official Revised 07/30/08 Green Building Plan Check Index of Green Building Points/Categories FA_. 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 • � t �. 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 POINTS 40 points Plan Review Process Work Book Page-12-Revised 3/25/08 Community Development 10300 Torre Avenue ;s Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 '4UPEkTINO Building Department JOB ADDRESS: PERMIT # ) D?"� S Z- (:::�0\--- V f 'gatl o 0 OWNER'S NAME: C" \vJ V R PHONE # G -- b L GENERAL CONTRACTOR: C v 4-r `'kaFAX# � b I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: F-a 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 1� -- Sheet Rock Tile Owner/Contractor Signature Date