09120015 (2) CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7820 CREEKLINE DR CONTRACTOR:R E ROOFING& PERMIT NO:09120015
CONSTRUCTION INC
'TIER'S NAME: LEE SHANNON P AND SUSAN B 15230 CLYDELLE AVE DATE ISSUED: 12/02/2009
u,vNER'S PHONE: 4082553556 SAN JOSE,CA 95032 PHONE NO:(408)626-9320
❑ LICENSED CONTRACTOR'S DECLARATIONI—
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License s ` Lic.#
�� / �� 10 MECH RESIDENTIAL COMMERCIAL
ContraFtor `-� Date
I hereby-affrrni tltut-1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF REMOVE EXISTING 1 LAYER OF ROOF,
INSTALL
(commencing with Section 7000)of Division 3 of the Business&Professions NEW 30#FELT&LIGHTWEIGHT TILE CLASS A 31 SQ
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 for which this Sq.Ft Floor Area: Valuation:$15000
permit is issued.
APPLICANT CERTIFICATION APN Number:36217040.00 Occupancy Type:
1 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 i 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 DA S FROM LAS CALLED INSPECTION.
with all-n - oint source regulations per the Cupertino Municipal Code,Section
9.18 _ t` �/Y�� IL 4^4
( l�� Z`0� Issued by: gate:
Date
❑ OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shaHbe inspected prior to any roofing material being installed.If a roof is
the following two reasons: alled withou 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. / Y� t
will do the work,and the structure is not intended or offered for sale(Sec.7044, '\' ( Z
Signature of A/\ nt: Date: `Z U
Business&Professions Code)
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 Healt &Saf Code,Sections 25505,25533,and 25534.
Compensation laws of California. If,after making this certificate of exempt' f
become subject to the Worker's Compensation provisions of the Labor C de,Pilus r>z a 2 II 0
forthwith comply with such provisions or this permit shall be deemed re-4ok4. Date:_
--- 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
he above mentioned property for inspection purposes.(We)agree to save
nify and keep harmless the City of Cupertino against liabilities,judgments, Lender'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
W, - t source regulat* er the Cupertino Municipal Code,Section
1 g ?_
I understand my plans shall be used as public records.
_
Signatu to U Licensed Professional
ITY F ERTIN
C O CUP O
RE,ROOF
CUPEkT1NO PERMIT APPLICATION
APN # // � 6 Q�) Date:
Building Address:
1 �20 �FA,,_C�S;6r-F* 1 ?0\/�
Owner's Name: SMWN�
L�/ Phone #:
HOA: Yes4 4 2 ��i — 3
❑ No If es provide letter from HOA
Contractor: Phone #: �
� ��� l N� � � o"Ir�9,1.0--"(1 �� ►"�- Fax #: (�Z
Cupertino Business License #: 2—0( Contractor License #:
l� -7 2
Type of hoof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
Asphalt Shingles ❑ Asphalt Shingles MnN
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) 'W Other (Specify) LlO<"wL1q1fT
Number of existing coverings ❑ Provide I.C.C.E.S. Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: J -� k4 KL
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
J 1 iS
I Have Read, QRdef, tand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 02/05/09
CITY OF C UPERTINO
a�l_ REROOF
CUPEkT]NO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Coinmercial B 1COMMLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commissio l Fee
1BSEISMICO Seismic Commercial B
3 1RER00FRES Re-roof Residential B 1SFDWLR00F
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commissio a Fee
1 BSEISMICRE Seismic Re 3idential B
1 REROOFMRES Re-roof Whi-Family B 1MFDWLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Re3idential 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 applied without first obtaining all inspection
and written approval from the building inspector. A final inspection and
approval shall be obtained from the b wilding inspector when the re-roofing
is completed.
3. All roofs shall be inspected prior to arty 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: � ti =�
Job Site Address: 20 .
Roofing Company Name:
Applicant's signature: �`—�---- Date: } v�
Greg Casteel _..
Building Official
Revised 07/30/08
M.Indoor Air ua ity and Finishes
1.Use Low1No-VOC P&4 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0
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 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQ/Health pts y=yes 0
0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes
7.Seal all wed PAMdepoarpl-car WF 4 IAQ/Health pts y=yes 0
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 IAQ/Health pts y=yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 3 Resource pts y=yes 0
2.Use Rapidly Renewable Flooring Materials 1 Resource-.pts y=yes 0
3.Use Recycled Content Ceramic Tiles 1 Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 1 Resource pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs 1 Resource pts y=yes 0
. 1 1 old
Total Points Available: 1 1401 1301 57
Total Points Project Received: 01 0 0
G:datalproaslgrembuildingguidelines/remodel ers/greenpointsfinal2.12.o4protected.xis