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09090029 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10804 ALDERBROOK LN CONTRACTOR:MAXIMUM ROOF PERMIT NO:09090029 CARE CORP uNER'S NAME: CHIA CHUN CHENG 423 QUEENS LN DATE ISSUED:09/04/2009 OWNER'S PHONE: 4082531294 SAN JOSE,CA 95112 PHONE NO:(408)441-0933 LICENSED CONTRACTOR'S DECLARATION r BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class- 3 Lic.# S5_6 qZi 4 MECH RESIDENT COMMERCIAL Contractor I hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION: TEAR OFF SHAKE ADD 1/2" OSB 30 ILB (commencing with Section 7000)of Division 3 of the Business&Professions FELT, GAF Code and that my license is in full force and effect. TIMBERLINE 40YR SHINGLE CLASS A 27 SQUARES I hereby affirm under penalty of perjury one of the following two declarations: 1 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:$9634 1 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:36920040.00 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. t 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, 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 by " --��� .ie: (� with all non-point ource regulations per the Cupertino Municipal Code,Section 9.18. c1 -�� RE-ROOFS: uture �` Date __L All roots shall be inspected prior to any roofing material being installed. if a roof is fi+7 nw.4 installed without first obtaining inspection,1 agree to remove all new materials for inspection. U OWNER-BUILDER DECLARATION t Signature of Applicant/ Date: / ��-1- I hereby affirm that 1 am exempt from the Contractor's License Law for one of —7 the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,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) 1,as owner of the property,am exclusively contracting with licensed contractors to 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. 1 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 1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections Z5505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this agent f� ate: permit is issued Owner or authorized Date: ILI__U 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 relating 'luilding construction,and hereby authorize representatives of this city to enter ,me above mentioned property for inspection purposes.(We)agree to save ,__ ,cmnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of th-. 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. Signature Date_[ " �.j,tTllHry aelo-1-1 CITY OF CUPERTINO REROOF CUPEkTINO PERMIT APPLICATION APN # Date: Building Address: Owner's Name: �� ;� ��Gh � Phone #: HOA: Yes ❑ No If yes, provide letter from HOA Contractor: Phone #: tf6f- b,�_ Fax #: Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: Proposed: • Built-Up Roof ❑ Built-Up roof • Asphalt Shingles )( Asphalt Shingles �C Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles �-- ❑ Other (Specify) )( Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report # LK To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: - 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: �C3 I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09 i CITY OF CUPERTINO REROOF CUPEkT]NO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM I Re-roof Commercial I B 1COMMLROOF 1BCBSC I Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICO Seismic Commercial I B 1REROOFRES I Re-roof Residential B 1SFDWLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE I Seismic Residential B 1 REROOFMRES I Re-roof Multi-Family I B I 1MFDWLROOF 1BCBSC I Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36920040 . 00 DATE ISSUED. . . . . . . : 09/04/2009 RECEIPT #. . . . . . . . . : BS000008613 REFERENCE ID # . . . : 09090029 SITE ADDRESS . . . . . : 10804 ALDERBROOK LN SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : CHIA CHUN CHENG ADDRESS . . . . . . . . . . : 10804 ALDERBROOK LANE CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4606 RECEIVED FROM . . . . : MAXIMUM ROOF CARE CONTRACTOR . . . . . . . : STEVE HUNTER LIC # 22369 COMPANY . . . . . . . . . . : MAXIMUM ROOF CARE CORP ADDRESS . . . . . . . . . . : 423 QUEENS LN CITY/STATE/ZIP . . . : SAN JOSE, CA 95112 TELEPHONE . . . . . . . . : (408) 441-0933 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 9, 634 . 00 1 . 00 0 . 00 1. 00 0 . 00 1BSEISMICR VALUATION 9, 634 . 00 1 . 00 0. 00 1. 00 0 . 00 1REROOFRES SQ FEET 27. 00 351 . 00 0. 00 351 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 353 . 00 0 . 00 353 . 00 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 353 . 00 AE --------------- TOTAL RECEIPT 353 .00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF 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 vaid 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: �- \_�e\ , Job Site Address: Roofing Company Name: h Applicant's Signature: 1 Date:' Greg Casteel Building Official Revised.07/30/08 M.Indoor Air Quality and Finishes 1.Use t_ow/No-V©C Paint 1 IAO/Health pts y=yes I D 2.Use Low VOC,`relater-Based Wood Finishes 2 IAOJHealth pts y=yes f D 3.Use Low/No VOC Adhesives 3 IAQ/Health pts y--yes( D 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y--yes i D 5.Use Engineered Sheet Goods with no added Ursa Formaldehyde 6IAQ/HeaJth pts y--yesi D 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes D 7.S"a l ;� ealolebe or K F 41AQ/Health. i)ts v=vesi_ 0 B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes D 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0 10.Install Vdhola House Vacuum System 3 IA011-lealth pts y=yes 0 � t o N.Flooring 1.Select FSC Certified Wood Flooring 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=yesi 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yesi 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y--yes 0 � P i Total Points Available: 1 1401 1301 571 Total Points Project Received: _� 01 01 01 G:datalprogslgreenbuildingguidelineslrzmodele rs/greenpointsfina1212.D4profeoted.xls