09090138 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10375 CALVERT DRIVE CONTRACTOR:WINTER ROOFING PERNIIT NO:09090138
INC
'%%NER'S NAME: PAS 151 WAYANDOTTE DR DATE ISSUED:09/18/2009
UWNER'S PHONE: SAN JOSE, CA 95123 PHONE NO:(408)363-8052
LICE"SED CONTRACTOR'S DECLARATION
r` BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class C-35
Lic.# 7S?0q7
'.\\�� MECH RESIDENTIAL COMMERCIAL
Contractor W 9 A%f g t?)(W� q #a ate —l?'®
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: TEAR OFF INSTALL 1/2 OSB,30YR
(commencing with Section 7000)of Division 3 of the Business&Professions SHINGLES CLASS A
Code and that my license is in full force and effect.
1 hereby affirm under penalty of perjury one of the following two declarations:
1 have and will maintair.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:$5400
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:37517026.00 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 compiy 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, 2,� c
costs,and expenses which may accrue against said City in consequence of the Issued byK �. 1J ' \ Date:
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
��((' f'�r^ RE-ROOFS:
,mdora� \ Dat _V '`/ 7 All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
13 OWNER-BUILDER DECLARATION
Signature of Applicant" ate l �J
1 hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I,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,
Busin,ss&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). 1 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 1 use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contamina iftz 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 havC and will maintain. Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 2V05,2553 and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this �
Owner or authorized agent: Dat . 1t
permit is issued.
1 certify that in the performance of the work for which this permit is issued,I shall
not employ any person it 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,1 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.1 agree to comply with all city and county ordinances and state laws relating
binding construction,and hereby authorize representatives of this city to enter
.gin the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION
nri.mnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,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 source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature _ Date_ __
Community Development
- 10300 Torre Avenue
;f. Cupertino CA 95014
Telephone(408)777-3228
COW Fax(408)777-3333
-UPEkTINO
Buildin De artment
JOB ADDRESS: PERMIT #
i . Y1� i 7 O Oto/ 3�
OWNER'S NAME: a PHONE # �L ?- - '
GENERAL CONTRACTOR: FAX # _
I am not using any subcontractors: f,, Si ature Date
Please check applicable subcontract and complete 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
F 9
er/Co tractor Signature Date
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 37517026 .00
DATE ISSUED. . . . . . . : 09/18/2009
RECEIPT # . . . . . . . . . : BS000008720
REFERENCE ID # . . . : 09090138
SITE ADDRESS . . . . . : 10375 CALVERT DRIVE
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER PAS
ADDRESS 10375 CALVERT DRIVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM WINTER ROOFING
CONTRACTOR MARTINEZ, JAVIER LIC # 21207
COMPANY WINTER ROOFING INC
ADDRESS 151 WAYANDOTTE DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95123
TELEPHONE (408) 363-8052
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- -------
1BCBSC VALUATION 5,400 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1BSEISMICR VALUATION 5,400 . 00 0 . 60 0 . 00 0 .60 0 . 00
1REROOFRES SQ FEET 20 . 00 260 . 00 0 . 00 260 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 261 .60 0 . 00 261. 60 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 261 .60 me
---------------
TOTAL RECEIPT 261 . 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
1 REROOF
CUPE1�TiN0 PERMIT APPLICATION
bqbqb 13F-
APN # U Date:
�l 2 Co • OC.�
Building Address:
�0_:� r(IN"C—Alf
Owner's Name: AS Phone #:
HOA: Yes ❑ No If yes, provide letter from HOA
Contractor: Phone
Fax #: M Tj
2& 1
Cupertino Business License #: Contractor License #:
r
r
Type of Roof Covering:
Existing: Proposed:
Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles xd�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:
1-c-4 k oa 64Q�p !�Ze C-Cf-. I X-7 C) E6 i, �b 9 CA 4A5
Residential mmercial
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: 5 0 00
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 02/05/09
ati-,
CITY OF CUPERTINO
REROOF
CUPEkT]NO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
IREROOFCOM Re-roof Commercial B 1COMMLROOF
IBCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICO Seismic Commercial B
n i) 1 REROOFRES Re-roof Residential B 1SFDWLR00F
IBCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
IBSEISMICRE Seismic Residential B
I REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
IBCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
IBSEISMICRE Seismic Residential B
IBUSLIC 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 1997 UBC Standards
and manufacturers specifications on re-roofing.
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 1/4" 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: OQ
Job Site Address: fo
Roofing Company Name:
Applicant's Signatu Date:
Greg Casteel
Building Official
Revised 11/2/04
INPUT Resources Energy IACI,'Heafth
M.Indoor it Quality and finishes
1.Use Low/No-VOG Paint 1 IAQ/Health pts y=yes 0
2.Use Low VOID,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 D
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0
7.Seal all Exposed Particleboard or MDF 4 IAQ/Health pts y=yes 0
8.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 Whole House Vacuum System 3 IAQ/Health pts y=yes 0
1 1 1
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 0
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=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
1 i 1
Total Points Available: 1 1401 1301 57
Total Points Project Received: ' 01 0 -�
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