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09090142I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10167 S FOOTHILL BLVD I CONTRACTOR: BAKER ROOFING PERMIT NO: 09090142 OWNER'S NAME: JANG LONG WEO 2067 LA CON CT. I DATE ISSUED: 09/21/2009 ER'S PHONE: 4087258375 CAMPBELL, CA 95008 PHONE NO: (408)559-5105 I W LICENSED CONTRACTOR'S DECLARATION _3T License Class (/ Lic. # �� / �A Contractor r ',6 , r R,, -X ate l —2— i 1 hereby affirm that I am licensed under the rovisions 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. 1 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 permit is issued. APPLICANT CERTIFICATION 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 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. _ 1 Signature �— Date G OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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. 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 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 it iify and keep harmless the City of Cupertino against liabilities, judgments, C( . nd expenses which may accrue against said City in consequence of the 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. Signature Date BUILDING PERMIT INFO: BLDG F_ ELECT i PLUMB MECH T_ RESIDENTIAL f— COMMERCIAL I— JOB DESCRIPTION: RE -ROOF TEAR OFF AND PUT BACK 7/16 OSB SHEATING AND 30YEAR GAF ELK COMPOSITION SHINGLES CLASS A 30SQ; BAKER ROOFING RENEWD BUS LIC 9/21/2009 Sq. Ft Floor Area: I Valuation: $11700 APN Number: 34214118.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issuetlby�?-��..._---��`�` � Date: �y RE -ROOFS: 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. Signature of pplicant: --- Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should 1 use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Ow er or authorized _� / Date:_ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional 3 ITEMS OF 3 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 34214118.00 DATE ISSUED.......: 09/21/2009 RECEIPT #.........: BS000008722 REFERENCE ID # ...: 09090142 SITE ADDRESS .....: 10167 S FOOTHILL BLVD SUBDIVISION ...... CITY CUPERTINO IMPACT AREA ...... OWNER JANG LONG WEO ADDRESS 10167 S FOOTHILL BLVD CITY/STATE/ZIP ...: CUPERTINO CA, 95014 - OPERATOR: patg COPY # : 1 RECEIVED FROM ....: JAMES L BAKER CONTRACTOR .......: JAMES BAKER LIC # 25384 COMPANY ..........: BAKER ROOFING ADDRESS ..........: 2067 LA CON CT. CITY/STATE/ZIP ...: CAMPBELL, CA 95008 TELEPHONE ........: (408)559-5105 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ---------- ----------------------- 1BCBSC VALUATION ---------- 11,700.00 ---------- 1.00 ---------- 0.00 ---------- 1.00 0.00 1BSEISMICR VALUATION 11,700.00 1.20 0.00 1.20 0.00 1REROOFRES SQ FEET 33.00 429.00 0.00 429.00 0.00 ---------- TOTAL PERMIT ---------- 431.20 ---------- 0.00 ---------- 431.20 0.00 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT AMOUNT --------------- 431.20 --------------- 431.20 VOICE ID DESCRIPTION -------- ---------------------------- 601 ROOF TEAR OFF REFERENCE NUMBER -------------------- #672 VOICE ID DESCRIPTION -------- ---------------------------- 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: - I . /v ti �I Ioq PERMIT # CD OWNER'S NAME: a PHONE # L— 3 0 u 6 6 GENERAL CONTRACTOR: FAX # I am not using any subcontractors: t —),/ — I Signature Date Please check applicable subcontractors and complete the following information: Owner/ Contractor Signature Date 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 y CITY OF CUPEkTINO APN # �5gAi -C Building Address: Owner's Name: HOA: Yes ❑ No vJJ \n/ I CITY OF CUPERTINO REROOF PERMIT APPLICATION Istiq If ves, provide letter from HOA Contractor:r &R� K0af� Cupertino Business License #: Existing: ❑ Built -Up Roof ❑ Asphalt Shingles Wood Shakes ❑ Wood Shingles ❑ Other (Specify) 7Ntu Tber of existing coverings To be Removed — Type of Roof Covering: Date: 4r .— Phone #: Phone #: q O 3 5`04 1� 6 Fax #: ContraT� � nes 3 Proposed: ❑ Built -Up roof Asphalt Shingles ❑ Wood Shakes ❑ Wood Shingles �/► IL/Other (Specify) ❑ Provide I.C.C.E.S. Report # ❑ Provide Mfgr. Installation Specs. Job Description: Vp ci.,f, p _N- C, Residential Commercial Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, include in plan set & the sheet index. Valuation: 117 dO i Confirmed with Planning Dept. if there are any restrictions: I Have Read, Understand and Will Comply with Cupertino's Tear -Off Policy: Signature Revised 02/05/09 CITY OF CUPERTINO CITY OF REROOF CUPEkTINO FEE SCHEDULE Number of Squares Fee ID Fee Description Fee Group Permit Type 1REROOFCOM Re -roof Commercial B 1COMMLROOF IBCBSC Cal Bldg Standards Commission Fee Seismic Commercial Re -roof Residential Cal Bldg Standards Commission Fee Seismic Residential Re -roof Multi -Family Cal Bldg Standards Commission Fee Seismic Residential B B B B B B B B ALL PERMIT TYPES 1SFDWLROOF ALL PERMIT TYPES 1MFDWLROOF ALL PERMIT TYPES 1BSEISMICO 1REROOFRES ' IBCBSC / 1BSEISMICRE 1 REROOFMRES IBCBSC 1BSEISMICRE 1 BUSLIC I 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 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 insRection 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: v\ 1� oVA Woon rr h Job Site Address: I 6 -1 `C -o o + � ! (C + l r7l Roofing Company Name: P v �n Applicant's Signature: Dater Greg Casteel Building Official Revised 07/30/08 1. Use Low/No-VOC Paint 1 IAQ/Health pts y=yes 2. Use Low VOC, Water -Based Wood Finishes 2 IAQ/Health pts y=yes. 3. Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes 4. Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 5. Use Engineered Sheet Goods with no added Urea 4 Resource pts y=yes Formaldehyde 61AQ/Health pts y=yes 6. Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 7. Seat all E posed Par3icleboard or MDF 4 IAQ/Health pts y=yes 8. Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 9. Use Finger -Jointed or Recycled -Content Trim 1 Resource pts y=yes 10. Install Whole House Vacuum System 3 IAQ/Health pts y=yes N. Flooring 1. Select FSC Certified Wood Flooring 8 Resource pts y=yes 2. Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 3. Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 4. Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 5. Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 6. Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes Total Points Available: Total Points Project Received: 140 130 57 G:datalprogs/greenbuildingguidelines/remodelers/greenpointsfinal2.12.Mprotected.xls