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09090105 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7648 KIRWIN LN CONTRACTOR:PRECISION REMODELING PERMIT NO:09090105 OWNER'S NAME: DIERKS FRANKLIN AND KATHLEEN A 1214 SIERRA MAR DR DATE ISSUED:09/15/2009 4ER'S PHONE: 5505912727 SAN JOSE,CA 95118 PHONE NO:(408)924-0484 LICENSED CONTRACTOR'S DECLARATION F BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# F MECH RESIDENTIAL COMMERCIAL Contractor ate 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF REMOVE EXISTING SHAKE ROOFING (commencing with Section 7000)of Division 3 of the Business&Professions INSTALL OSB Code and that my license is in full force and effect. BOARDS,INSTALL NEW 50YEAR COMPOSITION SHINGLES CLASS A 25SQ;PRECISION REMODELING RENWD BUS LIC 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. 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:$10500 permit is issued. APPLICANT CERTIFICATION APN Number:35922012.00 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 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 all non-point source regulations per the Cupertino Municipal Code,Section 9.18. / �j Issued�i . . - Date: S%�,/ Signature_ A Date LJ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that 1 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 agr _ to remove all new materials for 1,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: ' Date: 1,as owner of the property,am exclusively contracting with licensed contractors to constrict 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: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE 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. permit is issued. Additionally,should I use equipment or devices which emit hazardous air 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 O er or thorized agent: / forthwith comply with such provisions or this permit shall be deemed revoked. � /�� Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a constriction 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 -mnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address .,s,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 ARCHITECT'S DECLARATION 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 35922012 . 00 DATE ISSUED. . . . . . . : 09/15/2009 RECEIPT #. . . . . . . . . BS000008680 REFERENCE ID # . . • 09090105 SITE ADDRESS 7648 KIRWIN LN SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . . OWNER DIERKS FRANKLIN AND KATHLEEN A ADDRESS 7648 KIRWIN LN CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4357 RECEIVED FROM . . . . : REZA BANIKAZEMI CONTRACTOR RAY BANI LIC # 23736 COMPANY PRECISION REMODELING ADDRESS 1214 SIERRA MAR DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95118 TELEPHONE (408) 924-0484 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 10, 500 . 00 1 .00 0. 00 1. 00 0 . 00 1BSEISMICR VALUATION 10, 500. 00 1 .10 0 . 00 1 . 10 0 . 00 1REROOFRES SQ FEET 25 . 00 325 . 00 0 .00 325 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 327 .10 0 . 00 327 . 10 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 327 .10 MC --------------- TOTAL RECEIPT 327 . 10 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CUPERTINO U tT` REROOF CUPERTINO PERMIT APPLICATION APN # q t,;2 Date:� C( v Building Address: Owner's Name: 16 /1 T Z _D Phone_r� � �� kPiCCA r Ks�/ HOA: Yes El No If es, provide letter from HOA Contractor: Phone #: RS`► J ��•' iv► of) 4!�Zt �� - o o� 2— r Fax #: Cupertino Business License (�1 Contractor Lice se #: �71 ��3 4r Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles X Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify),/19.,/--1, Number of existing coverings ❑ Provide I.C.C.E.S. Report# To be Removed ❑ Provide Mfgr. Installation Specs. 4j -7 `,44 4, vl Job Description: Ale Y-eal �� o s� �� /Lf s 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: 4/0 5_0 0 � I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: /f,- 14Z/. d & //-,? Signature 0 vi,,/ Revised 02/05/09 a( - CITY OF CUPERTINO REROOF CUPERTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group jw— 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICO Seismic Commercial B 1RER00FRES Re-roof Residential B 1SFDWLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee / 1BSEISMICRE Seismic Residential B 1 REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B 1 BUSLIC 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 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: Job Site Address: 26"('Ja Roofing Company Name: Applicant's Signature: Date:Gz /�� Greg Casteel Building Official Revised 07/30/08 INPUT RLsources Energy 1ACHeafth Indoor tr Qua rty anYFfn1snes 1.Use Low/No-VOC Paint 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 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes D 7.Seal all Exposed Particleboard or MDF 4 IAQ/Health pts y=yes 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 Whole House Vacuum System 3 IAQ/Health pts y=yes 116 1 i N.Flooring 1.Select FSC Certified Wood Flooring B 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 130 57 Total Points Project Received: 01 0 0 0ell G:data/progs/greenbuildingguidelines/remodelers/greenpointsfinal2.12.D4protected.xis Paul Newman -rom: FPMCCARTHY@comcast.net Sent: Monday, September 14, 2009 3:24 PM To: Paul Newman Subject: Re: roof permit City of Cupertino, I Frank McCarthy, Trustee for the Kathleen M. Dierks Family Trust, hereby authorize Ray Bani of Precision Remodeling to reroof the property at 7648 Kirwin Lane, Cupertino (Assessor's Parcel#359-22-012). This was my sister's home who passed away last month. We are preparing the home for sale as soon as possible, and the roof is in desperate need of replacement. If you should have any questions or need additional information, please call my real estate agent,Paul B. Newman of Intero at 408-888-1452, or me at 650-722-0191. Kind regards, Frank P. McCarthy 1 Community Development sam", 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CIT$OF Fax(408)777-3333 XPE�TINO Buildin De artment JO ADDRESS: PERMIT # O R' NAME: ; PHONE # 6 �� 0�6_20 GENERAL CONTRACTOR: FAX# I am not using any subcontractors: l Signature Date Please check applicable subcontractors 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 V Roofing Septic Tank Sheet Metal Sheet Rock Tile tj/"- //� Ay er, ontractor Signature Date