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09090019
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10420 MANN DR CONTRACTOR:R E ROOFING& PERMIT NO:09090019 CONSTRUCTION INC "NER's NAME: SHOAEE HAMID ET AL 15230 CLYDELLE AVE DATE ISSUED:09/03/2009 OWNER'S PHONE: 6908622598 SAN JOSE,CA 95032 PHONE NO:(408)626-9320 LICENSED CONTRACTOR'S DECLARATIONr _� BUILDING PERMIT INFO: BLDG ELECT PLUMB License ClassC lot Lic.# Z �� ( MECH RESIDE NTJXL COMMERCIAL ntrac Date C Q / I hereb irm'fhata licensed under the provisions of Chapter 9 JOB DESCRIPTION: RE-ROOF REMOVE EXISTING I LAYER OF (commene igwith Section 7000)of Division 3 of the Business&Professions WOOD SHAKE Code and that my license is in full force and effect. INSTALL 1/2" CDX 30#FELT&CLASS A COMP 32 1 hereby affirm under penalty of perjury one of the following two declarations: SQUARES 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. Sq.Ft Floor Area: Valuation:$12500 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:32645012.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 certify that 1 have real this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I 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: . Date: _ wis non-point source regulations per the Cupertino Municipal Code,Section 18. lo RE-ROOFS: at Date A shall be inspected prior to any roofing material being installed. If a roof is \ nstalled wi t first obVining an inspection,I agree to remove all new laterials for inspection. L� OWNER-BUILDER DECLARATION Signattme-,of AppFdant: Date: i 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 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) I,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 1 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 main comp' ee with the Cupertino Municipal Code,Chapter .12 d _ I have and will maintain Worker's Compensation Insurance,as provided for by the=Safety&Safety Co c �25nd 25534. Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Owner or authorize 4i age Date: 1 certify that in the performance of the work for which this permit is issued,1 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,1 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 huilding construction,and hereby authorize representatives of this city to enter n the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION jemnify 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 Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 'UPEt�TINO Building Department JOB ADDRESS: PERMIT # o(t U v OWNER'S NAME: NE;AAPHONE # — 93 2D GENERAL CONTRACTOR: a* f FAX # 40Y— co 2 I am not using any subcon ctors: �--� (30 gnature 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 Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32645012 . 00 DATE ISSUED. . . . . . . : 09/03/2009 RECEIPT #. . . . . . . . . : BS000008601 REFERENCE ID # . . . : 09090019 SITE ADDRESS . . . . . : 10420 MANN DR SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : SHOAEE HAMID ET AL ADDRESS . . . . . . . . . . : 10420 MANN DR CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1141 RECEIVED FROM . . . . : RE ROOFING & CONSTR CONTRACTOR . . . . . . . : PROCTOR, PAUL LIC # 20615 COMPANY . . . . . . . . . . : R E ROOFING & CONSTRUCTION INC ADDRESS . . . . . . . . . . : 15230 CLYDELLE AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95032 TELEPHONE . . . . . . . . : (408) 626-9320 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 12, 500. 00 1 . 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 12, 500 . 00 1 .30 0 . 00 1 . 30 0 . 00 1REROOFRES SQ FEET 32 . 00 416 . 00 0 . 00 416 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 418 .30 0 . 00 418 .30 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 418 .30 1662 --------------- TOTAL RECEIPT 418 .30 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF -�, CITY OF CUPERTINO REROOF CUPEkT1NO PERMIT APPLICATION 0 q APN # 32Lp 450 CA2_.o c) Date: 9F�o Building Address: � o4zo � ,� AA 'N ��,�!•, Owner's Name: ANk Phone #: 2ql HOA: Yes ❑ No If es provide letter from HOA Contractor: Phone #: ( � vb r 32Z) 1 � 1 Fax #: rrLL\\�S X02 - -716�v Cupertino Business License #: Contractor License #: vl Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles X 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:jAek �� (��LSC i Ai; - Wu"_b '1 S+W�Ej IVJ -t ktL I" CD Cl(_M� (Wk COW, Residentia Commercial Y 4 1 VXJU 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: :Read, Understand an. omply with Cupertino's Tear-Off Policy: Revised 02/05/09 CITY OF CUPERTINO aF ___ REROOF CUPEkTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICO Seismic Commercial B 32— 1REROOFRES 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/ "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: 2 �'v Ait ` Roofing C%any e: _PP Rc)(d ? �Cll i ��of I A lick es Si atur Date: PP Greg Casteel Building Official Revised.07/30/08 • M.Indoc>r Air Quality and Finishes 1.Use Low/No-V©C Paint 1 IAOJHealth pts y=yes D 2.Use Low VOC,Water-Based Wood Finishes 2 IAO/Health pts y=yes D 3.Use Low/No VOC Adhesives 3 IADJHealth pts y--yes D 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y--yes D 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61A4/Health pts y--yes; 0 5.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes D 7.Sed ail E4madlRrADWcardflr MDF 4 IAQIHealth pts y=yes _. D 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 Ayes 0 10.Install Whole House Vacuum System 3 IAQlHealth pts y=yes 0 t o N.Fiooring 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/HeaJth pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 R83DUrCe pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y--yes 0 M LM 1 P 4 Total Points Available: 1 1401 130 57 Total Points Project Received: 01 O= .. r. G:data/progs/gresnbuildngguidelines/ramodelerslgreenpointsfinal2l2D4proteoted.xis