09090111 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11132 WILKINSON AVE CONTRACTOR:R E ROOFING& PERMIT NO:09090111
CONSTRUCTION INC
MvNER'S NAME: JENNY CHUANG 15230 CLYDELLE AVE DATE ISSUED:09/15/2009
.,NER'S PHONE: 4087779939 SAN JOSE,CA 95032 PHONE NO:(408)626-9320
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB
Lice Clash/ ( Lic.#
(( �
n
MECH f— RESIDENTIAL f— COMMERCIAL'Contrac r Dat0
I hbreby tflfi m4# am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF REMOVE EXISTING TILE&CAP
(commencing with Section 7000)of Division 3 of the Business&Professions SHEET,INSTALL
NEW 1/2"CDX,30#FELT&EAGLELITE"MALIBU"
Code and that my license is in full force and effect.
LIGHTWEIGHT TILE CLASS A 25SQ
I 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.
1 have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the perfonnance of the work for which this Sq,Ft Floor Area: Valuation:$14000
permit is issued.
APPLICANT CERTIFICATION APN Number:35617072.00 Occupancy Type:
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 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.
wit4-a11 non- " t source regulations per the Cupertino Municipal Code,Section
9f18. Date:
✓� l t �_�----
Q�^'•nature Date Issued y
❑ OWNER-BUILDER DECLARATION
RE-ROOFS:
1 hereby affirm that I 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 wi t first obtaining an inspection,I agree 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,
of A is t: Date:
Business&Professions Code) 'SignatureI
1,as owner of the property,am exclusively contracting with licensed contractors to
construct 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
perfonnance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 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.
Additionally,should I use equipment or devices which emit hazardous air
permit is issued. 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,l 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 Work Health&Safety Code,Sections 25505,25533,and 25531.,
Compensation laws of California. If,after making this certificate of emption,[
become subject to the Worker's Compensation provisions of the or Code,I must rtZh�'rized ent C (y
forthwith comply with such provisions or this permit shall be deemed revoked. Date: l
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 construction 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
the above mentioned property for inspection purposes.(We)agree to save
.unify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
a -pow urce re er the Cupertino Municipal Code,Section
I understand my plans shall be used as public records.
Si Date Licensed Professional
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub:, Blk: Lot:
APN 35617072 . 00
DATE ISSUED. . . . . . . : 09/15/2009
RECEIPT #. . . . . . . . . BS000008686
REFERENCE ID # 09090111
SITE ADDRESS . . . . . : 11132 WILKINSON AVE
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . . JENNY CHUANG
ADDRESS 11132 WILKINSON AVE
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4736
RECEIVED FROM . . . . : R E ROOFING & CONST
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
i
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
y4 1BCBSC VALUATION 14, 000 . 00 1 . 00 0. 00 1. 00 0 . 00
1BSEISMICR VALUATION 14, 000 . 00 1 .40 0. 00 1.40 0 . 00
1REROOFRES SQ FEET 25. 00 325 .00 0. 00 325 . 00 0 .00
---------- ---------- ---------- ----------
TOTAL PERMIT 327 .40 0 . 00 327.40 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 327 .40 #1691
---------------
TOTAL RECEIPT 327 .40
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
` Date: Q
APN # 7� C.' ( 00�
�� Cv
Building Address: 132
% 7 oj Aik ,
Owner's Name: - ,� � I, , Phone #:
HOA: Yes ❑ No
If yes, provide letter from HOA
Contractor: cr►� Phone #:
Coo a l��W L i 0j, 10 C.
� Fax #: - -
Cupertino Business License #: Contractor License #..
2_0 I Z�
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ( ❑ Wood Shingles I
Other (Specify) ��';X<I��C(L'�'�" �� Other (Specify)
Number of existing coverings Z ❑ Provide I.C.C.E.S. Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:J �� l,C (' ' Wv -T,
eA(TLC LA
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. 1
Valuation: Uj 5
ooU
I Ha Understand and Will Comply with Cupertino's Tear-Off Policy:
7 t
Signature --
Revised 02/05/09
i CITY OF CUPERTINO
REROOF
CUPS OF
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
1REROOFRES Re-roof Residential B 1SFDWLR00F
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
1BUSLIC 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: ��" 50M N — '
Job Site Address: I ' v `� 1 �J S M " `
Roofing Com an Name:
Applican 's Signatur . Date:
Greg Casteel
Building Official
Revised 07/30/08
INPUT Resources Energy IAO)Health—
Indoor Air uality an rntshes
1.Use LowND-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 LowMo 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 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 0
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 [70
1 i i
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 1 i
Total Points Available: 1401 130E-- 57
Total Points Project Received: 0 0 0
G:data/progsJgreenbuildingguidelines/remodelers/greenpointsfina12.12.D4protected.xls
Community Development
10300 Torre Avenue
ImL
Cupertino CA 95014
Telephone(408)777-3228
C.ITY OF Fax(408)777-3333
„UPE�TINO
Building Department
JOB ADDRESS: 1 \(� j � /�, r PERMIT # ?n�o
oe
OWNER'S NAME: v " '�I �1 i J PHONE # 4&-
GENERAL CONTRACTOR: FAX # L{of�-- Z( -
I am not using any subcon(actors: 5
- Si e 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