09110071 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19961 MERRITT DR CONTRACTOR:LOS GATOS ROOFING PERMIT NO:09110071
OWNER'S NAME: BECKY PAN P O BOX 1726 DATE ISSUED: 11/12/2009
ER'S PHONE: 4088924340 LOS GATOS,CA 95031 PHONE NO:(408)298-9399
® LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class 3`t Lia# 30070-7
MECH F_ RESIDENTIAL r COMMERCIAL �
Contractor Ly S 6cL�i s V.s".,.Date ll (Z. C
1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF REMOVE EXISTING SHAKE INSTALL
(commencing with Section 7000)of Division 3 of the Business&Professions 7/16'OSB,
Code and that my license is in full force and effect. FIBERGLASS REINFORCED FELT AND DURATION PREMIUM
SHINGLES BY OWENS CORNING CLASS A 31 SQ
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 Sq.Ft Floor Area: Valuation:$9094
permit is issued.
APPLICANT CERTIFICATION APN Number:31630069.00 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.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
Signature Date /Z C Issued by: Date:��/G
G 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 agree to remove all new materials for
I,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
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
performance 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,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 Own;rA author' gent: C,
forthwith comply with such provisions or this permit shall be deemed revoked. Date:/ / J
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I certify that 1 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
upon the above mentioned property for inspection purposes.(We)agree to save
it ify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
ct ,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 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 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31630069 .00
DATE ISSUED. . . . . . . : 11/12/2009
- RECEIPT #• . • • . •.•
• . . : ,BS000009181
REFERENCE ID # 09110071
SITE ADDRESS . . . . . : 19961 MERRITT DR /
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . . '
OWNER BECKY PAN
ADDRESS 19961 MERRITT DR
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-2443
RECEIVED- FROM . . . . : LOS GATOS ROOFING
CONTRACTOR RANDY BROWN LIC # 23481'
COMPANY LOS GATOS ROOFING
ADDRESS P 0 BOX 1726
CITY/STATE/ZIP LOS GATOS, CA 95031
TELEPHONE (408) 298-9399
UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC . VALUATION 9, 094 . 00 1 . 00 0. 00 1. 00 0 . 00
1BSEISMICR VALUATION 9, 094 . 00 1 . 00 0. 00 1. 00 0 . 00
1REROOFRES SQ FEET 31. 00 403 . 00 0 . 00 403 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 405 .00 0 . 00 405 . 00 0. 00
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
CUPERTINO PERMIT APPLICATION
APN # Date:
: ) �.�o_. 1� { 6
Building Address` 90- r
a rk
Owner's Name: Phone#:
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Contractor �/ Phone #: OS" � G —lO
Fax#:
Cupertino Business License#: �1 Contractor License#:
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Sao 7�/-) 7
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles _
❑ Other(Specify) �d Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O. Re ort#
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Des ,'ption
•
( . / '( l-�_.,C.:�' Imo' L•. f �✓� !> '(yfsL ' ri
`.' �7i,lr/+�s/J•� I'L 3. �„�r"_7
Ir
Residential 0 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, 'nclude in plan set & the sheet index.
Valuation:
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
i
Signat&er
Revised 6/16/08
CITY OF CUPERTINO
REROOF
aclCUPEi,TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COA4MLROOF
1BSEISMICO Seismic Commercial B
j 1RER00FRES ' Re-roof Residential B 1SFDWLROOF
/ 1BSEISMICRE Seismic Residential B
1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08
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:
o
Roofing Company Name:
r
Applicant's Signature: Date: G }
Greg Casteel
Building Official
Revised 07/30/08
Green Points Rating System for Remodeling Projects
Due to the diversity of remodeling project types,assigning a"total points"value to a project to be considered environmentally friendly is
not feasible.However,25 measures have been highlighted to signify that every effort should be made to incorporate them into your
projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with
ease of implementation and relative low cost. These measures can be used as a staving point for"greening"your project.
A.Site
ems„ ,.,
65 po r5,�= 2 points B0 4 roiriis up to 4 Resource pts 0
2.5afv2gq Rsusabh'Building Mztprials 4 Resource pts y--yes p
3.Remodel for Mixed Use,Adaptive Reuse,and
Historic Preservation 4 Resource pts y—yes 0
4.Protect Native Soil 2 Resource pts y=yes 0
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y—yes. 0
6.Implement Construction Site Stormwater Practices 2 Resource pts y=yes 0
7.Protect Water Quaiity with Landscape Design 2 Resource pts y=yes 0
S.Design Resource-Effici=nt Landscapes and Gardens 4 Resource pts y=yes 0
9.Reuse Materials/Use Recycled Content Materials
for Landscape Areas 2 Resource pts y—yes .0
10.Install High-Efficiency Irrigation Systems 2 Resource pts y=yes0
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yesF:::] 0
1 ! i
B.Foundation
1.Incorporate Recycled Flyash in Concrete
25%Recycled Flyash=2 points;Add 1 point for every 10%
increase of flyash,up to 5 points up to 5 Resouice pts 0
2.Use Recycled Content Aggregate 2 Resource pts y=yes 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes p
1 1 1
C.Structural Frame
1.Substitute Solid Sewn Lumber with Enaineared Lumber 3 Resource pts y=yes 0
2.Use FSC Certified Wood for framing
(For every 10%of FSC lumber used=2 points,up to 10) up to 10 Resource pts. 0
3.Use Wood kJoists for Floors and Ceilings 2 Resource pts y=yes 0
4.Use Web Floor Trusses 2 Resource pts y--yes 0
5.Design Energy Heels on Trusses 6"or more 2 Energy pts y—yes 0
6.Use Finger-Jointed Studs for Vertical Applications 2 Resource.pts y=yes D
7.Use Engineered Studs for Vertical Applications 2 Resource pts y=yes 0
8.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0
9.Use Structural Insulated Panels(SIPs)
a.Floors 3 Energy pts y=yas 0
b.Wall 3 Energy pts y=yes 0
c.Roof 3 Energy pts y=yes 0
10.Apply Advanced Framing Techniques 4 Resource pts y=yes 0
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y—yes 0
12.Use OSB
a.Subtl6 ire 1 Resource pt y=ye- 0
b,She�fu�ng 1 Resource pt y es 0
I 1 E
Community Development
10300 Torre Avenue
Cupertino CA 95014
GIN OF Telephone(408) 777-3228
UPEI INN Fax(408)777-3333
Buffding De- ��������� y
JOS ADDRESS:
PERMIT
_ OWNER'S NAME: PHONE ; � G
GENERAL CON 1 RACTOR: �-^ �i
-�� ,��� _.�J FAX
I am not using any subcontractors:
Please check a2plicable subcontractors and cont Tete the following i�--Lformation: D e
SUbCONTRACIOIR BUSINESS NAME I BUSINESS LICENSE
I Cabinets COZ Millwork I
Cement Finishing I
IElectrcaf I I
IExcavation I
Fencing I
Flooring: Carpefjng
Linoleum, / Wood I
Glass/ Glazing
IHeating
Lnsulation I I
Landscaping I I
I Lathing I
Masonry I I
Ornamental Sheet Metal
I
Painting/ Wa-Upaper I
IPaving I I
IPlastering
I Plumbing
Roofing
Septic Tank
I Sheet Metal I I
I..Sheet Rock
Tile
er -ontractor ignature
L i
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