09110045 CITY OF CUPERTINO BUILDING PERMIT
CONTRACTOR:BAKER ROOFING
PERMIT NO:09110045
BUILDING ADDRESS: 10395 RIVERCREST CT 2067 LA CON CT DATE ISSUED: 11/09/2009
OWNER'S NAME: EAGLETON JULIANNE PHONE NO:(408)559-5105
CAMPBELL,CA 95008
,ER'S PHONE: 4087615486
0 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB
'Z� Lic.# 2 Z D C 3 � MECH� RESIDENTIAL� COMMERCIAL
License Class( o�
E?�j .0 gme� c1l�W( Date 1 ( "
Contractor JOB DESCRIPTION:RE-ROOF TEAR OFF EXISTING ROOF APPLY
I hereby affirm that I am licensed under the provisions of Chapter 9 RADIANT OSB&
(commencing with Section 7000)of Division 3 of the Business&Professions PRESIDENTIAL SHAKES CLASS A 26SQ
Code and that my license is in full force and effect.
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. Valuation:$11000
I have and will maintain Worker's Compensation Insurance,as provided for by Sq,Ft Floor Area:
Section 3700 of the Labor Code,for the performance of the work for which this Occupancy Type:
pen-nit is issued. APN Number:32637003.00
rm
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 PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION.
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ^ _ Date:
Issued by:
9.18.
/ � t
Date- (l �
Signature
RE-ROOFS:
OWNER-BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being installed.If a roof is
I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for
the following two reasons:
.
inspection
I,as owner of the property,or my employees with wages as their sole compensation, —— Date:
will do the work,and the structure is not intended or offered for sale(Sec.7044, Signature of AP licant:
Business&Professions Code)
contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I,as owner of the property,am exclusively
construct the project(Sec.7044,Business&Professions Code).
one of the following three
1 hereby affirm under penalty of perjury
HAZARDOUS MATERIALS DISCLOSURE
declarations: I have read the hazardous
I have and will maintain a Certificate of Consent to self-insure re for Worker's California Health&Safety Code,Sections 25505 requirements25533,and 25534.Chapter 95 of the
1 will maintain
Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material.
I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air
Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
for which this permit is issued,I shall
Health&Safety Code,Sections 25505,25533,and 25534.
1 certify that in the performance of the work
h
not employ any person in any manner so as to become subject to teWorker's
Compensation laws of California. If,after making this certificate of exemption,I Owner or rued Date.
become
ate —
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. CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's
I certify that I have read this with all city arind Ws me that th -es and stabove te laws relating Lender's Nais for which me art is issued(Sec.3097,Civ C.)
ation
correct.I agree to comply Y
to building construction,and hereby for
authorize
representatives
of t is cit to santto e, Lender's Address
i-on the above mentioned property P purposes.( ) g
reeunify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION
�s,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply
the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
with all non-point source regulations per
9.18. Licensed Professional
Date_
Signature
CITY OF CUPERTINO
PERMIT RECEIPT OPERATOR: patg
3 ITEMS OF 3 COPY # : 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN 32637003 .00
DATE ISSUED. . . . . . . : 11/09/2009
RECEIPT #. . . . . . . . . BS000009148
REFERENCE ID # 09110045
SITE ADDRESS 10395 RIVERCREST CT
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER EAGLETON JULIANNE
ADDRESS . 10395 RIVERCREST CT
CITY/STATE/ZIP CUPERTINO CA, 95014-1027
RECEIVED FROM • • JAMES BAKERER LIC # 25385
CONTRACTOR . . . . . .
COMPANY BAKER ROOFING
ADDRESS . 2067 LA CON CT
CITY/STATE/ZIP CAMPBELL08) 559,5 05 95008
TELEPHONE
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC --NEW-BAL-
---------- ----------
--------
---------- 0 . 00
---------- ------------- 1. 00
1BCBSC VALUATION 11, 000 . 00 1 .00 0 . 00 1 .10 0 .00
1BSEISMICR VALUATION 11, 000 . 00 1 .10
0 .00
1REROOFRES SQ FEET 26 . 00 338 . 00 0 . 00 338 . 00 ------0_00
TOTAL PERMIT
340 .10 0 . 00 340 .10 0 .00
AMOUNT REFERENCE NUMBER
METHOD OF PAYMENT
-----------------
---------------
-- ---------
CASH 340 .10
---------------
TOTAL RECEIPT 340 .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
REROOF
CU P TY OF O PERMIT APPLICATION
APN # Date:
Building Address:
Owner's Name: jv ^ t Phone #:
HOA: Yes ❑ No ❑ If ves, provide letter fromHOA �6
Contractor: �, Phone #: Y 0V 3
A
Fax #:
Cupertino Business Li en #, I Con Z toor License
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
sf Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
e Other (Specify) "re 5'd-e"l""I�64jt s 4
❑ Other (Specify) )j�
Number of existing coverings Li Provide I.C.C.E.S. Report#
�r Li Provide Mfgr. Installation Specs.
To be Removed
Job Description: .1 �� e -rjS
2 ,', f Sti� � S Cog
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: P 0-0 �..
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 02/05/09
ayml
CITY OF CUPERTINO
REROOF
CUPEkTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
IREROOFCOM Re-roof Commercial B 1COMMLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
IBSEISMICO Seismic Commercial B
1REROOFRES Re-roof Residential B 1SFDWLR00F
2
/ 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
/ IBSEISMICRE Seismic Residential B
1 REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
IBCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
I BSEISMICRE 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 Raid 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: u ' "� °�`
Job Site Address:
tb3t1 S R�✓escr�Sfi
Roofing Company Name: k S I
Date:
Applicant's Signature:
Greg Casteel
Building Official
Revised 07/30/08
INPUT Re5ources Energy IAQ'Hentt-(
. ndoor rr ua ity an tnts es
0
1.Use LowRJo- 1 IAQ/Health pts y=yes
VOC Paint 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes.
3.Use LowMo VOC Adhesives
31AQ/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 0
Formaldehyde 61AQ/Health pts y=yes
Y 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts Y= es 0
7.Seal all Exposed Parrticteboard or MDF 4 IAQ/Health pts y=yes
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 0
� � 1
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
0
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 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
� � E
Total Points Available: 140 130
Total Points Project Received: 0 0 0
G:data/progs/greenbuildingguidelines/remodelers/greenpointsfinal2.12.D4protected.xis
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
Fax(408)777-3333
CITY OF
�UPEkTINO
Buildin De artment
JOB ADDRESS: PERMIT #
18 32
OWNER'S NAME: /l e �i�►c- c- �`�� PHONE # GW S .3 S 0 L14 Co
GAL CONTRACTOR: �„�' FAX#
ENER
I am not using any subcontractors: Date
ignature
Please check applicable subcontractors and com lete the folloEin BUSINESS LICENSE #
SUBCONTRACTOR BUSINESS NAM
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
Date
Owner/Co ctor Signature