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09110130
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 847 SEPTEMBER DR CONTRACTOR:KEVIN SULLIVAN PERMIT NO:09110130 ROOFING OWNER'S NAME: KWONG JAMES W AND PRISCILLA S 1696 VALLEY OAKS DR DATE ISSUED: 11/23/2009 G ER'S PHONE: 4082531552 GILROY,CA 95020 PHONE NO:(408)842-1057 . LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class �--' Lic.# b ! ) MECH f RESIDENTIAL f COMMERCIAL Contractor Date I I JOB DESCRIPTION: RE-ROOF TEAR OFF SHAKES/SHINGLES,INSTALL 7/16 1 hereby affirm that I am licensed under the provisions of Chapter 9 OSB (commencing with Section 7000)of Division 3 of the Business&Professions SHEATHING,30LB FELT&LIFETIME ASPHALT SHINGLES Code and that my license is in full force and effect. CLASS A 28SQ 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 Valuation:$12000 permit is issued. Sq.Ft Floor Area: APPLICANT CERTIFICATION anc Occu Type: I certify that I have read this application and state that the above information is APN Number:36212010.00 Occupancy YP 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. Issued,by: Si¢natu Date �/ ❑ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS: the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I ree to remove all new materials for will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. Business&Professions Code) Signature of Applican. 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: 1 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 I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the cate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certifi become subject to the Worker's Compensation provisions of the Labor Code,I must Owner or authorized agent: !r! 2 forthwith comply with such provisions or this permit shall be deemed revoked. Date. APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 1 certify that I have read this application and state that the above information is I hereby a correct.I agree to comply with all city and county ordinances and state laws relating affirm that there is a construction lending agency for the performance of work's to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.) n the above mentioned property for inspection purposes.(We)agree to save Lender's Name mnify 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 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 36212010 . 00 DATE ISSUED. . . . . . . : 11/23/2009 RECEIPT #. . . . . . . . . BS000009258 REFERENCE ID # 09110130 SITE ADDRESS 847 SEPTEMBER DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER KWONG JAMES W AND PRISCILLA S ADDRESS . 847 SEPTEMBER DR CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4148 RECEIVED FROM SULLIVANKEVIN E CONTRACTOR . . . . . . . KEVIN E. SULLIVAN LIC # 23810 COMPANY KEVIN SULLIVAN ROOFING ADDRESS 1696 VALLEY OAKS DR CITY/STATE/ZIP . . . : GILROY, CA 95020 TELEPHONE (408) 842-1057 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC --NEW-BAL- ---------- ------------- ---------- ---------- --- 00 1BCBSC VALUATION 12, 000 . 00 1 . 00 0 . 00 1. 00 0 • 1BSEISMICR VALUATION 12, 000 . 00 1 .20 0. 00 1.20 0 . 00 1REROOFRES SQ FEET 28 . 00 364 . 00 0. 00 364 . 00 ------0_00 ---------- ---------- ---------- TOTAL PERMIT : 366 .20 0 . 00 366 .20 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- -- --------------- ----- CREDIT CARD 366 .20 AMEX --------------- TOTAL RECEIPT 366 .20 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- -------------- __ -------- ----------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CUPERTINO a7 1 . CUPEkTINO PERMIT APPLICATION APN # Date: �5/6 Building Address: Jr Owner'.s Name: Phone #: k[W, �W�6__ Z HOA: Yes ❑ No If yes, provide letter from HOA Contractor: ` � e �/ Pho e #: Fax : t Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ ui1t-Up roof ❑ Asphalt Shingles Asphalt Shingles pood Shakes W ❑ Wood Shakes ood Shin les�2 ❑ Wood Shingles �li�� g ❑ Other (Specify) ❑ Other (Specify) tuber of existing coverings ?/ Li Provide I.C.C.E.S. Report# ,aN To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: 5 ,.�G-c am 1 t r�5-Oky� `7 t 16 f_ ��s-`sem----_ .; �- 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: L 2�, I Have Read, Unde and and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09 CITY OF CUPERTINO 'alREROOF OF CUPEI,TINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group Re-roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICO Seismic Commercial B 1REROOFRE \ Re-roof Residentia B 1SFDWLR00F 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES I Commission Fee / 1 BSEISMICRE Seismic Residential B I 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'A " 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: `� y Job Site Address: Roofing Company Name: t v Applicants Signature: Date: bJ Greg Casteel Building Official Revised 07/30/08 i M.Indoor it Quality and Finishas 1.Use Low/No-V©C Paint 1 IAOJHealth pts y=yes 2.Use Low VOC,Water-Based Wood Finishes 2 IAD/Health pts y=yes D 3.Use Low/No VOC Adhesives 3 IAQ/Health 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 61AQ/Health pts y--yes 6.Use Exterior Grade Plywood for Interior Uses 1 IAD/Health pts y=yes D 7.Seal jjE osed f is sbawd Qr MDF 4 IAD/Health pts - es B.Use FSC Certified Materials for Interior Finish 4 Resource pts yryes 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes D 10.install Whole House Vacuum System 3 IAQ1Health pts y=yes 1 1 1 N.Fl®oring 1.Select FSC Certified Wood Flooring B Resource pts Y--yes 0 2.Use f3apidly Renewahle Flooring-Materials 4 Resource pts y=yes � 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes o 4.Install Natural Linoleum in Place of Vinyl 5 IAWHealth pts y=yes 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes D 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes o 1 1 1 Total Points Available: 1401 1301 57 Total Points Project Received: 01 O= �eA G:data/progs/greenbuildingguidelines/ramodelers/greenpointsfinal2.12.O4profeoied.xls Community Development " 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 XPEkTINO Buildin De artment JOB ADDRESS: PERMIT # � / l u � 3 C OWNER'S NAME: PHONE # Z oS7 GENERAL CONTRACTOR: FAX # - 6 I am not using any subcontractors: Z 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 -Roofing Septic Tank Sheet Metal Sheet Rock Tile Date Owner ontractor Signatare