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09100228 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10176 MC LAREN PL CONTRACTOR:WING'S ROOFING PERMIT NO:09100228 INC OWNER'S NAME: JAI FU LIN 3243 SYDNEY WAY DATE ISSUED: 10/30/2009 NER'S PHONE: 5104687733 CASTRO VALLEY, CA 94546 PHONE NO:(510)889-9068 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class — Lic.# r s` MECH RESIDENTIAL COMMERCIAL $p;ht Contractor 6 Date U I herebyaffirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION: RE-ROOF TEAR OFF SHAKE, INSTALL 7/16" (commencing with Section 7000)of Division 3 of the Business&Professions OSB AND 154 Code and that my license is in full force and effect. FELT CLASS A ASPHALT SHINGLE 23 SQ 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. Sq.Ft Floor Area: Valuation:$6950 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:31621047.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. 1 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: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. J RE-ROOFS: Signature Date r 3� All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNE -BUILDER DECLARATION We4,---,7 Signature of Applicant: _Date: 1 hereby affirm that 1 am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVER GS TO BE CLASS"A"OR BETTER I,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) 1,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 1 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(x)should 1 store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 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 I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this ° permit is issued. Owner or authorized agent: i Al •h—k?A Date: 36 I certify that in the performance of the work for which this permit is issued,I 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 1 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 ,n the above mentioned property for inspection purposes.(We)agree to save mnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION ousts,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 CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN 31621047 . 00 DATE ISSUED. . . . . . . : 10/30/2009 RECEIPT #. . . . . . . . . BS000009093 REFERENCE ID # . . . : 09100228 SITE ADDRESS 10176 MC LAREN PL SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER JAI FU LIN ADDRESS 10176 MC LAREN PL CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-2335 RECEIVED FROM . . . . : WING CHEA CONTRACTOR CHEA, WING LIC # 21239 COMPANY WING'S ROOFING INC ADDRESS 3243 SYDNEY WAY CITY/STATE/ZIP CASTRO VALLEY, CA 94546 TELEPHONE (510) 889-9068 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ----- 1BCBSC VALUATION 6, 950. 00 1 . 00 0 . 00 1 . 00 0 .00 1BSEISMICR VALUATION 6, 950 . 00 0 .70 0 . 00 0 . 70 0 . 00 1REROOFRES SQ FEET 23 . 00 299 .00 0 . 00 299 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 300 .70 0 . 00 300 .70 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- --------------- CREDIT CARD 300 .70 AX --------------- TOTAL RECEIPT 300 .70 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- - 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF Community Development 11 ipa 10300 Torre Avenue s Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 17UPEkTINO Building Department JOB ADDRESS-ice, /a l7�, gCb�.rj2`j �, PERMITj,# bu z-Z—A OWNER'S NAME: au f PHONE # b GENERAL CONTRACTOR: i AX # I am not using any subcontractors: �3,)Icel-r--T Si ature Date Please check applicable subcontractors and co lete 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 AC/ Owner tractor Signature Date CITY OF CUPERTINO REROOF CUPEkTINO PERMIT APPLICATION APN # 1_5Date: � p I (o 2- 1 7,OC) Building Address: 6 o Et Owner's Name: Phone #: _5-/6 7� 33 HOA: Yes ❑ No If Yes, provide letter from HOA Contractor: n Phone #: 1[1!9 7�4 e�t( CA Fax #: lD Cupertino siness`L,icense V Contractor License 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) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report # A To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: -r16f 0 0 i C '7 A r� O.S� �� ► C 14 '311 [`e 2 3 � Residential C mmercial ❑ 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: I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: ( S ignatur Revised 02/05/09 a CITY OF CUPERTINO 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 1REROOFRES Re-roof Residential B 1SFDWLR00F 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES I 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/ "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: 0 " Roofing Company Name: t <� `t Applicant's Signature: �-� Date: tr Greg Casteel Building Official Revised 07/30/08 .In oor rr ua ity an tnrshes INPUT ResourcLs Energy ..'A'�'Heafth 1.Use Low/No-VOC P&# 1 IAQ/Health pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes. 0 3.Use Low/No 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 Parleboard 4r MDF 4 IAQ/Health. pts y=yes 0 B.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 1 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 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 i 1 Total Points Avallable: 1 1401 130 57 Total Points Project Received: 1 01 0 0 G:data/props/greenbuildingguidelines/remodelers/greenpointsfinal2.12.o4protected.xls