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09080387 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6772 JOHN DR CONTRACTOR:WESTSHORE ROOFING PERMIT NO:09080387 fqC f—NER'S NAME: FRED CHENG 2245-A FORTUNE DR DATE ISSUED:08/26/2009 0 vv NER'S PHONE: 4088914632 c AN JOSE,CA 95131 PHONE NO:(408)694-0060 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT r PLUMB License Class" 3C1 Li, MECH I- RESIDENTIAL� COMMERCIAL� Contractor f01 Date Z-GDaci JOB DESCRIPTION:RE-ROOF REMOVE 2 LAYERS COMP,INSTALL I hereby affirm that I am licensed under t e provisions of Chapter 9 :;OLB FELT, (commencing with Section 7000)of Division 3 of the Business&Professions 1,ANDMARK COMPOSITION ROOF,CLASS A,20SQ Code and that my license is in full force and effect. 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. I have and will maintain Worker's Compensation Insurance,as provided for by ;q,Ft Floor Area: Valuation:$7000 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:36923002.00 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct.1 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR 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 Issued b Date: – � 9.18. r �— .--._.i F' iture Dat' 2 6 ❑ OWNER-BUILDER DECLARATION RE-ROOFS: 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. 1,as owner of the property,or my employees with wages as their sole compensation, �101, �00/O-7 will do the work,and the structure is not intended or offered for sale(Sec.7044, Signature of Applicant• Date: �(q' Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: 1 have and will maintain a Certificate of Consent to self-insure for Worker's 1 have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material. 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 I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's p Compensation laws of California. If,after making this certificate of exemption,I Owne horize a Date: V 1 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 application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter the above mentioned property for inspection purposes.(We)agree to save Lender's Address i. anify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date -,, CITY OF CUPERTINO REROOF CUPERTINO PERMIT APPLICATION APN # Date:�� $ Zr0 Building Address: 6 - 2.- joA r) Owner's Name: rye°d GGA e%� Phone #: gctr �6 32 HOA: Yes ❑ No If yes, provide le tter from HOA Contractor: Phone #: C�S-6— o Zoo W esfiSLt,�e �obf Fax #: ysb o L 3j Cupertino Business License #: Contractor License #: 79 Z Type of hoof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof Asphalt Shingles ;W,Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings Z _ ❑ Provide I.C.C.E.S. Report# ATo be Removed ❑ Provide Mfgr. Installation Specs. Job Description: PewvV- Z j C-P W f/ -4'h 00t 11 76"b fe I t� LcndM&Yj<- CO►Mfv3Hi0n �a�F. jasS f�- . 2c7e?f 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:s I 000 I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09 CITY OF C UPERTINO RERCIOF CUP TYOF 0 FEE SCHEDULE Number of Fee ID Fee Descriplon Fee Permit Type Squares Group 1REROOFCOM Re-roof Convnerc:a:lFB1COMMLROOF 1BCBSCCal Bldg StandardsALL PERMIT TYPES Commission Fee IBSEISMICO Seismic Commercial B 1 REROOFRe-roof Resi lential B 1SFDWLROOF RES 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES / Commission Fee IBSEISMICRE Seismic Residential B 1 REROOFM EES Re-roof Multi-Family B 1MFDWLROOF 1BCBSC Cal Bldg Stz.ndards B ALL PERMIT TYPES Commission. Fee IBSEISMICRE Seismic Residential B 1BUSLIC Business Li,;ense 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 Ci+y,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 withou first obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be pe:-formed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fE e 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 abo,.re stated policy on re-roofing. Homeowner's Name: ✓e C tie VX 4) Job Site Address: Z J Okl✓1 5 t Roofing Company Name: W C 51skllovre F-Oafilnq rl�f C Applicant's Signature: Date: Greg Casteel Building Official Revised 07/30/08 114PUT Resources Energy A' - M.Indoor Air Quality and Finishes 1.Use LowMo-VOC Paint 1 IAQ/Health pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes 14 IAQ/Health pts y=yes 0 3.Use Low/No VOC Adhesives 'C IAQ/Health pts y=yes 0 4.Use Salvaged Materials for Interior Finishes ;I Resource pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde (I IAQ/Health pts y=yes 0 6.Use Exterior Grade Plywood for Interior Uses IAQ/Health pts y=yes 0 7.Seal all Exposed Particleboard or MDF I IAQ/Health pts y=yes 0 8.Use FSC Certified Materials for Interior Finish .1 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim I Resource pts y=yes 0 10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes I 0 ■ 1 i 1 N.Flooring 1.Select FSC Certified Wood Flooring 6 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 I)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. 1 i 1 Total Points Available: 1401 130 57 Total Points Project Received: 0 01 0 G:data/progs/gree nbuildngguidelines/remodelers/greenpointsfina12.12.o4protected.xls Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 .;UPERTINO Building Department JOB ADDRESS: 6 fiZ T PERMIT#j} -3<F7 OWNER'S NAME: Ckwevt4fj PHONE # 115 6 'O 200 GENERAL CONTRACTOR fi- 9,v f, FAX # Z-3 3 I am not using any subcontractors: 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 Owner/Contractor Signature D e