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09080325 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19483 PRUNERIDGE AVE CONTRACTOR:WATERPROOFING PERMIT NO:09080325 ASSOCIATES O'"H'ER'S NAME: HEWLETT PACKARD 915 TERRA BELLA AVE DATE ISSUED:08/24/2009 Ov..iER'S PHONE: 4084475174 MOUNTAIN VIEW,CA 94043 PHONE NO:(650)937-1299 ❑ LICENSED CONTRACTOR'S DECLARATION E UILDING PERMIT INFO: BLDG r- ELECT F PLUMB F License Class —4am Lic.# T / F F MECH RESIDENTIAL COMMERCIAL Contractor L I hereby affirm thnsed u"�ision�sof CVter�9 JOB DESCRIPTION:RE-ROOF REMOVE EXISTING ROOF&INSTALL (commencing with Section 7000)of Division 3 of the Business&Professions 5i8"GIPSON Code and that my license is in full force and effect. 1.5 POLYISOCYANURATE INSULATION 1/4"DENS DECK& 45MIL TITLE 24 FIBERLITE MEMBRAIN CLS A 227 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. 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:$163174 permit is issued. APPLICANT CERTIFICATION APN Number:31607044 Occupancy Type: 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 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 so gulations per the upertino Municipal de,Section 9.18. Issued b ' "'Z.... Date: S; 'ire Dat _...-�-,e.7 ❑ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of Xll 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 1,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: I,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 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 -ompliance 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 iafety Code,Section 25532(a)should I store or handle hazardous material. Wditionally,should I use equipment or devices which emit hazardous air permit is issued. ontaminants as defined by the Bay Area Air Quality Management District I will 1 certify that in the performance of the work for which this permit is issued,[shall naintain 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 C ns 25505,25533,and 25534. /11 Compensation laws of California. If,after making this certificate of exemption,1 become subject to the Worker's Compensation provisions of the Labor Code,I must 3w er u gent: forthwith comply with such provisions or this permit shall be deemed revoked. e' APPLICANT CERTIFICATION ONSTRUCTION LENDING AGENCY I certify that I 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 -- V 'ie above mentioned property for inspection purposes.(We)agree to save ii,. .nify 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 ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature __ Date _ Licensed Professional ol0 o�� CITY OF CUPERTINO ` REROOF CUPEkT1NO PERMIT APPLICATION APN '5 it, O—q- C>0# �r � Date: f Building A dress: �ZA,/ Owner's Name: Phone #: HOA: Yes No If yes, provide le-,-ter from HOA Lko— Contractor* Phone #: X—` Fax #650 upertino Busirtless Licens : �3 r Contracto LicenseA:Lf 0 d� Type of hoof Covering: Existing: Proposed: �$ ilt-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 # XTo be Removed ❑ Provide Mfgr. Installation Specs. Job Description: els _ ��/ sY� A-It. 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 inclex. Valuation: I Have Read, derstan and i 1 with Cupertino's Tear-Off Policy: Sig Revised 02/05/09 CITY OF C'UPERTINO a�-. REF;OOF CITY OF CUPEkTINO FEE SC:KEDULE 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 Commissio l Fee 1BSEISMICO Seismic Commercial B 1RER00FRES Re-roof Re;,idential B 1SFDWLR00F 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1 BSEISMICRE Seismic Residential B 1REROOFMRES 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 Tone 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 agi ee 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 Citi,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 nai.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:nspection 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 1/4 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: Job Site Address: f Ve All Roofing Company Name: ' Applicant's Signature,q�aDate: Greg Casteel Building Official Revised 07/30/08 M.Indoor Air Quality and Finishes- 1. inis es1.Use Low/No-VOC Paint 1 IAQ/Health pts y--yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 77 0 3.Use LowMo VOC Adhesives 2 IAQ/Health pts y=yes 0 4.Use Salvaged Materials for Interior Finishes Resource pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde E,IAQ/Health pts y=yes 0 6.Use Exterior Grade Plywood for Interior Uses IAQ/Health pts y=yes 0 7.Sea]all Exposed Particleboard or MDF IAQ/Health pts y=yes 0 8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes D 9.Use Finger-Jointed or Recycled-Content Trim Resource pts y=yes 0 10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0 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 : 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 Total Points Available: 140 130 57 Total Points Pro ect Received: 0 51 0 G:data/p srgre ibuildnggui eline remodelers/gr npoi sfina12.12.D4protected.xls / Community Development 10300 Torre Avenue as Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 CUPEkTINO Building Department JOB ADDRESS: e,("V Q6.4-e PERMIT # 09 0 b 3,:" � 1 q q Rrb� OWNER'S NAME: PHONE # GENERAL CONTRACTOR: # I am not using any subcontractors: �Z Signature D to Please check applicable subcontractors and con. lete the following information: SUBCONTRACTOR BUSI:vESS 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 9Z� Owner ontractor ' ature Date