09080118 (2) CITY OF CUPERTIND BUILDING PERMIT
BUILDING ADDRESS:,10325 WUNDERLICH DR CONTRACTOR:KAI JIN PERMIT NO:09080118
OWNER'S NAME: KAI JIN 10325 WUNDERLICH DR DATE ISSUED:08/13/2009
l ER'S PHONE: 5107095985 XPERTINO,CA 95014 PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r—
License Class Lic.# MECH f— RESIDENTIAL 1— COMMERCIAL
Contractor Date
JOB DESCRIPTION:RE-ROOF INSTALL SHINGLES ON THE PITCH
licensed 1 hereby affirm that I am licd under the provisions of Chapter 9
(commencing with Section cense of Division 3 of the Business&Professions AREA(I I00SQFT)INSTALL PLYWOOD ON THE PITCH AREA
;l/2"),ASTIN FELT PAPER(30LB)(30YRS
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.
1 have and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$5000
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued.
APN Number:37516022 Occupancy Type:
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
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
9.18. Issued b Date:
Signature Date —� 3 �
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 ant 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 foliowing two reasons: inspection.
I 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, Si n tureof Ap—plicant: Date:
Business&Professions Code) I
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 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.
Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air
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
Compensation laws of California. If,after making this certificate of exemption,I Owner or �grized
{ 01 ,
become subject to the Worker's Compensation provisions of the Labor Code,I must f_ J Date:
f forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRl1C"TION LENDING AGENCY
_APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's
I certify that 1 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
up,-the above mentioned property for inspection purposes.(We)agree to save Lender's Address —
i iffy and keep harmless the City of Cupertino against liabilities,judgments,
co-,..,,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
OWNER-BUILDER VERIFICATION
1. (Check one) I o7,A]l
immediate family ;parent,spouse or child) will perform:
the work authorized by this permit
B. A portion of the we rk
C. _ None of the work
If B or C is checked,complete 2 or 3 below.
2. A state licensed contractor will be hirec.to do:
A. All of the work
B. A portion of the work(complete section below)
Contractor Address/City. Phone # State License # Type of work to
3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or
portions of the authorized work. I understand that I may be an employer(see reverse side). A
Certificate of Insurance covering workers' corapensation must be on file at the City of
Cupertino Building Department office.
PersorVFirm Address/City . Phone Number Type of work to be
erformed
............................................................................ ..............
I declare under penalty of perjury that the above is true and correct. I have read and understand the
Owner-Builder Information (reverse side).
Date: J I
Property Owner's Signature:
Ido 0
M
job Address: Uadev
Any changes to the information Provided o:1 this form shall be submitted to the City of Cupertino Build
Department.
CITY OF 41UPERTINO
RE:ROOF
CUPEkT1NO PERMIT APPLICATION
APN # Date:
--7 �5 -/ o
Building Address:
i v
Owner's Name: ' hone #:
HOA: No If es provide letter from HOA -to 707
. Yes ❑
Contractor: Phone#:
f� —_7
Fax #:
Cupertino Busine License #: Contractor License #:
Type of F.00f Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
Asphalt Shingles \p/Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
ItImber of existing coverings ❑ Provide I.C.C.E.S. Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: h s a� $ i+� e S opt .V cCY 2G✓ , I 1 0feet
1�
tr W
pit ft�S �rc,�t., s �' �i C�-S ` - ' 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, � 0 oQ -
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 02/05/09
CITY OF C'UPERTINO
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
1 REROOFRES Re-roof Residential B 1SFDWLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Residential B
1 REROOFMRES Re-roof M ilti-Family B 1MFDWLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Residential B
1 BUSLIC 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 buildi:lg inspector. A final inspection and
approval shall be obtained from the f uilding inspector when the re-roofing
is completed.
3. All roofs shall be inspected prior to a1y roofing installation.
4. To receive a final sign off from the City,the following steps are
required:
1) Pre-inspection and/or tear off apFroval.
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 m aterial down to the sheathing,
so a proper City inspection can be pe rformed.
7. NOTE: If you call for a plywood nai:.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 cpm be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of "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: G'y
1n� ,,( A
Job Site Address: t? 3ZS v" ��V` t "
Roofing Company Name:
Applicant's Signature: Date:
Greg Casteel
Building Official
Rev sed 07/30/08
M.indoor Air Quality and Finishes
1.1Jse LDwMo-VOC Pairst 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes. D
3,Use Low44o VOC Adhesives 3 IAQ/Health pts y=yes D
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 D
7.Seal all(Exposed P"claboar3d or MY 4 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 1 Resource pts y=yes 1 D
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0
N.Fiooring
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0
2.Use f3apidly f3enewable 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 D
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
Nowt i E
Total Points Available: 1 1401 130 57
Total Points Project Received: 01 OF 0
G:data/progs/c reenbuildingguidaiines/remodelers/greenpointsfinal2.12.D4prote¢ted.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 #
�3
OWNER'S NAME:
PHONE # v-- • �o—
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and co m Tete the foil 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/Contractor Signature