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10010004 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7484 DE FOE DR CONTRACTOR:R.M.YOUNG ROOFING PERMIT NO: 10010004 OWNER'S NAME: MUNOZ JOSEPH M AND ANITA M 817 N 6TH ST DATE ISSUED:01/04/2010 NER'S PHONE: 4082521373 SAN JOSE,CA 95112 PHONE NO:(408)375-1686 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class C-1 ' `7 Lic.# MECH RESIDENTIAL COMMERCIAL Contractor LVV 7Gs.e.c�C� Date 1Q I herebyaffirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF PUT 1/2"OSB SHEETING 30LB FELT&40YR COMP (commencing with Section 7000)of Division 3 of the Business&Professions ROOF CLASS A 24SQ 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 Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$9450 permit is issued. APPLICANT CERTIFICATION APN Number:35924035.00 Occupancy Type: 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 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, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. .� ._.. .. Date: Signature Date l U Issued by: �- �=�=r`'�� s7 �--'" - C � LJ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All 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, J /�U Signature of Applicant: Date: Business&Professions Code) 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: HAZARDOUS MATERIALS DISCLOSURE 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 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& 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 permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain 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 Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I Own a thorize agent: become subject to the Worker's Compensation provisions of the Labor Code,I must Date: forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION 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 unon the above mentioned property for inspection purposes.(We)agree to save rnnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address 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 I understand my plans shall be used as public records. 9.18. Signature l Date Licensed Professional CITY OF CUPERTINO PERMIT RECEIPT OPERATOR: patg 3 ITEMS OF 3 COPY # = 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35924035 .00 DATE ISSUED. . . . . . . : 01/04/2010 RECEIPT # . . . . . . . . . : BS000009477 REFERENCE ID # 10010004 SITE ADDRESS . . . . . : 7484 DE FOE DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : MUNOZ JOSEPH M AND ANITA M ADDRESS . . . . . . . . . . : 7484 DE FOE DR CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4307 RECEIVED FROM . . . . : R.M. YOUNG ROOFING CONTRACTOR . . . . . . . : ROBERT YOUNG LIC # 29032 COMPANY . . . . . . . . . . : R.M. YOUNG ROOFING ADDRESS . . . . . . . . . . : 817 N 6TH ST CITY/STATE/ZIP . . . : SAN JOSE, CA95112 TELEPHONE (408) 375-1686 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT- -THIS_REC_ NEW-BAL- ---------- ------ --- ------------- --9, 450 . 00 1 . 00 0 . 00 1 . 00 0 .00 1BCBSC VALUATION 1 . 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 91450 .00 0 . 00 312 . 00 0 . 00 1REROOFRES SQ FEET 24 .00 312 . 00 TOTAL PERMIT 314 . 00 0 . 00 314 . 00 0 . 00 REFERENCE NUMBER AMOUNT METHOD OF PAYMENT _____________ CREDIT CARD 314 . 00 VISA --------------- TOTAL RECEIPT 314 . 00 DESCRIPTION VOICE ID DESCRIPTION VOICE ID -------- ----- -------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CUPERTINO ' REROOF CITYOF APPLICATION CU PE TINO PERMIT APN # Date: 7_ Building Address: 91111-7 5ar— Owner's Name: Phone #. 511111 '. 141 6 z 52 HOA: Yes ❑ No ® If Yes, rovide letter from HOA Phone #: . � Contractor: qe � - ,?75�-/� V Fax #: i License #: Contractor License #: Cupertino Business 7 7 01;;I IIIF Type of Roof Covering: Existing: Proposed: ❑ Built-UpRoof ❑ Built-Up roof ■ ❑ Asphalt Shingles Asphalt Shingles a Wood Shakes ❑ Wood Shakes a Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) -d existing coverings ❑ Provide I.C.C.E.S. Report# Number of ex g gs ❑ Provide Mfgr. Installation Specs. a. To be Removed Job Description:-I/ 36Z,�. ire- Z c� r-- /24 a [�] Commercial Residential ❑ • levant portion of the Confirmed with Planning Dept. if Green Building. Please complete re p ❑ Green Building Checklist & attach it to the application or if there are any restrictions: applicable, include in plan set & the sheet index. Valuation: 40� I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09 CITY OF CUPERTINO REROOF C1n bF FEE SCHEDULE CUPEi�TiNO Fie Description Fee Permit Type Number of Fee ID Group Squares 1 REROOFCOM Re-roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee iBSEISMICO Seismic Commercial B 2 � 1REROOFRES Re-roof Residential B 1SFDWLR00F � 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee B 1BSEISMICRE Seismic Residential 1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee B 1BSEISMICRE Seismic Residential 1 BUSLIC Business License B Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 Fax: (408)777-3333 BuildingDepartment Subject: Re-roofingpolicy 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. oof coverings shall not be applied without first obtaining all inspection 2. New r g 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. If plywood is installed, a plywood nail inspection is required. 5. p 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. not ready, 7. NOTE: If you call for a plywood nail inspection and the fob is y g you well 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. I.C.B.O.report is re aired to be on the job site at the time on inspection. 2. An I.0 p q I understand and will comply with the above stated policy on re-roofing. Homeowner ' Name: s Job Site Address: Roofing Company Name: ' r Date: Applicant's Signature: Greg Casteel Building Official Revised 07/30/08 Community Development ba- � 10300 Torre Avenue w Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 CITY�OF 'UPEkTINO Buildin De arum e nt OB ADDRESS: PER # J� HONE # R'S NAME: a� �Z P � y OWNS FAX # GENERAL CONTRACTOR: Mey' i am not using an subcontractors: gn I g Y Si e ate gn Please check applicable subcontractors and com lete the f D110Wing 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 Date INPUT • a! M.Indoor Air Qua ity an 1.Use LowlNo-VOC Paitrt 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 VOID 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 61AQ/Health pts y=yes 0 Formaldehyde 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0 7.SeW all .Particleboard or MDF 4 IAQ/Health. pts y=yes 0 S.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 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 Total Points Available: 1401 1301 57 Total Points Project Received: �,..�� 0 0 Do G:datalprogslgreenbuildingguidelineObdelers/ ointsfina12.12.04protected.xis