08070069 (2) CITY OF CUPERTINO � �,xrsry�wa r€a y fes^^� .gym
BUILDING DIVISIOrti PERMIT CO�I'TRACTOR IN ',oz� 'rrax, .
PERMIT NO.
But
I.gTcalTT'kMERSET DR PRINCIPLE ROOFING & 08070069
OWNER'S NAME: PERMIT ISSUE DATE
K.1*2T NGUYEN 10160 STERN AVE 07/11/2008
NE: SANITARY NO, CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
REMOVE EXISTING WOODSHAKES, BLDG ELECT PLUMB MUCH
O O I= O
i!Op LICENSED CONTRACTOR'S DECLARATION JobDescription
I hereby amore wt 1 am licensed uMcr provivoos of Chapter 9(commenting -----' ----„- „ ,•- ' '••-
with Section 70110 of Divimm S of dm Business and Profession,Cade,and my license u
nba ren omeanaert�IUe.4
>�=
in
cCara
Date Contractor –
ep ARCHITECTS be
DECLARATION
W U
In
uMuwnJ my plus Nall be used u public mcoNs
a.
L G�a Licensed Professional
3 OWNER-BUILDER DECLARATION
if 1 hereby atom that 1 am exempt from Ne Conuam es Licen m Law for the
00 following mason.(section 7013.Busincous and professions Codc:My city m county
S$ which re,rims a permit m eons rwa shcr,improw,dcom W,or repair any stratum,
prior to its issuance.am myuimm the applicant forsuch Permit to file a signed summer,
S0 aans
that he is licensedpunntMtheprovisioartheconnectorvc
sumLaw(Chaper9 Sq.Ft. Floor Area Valuation
yFs (commencing with Section 70D0)of Division Sof Ne Business and Professions Cade)err
But k u exempt therefrom attd the basis for the alleged exemption.My violatiut of
section 7011.5 by any applicant for a permit subjects ere applicant Is a civil pointy of APN Number Occupancy Type
ret Mort Bun five hundred dollars(5500).
1,u owner of Ne Pmpary,err my wployev with wage u Ne"vale campevadm,
lore do f os mk amd Ne he Consomme.
La co errawred Trials(Sec.to an ower o.
w property
mons code:The Conuumr,umnse mes ave an[apply M an awms is Required Inspections
propertylona beamoriMproves wm p and whodmawinwart araffeadNmuLb his
awn wr.l Wiprovided Natsuchmti.mldwi arenotinurdedm ledw.resale,if.
Wilda.Ne W eche,m iMPmwment is cold within ore yens of completim.Ne owe of
builder vela have the,WAm of proving Nu k did not brtiW a improve for pure-•-of
sale.).
1.u owner a Ne property.aro eultmvely cmusaing with liconsed conmmas M
conarium the Project(Sec.7014,Business and PmRssbm Coda:)The Coammo's U. .
cove raw does not apply te an owner of property who builds or improves Nemon,and
who contracts for such projects with a commusrts)licensed pursuant te the Contruloes
Lieemse law.
❑Iamuu,ammosm. ,B&PCrmmcsre»on
Owmr Dale
WORKERS COMPENSATION DECLARATION
I hereby alrim under penalty of Perjury arc or the following dedanuons:
1 marc and will reasons a CutiBmm ofCament M self-insure for Workers Carolina-
on.an for by Section 3700.1' man¢dw Labor Cade.our the pmfoof Ne
work ro rob Nu permit u issued.
have and will maintain Workrs Compo ummi Insuranm,u required by Section
1700 of circ labor Cadc,fa Ne peRormame of the work for which Nin permittsiaued. '
My Workers Compensation Insurance curl"and Policy number art:
timer. Policy No.: L19041GC< �
RTION
FROM WORKERS'
COMPENSATION INSURANCE
(ITismedm med not he completed lithe permit is foram hundred dollars(11100)
mless)
1 wtifv Nat in the poxfomamc of the won far which this permit in issued.I still ata
employ any person in any manmrm u to become sublut M the Wortus'Compensation
Laws of Celifamiu Dam
Applicant
NOTICE TO APPLICANT:IL star making this Cenifiam of Eumption,you should
becerne subject M Ne Wagers Compensation provisions of NC L mon Code.yea am
�aJ O forthwith--PIY with each ryovisiov a that permit small W dmmed rooked.
CONSTRUCTION LENDING AGENCY
'[—r��+ 1 krebY atom Nar there I..ormar coon lending agency for Ne perfamame of
tY > the work for which this permit ts issued(ree.3097.Civ.e.)
O Lenders Name
D z Lenders Address
()O I cutifY that 1 have mad this application and sum Nat tic shave information is
[I. comet.I agree M comply with all city and county ordinances and sum laws relating M
O Wilding cammu:tion,and hereby sunbeams mpruenuin,or this city to enter upon Ne
ahow-manuarmd lareporty,
costs
ra insp cum purposes
F y (Wc)agree m an,indemnify and keep harmless Ne City of Cupermw against
Z incoluv,jedcofthecvuand vpevNooll may in any way num against said City
t')Z A APPLICANT
of the taming of this D WI .may
ti APPLICANT UNDE0.5TANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:9 Date
SOURCEULA&iG TIQNS.
' 7 Re-roofs
Signature of Applicauutor Data
HAZA
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will this e Cupnr a FuturoipalSgemupapt teamorsundm Heallovmamriai
u mRmd by the 32(a)?m MuniriWl ode.Chapter 9.13.aro Ne HnIN and Safety
Code.Swam zssnp)7 All roofs shall be inspected prior to any roofing material being installed..
❑Yu o
If a roof is installed without first obtainingan inspection,I agree to remove
Will the applicant or future buil amupant ver cyuipmeM or devices whicM1 P g
u lmommv air con arahmou u reed by Ne Bay Arta Air Quality Management all new materials for inspection.
Id.'.
P❑YatI ham mad the bacardmu materials requkmmu under Chapter&95 of the Calif".
Ffulth&SafetyCarlo•Sccdom3M5.35533nm 5U.lundcrnandNuifde Wilding
ret cumntly haw a lenmt.dm it u my reapamibility M ratify the emLpml of da:
uirerge n, hmmtkmetpriormiauanceafaccnirKwofa Signature of Applicant Date
^~`— d��y� All roof coverings to be Class'1?"or better
Owncf ranthodmdagcnt Date" g
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36930010 . 00
DATE ISSUED. . . . . . . : 07/11/2008
RECEIPT # . . . . . . . . . : BS000005403
REFERENCE ID # . . . : 08070069
SITE ADDRESS . . . . . : 20219 SOMERSET DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : KIET NGUYEN
ADDRESS . . . . . . . . . . : 20219 SOMERSET DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-3131
RECEIVED FROM . . . . : PRINCIPLE ROOFING
CONTRACTOR . . . . . . . : DERECKLOI - LIC # 27564
COMPANY . . . . . . . . . . : PRINCIPLE ROOFING &
ADDRESS . . . . . . . . . . : 10160 STERN AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
TELEPHONE . . . . . . . . : (408) 898-7298
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
- ------------- ---------- ---------- ---------- --- - ----------
1BSEISMICR VALUATION 10, 000 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1REROOFRES SQ FEET 23 . 00 299 . 00 0 . 00 299 . 00 0 . 00
---------- ---- ---------- ----------
TOTAL PERMIT 300 . 00 0 . 00 300 . 00 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- -------------------
CREDIT CARD 300 . 00 master card
---------------
TOTAL RECEIPT 300 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS X605 FINAL REROOF
•
CITY OF CUPERTINO
REROOF
• Y OF
CUPEkTINO PERMIT APPLICATION
d�o�aa�v9
APN # Date:
U d/D,G�
Building Address:
ZOZ Iy zw- ,
Owner's Name: Phone #:
C400 640 - X9*5
Contractor: Phone #:
!016o S7-!4,1i Fax #:
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ ilt-Up roof
❑ ,Asphalt Shingles d Asphalt Shingles
or Wood Shakes ❑ Wood Shakes
o Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report #
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: ��� �s�� /��yG� Sf/ i yn�0`be l�� OSS c�Pj�
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. Z5—
Valuation: / 0 Oat/
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
• � e
Signature
CITY OF CUPERTINO
Z(oli-A REROOF
CITY Of
CUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
1REROOFRES Re-roof Residential B_ . 1SFDWLROOF
27
1BSEISMICRE' Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08
•
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 1997 UBC Standards
and manufacturers specifications on re-roofing.
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 1/4" 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:
Roofing Company Name: P ��c-��
T- 6
Applicant's Signature: Date:G/ 77�ua
Greg Casteel
Building Official
Revised 11/2/04
Green Building Plan Check
Index of Green Building Points/Categories
A. Category Example of an Index or Table of Green Plan Sheet or Page Points
Building Points Categories that must be
shown and referenced on the Project
Plans See below
a.
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 2 points
11. Permeable Paving, Note L-1 2 points
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 points
D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, detail S-2 2 points
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 2 points
F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 points
5. Tankless W.H., (Note/Spec.) A-2 2 points
11. A 2500 Gal. Tank, (Note/Spec L-1 10 points
G. Electrical 4. E.Ceiling Fans, (Note/Spec.) A-3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point
3. Energy Star Refrigerator, (Note/Spec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 40 points
•
Plan Review Process Work Book Page-12-Revised 3/25/08
Green Points Rating System for Remodeling Projects _
Due to the diversity of remodeling project types,assigning a'total points'value to a project to be considered environmentally friendly is •
not feasible. However,25 measures have been highlighted to signify that every effort should be made to incorporate them into your
projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with
ease of implementation and relative low cost. These measures can be used as a starting point for'greening'your project:
INPUT Resources Energy A0111eafth
A.Site
1.Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;'80%=4 points up to 4 Resource pts . 0
2.Salvage Reusable Building Materials 4 Resource pts y--yes 0
3.Remodel for Mixed Use,Adaptive Reuse,and
Historic Preservation 4 Resource pts y=yes 0
4.Protect Native Soil 2 Resource pts y=yes 0
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y=yes 0
6.Implement Construction Site Stormwater Practices 2 Resource pts y=yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 0
8.Design Resource-Efficient Landscapes and Gardens 4 Resource pts y=yes 0
9.Reuse Materials/Use Recycled Content Materials
for Landscape Areas 2 Resource pts y--yes , 0
10.Install High-Efficiency Irrigation Systems 2 Resource pts y=yes 0
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes 0
1 1 1
B.Foundation
1.Incorporate Recycled Flyash in Concrete
25%Recycled Flyash=2 points;Add 1 point for every 10% .
increase of flyash,up to 5 points up to 5 Resource pts 0
2.Use Recycled Content Aggregate 2 Resource pts y=yes 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yesF 0
1 1 1
C.Structural Frame
1.Substitute Solid Sawn Lumber with Engineered Luriibe"r' 3 Resource pts y--yes 0
2.Use FSC Certified Wood for framing
(For every 10%of FSC lumber used=2 points,up to 10) up to 10 Resource pts. 0
3.Use Wood I-Joists for Floors and Ceilings 2 Resource pts y--yes 0
4.Use Web Floor Trusses 2 Resource pts y=yes 0
5.Design Energy Heels on Trusses 6'or more 2 Energy pts y=yes 0
6,Use Finger-Jointed Studs for Vertical Applications 2 Resource pts y=yes 0
7.Use Engineered Studs for Vertical Applications 2 Resource pts y=yes 0
B.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0
9.Use Structural Insulated Panels(SIPS)
a.Floors 3 Energy pts y=yes 0
b.Wall 3 Energy pts y=yes 0
C.Roof 3 Energy pts y=yes 0
10.Apply Advanced Framing Techniques 4 Resource pts y--yes 0
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes 0
12.Use OSB
a.Subfioors 1 Resource pt y=yes 0
b.Sheathing 1 Resource pt y=yes 0 •
INPUT Resources Energy lAOlHeafth
Windows
1.Install Energy-Efficient Windows
• a.Double-Paned 1 Energy pt y--yes 0
b.Low-Emissivity(Low-E) 2 Energy pts y--yes 0
c.Low.Conductivity Frames 2 Energy pts y=yes 0
2.Install Low Heat Transmission Glazing 1 Energy pi y=yes 0
1 1 1
J.Heating Ventilation and Air Conditioning
1.Use Duct Mastic on All Duct Joints 2 Energy pts yryes 0
2.Install Ductwork within Conditioned Space 3 Energy pts y=yes 0
3.Vent Range Hood to the Outside 1 IAQ/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 0
5.Install Solar Attic Fan 2 Energy pts y=yes 0
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts Y--yes 0
8.Install Sealed Combustion Units
a.Furnaces 31AQ/Health pts y=yes 0
b.Water Heaters 3IAO/Health pts y=yes 0
9.Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wall Heat Pumps 3 Energy pts y=yes 0
10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts y=yes 0
11.Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes 0
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes 0
• 13.Retrofit Wood Burning Fireplaces
a.Install EPA certified wood stoves/inserts 1 IAQ/Health pt y--yes 0
b. InstalVReplace Dampers 1 Energy pt y=yes 0
c.Install Airtight Doors 1 Energy pt y=yes 0
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes 0
15.Install High Efficiency Filter 41A0/Health pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes 0
17,Install Separate Garage Exhaust Fan 3 IAO/Health pts y=yes 0
1 1 1
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes o
2.Install Solar Water Heating System 10 Energy pts y=yes 0
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes 0
4.Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=18 points) Up to 18 Energy pts 0
6.Select Safe and Durable Roofing Materials t Resource pt y=yes 0
7.Install Radiant Barrier 3 Energy pts Y--yes 0
1 1
L.Natural Heating and Cooling 1
1.Incorporate Passive Solar Heating 5 Energy pts y=yes p
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts , y=yes 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes p
•
0 1 0
Community Development
F 10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
�UPERTINO
Building Department
JOB ADDRESS: PERMIT #
2001g 6 --zdoG 9
OWNER'S NAME: (G' PHONE #
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors: CIO-/�����
Signature Date
Please check applicable subcontractors and complete the following information
66 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum / Wood
soGlass / 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