09070127 CITY OF CUPERTINO
BUILDIN Q DIVISION PERMIT � R� Z� � �� �
BUILDING ADDRESS: PERMIT NO.
10237 CRESTON DR O'NEAL ROOFING INC. 09070127
OWNER'S NAME: PERMIT ISSUE DATE
R(11\T & HARRIET- SH II`JON �—
A
1AM,EU AVE
_ONE: A O• CONTROL NO.
(408) 848-3958
ARCHI7ECT/ENGiNEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
a0p LICENSED CONTRACTOR'S DECLARATION Job Description
u I hereby affirm that I am licensed under provisions of Chapter 9(commencing
with Section 7000)of Division 3,f the Business and fcssions Code,an license is
%+iy in full force and effect n O RE-ROOF T/0 OLD RF & INSTL 28LBS FIBRGLS
j Z License Cl Lie•M_
Date Contractor BASESHEET, TWO-PLY 72LBS CAP SHEET CLS A 34SQ
A CHITECrS DECLARATION
I understand my plans shall be used as public records
DWU
4 C y Licensed Professional
n y OWNER-BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for thc
is G O following reason.(Section 7031.5,Business and Professions Code:Any city or county
K which requires a permit to construct.alter,improve,demolish,or repair any structure
y Z y prior to its issuance,also requires the applicant for such permit to file a signed statement
x`e that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation
yt- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $17680
y that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not more than five hundred dollars($500). 32637043 . 00
❑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 offend for sale(Sec.7044,Business
and Professions Code:The Contractors License Law does not apply to an owner of Required Inspections
property who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improvements are not intended or offered for sale.If,
however,the building or improvement is sold within one year of completion,the owner-
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
❑1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044.Business and Professions Code:)The Contractors Li-
cense Law does not apply to an owner of property who builds or improves thereon,and•
who contracts for such projects with a contractor(s)licensed pursuant to the Contractors
License Law.
❑I am exempt under Sec .B dt P C for this reason
Owner Dare
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑I have and will maintain a Certificate of Consent to self-insure for Workers Compen-
sation,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 Workers Compensation Insurance,as required by Section
3700 of the Labor Code,for the performance of the work for which this permit is issued.
My Workers pe 6onrance ger and Polity numb arc:
Cartier /V Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars($100)
or less.)
I certify that in the performance of the work for which this permit is issued,I shall not
employ any person in any manner so as to become subject to the Workers'Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject to the Worker's Compensation provisions of the Labor Code,you must
Oforthwith comply with such provisions or this permit shall be deemed revoked.
z''~ CONSTRUCTION LENDING AGENCY
PV) I hereby affirm that there is a construction lending agency for the performance of
1:4 the work for which this permit is issued(Sec.3097,Civ.C.)
QLender's Name
z Lcndees Address
()C-) I certify that I have read this application and state that the above information is
w correct.I agree to comply with all city and county ordinances and state laws relating to
Ubuilding construction,and hereby authorize representatives of this city to enter upon the
Uabove-mentioned property for inspection purposes.
(We)agree to save,indemnify and keep harmless the City of Cupertino against
c4� liabilities,judgments,costs and expenses which may in any way accrue against said City
U,z in consequence of the granting of this permit.
0"4 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NO POINT Issued by: Date
SOUR REGULATIONS.�
Re-roofs
Sign tare Applicant/Contractor ate
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupant store or handle hazardous material
as defined by the Cupertino Mun•ipal Code.Chapter 9.12,and the Health and Safety
Cote,Section 25532(a)? All roofs ;hall be inspected prior to any roofing material being installed.
C3 Yes D o
If a roof i;;installed without first obtaining an inspection,I agree to remove
Will the applicant or future building occupant use equipment or devices which
emit hazardous air contamin3N.
as defined by the Bay Arca Air Quality Management all new materials for inspection.
District? j
❑Yes
I have mut the hazardous materials 5requirements33 d25under Chapter that
if the Calling � S/ O
nia Health&Safety Cade,Sections 25505.25533 and 25534.1 understand that iC the building Y /b
does not currently have a tenant,thatjt is my responsibility m notify the upant of the
reyuircmen ich must met prior to i ce of a Certificate of Oce ancy. SS lgnatu�r 'of Applicant ate
Owner 0ra rizcdagent a� All roof coverings to be Class'jW'or better
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk.: Lot :
APN . . . . . . . . : 32E37049 . 00
DATE ISSUED. . . . . . . : 07/ 16/2009
RECEIPT # . . . . . . . . . : BSC00008204
REFERENCE ID # . . . : 09C70127
SITE ADDRESS . . . . . : 10237 CRESTON DR
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : ROY & HARRIET SHANNON
ADDRESS 10237 CRESTON DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-1013
RECEIVED FROM . . . . : CAF.Y O'NEAL
CONTRACTOR CAF.Y O'NEAL LIC # 30553
COMPANY 01YEAL ROOFING INC.
ADDRESS . . . . . . . . . . : 9021 WREN AVE
CITY/STATE/ZIP . . . : GIIROY, CA 95020
TELEPHONE . . . . . . . . : (4C8) 848-3958
FEE ID UNIT QUANTITY IMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- -- -------- ---------- ---------- ----------
1BCBSC VALUATION 17, 680 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1BSEISMICR VALUATION 17, 680 . 00 1 . 80 0 . 00 1 . 80 0 . 00
1REROOFRES SQ FEET 34 . 00 442 . 00 0 . 00 442 . 00 0 . 00
-- -------- ---------- ---------- ----------
TOTAL PERMIT 444 . 80 0 . 00 444 . 80 0 .00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 444 . 80 VISA
---------------
TOTAL RECEIPT 444 . 80
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
09 0-1 D 1 ,11
CITY OF CUPERTINO
Z ' � R F'ROOF
CUPEkTiNO PERMIT APPLICATION
APN # Date:� � Date: � � '?�-7 q �� � 1
_:�l �p
Building Address:/*0 L3-7 aE 5 T a t,) f) rL
Owner's Name: p N f 14Ag21 G+ 5 k A N//o Al Phone#: 3 q9 _ 45-5-4
HOA: Yes ❑ No [ / If yes, provide letter from HOA
Contractor: 0i 1yAt_ 20 f5r".- -,r-pc- Phone #: qo y 960 — 67-17(,
y� �a
8�
'�' Z I w��d Al-e- (, l�,v <7.��' z_o Fax #: 4/6 y 8
Cupertino Business License #: 1� �- Contactor Licen #:
;0 98
Type of hoof Covering:
Exi:MBuilt-Up
Proposed:
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#
ra/To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: Z/j,a�C'�,�,�
Se i�L
r ���� Js eczy
Residential EY Commercial ❑
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the a;:)plication or if there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuation:
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 02/05/09
CITY OF CUPERTINO
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
Commis;;ion Fee
1BSEISMICO Seismic Commercial B
3"-f 1RER00FRES Re-roof lZesidential B 1SFDWLR00F
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic :Zesidential B
1 REROOFMRES Re-roof Idulti-Family B 1MFDWLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic lZesidential B
1BUSLIC Business License B
INPUT Resources Energy AO
M.Indoor Air Quality and Finishes
1.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 0
3.Use Low/No VOC 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
Formaldehyde 61AQ/Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0
7.Seal all Exposed Particleboard or MDF 4 IAQ/Health pts y=yes 0
8.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 17770
. 1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring E Resource pts y=yes 0
2.Use Rapidly Renewable Flooring Materials Resource pts y=yes 0
3.Use Recycled Content Ceramic Tiles 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 i Resource pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs Resource pts y=yes 0
Total Points Available: 1 1401 130 57
Total Points Project Received: 01 5F 0
G:data/progslgree ibuildingguidelines/remodelers/grLknpointsfinal2.12.D4protected.xis
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 appli ed without first obtaining all inspection
and written approval from the buildi-ig inspector. A final inspection and
approval shall be obtained from the t uilding 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 na it 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 pei-formed.
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/ "per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be ori the job site at the time on inspection.
I understand and will comply with the above statedpolicyon re-roofing.
Homeowner's Name: Zow U.ff �A r Sl-� rJNo
Job Site Address: I 0 Z3_? C- �C �O AJ
Roofing Company Name:
i
Applicant's Signature: ti Date:
Greg Casteel
Building Official
Revised 07/30/08
Community Development
10300 Torre Avenue
' Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
,-UPEI�TINO
Building Department
JOB ADDRESS: PERMIT #
r O Z 3-7 c.e c s4,\) 'Pit, .-0 qo
OWNER'S NAME: Zo IJ � 14 /L21C"fi SG to N!?/Dk) PHONE #
GENERAL CONTRACTOR: ONEAL FAX#
I am not using any subcontractors: 7 Id61 a
Si;nature 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
OwKer/ Signature Date