09050012 CITY OF CUPERTINO � � � «
BUILDING,DIVISION PERMIT
BUILDING ADDRESS: PERMIT NO.
10696 S T 9TAU AVE COSMOS ROOF :
PERMIT ISSUE DATE
OWNER'S NAME:
i9(4— MlEGIEF A CONTROL NO.
ION ami 7')
(650) 969-7663
BUILDING PERMIT'INFO
ARCHITECr[ENGINEER: BLDG ELECT PLUMB MECH
u O p LICENSED CONTRACTOR'S DECLARATION Job Description
v 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing
with Section 7000)of Division 3 of the Business and Professions Code,and my license is
=y —RF Ti0 EXT BUR RPLC_ W/SAME 24SQ CLS A
in full force and effec —G u —RE
vn Z Lice I Class Lam•
n M Q Dale- 1 Con
ARCHITECTSDECL A ION
a< I understand my plans shall be used as public records
�yU
c y Licensed Professional
OWNER-BUILDER DECLARATION
1 hereby affirm that i am exempt from the Contractor's License Law for the
.20 2o following reason.(Section 7031.5,Business and Professions Code:Any city or county
y- which requires a permit to construct,alter,improve,demolish,or repair any structure
prior to its issuance,also requires the applicant for such permit to role a signed statement Ft.Floor Area Valuation
< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq
Ey.F--$ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $9770
y that he is exempt therefrom and the basis for the alleged exemption.Any violation of Occupancy Type
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number
not more than five hundred dollars(5500). 37537004 . 01
❑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,Business Required Inspections
and Professions Code:The Contractor's License Law dors not apply to an owner of
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 Contractor's 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 Contractor's
License Law.
❑I am exempt under Sec. B&P C for this reason
Owner Date
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-insum for Worker's Compen-
-tion,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 required by Section
3700 of the Labor Code,for the performance of the work for which this permit is issued.
My Worker's Compensation insurance carrier and Polity number ale: tb
Carrier. /�Uil/t� PolicyNo.:
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.1 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 Codc,you must
Z forthwith comply with such provisions or this permit shall be deemed revoked.
Z CONSTRUCTION LENDING AGENCY
(.r rte-, I hereby affirm that there is a construction lending agency for the performance of
p; the work for which this permit is issued(Sec.3097,Civ.C.)
W Q Lender's Name
Z Lender's Address
1 certify that i have read this application and state that the above information is
LUL correct.I agree to comply with all city and county ordinances and state laws relating to
U building construction.and hereby authorize representatives of this city to enter upon the
W above-mentioned property for inspection purposes.
(We)agree to save,indemnify and keep harmless the City of Cupertino against
in liabilides,judgmcnts,costs and expenses which may in any way accrue against said City
U Z in consequence of the granting of this permit. Date
0-4 AP ANT UNDERSTANDS AND WILL COMPLY WiTH ALL NON-POINT Issued b)':
S REGULA NS l
z�-?,-,)VL) Re-roofs —
Signature of Applicant/ContractorDare T of Roof
HAZARDOUS MATERI ISCLOSURE ype
Will the applicant or future building occupant store or handle hazardous material
as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety
Code,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
fi
❑Yesru.0building
Will the applicant or occupant use equipment or devices which
If a roof is installed without first obtaining an inspection,I agree to remove
est hazardous air contaminants as defined by the Bay Area Air Quality Management all new rlaterials for inspection.
,strict?
❑Yes
1 have read the hazard materials requirements under Chapter 6.95 of the Califor-
nia Health&Safety Code,Sections 25505.25533 and 25534.1 understand that if the building ( CVS
d currently have a tenant,that it is my responsibility to notify ft occupant of the
re ire nus which must t prior to issuance of a Certificate of Occupancy. Signature of Ap Date
11 roof verings to be)assA'or better
Owner or authorized Datc
CITY OI' CUPERTINO
REROOF
I F
CUPEkTINO PERMIT .APPLICATION
APN # 7 , 0 / Date:
y z��
Building Address:
,fid l a
Owner's Name: Phone M
�y
ff
Contractor: Phone #:
CoS �S ` ,�� Fax#: O-
6j
Cupertino Business License M / yY Contractor License #:
72�,-5- yY
Type of lZoof Covering:
Existing: 1 Proposed:
Built-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.B.O. Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
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:
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
CITY OF CUPERTINO
REROOF
CUPEkTiNO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Conimercial B
1 REROOFRES Re-roof Res:dential B 1 SFDWLROOF
1BSEISMICRE Seismic Res ldential B
1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1 BUSLIC 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 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 City,the following steps are
required:
1) Pre-inspection and/or tear off ap;:)roval.
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 niaterial 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 f�e of$176.18. The re-inspection fee must
be paid before another inspection c,m be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of lei "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: 'c? l�"f C. 9 (` A,
Job Site Address: /( to / `► 7' (,J Ay C
Roofing Company Name: 0S vl�l 01-S CD
Applicant's Signature: Date: 6
o
Greg Casteel
Building Official
Revi ied 07/30/08
_ 06 IP I/ 4 K4'?0 hvL
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 M MM
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, (mote) 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, (Not e,'Spec.) A-4 2 points
F. Plumbing 1. Insulate all H.W. pipes, (Note/3pec.) P-1 2 points
5. Tankless W.H., (Note/Spec.) A-2 2 points
11. A 2500 Gal. Tank, (Note/Spec i 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 I30INTS 40 points
/*
Plan Review Process Work Book Page-12-Revised 3/2508
INPUT RLsoumes Energy AQ
I.Windows
1.Install Energy-Efficient Windows
a.ruble-Paned t Energy pt Y=Yes 0
E 2 Energy pts Y=yes 0
b.Low-Ernnssi�ty{1mw' ) 0
c.Low.Conductivity fumes 2 Energy pts y=yes
2.Install Low Heat Transmission Glazing 1 Energy pt Y=yes 0
J.Heating Ventilation and Air Conditioning
1.Use Dud Mastic on AM Duct Joints 2 Energy pts Y=YeS0
2.Install Ductwork within Conditioned Space 3 Energy pts y=yesF 1 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 3 IAQ/Health pts y=yes 0
b.Water Heaters 3 IAQ/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. Install/Replace 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 4 IAQ/Health pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAO/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yes I 1 0
' 1 1 1
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes 0
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 1 B Energy pts 0
6.Select Safe and Durable Roofing Materials 1 Resource pt y=yes J01
7.Install Radiant Barrier 3 Energy pts yges
' ! 1 !
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes 0
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 0
- INPUT Resources Energy IAO/Health
M.Indoor Air Quality and Finishes
1.Use Low/No-VOC Paint 1 IAQ/Health pts y=yes p
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes. p
3.Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes p
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 p
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes p
7.Seal all Exposed Particleboard or MDF 4 IAQ/Health pts y=yes p
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 LZL Ip
N.Flooring
1.Select FSC Certified Wood Flooring B 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 5 IAQ/Health pts y=yes p
5.Use Exposed Concrete as Finished Floor Resource pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs Resource pts y=yes 0
Total Points Available: 1 14OF 1301 57
Total Points Project Received: 0t 01
s
G:daWprogs/gree ibuildingguidelines/remodelers/greenpointsfinat2.12.D4protected.xis
May 01 09 -08: 00a Cosmos Roofing (650)969-9905 p.2
Commug*Dwebrow
10304 Tens AV a
Cypmtimo CA 95014
Taapb=(409)777--3229
CUfflt INO Fa(409)m-33M
Buil&mg Department
JOB ADDRESS: PERbIIT#
10 ,4 &
OWNER'S NAME:t a v erg / 6,d, PHONES--
GENEIiALCONTRA FAX#
I am not using any subcon �� 2704r
Date
check =
Please chea livable subcontractors acum plabs the foltowm iJnforntadon:
SUBCONTRACTOR BUS114ESS NAME BUSINESS LICENSE#
Cabinets&Millwork
Cement Finishing
IIectsical
Excavation
Fencing
Flooring
Linoleum/Wood
Glass�Glazing
Heating
In4ulatiaal
Landscaping
Lathing
Chuntental Sheet Metal
Painting/Wallpaper
PwhW
---- ---- - ----- ---- __.._-. --- -. -- - ---Roaft
- --- - -
Pl
yy
Septic Tank
Sheet Metal
Sheet Rock
Til
- _ LZ7 We
ontractor Si Date