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10110068 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11883 SHASTA SPRING CT CONTRACTOR:THD AT-HOME SERVICES, PERMIT NO: 10110068 INC. r"'NER'S NAME: CATHERINE LIU&MICHAEL YAO 2690 CUMBERLAND PKWY STE 300 DATE ISSUED: 11/10/2010 c,-NER'S PHONE: 5108774550 ATLANTA,GA 30339-3913 PHONE NO:(510)731-1004 C� LI?CENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F ELECT r— PLUMB License Class� J Lic.# �— `s MECH RESIDENTIAL r COMMERCIAL Contractor 7 H i�) & I'1 o er 5rr2�4yate l I l I v ! JOB DESCRIPTION:RE-ROOF 23 SQ TEAR OFF EXISTING WOOD SHINGLES I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions NO RE-SHEET INSTALL GRAND CANYON MISSION BROWN COMP Code and that my license is in full force and effect. SHINGLE 50 YR COMP CLASS A 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:$14520 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:36655026.00 Occupancy Type: correct.I agree to comply with all city and county ordinances and state laws relating to building constriction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-point sourc tions per the Cupertino Municipal Code,Section 180 D YS FROM ST CALLED INSPECTION. 9.18. S`^nature Date < <U //b Issued by: Date: ❑ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS: the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an ins ion,I agree to remove all new materials for will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. Business&Professions Code) Date: I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: constrict 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: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE 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 read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. permit is issued. Additionally,should I use equipment or devices which emit hazardous air I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534. become subject to the Worker's Compensation provisions of the Labor Code,I must Owner ut rized agent: forthwith comply with such provisions or this permit shall be deemed revoked. ate: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a constriction lending agency for the performance of work's to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.) -r the above mentioned property for inspection purposes.(We)agree to save Lender's Name unify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Lender's Address granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36655026 .00 DATE ISSUED. . . . . . . : 11/10/2010 RECEIPT #. . . . . . . . . : BS000011970 REFERENCE ID # . . . : 10110068 SITE ADDRESS . . . . . : 11883 SHASTA SPRING CT SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : CATHERINE LIU & MICHAEL YAO ADDRESS . . . . . . . . . . : 11883 SHASTA SPRING CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : JEFF RAINEY CONTRACTOR . . . . . . . : FRANCES BLAKE LIC # 29818 COMPANY . . . . . . . . . . : THD AT-HOME SERVICES, INC. ADDRESS . . . . . . . . . . : 2690 CUMBERLAND PKWY STE 300 CITY/STATE/ZIP . . . : ATLANTA, GA 30339-3913 TELEPHONE . . . . . . . . : (510) 731-1004 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 14, 520 . 00 1. 00 0. 00 1. 00 0 .00 1BSEISMICR VALUATION 14, 520 . 00 1.45 0. 00 1.45 0 .00 1REROOFRES SQ FEET 23 . 00 299. 00 0. 00 299. 00 0 .00 ---------- ---------- ---------- ---------- TOTAL PERMIT 301 .45 0 . 00 301.45 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 301 .45 VISA --------------- TOTAL RECEIPT 301.45 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 309 EXTERIOR LATH 311 SCRATCH COAT 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CUPERTINO FEE ESTIMAT R-BUILDING DIVISION ADDRESS: �1 E: REVIEWED BY: Its I APN: BP#: *VALUATION: 1$14,520 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex ;0 i,, 4 PENTAMATION 1SFDWLR00F USE: 1,704)"'1", rlf : PERMIT TYPE: WORK SCOPE FEE ID ROOF AREA s.L 1REROOFFRES 2,300 . 1"C'iI J lwi Cho A, —FT F-1 'I'A",» " 1 1;1<c.Inv, 1,c;), NOTE: Theseees are based on the preliminary in ormation available and are only an estimate. Contact the Dept-for addn'1 info. FEE ITEMS (Fee Resolutiofi 09-05I Ef 7%Ii70) FEE QTY/FEE MISC ITEMS P/on Chc'c;k Fe c: E'ttfrr2lf.:"llc'c1r.ilelec~ Mail C'hc"A" Permit Fee: $299.00 Safhhh Iftssh 1=(v f'lffrrrh._1kc�1t.;T'Ic<. C%nir f'��c': /'lffttth.%"1lcrth.%t:l�'t' /'e�tfrtrt CTc°c' t`ufz.N'11(1101z Tiff Jc:0101tc01 1i'c,viell Work Without Permit? 0 Yes (F) No $0.00 Tari cl 0octrttt"Watioll C cc',: Strong Motion Fee: IBSEISMICR $1.45 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $301.45 $0.00 TOTAL FEE: $301.45 Revised: 11/08/2010 INPUT Resources Energy e . n oor rrua ity an mis es 1.Use Low/No-VOC Paint 1 IAQ/Health pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAQIHealth pts y=yes 0 3.Use Low/No VOC Adhesives 3 IAQIHealth 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 I 1 0 1 I 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=yes0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 I 1 I Total Points Available: 1 1401 1301 57 Total Points Project Received: 01 01 0 G:data/propstgreenbuildingguidelineslremodelerslgreenpointsfinal2.12.04protected.xls Building Department City Of Cupertino ELI] 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: r j 4. z G PERMIT# 1100 U U OWNER'S NAME: G ,J E `I v PHONE# C) ZS Z c7 2 GENERAL CONTRACTOR: j-or4 C 5t2t)iC.t S BUSINESS LICENSE# ADDRESS: 2.456t) G CITY/ZIPCODE: S,+,J t-t?}t/ 452 7 *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Date Please check applicable subcontractors and c plete 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 Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Con r Signature Date REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E.,C.B.O.,BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•building(akupertino.ong PROJECT ADDRESS ,ry j `V I ,1,(.4_ G APN# OWNER NAME C6 7 �5 PHONE /y �fC� E-MAIL G M i a) -(A �Gj L L I �✓ j- I C I"LII , �D f�V 3 L rj 2 /Z STREET AD SSCITY, STATE,ZIP I FAX Q > 5 N ir5��t 5 ►�r G� , G v,�t;z ,J�. e A CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC.# 836021 C39 COMPANY NAME E-MAIL FAX THD AT HOME SERVICES 510-357-3750 STREET ADDRESS CITY,STATE,ZIP PHONE 2456 VERNA CT. SAN LEANDRO, CA 94577 510-887-4565 I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimum of one day before the requested inspection date. Please schedule inspections online or call (408)777-3228 between 7:30-3:30 (Mon-Fri). 3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof is torn off and all the nails/fasteners have been removed. Any and all dry-rotted wood shall be replaced prior to this inspection. A building inspector will be available within one hour. There are special hours for this service: 7:30 — 10:30am and 1:00—3:30pm(Mon—Thurs); 7:30 — 10:30am and 1:00—2:30pm(Friday). 4. If plywood is installed, a plywood nailing inspection is required. 5. In-Progress roof inspection is required. Call for an in-progress roof inspection to verify building is weather tight after installation of approximately 25% of the roofing material. 6. New roof coverings shall not be applied without first obtaining all inspections and written approvals from the building inspector. Any roofing which is applied without first obtaining an approved inspection will require the removal of all new material down to the sheathing so a proper inspection can be performed. 7. A final inspection and approval shall be obtained from the building inspector when the re-roofing is complete. To receive a final sign-off, the following items will be verified: a. Flat roofs shall have a minimum of 1/4"per foot of slope and must demonstrate there is no ponding. b. Listings from approved testing agencies for all pre-manufactured products used shall be available on-site to review at the time of the inspection. c. Proper spark arrestor installation. 8. NOTE: If you call for a tear-off or plywood nailing inspection and the work is not complete, you will be charged a re-inspection fee of$126.00. The re-inspection fee shall be paid before another inspection can be scheduled. By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the property owner's behalf. I rstan and agree to comply with the re- of policy stated above. Signature of Applicant/Agent: Date: It /el ReroofPolicy_201 0.doc revised 05/17/10 CITY Of CITY OF CUPERTINO III REROOF CUP RT'INO PERMIT APPLICATION 0 11 Ob to sr-' APN# Date: (; �t� Jp-0� 11 rc�� o Building Address: I 1 '0 Owner's Name: GAT N ` l- J t4 le-L-M / YA O Phone#: HOA: Yes ❑ No If yes, provide letter from HOAR Contractor: THD @ HOME SERVICES Phone#: 510-877-4550 Fax#: 510-357-3750 Cupertino Business License#: Contractor License #: 836021 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes Wood Shingles ❑ Wood Shingles ❑ Other(Specify) )iL Other(Specify) 6,c-,0P Number of existing coverings ❑ Provide I.C.C.E.S. Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: ���,� - 7t iAZ �rt� 5'71,,Jj iJ-t�7 50 ��•,� �r 5 . �J v rc✓�J �� �, 5;1�,✓� lr Residential 0 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: . / r I' 5 2- I I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09