09110032 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10129 RANDY LN CONTRACTOR:ABOVE ALL ROOFING PERMIT NO:09110032
700 NORTHRUP ST DATE ISSUED: 11/06/2009
OWNER'S NAME: MURPHY JOHN P
' SAN JOSE,CA 95126 PHONE NO:(408)292-4188
ER'S PHONE: 4083945853
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB
TT �- .� 5�
f
License Class G J� Lic.# MECH r— RESIDENTIAL COMMERCIAL
Contractor C �L—Date "� JOB DESCRIPTION:RE-ROOF TEAR OFF SHAKE,INSTALL NEW OSB
1 hereby affirm that I am licensed under the provisions of Chapter 9 7/16"
(commencing with Section 7000)of Division 3 of the Business&Professions INSTALL 30#FELT UNDERLAYMENT,INSTALL NEW 40YR
Code and that my license is in full force and effect. COMPOSITION CLASS A 50SQ
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 Valuation:$15000
Section 3700 of the Labor Code,for the performance of the work for which this Sq,Ft Floor Area:
permit is issued.
APPLICANT CERTIFICATION APN Number:31624041.00 Occupancy Type:
1 certify that 1 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 m y accrue against said City in consequence of the
granting of thispermit. ,tionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non- int s e regulat'ons per the Cupertino Municipal Code,Section /
9.18. _ Date:
Issued by,��
Signature Date
A�[� OWNER-BUILDER DEC ARATION 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 an roofing material being installed.If a roof is
the following two reasons: installed without first obtaining ani pection,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, Signature of Applicant: te: 1/1
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 CLAS A"OR BETTER
I hereby affirm under penalty of perjury one of the following three
DISCLOSURE
declarations: HAZARDOUS MATERIALS
I have and will maintain a Certificate of Consent to self-insure for Worker's
5 of
Compensation,as provided for by Section 3700 of the Labor Code,for the e
read the hazardou
Calrn a Health&Safety Code,aSections 25505 ls 525533r Chapter 9 h
and 25534. 1 will
performance of the work for which this permit is issued. corn Bance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by 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 de,Sections 25505,25533,and 25534.
Compensation laws of California. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Code,I must Ow r hor' ed agent: ate:_--�—lL— /
forthwith comply with such provisions or this permit shall be deemed revoked. �y L
CON TION 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 complywith 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 save Lender's Name
upon the above mentioned property for inspection purposes.(We)agree
mify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
1 ,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
Date Licensed Professional
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 31624041 .00
DATE ISSUED. . . . . . . : 11/06/2009
RECEIPT #. . . . . . . . . BS000009137
REFERENCE ID # 09110032
SITE ADDRESS 10129 RANDY LN
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER MURPHY JOHN P
ADDRESS . 10129 RANDY LN
CITY/STATE/ZIP CUPERTINO, CA 95014
RECEIVED FROM ABOVE ALL ROOFING S
CONTRACTOR KEN SULESKY LIC # 23092
COMPANY ABOVE ALL ROOFING
ADDRESS . 700 NORTHRUP ST
CITY/STATE/ZIP SAN JOSE, CA 95126
TELEPHONE (408) 292-4188
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
____ ____ ---------- --
---------- ----------
1BCBSC VALUATION 15, 000. 00 1 .00 0 .00 1. 00 0 . 00
1BSEISMICR VALUATION 15, 000 . 00 1 .50 0 .00 1.50 0 . 00
1REROOFRES SQ FEET 50 . 00 650 . 00 0 .00 650 . 00 ------0_00
---------- ---------- ----------
TOTAL PERMIT 652 . 50 0 .00 652 . 50 0 .00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --
--------------- -----
CHECK 652 .50 #17912
---------------
TOTAL RECEIPT 652 .50
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
_ -------- --------------------------
-- -------------
-
601_ ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
C>( <a
rITY OF
CITY OF CUPERTINO
2REROOF
CUPERTINO PERMIT APPLICATION
r
PN# lJ C/ /. C Date:uilding Address: /O ,Z L
Owner's=664_�Li� Phone #:
�D,, 3lz/- .S S 3HOA: rovide letter from HOA phone #: v� Z�Z
Contractor:
Fax#: y06 Z r z -
Contractor License#:
x7'1-
Cupertino Business License#: G3 9 s'
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ ,Asphalt Shingles ra�Asphalt Shingles
u/Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
#
Nabe Removed ber of existing coverings ❑ Provide I.C.C.E.S. Report
� ❑ provide Mfgr. Installation Specs.
d To
Job Description: �� d�F
30� �21i� vC1lG(r�/'�•o.�/t,� �/Zsl`til/�/IQ.t.J �vy� �/'t'l�as, �ra�
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,R-Jdnderst and Will Comply with Cupertino's Tear-Off Policy:
f
e
S nature
Revised 02/05/09
CITY OF
CITY OF CUPERTINO
REROOF
CUPEitTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMIVILROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISN UCO Seismic Commercial B
S� 1REROOFRES Re-roof Residential B 1SFDWLR00F
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Residential B
S.-0 1RER00FMRESTRe-roof Multi-Family B JN"WLROOF
1BCBSC Bldg Standards B ALL PERMIT TYPESommission Fee
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
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 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:
is Signature: - Date:
Applicangn
Greg Casteel
Building Official
Revised 07/30/08
INPUT Resources Energy IAC'Health
M.Inoor it ua Ity an meshes
1.Use LowlNo-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 IAO/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
B.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
N.Flooring
1.Select FSC Certified Wood Flooring B 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
G.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
1 1
1 ! f
Total Points Available: 1 1401 1301 57
Total Points Project Received: 01 01 0
G:data/proos/greenbuildingguidelines/remodelers/gree ntsfina12.12.o4prrottected.xls /
Community Development
10300 Torre Avenue
3Cupertino CA 95014
Telephone(408)777-3228
^CITY OF Fax(408)777-3333
"UPEkTINO
Buildin De artment
JOB ADDRESS: PERMIT #
�' /Z tel , r`
OWNER'S NAME: U rL W ci�_
PHONE #
GENERAL CONTRACTOR: Af ;I 1,v;1 all FAX #
I am not using any subco
ntractors:`'
Signature Date
Please check applicable subcontractors and complete the follow* 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