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09070192 CITY OF CUPERTIN O BUILDING PERMIT BUILDING ADDRESS: 1273 POPPY WAY CONTRACTOR:WESTERN ROOFING PERMIT NO:09070192 :;YSTEMS 0"'NER'S NAME: HUIE EDMUND M AND NANCY L 328 WHITE OAKS RD DATE ISSUED:07/28/2009 O,v,NER'S PHONE: 4082532967 -'AMPBELL,CA 95008 PHONE NO:(831)278-1837 ❑ LICENSED CONTRACTOR'S DECLARATION WILDING ILDING PERMIT INFO: BLDG ELECT(_ PLUMB r License Class 3 Lic.# (t "I �Z� �7 MECH r- T____COMMERCIAL� Contractor G✓ «/ ••�yj /Date "ZF'es 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OFF WOODSHAKE, (commencing with Section 7000)of Division 3 of the Business&Professions 'ILLSHEATING AS Code and that my license is in full force and effect. NEEDED,40LBS FELT INSTALL 26SQ METAL ROOFING CLASS A 1 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 ;;q,Ft Floor Area: Valuation:$15500 permit is issued. APPLICANT CERTIFICATION APN Number:36618019.00 Occupancy Type: I certify that I have read this application and state that the above information is correct.1 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, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Zf 'D ssued by:o ,� ❑ OWNER DER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS: the following two reasons: \Il roofs shall be inspected prior to any roofing material being installed.If a roof is nstalled without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, nspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) >ignature of Applica Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO ASS"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 have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance,as provided for by -ompliance 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 iafety Code,Section 25532(a)should 1 store or handle hazardous material. permit is issued. additionally,should I use equipment or devices which emit hazardous air 'ontaminants as defined by the Bay Area Air Quality Management District 1 will I certify that in the performance of the work for which this permit is issued,1 shall naintain 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 fealth&Safety Code,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 Jwner or authori ag _ZJ4 t forthwith comply with such provisions or this permit shall be deemed revoked. Date: APPLICANT CERTIFICATION <:CO STRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is hereby affirm tha is a construction lending agency for the performance of work's correct. I agree to comply with all city and county ordinances and state laws relating or which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name i he above mentioned property for inspection purposes.(We)agree to save it... ..nify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address costs,and expenses which may accrue against said City in consequence of the 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• understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 91 r`` REROOF CUPEI�TiNO PERMIT APPLICATION APN # Date: Building Address: (� Owner's Name: Phone #: HOA: Yes ❑ No [ If yes, provide letter from HOA Contractor: Phone#:,yv,3(9g y i 1')" N I s Fax #: Ydi- yrs 1�3� Cupertino Business License #: c� Contractor License #: r-- 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) ❑ Other (Specify) r"e Number of existing coverings / ❑ Provide I.C.C.E.S. Report# S�•Z Ce rTo be Removed ❑ Provide Mfgr. Installation Specs. Job Description: 2G /V% e+*- I h.V-W.:3. C /A.0 A- Residential IT Commercial El 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 ind ex. Valuation: I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09 CITY OF CXPERTINO 'C;n OF R IROOF CUPEkTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1 REROOFCOM Re-roof Cc mmercial B 1 COMMLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1 BSEISMICO Seismic Commercial B 2 / 1RER00FRES Re-roof Residential B 1SFDWLR00F 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee r 1 BSEISMICRE Seismic Re,3idential B 1 REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BCBSC Cal Bldg Stt�dards B ALL PERMIT TYPES Commission Fee 1 BSEISMICRE Seismic Rei idential B 1 BUSLIC 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 r,!-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 ar y 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 nai l inspection is required. 6. Any roofing which is applied without first obtaining an inspection, will require the removal of all new me terial down to the sheathing, so a proper City inspection can be per Eormed. 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 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: At, � c Job Site Address: 2 1040a�;' v" Roofing Company Name: �l l/✓ �Z�r/�/�C S`'i s �"`I Applicant's Signature: Date: Greg Casteel Building Official Revised 07/30/08 M.indoor Air Quality and Finishes 1.Use Law/N[rVOCPaint 1 IAQ/Health pts y=yes D 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes D 3.Use LowlN©VOC Adhesives 31AQ/Health pts y=yes D 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes D 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Health pts y=yes 0 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 7.5sal al Exposed Paritidsbowd or MBF 4 IAQ/H ealth. 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 1 1 1 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 D 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 D 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 1 1 1 Total Points Available: 1 1401 130 57 Total Points Project Received: 01 0 0 G:datalprogslgre.nbuildingguidelines/remodelers/greenpointsfina12.12.D4prot Is CITY OF CUPERTINO 3 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk . Lot : APN . . . . . . . . : 36E18019 . 00 DATE ISSUED. . . . . . . : 07/28/2009 RECEIPT #. . . . . . . . . : BSC00008297 REFERENCE ID # . . . : 09C70192 SITE ADDRESS . . . . . : 12i3 POPPY WAY SUBDIVISION . . . . . . CITY CUF'ERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : HUIE EDMUND M AND NANCY L ADDRESS 123 POPPY WAY CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5304 RECEIVED FROM . . . . : MIC'HAEL D LUNNEBORG CONTRACTOR . . . . . . . : MIC'HAEL LUNNEBORG LIC # 25896 COMPANY WEE-TERN ROOFING SYSTEMS ADDRESS 1328 WHITE OAKS RD CITY/STATE/ZIP . . . : CAMPBELL, CA 95008 TELEPHONE . . . . . . . . : (8= 1) 278-1837 FEE ID UNIT QUANTITY 1,MOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- -- -------- ---------- ---------- ---------- 1BCBSC VALUATION 15, 500 . 00 1 . 00 0 .00 1 . 00 0 . 00 1BSEISMICR VALUATION 15, 500 . 00 1 . 60 0 . 00 1 . 60 0 .00 1REROOFRES SQ FEET 26 .00 338 . 00 0 . 00 338 . 00 0 . 00 -- -------- ---------- ---------- ---------- TOTAL PERMIT 340 . 60 0 . 00 340 . 60 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF