08040012 CITY OF CUP TI
BUILD
NVC DIVISION PERMIT CC1I�ITRACT(JIt INFa? TIa)
Buff llq Tli'hRTA BLANCA ST CASTO ROOFING 0800012
OW NER'S NAME: PERMIT ISSUE DATE
DALY EDWARD P AND DONNA M 1938 OLD MIDDLEFIELD WAY 04/03/2008
0 SANITARY NO. CONTROL NO.
(650) 961-8922
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDO ELECT PLUMB MECH
0 � 0
�o o LICENSED CONTRACTOR'S DECLARATION Job Description
�+ I Mmby affirm that 1 am licensed under provisions of Chapter 9(commencing
w NSacuon 70 U)of Di✓vltlon3af NC Buvns>sicase yi�od ane mxuromais RMV EXSTNG RF, APLY OSB DECKNG, CLSA 385Q PRES
npy in full force a�ef(em' �.a 3.7`7 l 6HNGL5 .
y� L I'd Class
Dam Can
ARCHITECTS DEC
1 undersand my phos shall M used as public mcnrds
5 cad 5 Licensed Pmfassional -
y OWNER-BUILDER DECLARATION
f 1 Mrehy air,.
that 1 am exempt from the Conlnnm's License Law for the
is a following mason.(Section 703 L1,Business and Profession Code:Any city at county
S$til which requires a Permit 10 ennsuucL alma improve,demolish,or repair any stracture
zy prior m itsissuame,also requires the applicant for such permit to file a signed samment
Net M is licensed pursuam to On provisions of dm C,rdrachn's License law(Chapter9 Sq..Ft. Floor Area Valuation
$ (commmingwiNSecdon7OD0)ofDivision3afdeeBusinesandProfesaionsCaee)ser 517000
that he is exempt therefore and dee bash for the alleged eumpdon.My violation of
Section 7031.5 by any applicant for a permit subjects the applicant m a civil penalty of A..r)t�7 Number Occupancy Type
not mom On five hundred dollars(M). 32613047 :V19
0 I,u owmr of the property,or my employer with wages as their sole compensation,
windo the work,and On structure is nounanded oronered forwe(Sec.7014,Business Required Inspections
and Professions Cade:To Colossuses License n law donot apply a e ns an owner of q P
property who builds of im pores thereon.and who does such wok himself w though his
own emplay=.provided Nal such imp.veanena are nm inandee or.Besed for sale If.
however,the building or improvement I.sold within one year of completion,the owner-
builder will new the human of proving that M did int build or Improve for purpose of
❑I.or owner of the property am exclusively connecting wide licensed contracters a
contract the project(Sec.7014,Business and Pofnsiam Cod.:)T1s Contractors Lt.
cons,law don not apply a an owner of property who Milds or improves Neuron,and
who contracts for each Projects with a con racmr(s)licensed pursuant m the Contractor's
(.kens,law.
❑I sm exempt under See ,B&P C for this mason
owner Dam
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following decluWmu:
1 haw and will maintain a CeNficam ofConsanuo self-firearm for WorkeYs Compen-
rrn,as provided for by Section 3700 of the labra Code.for the performance of me '
for which this Permit is issued.
❑I have and will maintain Worma's Compensation Insurance,as required by Section "
17M of the Labor Code,for On performance or the work for which this permit is issued.
My Worker's C �Ierr and Polcy nu r '—ZWg>
Caller. i = Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(ThisxNon reed sot M completed lima Permit Is fm one hundred dollen($100)
of 1013.)
1 cardry that in the performance of the work for which this Permit in issued,l shall not
employ any person in any mucor aro an m become subject to On Workers'Compensation
Laws of Calif oo is.Dais
Applicant
NOTICE TO APPLICANT:IL alk,making Nis Certificate of Ecemptlan,you should
become subject at the Worker's CompcnWtion pmvisiom of Ne tabor Code.you most
0 O foMiwth comply with such provision or this permit shall M decreed revoked.
'�
,.� CONSTRUCTION LENDING AGENCY
y
[-a IMrebyaffirm dm Nem is a combustion lending agency fat the performance of
ai? the work for which this permit h issued(Sec.3097,Civ.C.)
Q Lendces Name
Lmdes Add.
V 0 I emtify that I have land this application and sea that the above information Is
LL r^ torten.I agree an comply with all city and county ordinances and some laws relating m
.0 SU' building construction,and hereby authome repte¢nutitrn of this city to enter upon the
[rl aMve-menuaned property for inspection purpmea
LL (We)agree to ave,indemnify and keep harmins the City of Cupertino against
Ir N
liabilities.Judgments,costs and expenses which may in any way acerae against said City A
C.) in s rmit.
APPLICANT UNDERSTANDS Aence of the granifing of IND WILL COMPLY WITH ALL NON-POINT Issued by: Date (r'�'2
SOURCE CUL TIO �J/
T Re-roofs
Si s01ndComracor Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
WE the applicant or futtac building occupantsare or handle locations material
as dented by the COmmina Municipal Code.Chapter 9.13,and dm Health and Safety
Cada,section 25532(.)? All roofs shall be inspected prior to any roofing material being installed.
❑Yrs ❑No
Will the applicant or future Wilding..pool use equipment or dsvicn which If a roof is installed without first obtaining an inspection,I agree to remove
t ha'ramnus air contaminants as defined by the Bay Ares Air Quality Management all new materials for inspection.
tier?
by. ONO
I have mal the buardaes materials requirements under Chapter 6.95 of the Califor.
nia Health&Safety Cade.Sections 25505,25533 and 25534.I undersand that ifthe Wilding
den not currently ham con that it is my maponsihility an notify the occupant of Ne
requirements which poor a issuance oft Certificate ores Signature of Applicant Date
Own o'md agent Dam'
All roof coverings to be Class'p"or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32613047 . 00
DATE ISSUED. . . . . . . : 04/03/2008
RECEIPT # . . . . . . . . . : BS000004338
REFERENCE ID # . . . : 08040012
SITE ADDRESS . . . . . : 22274 CARTA BLANCA ST
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : DALY EDWARD P AND DONNA M TRUS
ADDRESS . . . . . . . . . . : 22274 CARTA BLANCA ST
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1009
RECEIVED FROM . . . . : LINDSEY D CASTO
CONTRACTOR . . . . . . . : CASTO, LINDSEY LIC # 21324
COMPANY . . . . . . . . . . : CASTO ROOFING
ADDRESS . . . . . . . . . . : 1938 OLD MIDDLEFIELD WAY
CITY/STATE/ZIP . . . : MOUNTAIN VIEW, CA 940.43
TELEPHONE . . . . . . . . : (650) 961-8922
• FEE ID UNIT --- QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ---------- ---------- ---------- ---------- ---------- --- ---
1BSEISMICR VALUATION 17, 000. 00 1 .70 0. 00 1.70 0. 00
1REROOFRES SQ FEET 38. 00 494 . 00 0. 00 494 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 495.70 0 . 00 495 .70 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- - --------------------
CREDIT CARD 495.70 VISA
---------------
TOTAL RECEIPT 495 .70
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
605 FINAL REROOF
•
CITY OF CUPERTINO
► ` REROOF
CUPEkTINO PERMIT APPLICATION
APN # 2-Cp ?)o 4-7 O 0 Date: VIVO,?IVO,?
Building Address:
2 2 Z-7`-J Ga,� kg 8 1 a yr c g Sf'
Owner's Name: Phone #:
Qvw� .z Z410.7--733 - /� s8
Contractor: Phone #: G&b 96qz�,_
Oq S'�O '9!4C_ Fax #: 6 SZv 4(; 2-S
Cupertino Business License #: Contractor License #:
2132 3c 7.7
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles PK Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
Other (Specify) dz woo & ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
C r�'�O✓L E� l5+0 ✓OJ7 .L. CJ( �" 0.�6 �(-�.1 'pV l<"G 4-
Residential Commercial Lj
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation:
I� OJJ
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
�i e
CITY OF CUPERTINO
aou�lg REROOF
CUPEkTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
1RER00FRES Re-roof Residential B 1SFDWLROOF
/ 1BSEISMICRE Seismic Residential B
IREROOFMRES Re-roof Multi-Family B 1MFDWLROOF
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 1997 UBC Standards
and manufacturers specifications on re-roofing.
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 Y4 " 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 G,�w0.c- cD
Job Site Address: Qaa-7 -4' C os-r 4-CL. -1)1 Ct,VI CGL S 4- •
Roofing Company Name: ots•}z,:� (-)Of i fl a -T-V1 C .
Applicant's Signatu Date:V—V—DY
,
7 - 1
Greg Casteel
• Building Official
Revised 11/2/04
a
Community Development
1030 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
UPEkTINO
Building De artment
JOB ADDRESS: PERMIT #
2 CA✓ l9nC 5f OE 0(-( Oo1'l
OWNER'S NAME: C-'> PHONE # (p 5-0 C/- LL
GENERAL CONTRACTOR: 'C�ab{u Cook- l L_ FAX #
I am not using any subcontractors r ' /
Signature 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
Owner/Contractor Signature Date