08030123CITY OF CUPERTINO�q,'L:%*t"-
BUILDINC'DIVIsION' PERMIT
CONTRt1GT,O INF:ORMAT,ION.
BUIL1 G ESS:
T��5 PLACER SPRING CT
CASTILLO'S ROOFING
PERMIT NO.
08030123
ER'S NAME:
PERMIT ISSUE OATS
JAY JEYASEELAN
1703 CATHAY DR
03/21/2008
PHONE
SANITARY NO. CONTROL NO.
(408)251-3565
ARCHIECrfENGINBER:
BUILDING PERMIT INFO
BLDGELECT PLUMB MECH
L� l�
LICENSED CONTRACTOR'S DECLARATION
Job Description
o
vaChapter 9 mommaroing
I isometry straw War 1 am Ibmnaed under pmWona
with Section 7")aDiviian J afthe Business and Pablawfona Code.and my licence is
RE—ROOF,T/O EXT WD SHNGLS,IINSTL #30LBFLT, CLS A
U..mm1 f
mte. I Lic.N -
20SQ 50YR COMP
.
Das Combats
AR KM' rS I)ElffdAPUN
1 understood my pWm still x used as public accords
'
Licensed Pracest ml
OW NER-BUnrpBR DECLARATION
1 hereby License Law for the
(Su thus 1 from the Cenums,
li Cade: Any city or marry
I.S.eussw Co
mare.. (Saucer 7W IBusixeu and i
.
em ri repair any mueum
c. demolish.
which requires a permit no conawct alar. Imfrow,
which ac
er it t ned mem
h Permit
pdmWitoiuusnce.alwal to a Wovisioe of fordo sucConpermiUOrile a came C 9
Wthe
Sq. 1?I. Floor Area
Valuation
(commeccenaod purmunt ow(Chu
`7500
ode)
with iteratureon or Db4sioretina Businessad Prxatma Cnde)m
ivuionJ of WCeged
,
camtPrfMyvi
I than he u esmnPr therefrom uW de baso fm the WRW ",^^•ptiam My violation of
that mad
e,p Number
36655008:
ccu
OType
Occupancy yp
Seelan 7031.5 by tory applicant few a permit subjects the applicant he a Null penally of�
ret more man fia, hundred dolWa(S300).
tl
❑ I, as moratorium penitents. mmyemployem with wages uthelr mLL comlamaction,
Required Inspections
BLLLnW
Will da the wank, and the Nuemer rot Mended m sacred for We (Sac.In
an
and ona Cada: The ConrrsemYs License Lath dam rot apply W an awror of
whobforemimpmwa We rmreandwhadunsuehwmkhimWfne WougM1 his
arty wh
owns m, improwmwt an not lorded moQesnd far ule.IL
own cm
rprmseh
the building within one of compkdon. the
bovmwr. theebuis mMpa
romuuhalt
Wild purpose of
will Nw Use buNert of proving that k tit roe build u imprvw for pupose of
the
sam.).
uLL.).
❑ T. u owner of the pmperry ars uschrowly commusing MW licensed contractus an
construct the pmjee (Sec, 7W. Business and Professions Cade:) Tor Coruscate. Lf-
estate Law dean nor apply W m owner of prapary Who Wilds or impmwa WCRan. red,
who conueea for such projects with a conuscmr(G licensed personal an the Conuacmfm
License Law.
❑ larnusemptundm See ,B&PCfmttiareveo
Doo Dam
WORKERS COMPENSATION DECLARATION
I hereby affirm under penalty of perjury now of the following dmlanfene
❑ I ham and will meinWn a CutiRau of Conxnr se self-imam lm Worker's Compere
ution, an provided for by Section 37M of the Inbar Cade, for the perfo mmtce of the
wart Icer w 'eh this permit is burned.w
arM will mainuin Woftes Compensation Imwm, as, hems ed by Scafm
37M aft Lau Cade. for the peRarmmx ofthe wank fuwhich this Permit is issued.
'
MY Werkes'. Com wom Iwuamma and Policy number on:
Carrier. Polity No.: UO 9
CERTIFICA ^ OF EJ EMP ION FROM WO0.KERS'
COMPENSATION INSURANCE
(ThoseNm rcsd heabacanpleud if the perch is fmarohnnd ed dallm (SIM)
release)
I conify War in the perfurmma of the work fm which this permit is issued. I "I am
_
employ my person in my matter not as W become subject to rK Worked Compensation
..
Laws of California. Dau
Applicant
-
NOTICE TO APPLICANT: If. eller making this Corinna of Exemption, you should
become subjecs W We WorkcYa Compensation provisionsof the Labor Code ato
you m
' forthwith comply with each provWom or Wu permit shall on dcemed narked.
CONSfe AGENCY
is. cm momm. lNG
I hrwhichtm Wmmem is. fm We performance of
, Clargagenry
da work: fu which this permit u iuuet (Sec. ]09'1, Civ. C.)
'
Lender's Name
Lendefs Address
i I comfy that 1 haw toad this mpliea m, and eLLto to dm &bow [or ..Waft
' cermet I agree an comply with N dry and county onfinanaa and mule law. misting W
Wilding conmWCtion. and hereby aummice mprmanutiwa of this city be enter upon the
abuse-mantiamA progeny fu inspection purpmes.
(Wc) agree to sus., indemnify and keep harmless the City of Cuperuno aSol=
i liabilities, judgments. cats and expenses which may in my way acme against cold City
in consequence of the grating of this permit
V
' APPLICA UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT
Issued by: Date z
'
SOU E GU DNS.
3P
Re-roofs
Type of Roof �—
orAilliffmossucirronamer Dau
HAZARDOUS MATERIALS DISCLOSURE
Wm Ikapplicant buildingmalaquamre mhandleffesitomdSaLLl
defnnd by the ne Municipal ode. Ch@sur 9.11, and the Halth and Safety
oIM.ni
32(.)?
secties ssss2(.)7
All roofs shall be inspected prior to any roofing material being installed.
❑Yen No
If a roof is installed without first obtaining an inspection,agree to remove
Will We appuesm sur "sore bad' n ma:up,.1 bac wnipmem m dorha s which
emit haufdow air cmumimnts as d by the Bay Area Air Quality Management
.1
all new materials for inspection.
District?
❑Yen No
I havareal NehusNoua mamriaumquimmcnu umkr CM1epmr6.93 rete Uli(or-
O�
nu Hcslthd: SafmyCndc.Secuona 2330.T, 23371 an425534.1 undersand matiftho Wilding
�_/
dans not currently hew a Imam. thm It is my responsibility on routs the oecupmt Of ot
require new' We mel prior u iuumtre of. Curuficau orocapancy.
Signator Of Applicant Date
a ��
All roof coverings to be Class'A:s' or better
Dam .
wren wthorued agent
iCITY OF CUPERTINO
2 ITEMS OF 2 PERMIT RECEIPT
•
•
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 36655008.00
DATE ISSUED.......: 03/21/2008
RECEIPT #.........: BS000004230
REFERENCE ID # ...: 08030123
SITE ADDRESS .....: 11902 PLACER SPRING CT
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT
AMOUNT
---------------
260.80
---------------
260'.80
VOICE ID DESCRIPTION
-------- ----------------------------
601 ROOF TEAR OFF
603 ROOF BATTENS
605 FINAL REROOF
REFERENCE NUMBER
--------------------
#15006
VOICE ID DESCRIPTION
------------------------------------
602 ROOF PLYWOOD NAIL
604 ROOF IN -PROGRESS
OWNER ............:
JAY JEYASEELAN
ADDRESS ..........:
11902 PLACER SPRING CT
,
CITY/STATE/ZIP ...:
CUPERTINO CA, 95014-5102
RECEIVED FROM ....:
CASTILLO'S ROOFING
CONTRACTOR .......:'JOSE
CASTILLO LIC # 25850
COMPANY ..........:
CASTILLO'S ROOFING
ADDRESS ..........:
1703 CATHAY DR
CITY/STATE/ZIP ...:
SAN JOSE, CA 95122
TELEPHONE ........:
(408)251-3565
FEE ID
UNIT QUANTITY
AMOUNT PD -TO -DT THIS REC
NEW BAL
----------
1BSEISMICR
-----------------------
VALUATION 7,500.00
---------- ---------- ----------
0.80 0.00 0.80
----------
0.00
1REROOFRES
SQ FEET 20.00
260.00 0.00 260.00
0.00
TOTAL PERMIT
---------- ---------- ----------
260.80 0.00 260.80
----------
0.00
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT
AMOUNT
---------------
260.80
---------------
260'.80
VOICE ID DESCRIPTION
-------- ----------------------------
601 ROOF TEAR OFF
603 ROOF BATTENS
605 FINAL REROOF
REFERENCE NUMBER
--------------------
#15006
VOICE ID DESCRIPTION
------------------------------------
602 ROOF PLYWOOD NAIL
604 ROOF IN -PROGRESS
x$03 0(23
CITY OF CUPERTINO
REROOF
•CUPEkTINO PERMIT APPLICATION
APN# — / 5 v ok. (Std
lv
Date: O
I
Building Address:
5qQQ Placer
S ��
fi
Owner's Name:
Phone #:
gsee [n
n
C251-35 &s
Contractor: I IPhone
#:
Fax #:
Cupertino Business License #:
Contractor License #:
Type of Roof Covering:
Existing:
Proposed:
❑ Built -Up Roof
❑ Asphalt Shingles
o Built -Up roof
M--'�(sphalt Shingles
o Wood Shakes
1�Wood Shingles
❑ Wood Shakes
Wood Shingles
❑
❑ Other (Specify)
o Other (Specify)
Number of existing coverings
❑ Provide I.C.B.O. Report #
Abe Removed
? ❑ Provide Mfgr. Installation Specs.
Job Description: Te-grO
vac S�; r� VvOOG� s�ti vt(,e-_% t
e f F a A 5(j y R..
Co (, s h n5 fE
Residential M
Commercial El
Fire Zone: Yes ❑ No
Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation: 5 CX) 00
s
I Have Read, Understand and Will Comply with Cupertino's Tear -Off Policy:
CITY OF CUPERTINO
Gp1 REROOF
•CUPEkTiNO FEE SCHEDULE
Number of
Squares
Fee ID
Fee Description
Fee
Group
Permit Type
1REROOFCOM
Re -roof Commercial
B
1COMMLROOF
1BSEISMICO
Seismic Commercial
B
Zb 0
1REROOFRES
Re -roof Residential
B
1SFDWLROOF
1BSEISMICRE
Seismic Residential
B
1RER00FMRES
Re -roof Multi -Family
B
1MFDWLROOF
IBSEISMICRE
Seismic Residential
B
1BUSLIC
Business License
B
0
•
0
•
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 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: ���/ �e^^e ygSPC? inn
Job Site Address: l i q'1' o o_ gD i of c -e r ( J
Roofing Company Name: �_M S
Applicant's
Greg Casteel
Building Official
Revised 11/2/04
Date:
40
0
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
Building Department
JOB ADDRESS:
% l �D� GtCC'CS' �i n
PERMIT #
&� 3aCZ3
OWNER'S NAME: Qhu, 7PC?. A' C i4k
PHONE # 2s1 -35 -63 -
GENERAL CONTRACTOR:
FAX #
I am not using any subcontra - e) Q
Signature Date
Please check applicable subcontractors and complete the followine information:
--,-;2 /-d 8
Owner/ Contractor Signature Date
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
--,-;2 /-d 8
Owner/ Contractor Signature Date