08030103 CITY OF CUPERTINO S '�Y'5��-,'wc1•b 3'-T" �',4'���" `� �yT1`�
BUILDING DIVISION PERMIT yC�NTRACTC7IiiTNk,',
PERM FNO.
RUTLD1jarIA T'8IERRA SPRING CT CASTILLO' S ROOFING 08030103
OWNER'S NAME: PERMR ISSUE DATE.
DIANA MATLEY 1703 CATHAY DR 03/19/2008
E: SANITARY NO. CONTROL NO.
(408) 251-3565
ARCHITECrIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
op LICENSED CONTRACTORS DECLARATION Job Description
w 1 hereby affirm that 1 am liamed under previsions of Chapter 9(commencing
with SectionttlflU)afDlvision7ofdeBusinmaMProfessionsCoM.arWmyliceraseu RE—ROOF,RMV EXTNG WD SHNGLS, INSTL CLS A 20SQ
�H is full Parte and effc O
,q? LkenseC sLie.g
� Dam con r
5y$ ARCHITECTS DECLARONON
C T undenund my plans shall M used as public records
jyU
C
t; Licco d Profc en...I
5 OWNER-BUILDER DECLARATION
1 herehy wrirm Nm I me exempt from the Canmemer License Law for see
00 following rcunn.($tttian 77131.5,Business arm Professions CoM:Any city ar county
$ which requires a permit to conserver,alter,improve,Mmnluh,or repair anY nmctum
�zi Priwuits issuaree.sLLu requires de applicant foreschpemittofrleaslgnedsuummr
:♦<� that he is licensed Pursuant to the provisions of de Contractor's Umme Law(Chapter Sq FFt. Floor Area Va1Da[ion
(commencing with Section 7000)of Division 7 or the Business and Professions Code)or $8 2 0 0
a rt3 9 that he is exempt therefrom and the burs for the alleged memption.Any violation of
Section 7031.5 by any applldm for a permit subjects the applicant m a civil penalty of �,ppr Number Occupancy Type
nor more than five hundred dollars(s500). 36653051 .V V
❑Luownerthe k dd proPmq•,w my mirumded!cn withtarederak,(ankTOU,Business
will dotUsImU soddesuuctoreisme,Liens arawdoes,rtared adme(ply 0 an ow.a Required Inspections
and property
wh oho Cade The Conheame.License Law dad ter apply if an amid N q p
man= lay builds wimprova therrepur mwha ammut ihwarkbimvJforNrovgb his
man=play=.the d,ping or idururmatis id within
not earMrdwaBued for ala R,
build., .the have
t1ne o(impso ponvi is halo within arc year or Improve,
faron.thepose of
builder will have rhe human of proving Nu he did nm build m improv(w Purpose of
Dole.).
❑1.as owner a(the Property.w eaclusivcly...adios wild fiRnsnd aanurtas to
cadrmm the project face.7814.amounts and Pafeemos Code:)Th Conamaafs U.
¢are Law does mot apply to an owner of perpeny who builds or improves demon,and,
who concocts for such projects with a conuantor(s)licensed pursuant m the Coouactafa
License Law.
❑L am exempt under See ,B R P C ran aces reason
Com r Data
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one or the following dcelaruiane:
I lure and will maintain a Certificate of Conant to self-insure for Workers Compms-
momi,as provided fm by Section 3700 of the Labor Code.for Use peeformaa¢or de
work for w Nis Permit is issued.
ave and will maintain Worker's Compensation Insurance,as retained by Sechan
3700 of the Tabor Coda,for dm performance of the work for which this permit is issued.
My Werkeh Co�pt�N tion lance.dei and Policy number ue:OD�
Gofer. >'h/ ��1� Policy Ne.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
('This seNtas need mtbecompleed if the Permit is forms,hunde ddaBare(Slop)
or lou.)
I Damfv Not in the p uromance of the.,it far which this perch is issued.)shall nm
employ any person in any mannerso as to bccoma subject or the Wmiacee Cimpevatirm
Laws of California.Dam
A,000rt
NOTICE TO APPLICANT:If,after making this Certificate of Exemption.you shauM
become subject on the Worker's Compensation provisions of the Labar Code,you muss
.J z forthwith comply with such proved..or this permit shall be dttmed revoked.
z CONSTRUCTION LENDING AGENCY
[-. .�.. I hereby affirm d,m Nem is a contraction lending agency for the perfomur¢af
C4 „� de work for which this permit is issued(See.3097,Civ.C.) -
6i Q lender's Name
Z) z Lender's Address
U C) I certify Nat 1 have read this application and sista d,m dm above information is -
I,L F^ comer.I agree to comply with all city and county eminences and sum laws reatisg to
U buildin g construction,and hereby authorim representatives of Nis city to enter upon the
W ahove-mentioned Property for inspection proposal
OL (We)agree to ave,indemnify and keep harmless the City of Cupertino against
cn Iiabili0d.judgmcnu,costs and expeow which may in any way scene against sold City
U Z in cotamuance of the grandag of this Permit.
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POVIT Issued by: Date
SOU CE TIONS, _
/k O S-, Re-roofs
ignu a ppli HAAZAOnRt DOUS MATERIALS DISCLOSURE DateType of Roof
Will the applicant or future building occupant store or handle hammous material
as defined by tie Cupertino Muni'Pat .Chapter 9.12,and be Health and Safety
Cock,Section 255324)? All roofs shall be inspected prior to any roofing material being installed:
❑Yea ❑
41 Will thc applicant or fume thaildingoccupant use equipment or Mesas which If a roof is installed without first obtaining an inspection,I agree to remove
nit Im
at,on nus it conuntinants u d by rhe Bay AAmAir Quality Mangcmcnt all new materials for inspection.
Dix ?
Ihavcread the c,Seen 25505, 553u a dM534.der C'hmpmrd.95ofdm Glifa- J /� �✓ CrJY'/
.is HdTN&Safety Code,wm mer re I,i 25573 am125574,T to Dor,t thatifdc h,or t
dad not cumndy have•tenant.dist it is my respodlhllity m notil'Y the ott t or the
raqul am khmombcmatpriortoiscnartccor.CamOc f ignaureo Applicant Date
�i o
wwr 1mthwi edagent Date All roof coverings to be Class "B"or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: B1k: Lot:
APN 36653051. 00
DATE ISSUED. . . . . . . : 03/19/2008
RECEIPT #. . . . . . . . . : BS000004199
REFERENCE ID # . . . : 08030103
SITE ADDRESS . . . . . : 11771 SIERRA SPRING CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : DIANA MATLEY
ADDRESS . . . . . . . . . . : 11771 SIERRA SPRING CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5143
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 8, 200. 00 0.90 0. 00 0.90 0. 00
1REROOFRES SQ FEET 20. 00 260 . 00 0. 00 260.00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 260 .90 0. 00 260.90 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 260.90 #15000
---------------
TOTAL RECEIPT 260. 90
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
D. REROOF
•CUPEkTINO PERMIT APPLICATION
APN # 2 �3 0 S I 0 Date:
Building Address•
11 �►�►
Owner's Name: Phone #: L40 g - 25_7— 3 ZZ-1
DI �
Contractor: Phone #: g08..25 1 '3Sto s
CASTi LL6?, VD Fax #:
Cupertino Business License #: Contrac or License #:
30451
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof Built-Up roof
❑ ❑Asphalt Shingles Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
. 41 Wood Shingles a .Wood Shingles
❑ Other(Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report #
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: Q•ery- dd2, eyos4..i rl W OoA Sh i noleS ` -P54-(� I1 3O(b .
i q C-, Pj F Grana4 Can on eS;h i n91e�
Residential NJ Commercial
Fire Zone: YesEl No Confirmed with Planning Dept,
if
there are any restrictions: ❑
Valuation:
0 . 0 20 5
I Have Read, Und t and Will Comply with Cupertino's Tear-Off Policy:
ignatur
CITY OF CUPERTINO
REROOF
I F
•CUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B ICOMMLROOF
1BSEISMICO Seismic Commercial B
1RER00FRES Re-roof Residential B 1SFDWLR00F
/ 1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Community Development Department
Building Division
City of Cupertino
10300 Tone 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$176.18. The re-inspection fee must
be paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/4" per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: ✓ /(x-C�
Job Site Address: I I ( e
Roofing Company Name: 41,-b )J
Applicant's Signature: Date: `
Greg Casteel
Building Official
Revised 11/2/04
Community Development
S100
COp 0 Torre Avenue
rtinnoCA 95014
11 1 Telephone(408)777-3228
CITY OF Fax(408)777-3333
•CUPERTINO.
Building De artment
JOB ADDRESS: , I errs i PERMIT #
OWNER'S NAME: I p p1 PHONE # b$- 2 S('3S(o
GENERAL CONTRACTOR: FAX #
I am not using any subcon 5- R- c�
Signature Date
Please check applicable subcontractors d com lete 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 Sigfiature Date