08020063 CITY OF CUPERTINO *� t "
BUILDING DI%SION PylTRT 4Ql: iVEt� "� I"
*cora,.,..::_' .r„..1{rs¢
BUIIDI G qqD : PERMITNO.
ESS
1� U� TIMBER SPRING CT CASTILLO' S ROOFING 08020063
ER'S NAME:
PERMIT ISSUE DATE
SEEMA & JYOTI BHARDWAI 1703 CATHAY DR 02/11/2008
PHONE: SANITARY NO. CONTROL NO.
(408) 251-3565
ARCHITEC(ENGINEER: BUILDING PERMITINFO
BLDG ELECT PLUMB - MECH
Sop LICENSED CONTRACTOR'S DECLARATION Job DOSCTIptlOn
ee u 1 bombs 99.that l am licensed under proviaia=of Chapur 9(co comm 11
with5eetion]000)ofDiviaion7of the Buvness end Prof=aiou Cotle.and mylicertmis RE-ROOF,T/O COMP & INSTL 30LBS. FLT & INSTAL 50
D Lin full rase and efface 3 9 g¢36�/s!o
2 License Glu{ Lie.N YR
flak 2 /I/ conlracbr - �✓.s�tC'�
<]W crsDEc RAnoN 24SQ CLS A
ss 1 understand my plans shall W used u public mcmus
]yU
g sed Licensed poefcseimm
5g OWNER-BUILDB0.m Ce Coney ON '
4<E I hereby A(Sect that I am exempt from the Contrutofa Licctse Law for me
p O following meson.(Section t 7 connotes,
s,muss and w,dcra li Code:Any city oy s manly
9 which squires n e,alst re cawed rotor.Wpmw,de Permit
t ver mash ed tuement
ZS° prior uit tonedp,aluantto the theApplicantfor suchhpeures Licenrile ase
Law
rl
< Ihathc is Intoned puaco..7Ncpmvivimuaf dupe Beiito/and Ptollar.(Chapter Sq.Ft.Floor Area Valuation
�$ mat M is c g WithhheNon and the
Division r the
stage i exemption.
mW on.Any vi lattl.)or $9300
that W u eumpt therefrom Intl Ne best far the alleged eumpdon.Any violation of
Section 7031.5 by any applicant fm a permit subjects the applicant to a civil penalty of p ppt Number Occupancy Type
net fume than five hundred dollars(SSW). 36654 87:VV”
❑L a owner of the property.army employees with vergaeu thea ale campevadan.
will do then wark.and thet=its.isnatirmaded araffered foraafu(Sec.70th,Business Required Inspections
and PafesImm,Code:The Contractor's License Law does not apply to an owner of -._... q p
property,who Wildaorimpawmerean,andwhod.ss.hwarkhimalrmlluoughhiA
own cmplayeas,promdtal that such improvements ere at inuntlN ar offered for anle,if.
however,du building or improvement is sold within ane year of completion.the comas,
builder will bow me burden of proving that he did not Wild or Winnow for purpoa of
ale.).
❑I,As want of me property,am=elusively contracting with licensed contractors to
construct the pmj=t(See.7044.Business and Profession$Coda:)The Conaamfa Li, -
conse law dean not apply to an owner of Property who Wilds or impruwa thereon,and,
who contracts for such projects with aconauma(s)licensed pursuant W IM Conaactoh
Lice.L.W.
❑lomssemptundersec, .B&PCforthismson
ncr Data
WORKER'S COMPENSATION DECLARATION
1 hereby afRrm under penalty of perjury one of the following declare low
❑I ham and will maintain acertifaamof Consent on self-l=ure feeworker's Camper-
adan,u provided for by Section 3700 of the Labor Code,far gar performance of the
work for which this Permit is issued.
❑1 haw ad Will maintain Wmkcfa CampewAtian Insurance,As required by Section
3700 of me Labor Catle,far me,performance of the Work far which this permit is issued.
My Worker's Compensation Insurance carrier and policy num-beer�art:
rti
Caer. 5�1�-�«U/[J�Pallcy No,.2 35 x'3000
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Misxertoa netl atbecampleed if the pereaft Inherent.hundred sell.($100)
or less.)
1 ati that in the performance of the wart fm which Nie pe it is Wool,I shll net
employany person in my manor s u m becog1asub' t rs'Compewwon
Laws of California.Dam
Applicant 8E p
NOTICE TOLI ANT:If.after m W ng this Certificate of Exemption,you ateuld
become Subject to I m Warkeri Compensation previsions of the Later Code,you mum
.JO foMwith comply with Inch provisions m this Permit shall W deemed mwked.
'Z y CONSTRUCTION LENDING AGENCY "
[-a Ihereby affm that them is a construction lending agency for the performance of
r7 the work for which this permit Is issued(Sec.309.1,Civ.C.)
W 0 Lender's Name
z L..&eA Add. -
V 0 I cemly that I haw read this Application and stag thm 100 Abow Information ie
W E correct.l Agra as comply with all city and county ordinaaa and sum laws Remit,to
-0 building conswcton.and hereby aumarira mpmsmtatiws of this city to enter upon the
W above-mentioned property for inspection purposes
G (We)agree to same,indemnify ad kap harmless 0e City of Cupertino against
IV) liabilities,judgment.costs and expenses which may in any Way accrte against mid City
V z A APPLICANT
of the granting Smit permit // p
sen APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALLNON-POINT
/// /�J
Issued by: - Date
SOURCE REGUI.AIJQN$. �
IRe-roofs �_.
SI esu of Applian on
HAZARDOUS
Dam Dam US MATERIALS DISCLOSURE Type of Roof
Will applicant or future Wilding ocmpatmom or handleeaNaw mm
41dented auribyy It le Coconino Municipal Code.Chapter 9.13, d mHealth emm ad Surety
,sec,second 25532(.)7 / All roofs shall be inspected prior to any roofing material being installed.
❑res fo
Will the applicant or future building occupant use equipment or device which If a roof is installed without first obtaining an inspection,I agree to remove
emit hasumm s air contaminants u deE by the Bay Area Air Quality Management all new materials for inspection.
District]
❑yes ;No
I have mal me bacadous meeriatsmquimmems under Chaptrb.95 ofthe Califer.
niAHcal"Smey Cade,SwStearnsaStearnsx5505,25533 And 25334.Imsim nd thnlfde Wilding `/ L
dean not c.ad,have A¢nl out It is my respoto nsibility notify the aeeupal of the !!!/// az-0�""'
notion:mena Wlt to tWmmpdoruissuaceof.carifeau of0c "pmry S' atur ofApplicant Date
2
ver wthadrnd agent Dat All roof coverings to be Class"B"or better
D � 0), n � 3
CITY OF CUPERTINO
REROOF
•CUPEIIiTINO PERMIT APPLICATION
APN # �3 / r S L�OW-� t O o Date: 2 I O
Building Address:
M O I fn be--r S r', n 4-
Owner's Name: Phone #:
Contractor: 0 Phone #:
U S KO(x-H t, Fax #:
Cupertino Business License #: Contra for License #:
�30 �
Type of Roof Covering:
Existing: Proposed:
❑ B ilt-Up Roof ❑ ilt-Up roof
Asphalt ShinglesLe Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other (Specify)
Number of existing coverings a Provide I.C.B.O. Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: e of O W�fS h nO� 06 -Y\
Q • �01 S� 1 ( �i� h S �P
�r,s-1� ( 1 q boy ►zc°m� . 2 � S� .
Residential Commercial
Fire Zone: Yes No Confirmed with Planning Deptif
there are any restrictions: ❑
Valuation: -bco c /\
I Have Read, derstand and Will Comply with Cupertino's Tear-Off Policy:
Signatur
CITY OF CUPERTINO
• ' REROOF
cUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
�K w 1REROOFRES Re-roof Residential B 1SFDWLR00F
1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLR00F
1BSEISMICRE Seismic Residential B
IBUSLIC 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 teat 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 insuection 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: GA Lk 0. ' /
Job Site Address: 1 ( _T m );V SD_<N cl
Roofing Company Name:
Applicant's Signature: =�� - Date:U atd (:�e
c-
•
Greg Casteel
Building Official
Revised 11/2/04
• CITY OF CUPERTINO
2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36654087 . 00
DATE ISSUED. . . . . . . : 02/11/2008
RECEIPT #. . . . . . . . . : BS000003910
REFERENCE ID # . . . : 08020063
SITE ADDRESS . . . . . : 11701 TIMBER SPRING CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . .. : SEEMA & JYOTI BHARDWAI
ADDRESS . . . . . . . . . . : 11701 TIMBER SPRING CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5145
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 9, 300. 00 1 .00 0. 00 1. 00 0. 00
1REROOFRES SQ FEET 24 . 00 312 .00 0 . 00 312 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 313 .00 0. 00 313 . 00 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
---------------- --------------- --------------------
CHECK 313 . 00 #14937
---------------
TOTAL RECEIPT 313 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
------ ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
605 FINAL REROOF
x Community Development
10300 Torre Avenue
w-" Cupertino CA 95014
Telephone(408)777-3228
UDCO OF
CPTINO Fax(408)777-3333
Building Department
JOB ADDRESS: PERMIT #
X01 mb--r G o ri Ci. I e-7?-0 2-adG�
OWNER'S NAME: e har PHONE # q 61 & - C G20
GENERAL CONTRACTOR: CftS I u! 'S Z DFAX #
I am not using any subcon C)2 l 1 6
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
er/Contractor Signature Date