11110110 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11531 WELLSPRING CT CONTRACTOR:CASTILLO'S ROOFING PERMIT NO: 11110110
OWNER'S NAME: LIN YUAN-KAI AND HUILAN S 1703 CATHAY DR DATE ISSUED: 11/18/2011
ER'S PHONE: 4082551189 SAN JOSE,CA 95122 PHONE NO:(408)251-3565
LICENSED CO A R'S DECLARATION r r r
n 2� BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class li Lic.N (�J
/ // MECH r RESIDENTIAL r COMMERCIAL r
Contract r Dote
I hereby afli m el t em licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OFF WOOD SHAKE AND INSTALL COMP
(commencing with Section 7000)of Division 3 of the Business&Professions SHINGLES CLASS A 17SQ
Code and that my license is In full force and effect.
I 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.
1 have and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$9250
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. `
APN Number:36651041,00 Occupancy Type:
APPLICANT CERTIFICATION
1 certify that I have read this application and state that the above information is
correct.I 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 PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION.
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section n
9.18• p Issued by Date -• /A
111
A� p �
Sign aut- r ./ Date /
OWNER-BUILDER DECLARATION RE-ROOFS:
All roofs shall be inspected prior to any roofing material berg installed.If a roof is
ereby affirm that t am exempt from the Contractor's License Law for one of
1 installed without first obtaining an inspection,1 agree to remove all new materials for
the following two reasons: inspection.
1,as owner of the property,or my employees with wages as their sole compensation, //�
Al
will do the work,and the structure is not intended or offered for sale(Sec.70441 Signature o A p' rl/r Date:
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penalty of perjury one of the following three
declarations: HAZARDOUS MATERIALS DISCLOSURE
1 have and will maintain a Certificate of Consent to self-insure for Worker's 1 have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(x)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District 1 will
maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534.
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If,atter making this certificate of exemption,I Ow r nth ed agent:
become subject to the Worker's Compensation provisions of the Labor Code,1 must<
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's
I certify that 1 have road this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.)
correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
iftand expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION
Nig of this permit.Additionally,the applicant understands and will comply _
II non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.18.
Licensed Professional
Signature Date
, r
• CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36651041.00
DATE ISSUED. . . . . . . : 11/18/2011
RECEIPT #. . . . . . . . . : BS000015359
REFERENCE ID # . . . : 11110110
SITE ADDRESS . . . . . : 11531 WELL SPRING CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : LIN YUAN-KAI AND HUILAN S
ADDRESS . . . . . . . . . . : 11531 WELL SPRING CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5136
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
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 9,250.00 1. 00 0.00 1. 00 0. 00
1BSEISMICR VALUATION 9,250.00 0 . 93 0. 00 0 . 93 0. 00
1RER0OFRES SQ FEET 17.00 238 .00 0. 00 238 .00 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 239. 93 0.00 239. 93 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 239. 93 #17481
---------------
TOTAL RECEIPT 239.93
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
309 EXTERIOR LATH 311 SCRATCH COAT
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
� 100113
REROOF PERMIT APPLICATION �
COMMUNITY DEVELOPMENT DEPARTMENT" BUILDING DIVISION LJ V
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
® CUPERTINO (408)777-3228 • FAX(408)777-3333 • buildinG(ad)cupertino.ona
PRQMCTADDRFSS APN9,3/ .�(J�_ h _ o
OWNER NAME E-✓
�- i - S S- 1 MAE.
STREETADDRESsSfA.TE,ZW Y -
JJ C
APPLICANT NAME / PH S' E-MAIL
STREET ADDRESS Il' CrrY,STATEZIP FAX
. .
S C' 951 Zz-
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT S COM ACMN ❑COMTRAICrORAGENT ❑ AmIE ECT ❑ENGWESR ❑ DEVELOPER ❑ ENAM
CONTRACTOR NAMEIA S71-LLO S LICENSE NUMBER LICENSE TYPE C BUS.LIC.k
COMPANY NAME E-MAILFAX
STREET ADDRESS CITY,STATE, 96Ia PHO
ARCHITECnFNGINEER NAME LICENSENUMBER BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CrrY,STATE,ZIP PHONE
USE OF L.,eD or Duplex ❑ Multi-Family ROOF AREA: VALUATION:
STRUCTURE: ❑ Commercial ,� ' q
EXISTING ROOF TYPE: ❑BUB.T-UP ROOF 11 ASPHALT SHINGLES -2 W 000 SHAKES ❑WOOD SHNM F ❑OTHER(SPECIFY)
REMOVE(REPLACE AOYES IF NO, PLYWOOD ❑ 'A" ❑ PLYWD ❑ OSB PITCR ROOF
YPF
PROPOSED ROOF TYPE: ❑BV[LT•UP ROOF ASPHALT SHINGLES ❑WOOD SHARES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT N
DESCRIPTION OF WORK -TT_ Ap-- D WW /fib^
is r - hl soba I , G//J`/1
In,
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act an the property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to build con 'on. I authorize representatives of Cupertino tc enter the above-i entified property for inspection purposes.
Signature ofApplicanr/A Ot _ Date: k /
SUPPLEMENTAL D40RMATION REQUIRED
_Ifbuilding is associated with a Home Owner's Association,provide letter '+' -�' E�+CaK=ZT
Of approval from HOA. ?=
PP _ Y¢R:1'EIP'COiINTER. a'BLE�nrN!•rR,IfANREt"IEw
_Provide Planning approval to verify if there any restrictions.
Provide copy ofManufactureis Installation Specificadons.
<4".ti"..�.xt t�.ETRE.DEEL 3. d
'!Provide signed copy of Cupertino's Tear-OfF Policy.41
Reroof4pp_2011.doc revised 03/02111
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
• ADDRESS: 11531 wellspring ct. DATE: 11/18/2011 REVIEWED BY: bob s.
APN: BP#: "VALUATION: $9,250
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLR00F
USE: PERMIT TYPE:
WORK tear off wood shake and install comp shingles.
SCOPE
FEEID ROOFAREA
s.f.
1REROOFFRES 1,700
;t fe,•Ir. Plan Che,* P7uwL. Plon Check fifes Mint Chec:b`
Much. Permit Fur.: Plunih. 1'emlit Fee: Fla.. Perm¢Fee:
iter'ii•vll.jr-all, offier Mundt Insp. Onto Elec. Lapp. Ej
.
'11'ech.Imp. Fee 1'lweb. /nsp.Fer: filer.Inv?. Pee:
NOTE: This estimate does not Include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District etc. . These fees are based on the pmellinion in ormadon available and are onfy an estimate. Contact the Devi for addn'l Info.
FEE ITEMS flee Resohnion 11-053 EB 7/1/i II FEE QTY/FEE MISC ITEMS
Plan Check Fir:
Suppl. PC Fee
f G nn b,;;iTech.;Z�7ec
Permit Fee: $238.00
Suppl, btrp Pee
Flrunh.:;Neth./1sTec
1'inmh./:44sclaililec Permit Fee:
Construction 7nty
Administrative Fee:
Work Without Permit? O Yes (E) No $0.00
AJ),ancod Planning Fees:
Travel Documentation Fees:
Strung Motion Fee: IBSEISMICR $0.93 Select an Administrative Item
• Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $239.93 $0.001 TOTAL FEET 1 $239.93
Revised: 10/01/2011
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
• ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
C O P E RT I N O 10300 TORRE AVENUE -CUPERTINO. CA 95014-3255
(408)777-3228- FAX(408)777-3333-buildinc(Dcupertino.org
PROJECTADDRESS 1 S3 1 APN#
OWNERNAME ad Lo
S PHONE ZS - I I Q E-MAIL
STREET ADDRESS I r CITY, STATE.ZIP O`_((_ 9_4](J/ FA%
12
I
CONTRACTOR NAME OS LICENSE NUMBEl LLIICENNSETYPEnBUS.LIC.#
COMPANYNAME �A UU E-MAIL K (,' FAx
STREETADDRESS U• CITY,STATE.ZI +1� PHONE Of /-
35
I UND RS AND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable provisions of the 2010 California Codes.
2. An inspection request can be scheduled up to the day before the inspection date. Please call (408)777-
3228 from 7:30 - 3:30pm (Mon-Thurs)or 7:30 - 2:30pm (Friday) to schedule the next day inspection.
For Tear-Off and Nailing Inspections, you must also call on the day of the inspection only after that
phase of the work is completed. The building inspector will be available within one hour. Progress
and Final Inspections will be given a two hour window.
• 3. Tear-Off Inspection is required. Any and all dry-rotted wood shall be replaced prior to this inspection.
Unless new plywood roof sheathing is proposed throughout, all the nails/fasteners shall be either
completely knocked-down or removed prior to this inspection.
4. If plywood is installed, a plywood Nailing Inspection is required.
5. Roofing shall not be applied without first obtaining all prior inspection and written approvals from the
building inspector. Any roofing which is applied without first obtaining an approved inspection will
require the removal of all new material down to the sheathing so a proper inspection can be performed.
6. Progress Inspection is required when approximately 50% of roof covering is installed.
7. A Final Inspection and approval shall be obtained from the building inspector when the re-roofing is
completed. To receive a final sign-off, the following items will be verified:
a. Flat roofs shall have a minimum of Y<" per foot of slope and demonstrate there is no ponding.
b. Listings from approved testing agencies for all pre-manufactured products used shall be
available on-site to review at the time of the inspection.
c. Proper spark arrestor installation, vents painted, gutter/downspouts installed, debris removed.
8. NOTE: .If you call for a tear-off or plywood nailing inspection and the work is not complete, you will be
charged a re-inspection fee of$126.00. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the
property owner's behalf. I understand and agree to comply with the re-roof policy stated above. 1 also understand that
smoke detectors and carbon monoxide dere tors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Resid ' Cod . I //
Signature of Applicant/Agent: LQ4 Date:
RerogfPolicv_20//.doc revised 01/16/11
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: 408-777-3228
U P E RT I N O Fax: 408-777-3333
CONTRACTOR / SUBCONTRACTOR LIST
JOB ADDRESS: I 1 3 I RS!Q PERMIT# / D110
OWNER'S NAME: PHONE#
GENERAL CONTRACTOR: BUSINESS LICENSE#
ADDRESS: CITY/ZIPCODE:
*Our municipal code requires all busines s working in the city to have a City of Cupertino 6Wness license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractor . �— /� /�
Signature Date
Please check applicable subcontractors and complete the following information:
V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring/ Carpeting
Linoleum/Wood
Glass/ Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting/Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile —
Owner/Contractor Signature Date