07020060 CITY OF CUPERTINO
BUILDING DIVISION PERMIT � ' �MI (?R1VITI(IN
PERMIT NO.
BUILJIjJ r�gRESUNSET SPRING CT CASTILLO I S ROOFING 07020060
l j PERMIT ISSUE DATE
OWNER'S NAME:
SARIKA AGRAWAL 1703 CATHAY DR. 02/09/2007
SANITARY NO. CONTROL NO.
ONE:
(408) 25'--3565
BUILDING PERMIT INFO
ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH
p C LICENSED CONTRACTOR'S DECLARATION Job Description
uI hereby affirm that I am licensed under provisions of Chapter 9(commencing
Z with Section 7000)of Division 3 of the Business and Professions Code,and my license is REROOF- TEAR OFF COMP, INSTALL NEW GAF GRAND
"40- in full force andeCfec 3 Lic.tr 0 CANYON SHINGLES. 25 SQUARES. CLASS A
)t2z License d Contractor 0
y Date
� ARCHITECTS DECLARATION
I understand my plans shall be used as public records
6
U. Licensed fcssional
y
OWNER-BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contractor's License Law for the
<O following reason.(Section 7031.5,Business and Professions Code:Any city or county
< improve,demolish,or repair any s
,�, which requires a permit to conswct,alter, structure
u"y prior to its issuance,also requires the applicant for such permit to file a signed statement $q.Ft.Floor Area Valuation
z< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 $8000
t=- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or
i that he is exempt therefrom and the basis for the alleged exemption.Any violation of Occupancy
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3665201 Number P Y Type
not more than five hundred dollars(5500).
❑I,as owner of the property,or my employees with wages as their solo compensation,
will do the work,and the structure is not intended or offered forsale(Sec.7044,Business Required Inspections
and Professions Code:The Contractor's License Law docs not apply to an owner of
property who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improvements are not intended or offered for sale.If,
however,the building or improvement is sold within one year of completion,the owner.
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
❑1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business and Professions Code:)The Contractor's U-
,
cense Law does not apply to an owner of property who builds or improves thereon,and
who contracts for such projects with a conuactor(s)licensed pursuant to the Contractor's
License Law.
❑1 am exempt under Sec. B&P C for this reason
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑I have and will maintain a Certificate of Consent to self-insure for Worker's Compen-
sation,as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑I have and will maintain Worker's Compensation Insurance,as required by Section
3700 of the Labor Code,for the performance of the work for which this permit is issued.
My Worker's Cor penaatiou 1 sumtce cr and Policy number are:
Carrier. X17 Policy Na.:
X0 0009'9
CERTIFICATE OF CEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section aced not be completed if the permit is for one hundred dollars($100)
or less.)
I certify that in the performance of the work for which this permit is issued,I shall not
employ any person in any manner so as to become subject to the Workers'Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT.If,after making this Certificate of Exemption,you should
become subject to the Worker's Compensation provisions of the Labor Code,you must
2 forthwith comply with such provisions or this permit shall be deemed revoked.
Z� CONSTRUCTION LENDING AGENCY
►fir I hereby affirm that there is a construction lending agency for the performance of
�i> the work for which this permit is issued(Sec.3097,Civ.C.)
W M Lender's Name
=z Lcnder's Address
U C—) I certify that I have read this application and state that the above information is
[L correct I agree to comply with all city and county ordinances and state laws relating to
V building construction.and hereby authorize representatives of this city to enter upon the
0 W about-mentioned property for inspection purposes.
LL (We)agree to save,indemnify and keep harmless the City of Cupertino against
tF-t liabilities,judgments,costs and expenses which may in any way accrue against said City
U Z in consequence of the granting of this permit. Date
►� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:
f.d
URCE RE ULAT7 NS. /��
�D 7 Re-roof;
u of Appli ontractor Type Of Roof
HAZARDOUS MATERIALS DISCLOSURE YP
Will the applicant or future building occupant store or handle hazardous material
efined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
ode,Section 25532(a)? All roof s shall be inspected prior to any roofing material being installed.
❑Yes 1A If a roof'is installed without first obtaining an inspection,I agree to remove
Will the applicant or future building occupant use equipment or devices which
emit hazardous air contaminadc1mcd by the Bay Area Air Quality Management all new materials for inspection.
District?
Cl Yes
Ycs No
n
I have read the hazardous materials requirements under Chapter 6.95 of the Califor- �J
nia Health&Safety Code,Sections 25505.25533 and 25534.1 understand that if the building ems'
does not currently have a tenant,that it is my responsibility to notify the occu ant of the Date
requi me e0hi ust be met prior to issuance of a Certificate of cup�. S 1 natu'e 0 Applicant
-- All roof coverings to be Class"B"or better
Owner orNu rued agent Date
CITY OF CUPERTINO
2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: amyw
COPY # 1
Sec: Twp: Rng: Sub: Bl-.c: Lot:
APN . . . . . . . . . 363)52019 .00
DATE ISSUED. . . . . . . : 02 /09/2007
RECEIPT #. . . . . . . . . . BS;)00000437
REFERENCE ID # . . . : 07)20060
SITE ADDRESS . . . . . : 11.3)15 SUNSET SPRING CT
SUBDIVISION . . . . . . .
CITY CU?ERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SAZIKA AGRAWAL
ADDRESS . . . . . . . . . . .
CITY/STATE/ZIP . . . : SA:Q FRANCISCO CA, 94123
RECEIVED FROM . . . . : RECEIPT INTERFACE
CONTRACTOR . . . . . . . : JO3E CASTILLO LIC # 25850
COMPANY . . . . . . . . . . : CA3TILLO'S ROOFING
ADDRESS . . . . . . . . . . . 17 )3 CATHAY DR.
CITY/STATE/ZIP . . . : SAJ JOSE, CA 95122
TELEPHONE . . . . . . . . : (4)8) 251-3565
FEE ID UNIT QUANTITY .%MOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 8, 000. 00 147 .96 0. 00 147 .96 0. 00
BSEISMICRE VALUATION 8, 000. 00 0.80 0. 00 0.80 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 148.76 0. 00 148 .76 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 148.76 14336
---------------
TOTAL RECEIPT 148 .76
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
,UPEI�TINO
Building Department
JOB ADDRESS: � � PERMIT #
11 1 SUr�se i 6Y76)Aao
OWNER'S NAME: 6 A Y i ISA � c:� PHONE # S r -t - D-
GENERAL CONTRACTOR:
r
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and comalete the following information:
60 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
a
Owner/Contractor Signature Date
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 applies L without first obtaining all inspection
and written approval from the buildinp 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 apprc val.
2) In-progress inspection approval.
3) Final inspection approval.
a) Spark arrester installation.
5. If plywood is installed,a plywood nail nspection is required.
6. Any roofing which is applied without f rst 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 :)f$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.
ly
Homeowner's Name: `� A 12- FA0 N 1
Job Site Address: J l I 1
Roofing Company Name:
Applicant's Sign tures- Date:
(off
Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
RK, OOF DrID2 C�
CUPITPERMIT APPLICATION FORM
APN# Date:
Building Address: I ��
Owner's Name: Phone#:
Sarlr
0, 2sI
Contractor: License#: i f 5 o t _5 j
'T "( HCl
Contact: Cupertino Business License #:
S
Type of f:oof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑/Built-Up roof
ljo Asphalt Shinglg§ `V Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report#
❑ To be Removed ❑ Provide Mfgr.Installation Specs.
I Have Read,Understand and Will Comply With Cu ertino's Tear Off Policy: (06s,
Job Description:
Uftw W ►� F ran �ai� ars �jh Ips
Residential--v ommercial ❑
Fire Zone: Yes El IL Confirmed with Planning Det. if
there are any restrictions: LJ
Cost of Pro*ect: TVDe of Constniction: Occupancy group:
b0er�-o�� �=
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING