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08100140 CITY OF CUPERTINO BUILDING DIVISION PERMIT ,C'�E!ITRr�CT,(3RINFQRMtkT=IOO;N lZ' aS'r: •h'.,E7 !%' BUILDING ADDRESS: PERMIT N0. 11659 QLIVR qPRTNG CT CASTILLO' S OWNER'S NAME: PERNUT ISSUE DATE —'IBA 1:703 GATHAY DR A CONTROL NO. 408) 251-3565. ARCHITEC AINGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH A O p LICENSED CONTRACTOR'S DECLARATION 1 Wmby afline Wt 1 Am Ice nerd under pmvisimu of Chapter 9(commencing Job Description -Z"n wiNsec NaODfifottrLoivis;an3ard+aBninn.enePrrusiamCaae.awmyBanxl= RE—RF T/O EXT RF INSTL #30LB FLT, INSTL CMP :�� IleerseGlm t- Date Conuacm SHNGLS [[qq ARCHTIECI'S DECLARA ON tl2Its dmy plan 1W v licsecor-m_—_ CLS A 19SQ A. ; � Lice prof o OWNER-BUILDER DECLARATION .�i 4 I hereby affirmNat 1 am ea=mpt from Be Conummes Liccnsu law!Or 1W OO following mown.(Section 7031.5.Budecss ard Profession Code:Any city or enemy S$ which m9uires A permit to eAmmuct.alter.improve.demWuh,As repair any suuctme mita issuance.also acumR.the applieant fnrsuch permit m III,.signnd statement pps Hum he is licensed pursuant mthe provisions OfWeConlucmr'eLicense LAW(Chapmr9 Sq.Ft.Floor Area Valuation Y l-� (commencing with Section 7030)of Division 3 of the Business and Prafesdons Code)or — that he u exempt therefrom and the Isamu,for the alleged exemption.Any violation of $9500 Semon 7031.5 by Any appllunt fat a permit subjects the applicant 10•civil penalty of APN Number Occupancy Type not mom than five hundred dollars(1300). p y yp ❑l.uawrcr oflha propvty.atmy wPloyma wvh wage uNe'vsule campensatim, 36654094 . 00 will do the work,-and the sweum is Am intended martered for tate(Sec.701/.Buri. and Professions Cods:The COWAmah Licenm Law dam an,Apply b an owner of Required Inspections propertywho builds at improves Hereon,and who dOesauchwork himselfor through his awnemployee,providedthatsuchimprosemenuartnotin„M, maReredforale B. howcass.0WildingmimprovemWham wuwild withinone Weer complmon,theowner- buildwip er have the of proving doK t did rot build a m improve fm Puryose of ale.), ❑1,as owner Of the property,Am exclusively concocting with licensed conuacmrn An construct the project.(Sec.7044.B V Wes and Professm ns Code)The Cavuxmr'a Li- e=ve law dons at apply to an owner of property wW Wilds m improve thereon.end who contracts for such projects wit a conwctor(s)licensed pursuant m the CanuacmYs License Law. ' ❑lamexemptunderse, .BdtPCrmthismawn Owner Das WORKER'S COMPENSATION DECLARATION 1 hereby a m order perWty of perjury sae of the folNving vtodeclarations: I ham and will maintain a Certificate of Consent self-insum for Worker's Camper- on,m provided fm by Section 3700 of the Labor Code,far the performmen of the work fm ch this pmol,I.issued. 3 have card will maintain Worker's Compensation W"AWa,u no Bred by Section 37W Of the Labor Code,for can perfmmmes of the wort for which this permit u Wood. My Workma Compensation I...canicr and Polity number art: caud,5M-kC f::�Jnd Po,.cy,..: Z390o6i9 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE Cads sermon need m,W cmnplemd time pamnh Infatuate hundred dOBus(SIM) m cast) 1 certify that in the purf smance of the work for which this permit is Wood,I shall not employ any person in my mortar an As to become subject to the Worlmn'Compensation Lam of California.Data Applicant NOTICE TO APPLICANT:If. net making this Cemifiute of Eacteplion,you should become subject to It.Worker's Compensation provisions of the taWr Coda,you mum wJ O forthwith comply with such pmvism.m mm this permit shall W secured wked. 'z”! CONsmuc 10N LENDING AGENCY [—tom I hereby aRnn that there is a construction lending agency,for the performance of CC w�-t the work for which this permit Is Leaned(Sec.3097,Clv.C.) aQ lsndces Name z 4mdefs Address V Q 1 certify that 1 have read this application and stain that the eWu,information u U. cored.I agree On comply with all city and county ordinances and mite laws relating An .p Wading consuvtion.and bemby mthorin rtpavmutivcs of this city to now upon the W abon-mutiovd pmpeny fat inspection purpmes g� (We)agree to ave.indemnify and keep ham les the City of Cupertino Against h IiabilklesjudgmcatacaM and expenses which may in my waynerm against said City V z in coastal s or the gcmting Of this pemm. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINTIssued by: 9 Date SO RCERE LATIONS. LA? OO Re-roofs rt of AMliunuConuactor Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Willdsapplicantmfuture WildingmupantaIOMarbandlchux owmateriai as defined by the Cupertino Municipal Code.Chapter 9.12,and the Heald and Safely Code,section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. 0y. Will the applicmt or future building Occupant use ayuipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove It Wa i us air camaminsns u d d by the Bay Arta All Quality Management all new materials for inspection. ucY Yex u Lhave must the hoearrdami.homwosmulQrChamterd.95ol the Glifor- tea Health tedos25M5.25533And!25534. WtJdte aid dote rot cumeoly Avco•tenant that it u my rom,005 bility b ratify the amuI of mqui men 'hmvtMMCI prior A,isausuceofaCertificate ofOccupancy. Signature pplieant Date ��w All roof coverings to be Class'V'or better Ower ,authmismdagem Data CITY OF CUPERTINO • 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36654094 . 00 DATE ISSUED. . . . . . . : 10/22/2008 RECEIPT # . . . . . . . . . : BS000006435 REFERENCE ID # . . . : 08100140 SITE ADDRESS . . . . . : 11659 OLIVE SPRING CT SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : SHOLEH DIBA ADDRESS . . . . . . . . . . : 11659 OLIVE SPRING CT CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5141 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, 500 . 00 1. 00 0 . 00 1 . 00 0 . 00 1REROOFRES SQ FEET 19 . 00 247 . 00 0 . 00 247 . 00 0 . 00 -------- ---------- TOTAL PERMIT 248 . 00 0 . 00 248 . 00 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER --- --------------- ---- ---- CHECK 248 . 00 #15426 --------------- TOTAL RECEIPT 248. 00 , VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF • Community Development 10300 Torre Avenue i*av)iv Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 *UPERTINO Building Department JOB ADDRESS: PERMIT #11 tp 51 Q iVe S o / 00 / 0 OWNER'S NAME: ole PHONE # q' " - 2 GENERAL CONTRACTOR: p' FAX# 140W-251-3546 I am not using any su .nom? (O 2Z Cog Signature Date Please check applicable subcontractors an complete the followinginformation: 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 Q or Signature Owner/ ate 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 2007 IBC Standards and manufacturers specifications on re-roofing. All roofs are Class "A"per Cupertino municipal code 16.04.080. 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 /a "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: s h//o I e-h GN bc, Job Site Address: 111959 O 1 V e` cp� 'T Roofing Company Name: O_PT �4 I (d S 2U]11 1 JlS� Applicant's SignDate: // ZZIa • Greg Casteel Building Official Revised 07/30/08 CITY OF CUPERTINOj� gagp� REROOF CITY OF •CUPERTINO PERMIT APPLICATION APN #3 I o O� ,'-(I ` O c) Date: Building Address: 0 6,S ) I lC r i an Owner's Name: Phone #: Shole.h 10-1a. 7 3- 9(D22 Contractor: Phone #: 3JCo eAsfi II0S 4,"Zj Fax#:((�� s Cupertino Business License #: Contractor Liccen�e Type of Roof Covering: * Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles %/Asphalt Shingles V"Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.B.O. Report# w/To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: Tear o 4'-� 12oo_F 1],75_ta 11 3b 2 I nswl Cowlp . shi led . r Residential Commercial Lj Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: ❑ applicable, include in plan set & the sheet index. Valuation: ,o I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: r Signa e Revised 6/16/08 CITY OF CUPERTINO lim kk Ilia REROOF CUPERTINO FEE SCHEDULE • Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 1RER00FRES Re-roof Residential B 1SFDWLR00F 1BSEISMICRE Seismic Residential B 1RER00FMRES Re-roofMulti-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B Revised 6/16/08