08110042 CITY OF CUPERTINOt
BUIIriPING Dl"ISION PERMIT -OKINFORMATION'
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BUILDING AOD0.F55: PERMIT NO.
11802 TRINITY SPRING CT CASTILLO' S R0Qj_jkjQ_ 081 1 0042
OWNER'S NAME: FERNI TISSUE DAM
ONE: A CONTROL NO.
(408) 251-3565
ARCNIIECDFNGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
uolp LICENSED CONTRACTOR'S DECLARATION - Job Description
Ig
1 hereby mine Net I am limned under provisions of Chepnr 9(commencing
wire Seedan 70,'IB3 of Division 3 of dm Stand.and Prorcum.Code.and my licensee
,nF inrtllraren,nderteer. O �f-� RE-RF T/0 EXT WDSHK INSTL 30LB FLT NEW CMP GAF
C,�Z Liccna Clm C35 Lle.p
at- ton -�/�- canu,cmr SHNGLS CLS A 16 . 5SQ
0ee A0.CHIlECfS DEC A N
- Ion ¢rsund IpWuslWl be luWy public_ Ns
D,,u �—
k i rr Lickftd PcIressional
503 OWNER-BUILDER DECLARATION
T, I hereby alnnn that I am exempt from me Contractor's License Law for the
00 following mums.(Smtion 701.5,Business and Professions Cole:My city or mumy,
$ which requires a permit to eonvruet,alter.Improve, kenollm.or repair my mmeru e
Prior to its ismorce,also Inquires tbo applicant forsuch permit to rile,signed statement
ppr
that oislicensed fnnrsuanInthe pmvisiouoftheContra<mr'sLiccnseLaw(Clupur9 Sq.Ft.Floor Area Valuation
Yom$ (commencing with Section 7000)of Division 3 of dm Box.and Pror.m.Code)or
that he is exempt shen(rom and de osis fm the alleged ceempdon.Any violation of $8500
Secdan 7071.5 by any applleant for a Permit mbjecta the applicant to a civil penalty Of APN Number Occupancy e
not roam dun five hundred dollars(M). 36653044 . 00 P yTyP
I,u ower of the property.m my employccs with"gnu lW'v=le eompewtim,
will dothewomk,anddm TIM
Chromate,
need.1 apply 7Dae,euaineca Required Inspections
and Prey who
Cadc Tho vesdummr's Liana law,aces rot apply m an owner of q P
property who Wilds idea Unvuch mesio and who m ema ro workhisf rset hu
awn employees.the W provided this such improvemmu are not inun fe maBereA(maa4lf.
however.aseave the m Mproammt4cold within ot yw of mprove foon.r
to owe of
builder MB have the WNm of proving that he did not build Or improve(ser puryose of
sale.).
0 1,as awns of the Property.w exclusively contracting with licensed mntmemrs he
comuuct dm pospa(Sec.7044,Badmen and PmRsslam Cade:)The Commences U. ,
m ue Law docs not appy as an owner of Progeny who Wilds or improves dureem.and
who contracts for such Projects with a contractor(s)linumed pursuant m me,Conuammes
License Law.
❑lamuernptunderSec .BdPCformismamn
Owner Dau
WORKER'S COMPENSATION DECLARATION
I hereby anion under penalty of perjury,oro of the following dmlaratiau:
have and will maintain a Cmifiau ofComemt to self-Wum for WorkefsCompen-
on,as provideL for by Section 7700 of to labor Cade.for de Perfores.of the
work for which this permit Is issued.
❑1 have and will maintain Worker's Compensation huurana,as nurtured by section
7700 of the Labe Code.for the performance oflW wast for which thiel Permit is leaned '
My Worker's Co 1pe]nu/don Imunna am/r{and Policy number(/ye
Carrier. AT1��U�4 PoHey Na:5 '/k 5 t1)91
CERnFlCATE OF IXEMMON FROM WORKERS'
COMPENSATION INSURANCE
freer soxm leo not becanpicnd if the Permit 4 rams,hundred Ao tars($100)
or less)
1 sundry shut in he performance of the work for which this Permit is issued.I shall not
employ any person in any mannerw as an harem,subject to the Worker'CampeuNan
Laws of Califamia.Dan
Applicmt
NOTICE TO APPLICANT:IL afar making this Ceniriean of Exemption.you should
become subject to me WOrkeer's Cmnpenvtion provision of the Lahw Code,you must
.,O raMwith comply wish such provisions or this pcmi,most o deemed revoked.
z CONSTRUCTION LENDING AGENCY
.(11. I hereby aRm that mem u a eoruuuminn lending agency for the Performance of
a > do work for which this Permit Is issued(Sm.3099,Civ.C.)
Wlender's Name
ry Q ,
Z)Z Lender's Address
t.)Q 1 cco fy that I have mad this application and sum met to move information is
17w cor¢t.l agree to comply with all city and county aNbnrwrs and soon Ian slating Is
0 Wilding communion,and hereby authorise mmum utives ofthu city to enter upon the
W above-mentioned property for inspection pumpnaa
(We)agree to save,indemnify and keep harmless the City of Cupertino agsimt
liabilities,judgments,costs and expemmsee which may in my way scene sores said City
V Z in corvequence of the emoting of this permit. ) .1
APPLICA UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOUR ECU ONS
d
ppgaR //- Date Re-roofs
Re-roofs
JS
i um I' EDISCLOSURE
e Type Of Roof
wit to pplieanlorfulurt Wilding occupant Wore or handle hmasdaus material
v
de, by CUNm.Muni Opal cult.Chapmr 9.12,and the Health and Safety
❑Yu
code.Scan 25532(e)9 All roofs shall be inspected prior to any roofing material being installed.
Will the apple=(or future Wilding Occupant use equipment a devices which If a roof is installed without first obtaining an inspection,I agree to remove
t hvaNnas,ir conumin=ta n defined by the Bay A.Air Costly M....cmtnt all new materials for inspection.
Act? — r
[3 Yes
l ore re>v she hvaNmmxmanrlalsmquiremcnu unskrCNPter6.95 ofthe Caiifor- '/V ev
nu HeslmkSafmyCod,,Smd=nM5.25537md2534.1u mud U
V CIY
ams
net cumndy hers a meant that It is my ma xamfluiliy m minify amupmt
requimnsnu which muv on met 'arm issues,,ora CmiEumof Ocmpanry. Sign erre of Applicant Date
'/_/d-U� All roof coverings to be Class'W'or better
Ow r Omcd,,em Dau'
� 1
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36653044 . 00
DATE ISSUED. . . . . . . : 11/10/2008 .
RECEIPT # . . . . . . . . . : BS000006588
REFERENCE ID # . . . : 08110042
SITE ADDRESS . . . . . : 11802 TRINITY SPRING CT
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : KEARLY DEBORAH J ET AL
ADDRESS . . . . . . . . . . : 11802 TRINITY SPRINGS CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5146
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, 500 . 00 0 . 90 0 . 00 0 . 90 0 . 00
1REROOFRES SQ FEET 16 . 50 214 . 50 0 . 00 214 . 50 0 . 00
---------- --- ---------- ----------
TOTAL PERMIT 215 .40 0 . 00 215 . 40 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 215 . 40 #15473
------ --
TOTAL RECEIPT 215 . 40
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
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.
S5. 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 Raid before another inspection can be scheduled
IMPORTANT:
1. Flat roofs must have a minimum of 1/ "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: M In cfin n
Job Site Address: Tr_� I O-A G4 ,
Roofing Company Name: �S� 6S
Applic s-Si a Date:i 1 ( 0/d
• Greg Casteel
Building Official
Revised 07/30/08
CITY OF CUPERTINO
REROOF
0CUPERTINO I PERMIT APPLICATION
APN # Date:
\(: lX
Building Address:
Sa2 r-; ni Au -
Owner's Name: Phone #:
1 A I V1 8(0-� - -I X29
Contractor: Phone #:
N sfi �ab Fax#:
Cupertino Business License #: Contractor Li -ense
Type of Roof Covering: ✓LJ
Existing: Proposed:
❑ Built-Up Roof ❑ -Up roof
❑ Acsphalt Shingles Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Num er of existing coverings ❑ Provide I.C.B.O. Report#
o be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: —� e ��h11� WU�shy f� ( Th c� I
Co l� s
Residential EV Commercial
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:
JOO . p�
I Have Re d, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
a
CITY OF CUPERTINO
a REROOF
1 a 'fill
CUPEkT1NO I 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 1SFDWLROOF
r 1BSEISMICRE Seismic Residential B
IREROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08