08120070 CITY OF CUPERTINO a k ew..a�y
BUILDING DIVISION PERNIIT ®1�,aTaRAC�'TOwl ,T,Ida ,
BUILDING ADDRESS: PERMIT NO.
11709 OLIVE SPRING CT CASTILE '
OWNER'S NAME: PERMIT ISSUE DAM
O SA CONTROL N0.
ARCHIIEC(ENGINEER: BUILDING PERMIT INFO
BLIX'i
ELECT PLUMB MECH
RE-ROOF TEAR OFF EXISTING O O O O
fop LICENSED CONTRACTOR'S DECLARATION ROOF, INSTALL 30 ILB Job Description
U 1hmeby affiam Nat 1.li¢Hedmode,pmvismuofatsiam9(cmnmencing ,_-....._ _ _ ._�..... ..........
with Section]IXIO)Of Diviaien Sof the Business and Professions Code,end my license is
^� in full farce and effen C3 H
,12- L imec Class Lk.g
=� Date Or Con _
ARCHITECTS D R ION
< 1 unMmanJ my plum ahAll W used u publk records
3�U
g9l; Menued Pmfrssonal
3 OWNER-B UILl)ERDECLARATION
qy I hereby aRmt that 1 am exempt from ft Contractor's Liccnw law for Ore
i p O fallowing moon.(Section 7011.5,Business and Pmfessioes Calc:Any city or county
m which mgd,al A parmit in convect able.improve.demollah,or repair any eoLLture
2y prior u,its LYuae.also require applicant forsuch permit N rile a signed statement
ss< the he is licensed pursuant w the provisions of the Common's Limes{law(Chapter9 Sq.Ft.Floor Area Valuation
rxe{N
xk- (commenting with Section 7000)at Division 3 Of the Business and Professions Code)or
Wthat he u exempt Nemf een and the bub for the Alleged cumpuon.Any violation of
Section 7071.5 by any applicant For a permit mbjccu the applkanl to a civil penalty of APN Number Occupancy Type
Ann,...thaO five hundred d011an($500).
❑I.As Owner of the property,m my anplayces with wages u their auto compemadon,
will dO the weal{And theA,ocare Bret intended osaRacd for AAlC(Sec.7044.Buainw Required Inspections
and Prolamines Code:The Cuntrxw/s Liven law dual not apply N ns sal owner Of q P
property who WMs orimpraw Neaten.andwho doessuchwosk himselfor duough his
mwemployees,provided t pro ire is semmu art not inteoded osoRetvd(orale.I4
Wilder,Ne Wilding Orimprovemant4hat withinarc)earofmmpleuon,theowner-
builder will love Jos WNen of proving Nu K did not Wild or improve for purpose of
akJ.
❑I.as cam Of the property,Am exclusvely conmcdnt with lictnsed rnnuacwn in
construct Alto Project(Sec.7000,Business and Profalsons Code:)M Contnetofs Li-
«nse law does Out apply in an owner of property who Wilds or improves Hereon.amd.
aha..,mu Fos such projects aids A canosswa(s)Balled possum,w due Cmaboa thea
Lima.law.
0 I un mamp,mod,See .B&PC for this won
caner Data
WORKERS COMPENSATION DECLARATION
1 hereby I.under pevalty of perjmy arc of the fallowing declaruimts
❑Ibawandw0lmainuina Cenift=wofconeentiowlf-Wumrawokxescompen-
satin,as proviNA for by Section 1700 Of the labor Code,for the perfarmana of Ne
weak swhich this permit is issued.
I have And will maintain Workee.Compcnsadon Insurance,as acquired by Sada. -
37W of the Inbar Cud{,for the performance of the work For which Nb permit b 111i
My Warketa Co peamon has caJa r9and Policy numher are: t.�s
Grrier. S iE "Ve Palley No.:
CERTIFICATE OF EXEMPTION FROM WORKERS T
COMPENSATION INSURANCE
Crib scotion trait an,be completed if tic portents fa One hundred dollen($1001
of lala)
I cuufy Nat In the pelfomnnm a the weak fee which this permit is Waited.I shall net
cotploy any permn in any manner an As At becmne subject w the Warkes'Compensadon
Laws Of Csifamia.Data
AppOalnt
NOTICE TO APPLICANT:If,afor making this Cerdncam of Exemption,yen should
become subject in the Wartces Compensation provisom of Nc labor Code,YOU must
0 z forthwith comply aiH such provisom,Nis permit shAll k deemed mated.
z„1 EN
CONSTRUCTION LENDING AGENCY
(-+r--� I Web,aRrm NU Uxn b m com ucrinn lending agency,fm the parformana of
C om+ dm wok for which does permit b hoped(Sec.3097,Civ.C.)
0. 0 lam efa Nunc
D z Itnde's Address
U O` 1 cedfy Nn I haw mad this application and state d a the Above information is
Is,V corral.1 agree in comply with All city and county ordinances and state law,relating to
.� Wilding eomtrucaion,and Wmby audtorire mpmsinutivesof Nbcity venter upon No
r W AlArve-ram u med property for impaction purposes.
(We)agree to save,indemnify and keep harmless the City of Cupertino against
liabilities judgments.costs and exp'....which may N any way Acave,gmi at said City
U z in consequence of the tenting of Nb permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SO R G TIONS.
Oy Re-roofs
Ilij�jbluae Of ApplicuWContncwr Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will dm applicant or future Wilding aecupant ere,or handle bnsrdous material
As defined by the Cupertino Muneved Code.Chapter 9.13,and the Health and Safety
Cade,Stolon 35533(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yu o
Will the applicant Or future Wilding ocmpant use cquiproenl0r devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit harafdous air contaminants As tic it by the Bay Area Air Quality Management all new materials for inspection.
Distrlct7
Ely.
o
I have read Ne bavardmu macrisa mquUUnA,,tsunder"&pter6.95oftho Califon-
nu Health&SafayCodc.Setvam23503,255J1sod25534.1uodernandthnifdc Wilding
doss nal currently have A sena,.Nm it b my rcapomihilitY in noir,Ne no spans of do �7
rcquimmcnts hchfm'`�bcmclpriarwissuanccof.cenric.be fOccu ey. Sig ature o M pplicant Date
5Ue All roof coverings to be Class'W'or better
0 nor air ovnd agent ate
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36654099 . 00
DATE ISSUED. . . . . . . : 12/05/2008
RECEIPT #. . . . . . . . . : BS000006773
REFERENCE ID # . . . : 08120070
SITE ADDRESS . . . . . : 11709 OLIVE SPRING CT
SUBDIVISION . . . . . . :
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . :
OWNER . . . . . . . . . . . . : BAER THOMAS A AND BARBARA S
ADDRESS . . . . . . . . . . : 11709 OLIVE SPRING CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5141
RECEIVED FROM . . . . : CASTILLO ROOFING
CONTRACTOR . . . . . . . : JOSE CASTILLO LIC # 25850
COMPANY . . . . . . . . . . : CASTILLO' S ROOFING
ADDRESS . . . . . . . . . . : 1703 CATHAY DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95122
STELEPHONE . . . . . . . . : (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 17 . 00 221 . 00 0 . 00 221 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 221 . 90 0 . 00 221 . 90 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 221 . 90 15526
---------------
TOTAL RECEIPT 221 . 90
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.
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$176.18. The re-inspection fee must
be paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of I/4 " per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply
--with the above stated policy on re-roofing.
Homeowner's Name: l D 1 Ty7_ p J'
Job Site Address:
Roofing Company Name: /J
• APphc to Date: 12-A16 D
Greg Casteel
Building Official
Revised 07/30/08
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
SCUPEkTINO
Building Department
JOB ADDRESS: PERMIT #
rlocl 01> Ve
OWNER'S NAME: To ey— PHONE # 02513 �S
GENERAL CONTRACTOR: c S FAX #
I am not using any subcoQLors: I 0
Si ature Date
Please check a licable subcontractors and com ete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
• Linoleum/ Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
e
Owner/Contractor Signature Date
-� CITY OF CUPERTINO
REROOF
CITY OF
*CUPERTINO PERMIT APPLICATION
x812 oat
APN # d DO Date:
5 I2- 5 -0$
Building Add ss: I I —7 ��
I Ve ri z
Owner's Name: Phone #:
I om e-r— S7 2- L443$
Contractor: Phoue#- �5� 35(
r oS
�0 S � , 1sZ Fax((#:
Cupertino Business License #: 2� CS�� Contractor License #:
J� Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report#
v`�To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: O F—F ex 14fi ncc O r • S I t b, Fe 41 :FO5*11
� to yore sh%ny�s. c(e fA ,
Residential Z Commercial El
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:
•I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
Ia'- CITY OF CUPERTINO
REROOF
CUPEI,TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
1RER00FRES ' Re-roof Residential B 1SFDWLROOF
/ 1BSEISMICRE Seismic Residential B
IREROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08
•