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12010086CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1 i 787 FINE BR( -)(--)K CT CONTRACTOR: CASTILLO'S ROOFING PERMIT NO: 1201008E OWNER'S NAME: LI JUN AND MIN 1703 CATHAY DR DATE ISSUED: 01,11/2012 OWNER'S PHONE: 4089212168 SAN JOSE, CA 95122 PHONE NO: (408)2.51-3565 d LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class , -/ 1 Lic. # COMMERCIAL ) COMMERCIAL MECH RESIDENTIAL Co€rtrac Date � / r / JOB DESCRIPTION: RE -ROOF TEAR EXISTING SHAKE ROOF, INSTALL 30LB I hereby affirm tha I aur licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions FELT INSTALL GAF YHON,EXISTING SOLID LASS A t65Q SHEETING TO REMAIN N CLASS 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. I have and will maintain Worker's Compensation Insurance, a, provided for by Sq. Ft Floor Area: Valuation: $8500 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 36604058.00 Occupancy Type: APPLICANT CERTIFICATION I 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 upon the above mentioned property for inspection purposes. (We) agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indemnity and keep harmless the. City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally, the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. /—� -- / IssuedY Data: Si Date ❑ OWNER -BUILDER DECLARATION RE -ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed. If a roof is the following two reasons: installed without first obtaining an inspection, I agree to remove all new materials for 1, as owner of the property, or my employees with wages as their sole compensation, inspection. will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) Sig %e� f pplieant : �_ Date: 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: I have and will maintain a Certificate of Consent to self -insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation. as provided for by Section 3 700 of the Labor Code, for the I have read the hazardous materials requirements under Chapter 695 of the performance of the work for which this permit is issued. California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain I have and will maintain Worker's Compensation Insurance, as provided for by compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Section 3700 of the Labor Code, for the performance of the work for which this Safety Code, Section 25532(a) should I store or handle hazardous material. 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 I will I certify that in the performance of the work for which this permit is issued, I shall maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health & Safety Code, Sections 25505, 25533, and 25534. Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I mu -t O ner or a49mrized ent: � / / /� forthwith comply with such provisions or this permit shall be deemed revoked. Date: CONSTRUCTION LENDING AGENCY APPC.ICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued (Sec. 3097, Civ C.) to building construction, and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, Lender's Address costs. and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply ARCHITECT'S DECLARATION with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CUPERTINO REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - building(&-cupertino.org PROJECT ADDRESS - - APN # OWNER NAME PHONE �% �� E-MAIL STREET ADDRESS �� t CITY, STATE, ZIP �r� I FAX CONTRACTOR NAME LICENSE BER LICENS BUS. LIC. # COMPANY NAME() E-MAIL FAX STREET ADDRESS CITY, STATE Q5Z f PHONE v - I UNDE TAND AND AGREE PO 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 1/" 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. I also understand that smoke detectors and carbon monoxide Bete tors are required to be installed in accordance with Sections R314 nd R315 of the 2010 California R al _ Signature of ADDlicant/Arent: c / / _ Date: �� ReroofPolicv 2011.doe revised 02/16/11 3 ITEMS OF 3 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: RYlg: Sub: Blk: Lot: APN ........: 36604058.00 DATE ISSUED.......; 01/11/2012 RECEIPT #......... BS000015738 REFERENCE ID # ...: 12010086 SITE ADDRESS .....: 11787 PINE BROOK CT SUBDIVISION ....... CITY CUPERTINO IMPACT AREA ....... OWNER ............. LI JUN AND MIN ADDRESS ..........: 11787 PINE BROOK CT CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: patg COPY ## : 1 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 ---------- 8,500.00 ---------- 1.00 ---------- 0.00 ---------- 1.00 0.00 lBSEISMICR VALUATION 8,500.00 0.85 0.00 0.85 0.00 1REROOFRES SQ FEET 16.00 224.00 0.00 ---------- 224.00 ---------- 0.00 ---------- TOTAL PERMIT ---------- 225.85 0.00 225.85 0.00 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT : AMOUNT --------------- 225.85 --------------- 225.85 VOICE ID DESCRIPTION -------- ---------------------------- 309 EXTERIOR LATH 601 ROOF TEAR OFF REFERENCE NUMBER -------------------- #17584 VOICE ID DESCRIPTION -------- ---------------------------- 311 SCRATCH COAT 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF CUPERTINO REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinga5cupertino.org 1427 0/ () rv//,-� PROJECT ADDRESS TA7# 3 f� o �l lJ _4 OWNER NAME _ L,' PHONE ' l E-MAII, 1 b STREET ADDRESS Sw1 0'L `^ n 'zm -CITY STATE ZIP 9 �' , g U( APPLICANT NAME � � � \ ,.�� PHONE ,. E -MATT, STREET ADDRESS�" '� CITY, STAZ & ^ S J (3 �y ^ FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT XCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHI'I7;CT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ` t LICENSE NUMBER LICENSE TYPE/" (_ BUS. LIC. # COMPANY NAME .. _ E-MAII. FAX STREET ADDRESS CITY, STATE, ZIP PHONE 5/ L' ARCHITECTIENGINEERNAME LICENSE NUMBER BUS. LIC. # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF FD or Duplex ❑ Multi -Family ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES WOOD SHINGLES ❑ OTH;R (SPECIFY) REMOVE /REPLACE YES IF NO, T,7PMLyCWKOOD ❑ h" ❑ PLYWD ❑ OSB PITCH: ROOF ❑ NO # LAYERS NESS: ❑ 5/8" TYPE: ❑ CDX :12 CLASS: A PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF XASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ 0= ICC -ES REPORT # DESCRIPTION OF WORK r 1 W bs 12 Mod,s �� soled, s By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on 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 law�relatingto innstruction. I authorize. representatives of Cupertino tc enter the above -id t Led p parry inspection purposes. Signature ofAppli Date: 1 SUPPLE ME INFORMATION REQUIRED _ If building is associated with a Home Owner's Association, provide letter�� of approval from HOA. Ph— Ph-=M-0- Provide _ Provide Planning approval to verify if there any restrictions. _ Provide copy of Manufacturer's Installation Specifications. rovide signed copy of Cupertino's Tear -Off Policy. �r- ReroofApp_2011.doc revised 03/02/11 CITY OF CUPERTINO IWV V V CTi CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: PERMIT #�O OWNER'S NAME: U PHONE # C9!5- GENERAL jGENERAL CONTRACTOR: �� - `s -c BUSINESS LICENSE # ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses w king in the city to have a City of Cupertino bu ness 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 subc ct rs: Signature Date Please check applicable subcontractors and complete the following information: Owner / Contractor Signature Date 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