12050121 CITY OF CUPERTINO BUILDING PERMIT
[III ILDING ADDRESS: 11621 ORCHARD SPRING CT CONTRACTOR:CASTILLO'S ROOFING PERMIT NO: 12050121
OWNER'S NAM F.: FLEANOR WENG 1703 CATIIAY DR DATE: ISSUED:05/142012
OWNER'S PHONE: 4087161888 SAN JOSE,CA 95122 PHONE NO:(408)251-3565
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 OAIMERC,IAI.
License Class Lic.H��t RE-ROOF 19 SQ-TEAR OFF EXISTING WOOD SHAKES,
/ �� INSTALL 30 LB FELT INSTALL GAF GRAND CANYON
Co met Dale CLASS
I hereby affirm Ihs I am licensed under the provisions of Chepler 9 A
(commencing with ection 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
I hereby affirm under penally of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insum 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. Sq.F1 Floor Area: Valuation:$9500
1 have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this APN Number:36654029.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and slate that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAY M LAST CALLED INSPECTIO
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accme against said City in consequence of the Issued bv: Dale:
granting of this permit. Additionally,the applicant understands and will comply
with all non-poin(source regulations per the Cupertino Municipal Code,Section
9.18.
T— _ RF.-ROOFS:
Signautr Dolma — - /� All roofs shall be inspected prior to an) roofing material berg installed.If a roof is
- installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
D \VNER-BUILDER DECLARATION �_1 /))
Signature of Appht-dnt] 0 Date:
1 hereby affirm that I am exempt from the Contractor's License Law for one of I
the following two reasons: ALI,ROOF C{ VERINGS TO BE CLASS"A"OR BETTER
1,as owner of the properly,or my employees with wages as their sole compensation,
will do the work,aid the Slmclure is not intended or offered for sale(Sec.7044,
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE:
construct the project(Sec.7044,Business&Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. 1 will
1 hereby affirm under penally of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Ileallh&Safely Code,Section 25532(x)should 1 store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District 1
performance of the work for whichthis permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health& - Eery C'e e,Secfans 25505 25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this \ /
permit is issued. p Owner or authorized agent: • Dnle��
I cenify,that in the performance of the work for which this permit is issued,I shall
not employ any person inany manner so as to become subject to the Worker's
Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must 1 hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked, w'ork's for which this permit is issued(Sec.3097.Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
I certify that I have read(his 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 properly for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCIIITF-CT'S DECLARATION
costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Dale
CITY OF CUPERTINO
FEE ESTIMATOR— BUILDING DIVISION
10 ADDRESS: 11621 Orchard Spring Ct. DATE: 05/14/2012 REVIEWED BY: gs
APN: BP#: 'VALUATION: $9,500
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY PENTAMATION
USE: SFD Or Duplex PERMIT TYPE: 1SFDWLROOF
WORK tear off existing wood shakes. install GAF Grand Canyon. Existin plywood to remain.
SCOPE
FEE ID ' ROOF AREA
s.f.
1REROOFFRES 1,900
,11o,:4. Poon Check
Plumb. Plan Check Elec. Plan Chrrk
F1,01, Porwil Fee: Pbmnh. P0, nir F,e Flet. Pennir Fee:
Orhar,licrh. Ingr. Ocher Plumb In.ep. 011ier/ileo. Insp.
11IM1. Imp. I'de: Plumb. hrsp. Fee: Eler.Insp. Fce:
NOTE: This estimate does not includejees due to other Departments(Le. Planning,Public Works, Fire,Sanitary Sewer District,School
District,etc). Thesefees are based on the relimina in ormation available and are only an estimate Contact the Dent for addn'1 info.
FEE ITEMS (Fee Resohnion 11-053 E2 7/1//1) FEE QTY/FEE MISC ITEMS
Plan Check Fee
Supp/. PC Fec
I'hunh./,blech.
Permit Fee: $266.00
Suppl. Insp Fee
rhmeh./aaer:r,./r:tee:
Plumh./d•lech./l,lec Permil Fee:
C onsn'u(lion Tax.
riefin ui.vireawe Pec:
Work Without Permit? 0 Yes E) No $0.00
Arlroucerl Plurmiq¢ Fees:
Trured Docionentatiun Fees:
S[ronc Motion Fee: IBSEISMICR $0.95 Select an Administrative Item
Bldg Stds Commission Fee: . IBCBSC $1.00
SUBTOTALS: 1 $267.95 $0.00 TOTAL FEE: 1 $267.95
Revised: 04/01/2012
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: -Sub: alk: Lot :
APN . . . . . . . . .. 36654029.00
DATE ISSUED.,. . . . . . : 05/14/2012
.RECEIPT #. . . . . . . . . : BS000016814
REFERENCE ID # . . . : 12050121
SITE ADDRESS . . . . . : 11621 ORCHARD SPRING CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ELEANOR WENG
ADDRESS . . . . . . . . . . : 11621 ORCHARD SPRING CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5222
RECEIVED FROM . . . . : CASTILLO
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 9,500.00 1.00 0 . 00 1. 00 0 . 00
1BSEISMICR VALUATION 9, 500.00 0. 95 0 . 00 0. 95 0. 00
1REROOFRES SQ FEET 19.00 266.00 0 . 00 266 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 267.95 0.00 267.95 0.00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 267. 95 17793
---------------
TOTAL RECEIPT 267. 95
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
309 EXTERIOR LATH 311 SCRATCH COAT
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
`✓•.. 1--,+..h.�.�:=�:.:i-:.�V,::::ti:X...-i.A.,-.,v .,.- _. �r ..,. y^T�,cTJ[�;•:",TM_'t_
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
CUPERTINO
(408)777-3228• FAX(408)1777-3333•building(a)cuoertino.org
PROJECT ADDRESS
OWNER NAME y,P ^-1 E-MAIL
STREET ADDRESS` ,`��� i1 Y 0. ..I,l. C STjTr LP: PI L11I/l.i�/i� • ,If.q 0I I' FAX
CONTRACTOR NAME, • L'ICEI ENUMBE fit' LICEN;F,TAPE I BUS.LIC.0
_ I /•_
COMPANY NAME. Y"` E-MAIL - FAX
STREETADDRESS ' ,� -�� I , 41• �I " \ CITY TATE.14 ;IP I PH N 1/, ��( /_
�UI�_q I /TF;ND AND AI REE QiTHE FOL LOWING: n C!
1. The re-roofp gject;shall comply with all applicable provisions of the 2010 California Codes.
2. An inspection requ6st•'�t,,be- cl3e{l�led up tathe.day%before.the l spection date. Pleas call (408)777-
3228 from 730 - 3:30pm (Mrt-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'tnspection is required. Any and all dry-rotted wood shall be replaced.prior to this inspection.
Unless new plywood roof sheathing is propds�c� thr64ghout, all the nails/fas'tedr{s hall be either
completely knocked-down or removed'ifr to this Inspection. I
4. If plywood-is installed, aplywood Nailing Inspection is required. _
5. Roofing shall not be app9llied without first obtaining all prior inspection and written approvals from the
building inspector. Anyydb5fing 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. Prop-ress Inst ection-is Ie C: I-
hen app o>?mately-50% ��c✓' gI. i\ f
1 bfrbofcovenn i� installed.
7:0 - I A•Fid Idnspection and addrova��il be obtal 8 &om_th� liiiilding mspec)c�r vSl�en the re-roofing is
�• co�pletgd) To receiv� fhal s Qr1 o(flth�fP'lowin �tert4�s will)b�e(ve�ifed:
a. Flat rdofs shall have a minimum of'/4" p�r 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.Iite o reviewlat the time of the inspection.
C. Proper spark\\drr to tnsta ation, vents painted, gutter/downspouts I stalled, debris removed.
8. NOTE: .If you call fl 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-inspect�n fee shall be paid before another inspection
can be scheduled.
By my signing below, I certify each of the following is true: 1 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. 1 also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential C de. /
Signature of Applicant/Agent: Com_-1 L—' Date:
Remo/Pnlicr_?Ill 1.tlnc reri-ced 02/I6/1[
.11L
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228•FAX(408)777-3333•buildinana
.cuoertinO.Or
1205-012- )
PRI)IECT ADDRESS 1 APN0 ��'1✓✓✓„���
OWNER NAME PHO b% 2( � IOwW/� E-MAIL
P.I We ha I AIN
STREET ADDRESS i CT'. TATE,21P (�r� e of �♦� FAX
ny-I-Iian Of
OA
CONTACT NAME •C PHON ' "I JE-MAIL
STREET ADDRESS J CR TATE, Z O (�� ^+� FAX
Inn 5C - rL
❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME LICENSE NUMB LICE 1P BUS.LIC.k
COMPANY NAME E-MAIL (� FAX
STREET ADDRESS ,STATE. P ��'^^ PHONE -�, f;&S*
• 1
ARCHITEC'GENGINEERNAME LICENSENUMDER BUS LICA
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY.STATE,ZIP PHONE
USE OF SFD or Duplex ❑ Muki-Family 0.00E AREA: VALUATION'. _
STRUCTURE. ❑ Commercial �J• VV�•
EXISTING ROOF TYPE: 11 BUILT-UP ROOF ❑ASPHALT SHINGLES WOOD SHAKES ❑WOODSHINGLES ❑OTHER(SPECIFY)
REMITV'E IREPLAC YES IF N0, PLriVOOD ❑ ' ❑ PLY' ❑ USB PITCH. ROOF
13 NO 41- YE KNE ❑ VS" TYPE ❑ CDX :12 LASS- 'a
PROPOSED ROOF TYPE: 11 BUILT-UP ROOF /rASPH.ALTSHINGLFS ❑WOODSHAKES 13 WOOD SHINGLES 13 OTHER ICC-ES REPORT
DESCRIPTION OF WORK. -Tp IM
1
By my signature below.I certify to each of the following- 1 am the property owner or authorized agent to act on the property owner's behalf. 1 have read this
application and the information 1 have pr piled is correct. 1 have read the Description of Work and verifv it is accurate_ l agree to comply with all applicable local
ordinances and stare laws relating bui ing u coon. I llorize representatives ofCupertino m enter the above-id Gf�ie)d p p/o7ny�Aur irepeaion purposes'.
Signature of ApphcanUAsen Date'. 57Iq T'2..)
SUPPLEMENTAL 1 ORMATION REQUIRED OFFICE USE ONLY
_ If building is associated with a Home Owners Association,provide letter PLAN CHECK TYPE ROUTING SLIP
of approval from HOA. OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
_ Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
_ Provide cop; of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT
Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTTER:
Reroofdpp 2011.doc revised 03%16/11