12090202 CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS: 21547 RAINBOW DR CONTRACTOR:CASTILLO'S ROOFING PERMITNO: 12090202
OWNEIt'S NAME: STIR-JIE'T%ENG C HANG 1.1 1703 C THAY DR DATE ISSUED:09Q4f2012
OWNER'S PHONE: 4085/51332 SANJOSE.CA 95122 1'I JOSE N'O:(40x)251-3565
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INTO: BLDG r ELECT r PLUMB r
License ClassLic.N� r
AIEC11 RESIDENTIAL r COMMERCIAL r
Contracto Date 9 a
1 hereby affirm I I 1 am licensed under the precisions of Chapter 9 JOB DESC121P'I'ION::I'GAROFI'SHAKES.INSTALL 19SQRS-7/16"OS13,
INSTALL 30d FEI;)',INS"I ALL GAF GRAND CANYON COhl1'
(commencing frith Section 7000)of Division 3 of the Business.4 Professions SHINGLES
Code and that toy license is in full force and effect.
I hereby affirm under penalty of perjury one of the following Iwo 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
perl'onnance of the work for which this permit is issued.
I have and will maintain worker's Compensation Insurance.as provided for by
Section 3700 of the Labor Code,Ion the performance o1'lhe work for which this Sq.FI Floor Arca: Valuation:$9800
permit is issued.
APPLICANT CERTIFICATION APS Number:35623027.00 Occupancy'l'ype:
I certify that 1 have read this application:and state that the above information is
correct.I agree to comply with all city and county ordinances and stale laws relating
to building construction,andhereby 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
indemnify and keep harmless the City of Cupertino against liabilities,judgments, FYI I'IIIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said Cit•in consequence of the
granting ofthis permit. Additionally,the applicant understands mrd will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Nfunieipal Code,Section
Signnt�/_i�.Fr SG/ Date. oma_/• KZ1.(
❑ ON;\ER-BUILDER DECLARATION
RF:soots:
I hereby uffnrn that I am exempt from the Contractor's License Lao for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the follmring two reasons: installed without first obtaining an inspection,1 agree to remove all new materials for
I,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 K Professions Code) Signature of Applicant: Date:
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sce.7044,Business&Professions Code), ,AI.1.ROOF COA'EItINGS TO III,'CLASS"A"OR 131',ITE.R
1 hereby affirm under penalty of perjury one of the following three
declarations: HAZARDOUS MATERIAI S DISCLOSURE
I have and willmaintain a Certificate of Consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the 1 have read the hazardous materials requirements under Chapter 695 of the
performance of the work for which this permit is issued. California Ilcallh S Safety Code.Sections'_550i,25531.and 25534. I will maintain
I have mid will maintain Worker's Compensation Insurance.as provided for by compinuhec with the Cupertino\municipal Code.Chapter 9.12 and the Health S
Safety Code,Section_.5y3_(i)should I store or handlehazardous material.
Section 3700 of the Labor Code,for the perf finance ol'the work Ion which this ,Additiunallr,should 1 use equipment or devices which emit hazardous air
pemmil 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 I Iralth\Safety Code.Sections 25505.'_5537.and 25534.
Compensation laws of California. If,alter making this certificate of exemption,I
beconhe subject to the Worker's Compensation provisions of the Labor Code,I must Owner r act tjrized agent:
Ilohtc:
forthwith comply with such provisions or this permit shall be deemed revoked. C
CONSfRUM 10N LENDING AGENCY
A ITI ICANI'CICR'1'IFICATI0N
I certify that I have read this application and state that the above information is 1 hereby zBimm that there is a construction lending agency Ibr the performance of work's
correct. I agree 10 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 Cit in consequence of the
granting of this permit.Additionally,the applicant understands and ss'ill comply AKC111'I'ISCI"S 111CCL.A ILVI'ION
with all non-point source regulations per the Cupertino Municipal Code.Section
9.18. 1 understand my plans shall be used as public records.
Signature Date Licensed Professional
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228 • FAX(408)777-3333•buildingliDcuoertino.oro
PROJECT ADDRESS 91s 1 ,�y l \ 10 'PN x 3 ddW
OwNER NAME W- ` t-ole 'OnPHONE 51J _17/1 E-MAR
STREET ADDRESS nnn0n t CITt', STATE,ZIP /� �/[rtl/I FAX
CONTACT NAME Oasb1jb WV 1n P NEv 1_, ``��E-�NIAIAI!j �j�� - �1-
STREET ADDRESS 11,1/L�,11cUUJ \ CITY,
❑ OWNER ❑ OWNER-BUILDER ❑ O\\TIERAGENT - CONn ACTOR ❑CONIRACTORAGENr ❑ ARCHIIECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTORNAME 1-U�Gr• LICENSENUMBERLICENSE TIPte�;q BUS.LIC.q07_57G'-S-/,
COMPANYPIAME (19LMS�IJ ft iln E-RtAIL Y\Ib ISA1 a po Ctiln FAX
(J -JCJ
STAEET_4DDRESS_�Ar-.�I\'r rilhp _ _ CITI',STATE.ZIIPVt-3Ah��_� 951�z— PHONE
ARCHITECIENGINEER KANIE �1 LICENSE NURSER BUS.LIC.9 BOJ
COMPANY NARB3 E-MAIL - FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF 05FD or Duplex ❑ Multi-Family, ROOF AREA: VALUATION:
STRUCTURE: ❑ Commercial I e�
EXISIIOG ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
RFAIOI'E atEPLACE R<S IF N0, PLtI\'000 ❑ :5' 13�.f I/ PLYWD OSB PITCH: ' ROOF
❑ 0 M AYERC (.� ICK C ❑ SIS" �L PE' Cl CD% —•12 CLAS9 A
PROPOSED ROOF TYPE: ❑BUILT-UPROOF ASPHALT SHINGLES ❑WOOD S ❑WOOD SHINGLES ❑OTHER aaa IC6E5 REPORTtl
HAKES
DESCRIPTIONOF\t'ORK: /I _Ll
lOranU�(JC�an oY)
By my signature below.I certify to each of a following: I am die property owater or authorized agent to act on the property owner's be al C. I have read this
application and die information have pro ded is correct. I have read the Description of Work and verify it is accurate. 1 agree to comply With all applicable local
ordinances and state Jaw m ding to cion. 1 authorize representatives of Cupertino to enter the abyvp-i erPj i d a•for inspection purposes.
V C�
Signature ofApplicantIAgenu Date:
SUPPLEMENTAL IN ORMATION REQUIRED - _ OFFICE USE ONLY
_If building is associated with a Home Owners Association,provide letter PL\6 CHECK TYPE-_ ROUTING SLIP
of approval from HOA. ❑ OVER:THB-COUNTER ❑ RUILUING PLAN RE\lEw
_Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
_Provide copy of Manufacturer's Installation Specifications. ❑",MkNIMau., ❑ FIRE ncrr
Provide signed copy of Cupertino's Tear-Off Policy. - ❑ OTHER:
Reroofdpp_2011.doe revised 03116/11
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)777-3333-building(D)cupertino.orD
PROJECT ADDRESS �,f"j /� APNN �
OWNER NAME ^; ;/^^ / �a•/� 1� PHONE 5/4^ /Z3p E-MAIL J O�
STREET ADDRES 7 15 7 I/ T� CITY,STATE,2IP J 1�i/ i.` T /t_ FAX '
CONTRACTOR NAME G LICENSENUMBER LICENSE TYPE . BUS.LIC.#,,; �4'�\
COMPANYNAME E-MAIL �-y FAX ((�� .•��.•//
STREEr ADDRESS I �63 CIN,SiATE.L Nr • /S''J PHONE -?�J_ C-
ATL / l�Y4 K/ .JJ'r�
1 UN ERSTAND AND AGREE TO E 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 Y<" 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 8126.00. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing below, 1 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. I also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R3 4 and R315 of
the 2010 Calif sidentia Cod
Signature o Date:
RerooJPolicv_20l l.doc revised 02/16/1l
CITY OF CUPERTiNO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 21547 Rainbow DATE: 09/24/2012 REVIEWED BY: jsg
APN: BP#: w co C5�— 'VALUATION: $9,800
*PERMITTYPE: Minor Building Permit PLAN CIIECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLROOF
USE: PERMIT TYPE:
WORK Remove wood shakes install con
SCOPE
FEE ID ROOFAREA
s.f.
1REROOFFRES 1,900
Xlecb. Plan Check Plumb. Plan Check Flee. Plan Check
blech. Perna Fre: Plumb. Permit Fee: E-lec.Permit Fee:
Odrer dlech. /nap. Other Plumb Insp. Other Elec.Insp.
loch.Insp. Fee: Plumb. hup. Fee: Elcc. Insp. Fee:
NOTE: This estimate does not include jeev due to other Departments(i.e. Planning, Puhlic 11'arks, Fire,Sanitary Sewer District,School
District,etc.). These fees are baser/on lite prelinzinaq information available and are only an estinune. Contact the Det or adeln'I info.
FEE ITEMS (Fee Resolution I1-053 Ell W I/I FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Supp/. PC Fee
Plumh.1 lech./Flee
Permit Fee: $285.00
Sapp/. lisp Fee
Plumb./ddech./Elec
Phtnib./nblech./Flec Permit Fee:
Construction Tux:
Administrative Fee:
Work Without Permit? O Yes 0 No $0.00
Advanced Planning Pees:
Travel Documentation FLes:
Strong Motion Fee: IBSEISMICR $0.98 Select an Administrative Item
Bldg Stds Commission Pee: IBCBSC $1.00
SUBTOTALS: $286.98 $0.00 TOTAL FEF,: $286.98
Revised: 07/01/2012
Building Department
City Of Cupertino
_ IWo Torre Anne
C U P E RT I N O Telephone: 408-777-3228
Fax: 408-777.-3333
CONTRACTOR/-SUBCONTRACTOR LIST
JOBADDRESS: %AOUuo OC PERMIT
OWNER'S NAME: I Icm L OVI PHONE # b$ 2Sk
GENERAL CONTRACTOR: Q BUSINESS LICENSE #
ADDRESS: a CITY/ZIPCODE: QS
*Our municipal code requires All businesses working in the city to have a City of Cupertino business 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. /2y/Ia
I am not using any subcontractors: /
Signature Date
Please check applicable subcontractors and complete.the following information:
✓ SUBCONTRACTOR BUSINESS NAME BUSINESS LICE-NSE #
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
q4411
Owner/Contractor Signature Date