12100179 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11867 WOOD11ILLCT ' CONTRACTOR:CASTILLO'S R0017ING PERMIT NO: 12100179
OWNER'SNAME: WANG KEVIN-KUAN PAND SUE-PEI 1703 CATIIAVDR DATE ISSUED: 10242012
OWNER'S PIIONF-: 4082572755 SAN JOSE,CA 95122 PRONE NO:(408)2514565
❑ LICENSED CO\'RAC'FOR'S DECLARATION BUILDING PERMIT INFO: BLDG 17 ELECT r rl
PLUMB
License Class J Lie.H e- _
NIECH r RESIDENTIAL r COMMERCIAL r
Conlracto I � Done 2
1 hereby affirm t nt I tan licensed under the provisions of Chapter 9 JOB DESCRIPTION: RE-ROOF,fEAR OFF WOOD SHAKE,INSTALL N30LB FELT
(commencing with Section 7000)of Division 3 of the Business& Professions APPLY GAIT GRAND CANYON CONIP,1800 SQf-1CLASS
Code and that my license is in full force and effect. A;EXISTING SOLID SHEETING TO REMAIN
1 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,as provided for by
Section 3700 of the Labor Code,for the perfommnce of the work for which this Sq.Ft Floor Aron: Valumlon:$9500
pemuit is issued.
APPLICA\1'CIiRT'IFIG\TION A PNNumber.36604066.00 Occupancy Type:
I certify that I have read this application and state that the above information is
correct.1 agree to comply with all city and county ordinances and state Imus relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned propeny 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,
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of thispertnit. Additionally,the applicant understands.mdwill comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal C de,Section
\ Done 2_ Issued by: ✓/�/ V �/ Date:/G'ay
Sign �a
❑ OWNER-RUILDER DECLARATION
RE-ROOFS:
1 hereby affirm that 1 am exempt from the Contractor's License Law for One Of All roofs shall be inspected prior to a y rooting material being installed.If it roof is
the following two reasons: installed without first obtaining;"inspection,1 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 stmcture is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signage f Ap Iicmm: ""*"-" Date:
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7D44,Business&Professions Code). A 1,1-ROOF COVERINGS TO BE CLASS"A"OR BETIT IT R
I hereby affirm under penally of perjury one of the following three
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's DA'J.ARDOUS MATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the I loo read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued California Ilealth&Safety Code.Sections 25505,25533,and 25534. I will maintain
I have and will maintain Workers Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code.Chapter 9.12 and the Ilealth&
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.
Additionaliv.should I use equipment or devices which emit hazardous air
permit is issued, contaminants as defined by the Ray Area Air Quality Management District I will
I cenify that in the performance of the work forwhich 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 Ilealth&Safety Code,Sections 25505,25533,and 2.5534.
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 nos Owal ora ho ized a eat: Unto; O
L
I'orthwdilh comply with such provisions or this permit shall be deemed revoked.
APPLIG\N'I'Ct:R'I'IPIG\"PION CONSTRUCr1ON LENDING AGENCY
I cenify 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.1 agree to comply with all city and county ordinances and suite 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
toss,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCIIITECI"S DECLARA'T'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
n
121
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•buildino(ftupertino.or0
PROJECT ADDRESS I ,(� C: I_ 1 I G� . .APNa
OWNER NAME III_J, f v ^�! E-MAIL
STREET ADDRESS - 1 1`,, C_11 w• I ^ ` . CITY. UTE,ZIP ✓ FA%
w 1 lel r+
f
CONTACT NAME , S \ PHONE^J `�� E-NIHIL
STREET ADDRESS I CITY,STATE 2 J ��(�G I.-1- FAX
r 1 �JJ
❑OWNER ❑ OW'NER-BUILDER ❑ OWNERAGENT er CON[RACroR ❑CONTRACTORAoENT ❑ ARCNrrwr ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME ' , LICENSE NUMBER 47MLICENSE TY PE � BUS.LIC.a
COMPANY NAAIE. l'�1 E-bLAB. FAN
STREET ADDRESS CITY,STATE,ZI PHONE ,1
-1�1 - C = t -a� - -a51
1 w -
ARCHITECbENGiNEER NAME LICENSE NUMBER BUS.LIC.tl
COMPANY NAME E-0W L FAX
STREET ADDRESS CITY,STATE ZIP PHONE
USE OF ;/S FD or Duplex ❑ h'tHID-ramily, ROOF AREA: VALUATION:
STRU TURF: ❑ Convnercial I , 1 J
ba —
EXISTING ROOF TYPE: ❑BUILT-UPROOF ASPHALT SHINGLES 'OOD SHAKES ❑W'OOD SHING LES ❑OTHER(SPECIFY,
RENIOVE/REPLACE YES IF NO. %, PLYWOOD [Iti- ❑ PuwD ❑ OSB PITCH: c� ROOF
c] No tl S' v G . ❑ 5B" TYPE-_ ❑Co :1] CL A
PROPOSED ROOF TYPE: 11BUILT-UPROOF ASPHALT SHINGLES 11WOOD SHAKES 13WOOD SHINGLES ❑OTHER ICC-ES REPORT M
DESCRIPTION OF WORK: � V- ,,I"- I n'\I l•. /�/J ' 1� �..I./1 '/ #�/\I /�,.��1}
/VY1F QI'� (-'vGl l�� �1�•(�. 1 1117 .-�;J ((// I 1
-�p f
By my signature below,1 certi v to each of the following: I am the prop",owner or authorized agent to act on die properi owner's behalf. I have read this
application and die information I ave prooed is orrecI 1 have read the Description of Work,and verify it is accurate. I agree into iply with all appliwblc local
Ordinances a sta¢i lacing mg co s Euion. 1 au rize re rives of Cupertino ro enter the above-i en ed r p' •f9rinspection purposes.
Signature of App lean AgenC Dace:
SUPPLEMENTAL IN ORMATION REQUIRED - o FIcE d;EONOY
_If building is associated with a Home Owner's Association,provide letter vt.AN CHECN'TYPE - ROUTING SLIP
of approval from HOA. ❑ OVER-Titc-CODOTER, ❑ BUILDING PLAN REVIEW
_Provide Planning approval to verify if there an)-restrictions. ❑ e\PRFSS ❑ PLANNING PLAN REVIEW
_Provide copy of Manufacturer's Installation Specifications. ❑ t-ANDARD ❑ IaRE Dcrr -
ProvidesignedcopyofCupertino's Tear-Off Policy. ❑ OTHER:
XeroofApp_2011.doc revised 03/16/11
REROOF TEAR-OFF POLICY
G 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• buildinD0cuoertino.orD
PROJECT ADDRESS 1 GI _—f wood
U oo I I I ' I Mh tl
t7v� ( V
OWNER NAA¢ PHONE / E-MAIL
/ J
STREET.ADDRESS I I CITY,STATE,ZT
CONTRACTOR NAME �7�1�j '„( LICENSENUNMER ...'C LICENSE TYPE �jfi Bus.LIC.tl
COWANY NAME �{ E-MAIL Lf J/ FAX a
STREET ADDRESS 1112 / • tl CITY,STATE,Z „Q PHONE
CQ I
lJ1 UUNrDER AND AND AGREE T T(1HE FOLLOWING: �C / JU✓
1. The re-roof project shall comply with all applicable provisions of the 2010 California Codes.
2. An inspection request can be scheduled un to one business day before the requested inspection date.
Please call (408) 777-3228 from 7:30-3:30pm (Mon-Thurs) or 7:30-2:30pm (Friday) to schedule
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.
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. A Final Inspection and approval shall be obtained fiorn 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 14" 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.
7. 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. 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 Ino oxide detect are required to be installed in accordance with Sections R314 1d R31 5 of
the 2010 Calif to Re
Signature of Applicant/Agent: - Date:
RerooJPolicy%2012.doc revised 10/7/12
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 11867 woodhill ct DATE: 10/24/2012 REVIEWED BY: mendez
\ APN: BPft: 'VALUATION: $9,500
*PERMITTYPE: Minor Building Permit PLAN CII ECK TYPE: Re-roof
PRIMARY SFD or Duplex PENPANIATION 1SFDWLROOF
USE: PERMIT TYPE:
WORK
SCOPE
FEE ID ROOFAREA
s.f.
1REROOFFRES 1,800
Alech. Plan Check Plumb.Plan Check Flee.Plan Check
btech. Permit Fee: Plumb.Permit reg: Elec.Pertna Fee:
Other khech. Insp. 0/her Plumb Insp. Other Elec.Insp.
Ll I—
Alech.Insp.rec: Plumb. h/sp. Fee: Flee.Insp. Fee:
NOTE: This estimate sloes not include fees due to other Departments(i.e. Planning, Public(Forks, Fire,Sanitary Sewer District,School
District,etc.). These ees are based on the prelinzinanr information mailable and are o nh,an estimate. Contact the Dept/or addn7 info,
FEE ITEMS (Fee Resohaion 11-053 Eff 711112) FEE QTY/FEE MISC ITEMS
Plan Check Pee:
S11PPL PC rce
Phimb.111ech./Elec
Permit Fee: $270.00
SuppL Insp Fee
Plumb.IlleclUrlec
Plunrb.YAlech.1E1ec Permit Fee:
Cmtsawction Tae:
Administrative Fee:
Work Without Permit? O Yes 0 No $0.00
Advanced Planning tees:
Travel Documentation Pees:
Strong Motion Fee: IBSFISh1ICR $0.95 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $271.951 $0.00 TOTAL FEE: 1 $271.95
Revised: 10/01/2012