13020134 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11513 COUNTRY SPRING CT CONTRACTOR:CASTILLO'S ROOFING PERMIT NO: 13020134
OWNER'S NAME: JU-CHING LIU 1703 CATHAY DR DATE ISSUED:02/252013
OWNER'S PHONE: 4089738177 SAN JOSE,CA 95122 PHONE NO:(408)251-3565
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
License Class �3 `7 Lie.# 3i!NREMOVE(E)WOOD SHAKE,INSTALL 30#FELT,CLASS A
LIFETIME COMP
Contra tar Date
I hereby affrrr hat I am licensed under the provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business&Professions
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. Sq.Ft Floor Area: Valuation:$9500
I 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:36651045.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state 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 DA� T 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 LED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the i3
granting of this permit. Additionally,the applicant understands and will comply YI a
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signatur� 171[1 LC;-' Z 3 All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Signature cf7cppi an: CDate: d`S
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF W'�RINGS TO BE CLASS"A"OR BETTER
1,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure 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). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Cade,Chapter 9.12 and the
declarations: - Health&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I 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 which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
r
I have and will maintain Worker's Compensation Insurance, Health&S Code,Se ions 05,25533,and 25534.surance,as provided for by �7 nn
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized age ` Datr
permit is issued.
I certify that in the performance of the work for which this permit is issued,I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If,atter making this certificate of exemption,I CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must I 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. work'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 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 ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
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 Date
REROOF PERMIT APPLICATION ��\
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228•FAX(408)777-3333•buildinaLacuoertino.ora
(/ \ lI
PROTECT ADDRESS 11515 S �+ �Na 1 ' O
OWNER NAhIE �U^^'' ` I V P -�^ , E-MA
h �,\
STREET ADDRESS STATE, qJV 14 FAX
CONTACT NAME S a c8 -as- •mss MAI- V
STREET ADDRESS I�O �\ (Z • CITY, �ZB' Off• !1 95i a', FAX
❑OWNER ❑ OwNFR-BunnEa, ❑ OwNERAGENr\„J CONTRACTOR ❑CONTRACrORAGENT �❑ AARCHMEC` ❑ENCRJFEK ❑ DEVELOPER ❑TENANT
CONTRACTORNAMECOSi • !_� LICENSE ER LI ETYPE BUS LIC.#
O S TJ
COMPANYNAMEE• L Cc1Yv�- FAX
STREET ADDRESS11 C)5CI�STATE, W �Sta� PHONE
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.#
COMPANY NAME EMAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF SFDorDuplex ❑ Multi-Family ROOF AREA: (� VALUATION: /'] !S�
W
STRUCTURE: C) Commercial ,% 5C1 500.
EXISTINGROOFTYPE: 13 BUILT-UP ROOF ❑ASPHALT SHINGLES WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE)REPLACE RrYFS I+NO. PLYWOOD ❑ K" ❑ PLYWD ❑ OSB PITCH: OF
❑ NO q �f� ❑ TYPE ❑ OX :12 CLAS A
PROPOSEDROOF TYPE: ❑BUI3-UPROOF /ASPHALT SHINGLES ❑WOOD SHAKES 11 WOOD SHINGLES 13 OTHER IMES REPORT#
DESCRIPTIONOF WORK: _, r 0 ` O 0 ` - ' _ A� C I 1 .1--SQ j ) I
an SAF--c I 1 Cn tic F rand �CL.{G nG J o
i ssh� s -r d ee � in
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 laws relating to building nstru ' a. I authorize representatives of Cupertino to enter the abovn fieri pr r. Cpection purposes.
Signature ofAppli= Date:
SUPPLEMENTAL RMATION REQUIRED ,is�h'�K,
PLAN ?1'1P "!Z03 tN'y�G SLIP kiI4aA6
_If building is associated with a Home Owner's Association,provide letter „
of approval from HOA. 0 - R B�IILD,W�w �REVEE
Provide Planning approval to verify if there any restrictions. - �' Lt
L,Ct�xevawi s
'iy3 I tly
Provide copy of Manufactures s Installation Specifications. [] sTANDARo r �i � ❑ FI� 5
,
Provide signed copy of Cupertino s Tear-Off Policy.
2(vg- t�
ReroofApp_20/I.dac revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 11513 COUNTRY SPRING CT DATE: 02/25/2013 REVIEWED BY: MELISSA
APN: 366 51 045 1 BP#: *VALUATION: $9,500
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Repair
PRIMARY SFD Or DUp16X PENTAMATION 1SFDWLROOF
USE: PERMIT TYPE:
WORK REMOVE E WOOD SHAKE INSTALL 30# FELT CLASS A LIFETIME COMP
SCOPE
yz n. R' ;;.a :•
�Y 9
Xlech. Plan.C'heck Plumb. Plan Check Elec. Plan Check
Nlech. Permit Fee: Plumb. Permit Fee' Flec. Permit Pee:
Other blech. Insp. Other Plumb Insp. Other Elec.Insp. Li I
;Meeh.Insp. l'ce: Plumb. htsp.Fee: Elco.Insp.Fee.-
NOTE:This estimate does.not includejees due to other Departments(ie.Planning,Public Works,Fire,Sanitary Sewer District,.School
District etc.).. These ees are based on the prelimina in ormadon available and are only an estimate. Contact the Dent for addn'1 info.
FEE ITEMS (Fee Resolution I1-053 E . 7� FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 EiK s.f. Re roof
Suppl. PC Fee: 0 Reg. 0 OT0.0 hrs $0.00 $270.00 IREROOFRES
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Fee.e Reg. 0 OT 0,0 1 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Crnrsbvction Tac:
Administrative Fee: O
Work Without Permit? 0 Yes 0 No $0.00 0
Advanced Planning Fee: $0.00 Select a Non-Residential O
Travel Documentation Fees: Building or Structure 0
i
Strong Motion Fee: IBSEISWCR $0.95 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
:•xi H �' x' IMI $1.951 $270.00 ft" ,,. , ` ITO�AC SEE $271.95
rl' . Revised: 01/01/2013
PIof2
Seven Springs Owners Association
Application For Approval of CATEGORY C Architectural Change/Addition
Category C- Modifications that are exterior modifications with no changes to the original building
structure or floor plan. All roofing,siding,or window material change,or exterior paint color change,or
addition of a roof attic fan,fall into this category.
Date: lZ l /o l /2
To: Architectural Control Committee
Subject: Request for Approval of Proposed Change
T PLEASE PRINT THE FOLLOWING INFORMATION
Name: �J udy L I m Address: I I SI 3 noun}ry 5 or ��
Home Phone: (40o q73- 8171 Work Phone: S Zt n G
Description of Proposed Change:
i) Paint color change:
New Exterior Siding Color
New Exterior Trim Color
2) Roofing Material change
New Roof Material Gt�F. al ra�r+ol_canya» = M i 5S t`art Rr"o CAIsr-
3) Siding Material change
New Siding Material
Which sides are you are changing material (front,back,left or right?)
4) Window Material and Design change
New Window Material and Design
S) Adding a roof attic fan or Tubular Skylight
New attic fan or skylight description ',
Please attach information regarding the proposed change.Application must include dimension,
color of the proposed fan and its location on the roof. Please include detailed drawings,
specifications,and product brochures if available.
Homeowner's Signature: `
9i
.r-
P2of2
Yiit#R#YS!#Siti#i!S#i!liiilii##SRRilklik###slSksRRYSYktikikilikiissYYY#ik#knit;k###t
ARCHITECTURAL CONTROL COMMITTEE/BOARD ACTION
Approved v Approved Pending
Denied_ Denied Pending
Architectural Control Committee/Board Comments:
Architectural Control Committee/Board Signatures:
��� Date:
13<�5za3 �
IsREROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333•buildinc(cDcuoertino.orc
PROTECT ADDRESS
1 1C F� Q J C � APNq
OWNER NAME V J PHO -I �1-n E-MAIL
STREET ADDRESS CZf.ATEC FAX
CONTRAC70ANAME LICE E NUMBER '��t(C LICENSETYZ BUS.LIC.q
COLMANY NAME �i 1 _ E•MAIL `J`J-i J �(� FAX
STREET ADDRESS �'-1�Q0�{�•• , CnY,STATE,Z CEE PHONE
I UNDERSTAND AND AGREE TO 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 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 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 1/4"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 monoxideldetec.Wrs ar required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residenti
Signature of ApplicanUAgent: Date: "4
RerooJPolicy_2011.doc revised 1017112