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11090118 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11577 FALLCREEK SPRING CT CONTRACTOR:CASTILLO'S ROOFING PERMIT NO: 11090118 OWNER'S NAME: VIOLA LENG 1703 CATHAY DR DATE ISSUED:09/19/2011 OWNER'S PHONE: 8052057552 SAN JOSE,CA 95122 PHONE NO:(408)251-3565 LICENSED CONTRACTOR'S DECLARATION _ BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class�i� Lic.# MECH r— f—f— COMMERCIAL Contractorc� Date I hereby affirm t at I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF REMOVE SHAKES,REPLACE WITH GAF (commencing with Section 7000)of Division 3 of the Business&Professions GRANDCANYON LIFETIME,30LB FELT,RIDGE VENT CLASS Code and that my license is in full force and effect. A 14SQ 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,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$7500 permit is issued. APPLICANT CERTIFICATION APN Number:36651018.00 Occupancy Type: 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 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 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 q 9.18. �-�Issued Date: �� " Signature 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 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&Professions Code) Signatur of A p Date: I,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: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 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 must Owner o an or' d agent: % /' // forthwith comply with such provisions or this permit shall be deemed revoked. Date: `t `7 APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 Aork'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 co— and expenses which may accrue against said City in consequence of the g of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION Al 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 CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36651018. 00 DATE ISSUED. . . . . . . : 09/19/2011 RECEIPT #. . . . . . . . . BS000014796 REFERENCE ID # . . . : 11090118 SITE ADDRESS . . . . . : 11577 FALLCREEK SPRING CT SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER VIOLA LENG ADDRESS 11577 FALLCREEK SPRING CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 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 7, 500 .00 1. 00 0. 00 1 . 00 0. 00 1BSEISMICR VALUATION 7, 500 . 00 0. 75 0. 00 0 .75 0. 00 1REROOFRES SQ FEET 14 . 00 196. 00 0. 00 196 .00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 197.75 0 . 00 197.75 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 197 .75 #17337 --------------- TOTAL RECEIPT 197. 75 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 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 11577 fall creek ct DATE: 09/19/2011 REVIEWED BY: larry s APN: BP#: VALUATION: 1$7,500 PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Du lex PENTAMATION 1SFDWLR00F USE: P PERMIT TYPE: WORK remove shakes replace with gaf grandcanVon lifetime 30 Ib. felt ridge vent. SCOPE FEE ID ROOF AREA s.f. 1 REROOFFRES 19400 LJ I NOTE. This estimate does not include fees due to other Depts(i.a Public Works,Sanitary Sewer District,School District,etc.). Thesefees are based on the preliminary in ormation available and are only an estimate. Contact the De t or addh7 info, FEE ITEMS (Fee Resohition 11-053 E(f.' IiUl1) FEE QTY/FEE MISC ITEMS Permit Fee: $196.00 Work Without Permit? 0 Yes No $0.00 i Strom Motion Fee: 1BSEISMICR $0.75 Select an Administrative Item 131du Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $197.75 :$0:0±0 TOTAL FEE: $197.75 Revised: 09/02/2011 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333 • buildingecupetno.org PROJECT ADDRESS OWNER NAME C PHONFi� 1 + Z 7MAZ_ STREET ADDRESS APPLICANT NAMECI E-MAIL STREET ADDRESS STATE FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME \ i U T LICENSE NUMBEI l ' 1 5b LICENSE TY� BUS.LIC.# COMPANY NAME E-MAIL FAX i STREET ADDRESSi / CITY, Z1P PHO ` i ARCI=CT/ENGINEERNAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL, FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE of SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE ffYiS IF NO, r} PLYWOOD ❑ K- ❑ PLYWD ElOSB PITCH. ROOF ❑ NO #LAYERS: v�THICKNESS: El 5/8. TYPE: ElCDX :12 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF 21A ;HALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK ✓� CVa.nd C) 1, Cerner rD \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 provide . correct I have read the Description of Work and verify it is accurate. I agr a to comply ith all applicable local ordinances and state laws relating to building onstru n. I authorize representatives of Cupertino'Lc enter the above-1tiff d property fo insp ction purposes. Signature of Applicant/ Date: – rlSUPPLEMENTAL Dql'ORMATIO!NyEQUIREDc � ��s __, _If building is associated with a Home Owner's Association,provide letter ' _ of approval from HOA. , ' Provide Planning approval to verify if there any restrictions. S _ � sLyy, Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cupertino's Tear-Off Policy. _ _— ' ReroofApp_2011.doc revised 03/02/11 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•buildinga-cugertino.org PROJECT ADDRESSG # J -7 OWNERNAME PHONE i^- E-MAIL STREET ADDRESS / TY, S TE,ZIP G CONTRACTOR NA / +41CINUMBER LICENSE TY F� BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS �j I, CITY,STATE L} ^3 �� , PHONELl 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 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'/" 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 detectors are required to be installed in accordance with Sections 314 nd R315 of the 2010 California Residential Cod n x" Signature of Applicant/ en : Date: 7 ( � ReroofPolicy_2011.doc revised 02/16111 Building Department City Of Cupertino L2 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# OWNER'S NAME: t; PHONE# GENERAL CONTRACT ` BUSINESS LICENSE# is 12a ADDRESS: V-.)a- CITY/ZIPCODE: "Our municipal code requires all businesse orking in the city to have a City of Cupertino bU sin ess'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 subcontraetJ ! Signature Date Please check applicable subcontractors complete the following information: V 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 -t Owner/Contractor Signature Date