11090009CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 11718 RIDGE CREEK CT I CONTRACTOR: CASTILLO'S ROOFING I PERMIT NO: 11090009
OWNER'S NAME: CHOU WEN L AND HSI HSIAO M 11703 CATHAY DR i DATE ISSUED: 09/01/2011 1
'?`-'NER'S PHONE: 4089730940
LICENSED CONTRACTOR'S DECLARATIOOWN,
License Class Lic. #
Conti Date
I hereby affirm that am licensed under the provisions of Chapter 9
(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 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
permit is issued.
APPLICANT CERTIFICATION
1 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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18. 9
Signatu �Z Date
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
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
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, after making this certificate of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
v - and expenses which may accrue against said City in consequence of the
ag of this permit. Additionally, the applicant understands and will comply
all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
SAN JOSE, CA 95122
PHONE NO: (408)251-3565
BUILDING PERMIT INFO: BLDG f— ELECT I— PLUMB I—
MECH F RESIDENTIAL COMMERCIAL r—
JOB DESCRIPTION: RE -ROOF TEAR OFF SHAKE ROOF & INSTALL 30#
FELT.INSTALL GAF GRAND CANYON COMP EXISTING SOLID
SHEETING TO REMAIN CLASS A 18SQ
Sq. Ft Floor Area: I Valuation: $9500
APN Number: 36604074.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Date:
RE -ROOFS:
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. � n
Signature of Applican . v Date
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Date: tl
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Signature Date I Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ialADDRESS:
11718 ridge creek ct.
DATE: 09/01/2011
REVIEWED BY: bobs.
APN:
BP#:
'VALUATION: 1$9,500
PERMIT TYPE: Minor Building Permit
PLAN CHECK TYPE: Re -roof
PRIMARY SFD or Duplex
USE:
PENTAMATION 1SFDWLR00F
PERMIT TYPE:
WORK
tear off shake roof and install comp shingles, sheathing to remain.
SCOPE
FEE ID ROOF AREA
s.f.
1REROOFFRES 1,$00
NUI E. These tees are based on the vrettnunary information available and are only an estimate. Contact the wept for aaan'l info.
FEE ITEMS (Fee Resolution 11-053 Eff. ' .-"11) FEE QTY/FEE MISC ITEMS
Permit Fee: $252.00
Work Without Permit? 0 Yes No $0.00
i
Strona Motion Fee: 1BSEISMICR $0.95 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $1.00
SUBTOTALS: $253.95 $0.00 TOTAL FEE $253.95
Revised: 07/04/2011
CUPERTINO
REROOF PERMIT APPLICATION --
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building a cupertino.org
PROJECT ADDRESS 7APN
OWNER NAME
PHONE `3
E-MAIL
STREET ADDRESS
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STATE, ZIP 11
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FAX
APPLICANT NAME 1
PHO
STREET ADDRESS \
STATE, ^ .95 o
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ElARCHITECT ElENGINEER ❑ DEVELOPER El TENANT
CONTRACTOR NAME � ,
LICENSE NUMBER L y
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LICENSE TYPEC �
BUS. LIC. #
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COMPANY NAME
E-MAIL
FAX
STREET ADDRESS I .� , ,
Crit, STATE ZIP . n
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ARCHITECT/ENGINEER NAME
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 SHAICES ❑ WOOD SINGLES ❑ OTTER (SPECIFY)
REMOVE /REPLACE
IF NO.
PLYWOOD ❑ h" ❑
PLYWD ❑ OSB
PITCR
' 12
FCLIAOSFS
A
❑ NO
# LAYERS:
CICNESS: ❑ 5/s"
TYPE: ❑ CDX
:
PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF 01ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER
ICC -ES REPORT #
DESCRIPTION OF WORK —r� r 41-- T
G
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 is correct. I have read the Description of Work and verify it is accurate. I ee to comply with all applicable local
ordinances and state laws relating to uildin o I authorize. representatives of Cupertino tc enter the above -ire 'fie rinspection purposes.
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Signature of, g – Date:
SUPPLEMENTAL RMATION REQUIRED^
'-�.�,�_�
.�..r 5 - M5_
If building is associated with a Home Ownei s Association, provide letter
_
of approval from HOA.�-
_ Provide Planning approval to verify If there any restrictions,
.r.-
Provide copy of Manufacturer's Installation Specifications.,��u„bT
_
rovide signed copy of Cupertino's Tear -Off Policy.
_6
ReroofApp_2011.doc revised 03/02/11
J2
CUPERTINO
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
(408) 777-3228 - FAX (408) 777-3333 - build ing(&cupertino.org
PROJECT ADDRESS'Ang
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APN #
OWNERNAME �-�
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E-MAIL
STREET ADDRESS
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FAX
CONTRACTOR NAME r
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LICENSE
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BUS. LIC. #
COMPANY NAME
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FAX
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I UNDERSTAND AND AGREE TO THE FOLLOWING:
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. Proeress 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 R3 4 and R315 of
the 2010 California Residential Code.
Signature of Amlica Date:
ReroofPolicv_2011.doe revised 02/16/11
CUPERTINO
CONTRACTOR / SUBCONTRACTOR LIST
10300 Toftment
Cupertino, CA 95014-s,-_
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: Ig r
PERMIT #
OWNER'S NAME: wen
PHONE # Q��J
GENERAL CONTRACTOR: t S
BUSINESS LICENSE #
ADDRESS:
CITY/ZIPCODE C5 109-
*Our municipal code requires all busines4o working in ine city to nave a 1ty v, -up%,l SIA......-
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL UBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE. i
f
1 am not using any subcontractors:
Signature ate
Plence check annlicable subcontracto and complete the following information:
Owner / Contractor Signature
t
Date
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
Owner / Contractor Signature
t
Date