11090069 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11581 SEVEN SPRINGS DR CONTRACTOR:CASTILLO'S ROOFING PERMIT NO: 11090069
OWNER'S NAME: SU ANNIE CHING TAI 1703 CATHAY DR DATE ISSUED:09/09/2011
OWNER'S PHONE: 4082556605 SAN JOSE,CA 95122 PHONE NO:(408)251-3565
LICENSED CONTRACTOR'S DECLARATION
o �� � BUILDING PERMIT INFO: BLDG ELECT PLUMB
C. 15License Class / Li,.#
MECH F RESIDENTIAL COMMERCIAL
Contractor Date
I hereby affirm t at I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REROOF,SFDWL,14 SQ,TEAR OFF SHAKE AND REPLACE
(commencing with Section 7000)of Division 3 of the Business&Professions WITH COMP SHINGLES,EXISTING SOLID SHEETING TO
Code and that my license is in full force and effect. 41 REMAIN
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:$7900
permit is issued.
APPLICANT CERTIFICATION APN Number:36652045.00 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
9.18. r
----_.�.._._---�--•--'...__ Date: �
qj Issued by--
Signa 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
1,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, (7
Business&Professions Code) Signature o App icant: i 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 or authorized agent:
forthwith comply with such provisions or this permit shall be deemed revoked. Date:
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
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 work'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
-ts,and expenses which may accrue against said City in consequence of the
ting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
a all non-point source regulations per the Cupertino Municipal Code,Section
9.18. 1 understand my plans shall be used as public records.
Signature a4 Date Licensed Professional
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
(a)cugertino.org
PROJECT ADDRESS I ` ��f APN#
OWNER NAME PHONES (s:� E-MAIL
STREET ADDRESS TY, STATFAX
CONTRACTOR NAME ENSE NUMBER LICENSE TYPE BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS , CITY,STATE,ZIP > ( ,A(� PHONEqbg
AAtAl
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 I/"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 R314 and R315 of
the 2010 California Residential Code.
Signature of Applicant/A nt: " Date:
ReroofPolicy_2011.doc revised 02116111
REROOF PERMIT APPLICATION -
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 \\
(408)777-3228• FAX(408)777-3333 • building cupertino.0m \
CUPERTINO
PROJECT ADDRESS APN#
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APPLICANT NAME ` l .\ PHONE 2� E M�
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STREET ADDRESS CITY,STATE,ZAP!_ FAX
❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRA_=R AGENT ❑ ARCHITECT ❑ENGWEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME/ ; ' C LICENSE NUMBER LICENSE TYPE- BUS.LIC.
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COMPANY NA �� J E-MAIL FAX
STREET ADDRESS CITY,STATE� ���� PHONEnN S
ARC'HITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF FD or Duplex ❑ Multi-Family ROOF AREA:/ VALUATION: �/'�
STRUCTURE: ❑ Commercial i ( x— 0_
EXISTING ROOF TYPE: ❑ UILT-UP ROOF ❑ASPHALT SHINGLES WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE ZIYES IF NO, PLYWOOD ❑ h" ❑ PLYWD ElOSB PrrCIi ROOF
❑NO #LAYERS: THICKNESS: El 5/8 TYPE: 13CDX '12 CLASS: Ill
ICC-ES REPORT#
PROPOSED ROOF TYPE: ❑B=-UP ROOF ASPHALT SHINGLES pr❑WOOD SHAKES ElWOOD SHINGLES/ ❑OTHER
DESCRIPTION OF WORK _
J k,
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 ilding c coon. I authorize representatives of Cupertino to enter the above-identified pro e ;for inspection purposes.
Signature ofApplicant/A t Date' C[
SUPPLEME AL INF TION REQUIRED �� (+ ♦gyp
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If building is associated with a Home Owner's Association,provide letter �„„_.�$LAI=�CICF x.__V ''�
ITI
of approval from HOA. x�mt _ stmI�v =_ Z
Provide Planning approval to verify if there any restrictions. - Q}�P�A_ GPrrAN RT
Provide copy of Manufacturer's Installation Specifications. � �*MD l-aF-M �
Provide signed copy of Cupertino's Tear-Off Policy. r-U — o ..5�, ��2
ReroofApp_2011.d6c revised 03/02/11
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
CUPERTINO Fax: 408-777-3333
CONTRACTOR / SUBCONTRACTOR LIST
JOB ADDRESS: PERMIT# �U
OWNER'S NAME: L PHONE#
GENERAL CONTRACTOR: 09stO Z 1/1 BUSINESS LICENSE# J�
ADDRESS: C3 ��fi�a CITY/ZIPCODE: s U- u512Z
*Our municipal code requires all bbsinesses 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 COPE /TINO
BUSINESS LICENSE.
I am not using any subcontractors: Signature Date
Please check applicable subcontractors and complete the following information:
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
Date
Owner/Contractor Signature
CITY OF CUPERTINO \
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 11581 seven springs dr. DATE: 09/09/2011 REVIEWED BY: bobs.
APN: BP#: `VALUATION: $7,900
RIPERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY PENTAMATION 1SFDWLROOF
USE: SFD or Duplex PERMIT TYPE:
WORK tear off shake and replace with comp shingles.
SCOPE
FEE ID ROOF AREA
s.f.
1 REROOFFRES 1,400
Li 777 El
NOTE. This estimate does not include fees due to other Depts(i.e.Public Works,Sanitary Sewer District,School District,etc.).
Thesefees are based on the preliminary in ormadon available and are only an estimate. Contact the De t or addn'l info,
FEE ITEMS ( ee Resoli lion 11-053 Eff ''1;'11) FEE QTY/FEE MISC ITEMS
F_
Permit Fee: $196.00
FT
Work Without Permit? Q Yes (D No $0.00
i
Strom Motion Fee: IBSEISMICR $0.79 Select an Administrative Item
I31da Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $197.79 $0.001 TOTAL FEE: $197.79
Revised: 09/02/2011