11080085 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11857 WOODHILL CT CONTRACTOR:CASTILLO'S ROOFING PERMIT NO: 11080085
OWNER'S NAME: SIMON RALPH E AND ELENA TRUSTE 1703 CATHAY DR DATE ISSUED:08/10/2011
OWNER'S PHONE: 4082579157 SAN JOSE,CA 95122 PHONE NO:(408)251-3565
L LICENSED CONTRACT R'S DECLARATION
t _ BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class 1 G Lic.# r
�' C MECH RESIDENTIAL COMMERCIAL
Contractor e � Date
I hereby affirm th I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OFF SHAKE INSTALL NEW COMP
SHINGLES
(commencing with Section 7000)of Division 3 of the Business&Professions
EXISTING SHEATHING TO REMAIN CLASS A 16SQFT
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. Sq.Ft Floor Area: Valuation:$8750
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:36604065.00 Occupancy Type:
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, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
SignatuDate / Issued by:• �/� Dater,
7
r NER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
1,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspectio
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to Sign re of A p iTz - � Date:
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
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 read the hazardous materials requirements under Chapter 6.95 of the
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.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534.
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_.._._-. Owner or auth ized a nt: Date:
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
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 I hereby affirm that there is a construction lending agency for the performance of"ork's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
c--t-,and expenses which may accrue against said City in consequence of the Lender's Address
',ng of this permit.Additionally,the applicant understands and will comply
�, all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 11857 woodhill ct. DATE: 08/10/2011 REVIEWED BY: bobs.
APN: BP#: VALUATION: 1$8,750
°PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Du lex PENTAMATION 1SFDWLR00F
USE: P PERMIT TYPE:
WORK tear off shake install new comp shingles existing sheathing to remain
SCOPE
FEE ID ROOF AREA
s.f.
1REROOFFRES 1,600
".77
F-1 Li
NOTE: Thesefees are based on the preliminary information available and are only an estimate. Contact the Dept./or addn 7 info.
FEE ITEMS (Fee Resolution 11-053 E;t� l) FEE QTY/FEE MISC ITEMS
Permit Fee: $224.00
Work Without Permit? 0 Yes No $0.00
Strom Motion Fee: 1BSEISMICR $0.88 Select an Administrative Item
Bldg�Stds Commission Fee: 1BCBSC $1.00
SUBTOTALS: $225.88 $0.00 TOTAL FEE: 1 $225.88
Revised: 07/04/2011
L9REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTtN{ (408)777-3228• FAX(408)777-3333 • building(Mcupertino.org
PROTECT ADDRESS 1 C \A, C APN# 04
0r _
2
OWNERNAME J �� PHONE ("„ E-MAIL
STREET ADDRESS CITY, STATE ZIP FAX
APPLICANT NAMEPHONE 251 '��J E-MAIL
STREET ADDRESS CITY,STATE,ZIP
qL :�4 iyX
❑ OWNER ❑ OWNER
R--BUILDER ❑ OWNERAG CON-R AcToR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME / ` n ' • LICENSE NUMBER / i LICENSE BUS.LIC.#
COMPANY NAME l ,f, E-MAIL 1 C FAX
STREET ADDRESS , `�._ NE
" I I fJ�` CITY,STATE,ZIP /� J T PHO
ARC1-=CT/ENGINEER NAME `-�/ / �'®LICENSE NUMBER f\ Q' BUS.LIC.# J
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 YES IF NO, PLYWOOD ❑ h" ❑ PLYWD ❑ OSB PrrCH ROOF
11 NO #LAYERS: THICKNESS: 135/8" TYPE: ❑ CDX '12 CLASS: A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT#
DESCRIPTION OF WORK Tc--A p— v u '`1 r rI^ j1 ,E011
'C r
`YtJL tem Iq
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 construction. I authorize representatives of Cupertino is enter the above-identified p�py for ipspegtion purposes.
Signature of Applicant/ -- Date: :) l I
SUPPLEMENTAL EkFORMATION REQUIRED .�'IIs
_If building is associated with a Home Owner's Association,provide letter MUM- _6M 17111
of approval from HOA. %
Provide Planning approval to verify if there any restrictions. _ � - __�
— � 'SS'- ❑,'ESA-LZ�III�f�-Pr,ti'N-a�'
—Provide c of Manufacturer's Installation Specifications.
PY p II_ xv�►an rR 1 1TG 1ST s
ide signed copy of Cupertino's Tear-Off Policy.
-T
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(�cupertino.org
PROJECT ADDRESS 1 1 1 y ( C APN#
n �
OWNER NAME 1 , ; PHONE. E-MAIL
\x/ C
STREET ADDRESS f ��O � ' /w CITY, STATE,ZI 2( ),Ir r/� J FAX
CONTRACTOR NAME LICENSE NUMBER LICENSE%TYPE BUS.LIC.#
COMPANY NAME r� E-MAIL FAX
STREET ADDRESS r CITY,STATE,ZIP (' PHONJ& 0�
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 Re e�l Co e.
Signature of Applicant/Agent: Date: s
ReroofPolicv_2011.doe revised 02/16/11
CITY OF CUPERTINO
3 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 36604065 . 00
DATE ISSUED. . . . . . . : 08/10/2011
RECEIPT #. . . . . . . . . BS000014391
REFERENCE ID # . . . : 11080085
SITE ADDRESS . . . . . : 11857 WOODHILL CT
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER SIMON RALPH E AND ELENA TRUSTE
ADDRESS 11857 WOODHILL 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 8, 750 .00 1. 00 0. 00 1 .00 0. 00
1BSEISMICR VALUATION 8, 750 . 00 0 .88 0. 00 0 .88 0. 00
1REROOFRES SQ FEET 16 . 00 224 . 00 0 . 00 224 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 225. 88 0. 00 225 .88 0. 00
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
Building Department
City Of Cupertino
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: 1 , ` 1 PERMIT
OWNER'S NAME: Sk a_vt _ NI PHONE# 2S `�J J�
GENERAL CONTRACTOR: BUSINESS LICENSE#
ADDRESS: k� CITY/ZIPCODE:-S'6' b _ �
*Our municipal code requires all businesses 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 CU ERTINO
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
4�OLer/Contractor Signature Date