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11040094 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11706 PALM SPRING CT CONTRACTOR:CASTILLO'S ROOFING PERMIT NO: 11040094 OWNER'S NAME: JACKSON ALVIN H JR AND JACQUEL 1703 CATHAY DR DATE ISSUED:04/13/2011 �"VNER'S PHONE: 4082554701 SAN JOSE,CA 95122 PHONE NO:(408)251-3565 LI LICENSED CONTRACTOR'S DECLARATIONF / BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class C— 3 -7 Lie.# 5� �,// 3/// MECH RESIDENTIAL[_ COMMERCIAL� Contractor Date `?` I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:SFD RERROF,15 SQUARES,TEAR OFF WOOD SHAKES, (commencing with Section 7000)of Division 3 of the Business&Professions INSTALL 30 FELT,INSTALL GAF GRAND CANYON COMP, Code and that my license is in full force and effect. EXISTING SOLID SHEETING TO REMIAN,PITCH 5:12,OSB 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:$7000 permit is issued. APPLICANT CERTIFICATION APN Number:36654112.00 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. / -3// Issued by: Date: bit 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, Business&Professions Code) Signature o Applic � Date: 1,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, or 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 s,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 with all 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 O� CITY OF CUPERTINO FlaFEE ESTIMATOR-BUILDING DIVISION ADDRESS: 11706 Palm springs Ct. DATE: 04/13/2011 REVIEWED BY: gs APN: BP#: "VALUATION: $7,000 'PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Du lex PENTAMATION 1SFDWLROOF USE: P PERMIT TYPE: WORK SCOPE FEE ID ROOF AREA s.f. 1 REROOFFRES 1,500 NOTE: Thesefees are based on the prefindnary in ormation available and are only an estimate. Contact the De t or addh 7 info. FEE ITEMS (11'ee Resolution 09-05.1 I ff. '-1,10) FEE QTY/FEE MISC ITEMS Permit Fee: $195.00 Work Without Permit? 0 Yes No $0.00 Strong Motion Fee: IBSEISAKCR $0.70 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $196.70 $0.00 TOTAL FEE: $196.70 Revised: 01/15/2011 REROOF 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•building(a)cupertino.org PROJECT ADDRESS _4 APN# r OWNER NAME PH E-MAIL �S STREET ADDRESS CITY, STATE,ZIP ' FAX CONTRACTOR NAME _ NSE NUMBE LICENSE TY4 BUS.LIC.# COMPANY NAME E-MAIL /`'- FAX STREET ADDRESS CITY,STATE,ZIP CJ15�-ZZ PHONE (-3S (� `"1 � l I UNDERSTAND AND AGREEO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimum of one day before the requested inspection date. Please schedule inspections online or call (408)777-3228 between 7:30-3:30 (Mon-Fri). 3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof is torn off and all the nails/fasteners have been removed. Any and all dry-rotted wood shall be replaced prior to this inspection. A building inspector will be available within one hour. There are special hours for this service: 7:30 — 10:30am and 1:00—3:30pm (Mon—Thurs); 7:30 — 10:30am and 1:00—2:30pm (Friday). 4. If plywood is installed, a plywood nailing inspection is required. 5. In-Progress roof inspection is required. Call for an in-progress roof inspection to verify building is weather tight after installation of approximately 25% of the roofing material. 6. New roof coverings shall not be applied without first obtaining all inspections 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. 7. A final inspection and approval shall be obtained from the building inspector when the re-roofing is complete. 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 must 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. 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 n .behalf. I and tand and agree to comply with the re-roof policy stated Bove. Signature of Applicant/AgeDate: � l 1 ReroojPolicy_2010.doc revised 05/17/10 Building Department City Of Cupertino -93 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: PHONE# GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all busin sses working in the city to have a City of Cupertino WsinesJ 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. - am not using any subcoors: `3 Signature Date Please check applicable subcontractors a 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 r 12 i Owner/Contractor Signature Date REROOF PERMIT APPLICATION 0_ COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333•building CUPERTINO I cupertino.org PROJECT ADDRESS / -70( APN# OWNER NAME • HONEC L s �''� E-MAIL /0"Afka n STREET ADDRESS / CITY, TATE,ZIP Jon CONTACT NAME / PHONE �S— E-MAIL '124& 1 STREET ADDRESS ( /j CITY,STATE, ZIP - qs� FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR 11 CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ,t� LICENSE NUMBER {j t/ LICENSE TYPE CM BUS.LIC.# COMPANY NAME / ! f Fk4 E-MAIL FAX STREET ADDRESS l] CITY,STATE,ZIP �^ ,(�C I PHONE ��' —� S N ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF Ee<FD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial I 7 EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE eYES IF NO. PLYWOOD ❑ '/:" ❑ __ PLYWD 13 OSB PITCH: ROOF [] NO_ #LAYER5: THICKNESS: ❑ 5/8" TYPE: 1:1CDX I 12 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT///#�� DESCRIPTION OF WORK: e k�s— � + �0 -Aa 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 bu'din nstn�nn. I authorize representatives of Cupertino to enter the abo id ntified pr erty for inspection purposes. Signature of Applicant/Ag ` Date: SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY _If building is associated with a Home Owner's Association,provide letter PLAN CHECK TYPE ROUTING SLIP of approval from HOA. OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT _Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER: ReroofApp_2011.doc revised 03/16/11