11060218 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11907 WOODHILL CT CONTRACTOR:CASTILLO'S ROOFING PERMIT NO: 11060218
OWNER'S NAME: SHERVIN ROOHPARVAR 1703 CATHAY DR DATE ISSUED:06/28/2011
OWNER'S PHONE: 4088338338 SAN JOSE,CA 95122 PHONE NO:(408)251-3565
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.# Tc3D/ Z
MECH RESIDENTIAL COMMERCIAL�
Contractor Date (o �D `! /
JOB DESCRIPTION:RE-ROOF TEAR OFF EXISTING WOOD SHAKES,INSTALL
I hereby affirm t at I am licensed under the provisions of Chapter 9
30LB
(commencing with Section 7000)of Division 3 of the Business&Professions FELT,INSTALL GAF GRAND CANYON COMP.EXISTING
Code and that my license is in full force and effect. SOLID SHEETING TO REMAIN.CLASS A 16SQ
I hereby affirm under penalty of perjury one of the following two decla 'tions:`
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:$9200
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:36604070.00 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. Z
SignaJu Date �o`-O / Issued Date:
OWNER-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, inspection.
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to Si 'lure of Appli t: Date:
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:
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
[have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
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 Ownpr u ized agent:
forthwith comply with such provisions or this permit shall be deemed revoked. oDate:!/�
r
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 work'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,
<s,and expenses which may accrue against said City in consequence of the Lender's Address
ting of this permit.Additionally,the applicant understands and will comply
with 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
JJADDRESS: 11907 woodhill ct. DATE: 06/28/2011 REVIEWED BY: bobs.
PN: BP#: "VALUATION: $9,200
°PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY PENTAMATION 1SFDWLROOF
USE: SFD or Duplex I I PERMIT TYPE:
WORK tear off shake roof replace with comp shingles.
SCOPE
FEE ID ROOF AREA
s.f.
1 REROOFFRES 9,200
NOTE: These fees are based on the preliminary information available and are onL an estimate. Contact the Dept for addn 7 info.
FEE ITEMS (lee Resolution 09-051 Fff. ' .'/0) FEE QTY/FEE MISC ITEMS
Permit Fee: $1,196.00
Work Without Permit? 0 Yes G No $0.00
A
Strong Motion Fee: IBSEISMICR $0.92 Select an Administrative Item
Bldg, Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $1,197.92 $0.00 TOTAL FEE: $1,197.92
Revised: 04/29/2011
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36604070. 00
DATE ISSUED. . . . . . . : 06/28/2011
RECEIPT #. . . . . . . . • : BS000013911
REFERENCE ID # . . . : 11060218
SITE ADDRESS . . . . . : 11907 WOODHILL CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . . CUPERTINO
IMPACT AREA
OWNER . . . . . . . . . . . . : SHERVIN ROOHPARVAR
ADDRESS 11907 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 9, 200 . 00 1. 00 0. 00 1 .00 0 .00
1BSEISMICR VALUATION 9,200 . 00 0 . 92 0. 00 0 .92 0. 00
1REROOFRES SQ FEET 16 .00 208. 00 0. 00 208 .00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 209. 92 0. 00 209 .92 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 209. 92 #17169
---------------
TOTAL RECEIPT 209. 92
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
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• building6H�cupertino.orq
PROTECT ADDRESS \ O \ APN# 0!4 0_70,W
OWNERNAME Ske1V 'n, 1, - PHONE110 3
STREET ADDRESS \ ` CITY, STATE,ZIP � - .Q
w � +
CONTRACTOR NAME C LICENSE NUMBER LICENSE TYP BUS.LIC.# /
COMPANY NAME 6m
_ eJ EMAIL IL0 A Sy 7 5 2^0 t . �G� FAX�51`3 S�U�`
'ADDRESS 1 �,\ CITY,STATE,ZIP � n �' HONE
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 shall be scheduled 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.
On the day of the inspection, a building inspector will be available within one hour for either a Tear-Off
Inspection or Nailing Inspection if you call again on that day between the hours specified.
3. The following inspections are required:
a. 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.
b. If plywood is installed, a plywood Nailing Inspection is required.
c. Progress Inspection is required when approximately 50% of roof covering is installed.
4. New roof coverings shall not be applied without first obtaining all 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.
5. 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/4"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.
6. 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 Cod r
Signature of Applicant/Agen : - Date: `
ReroofPolicy_2011.doc revised 02/16/11
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
:,U P E RT I N O Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: -1 1i PERMIT#
OWNER'S NAME: PHONE# 4I- S
GENERAL CONTRACTOR: i BUSINESS LICENSE#
ADDRESS: ( CITY/ZIPCODE: CA .9512-2
*Our municipal code requires all busi esses 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 CUPERTINO
BUSINESS LICENSE. f _
I am not using any subcontr (sz�
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
Owner/Contractor Signature Date
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•building(c1cupertino.org
PROJECT ADDRESS , j APN# �Li
O
go-Ic+, _ >
OWNER NAME S,� J VI, &0h.
1 PHONE qNA-3✓4338 I
E-MAIL
STREET ADDRESS , ( CITY, STATE,ZIP Y � •r
� 50pX
APPLICANT NAME \t PHONE N� '- _, i E-MAIL
STREET ADDRESS p O p}f ll ' CITY,STATE, ZIP C ' 1�y`f- FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME /`�n S 1 ' `O S �� LICENSE NUMBER 4.) ^,1� LICENSE TYPE BUS.LIC.#
COMPANY NAME �,'1 E-MAIL j'1 FAX
STREET ADDRESS ,-1O CITY,STATE,ZIP
�rn 5,o e nA q t I-^I-L "Eft 151-3,S1kS_
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 I Sib I a
EXISTING ROOF TYPE,:: ❑BUILT-UP ROOF El ASPHALT SHINGLES WOOD SHAKES I-]WOODSHINGLES C3 OTHER(SPECIFY)
REMOVE/REPLACE I�YES IF NO, PLYWOOD ❑ w ❑ PLYWD ❑ OSB FITCH
ROOF
El NO #LAYERS: THICKNESS: 1115/8" TYPE: ❑ CDX �'12 CLASS: A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT#
DESCRIPTION OF WORK Y J J `W^-1�� I I •�Ie
C C�Prr CGi rl vr7 IS
1 4•
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 o b 'ding c truction. I au horize re resentatiyes of Cupertino tc enter the bov identifie propem;for inspection purposes.
Signature ofApplica en �. Date:
SUPPLEMENTAL 14FORMATION REQUIRED L oFFcE usE'cNi
_If building is associated with a Home Owner's Association,provide letter PLAN LM«TSE ,u ROUTING SLIP
of approval from HOA. ❑ UYER rl -CCIUNTFR ❑ BUILDING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. ❑mExPiiz ssa ❑ FLANNING'PLAxREVIEW,
Provide copy of Manufacturer's Installation Specifications. ❑
STANDARD ❑ FIREDEPT
Provide signed copy of Cupertino's Tear-Off Policy. ❑ oIEER ,
ReroofApp_2011.doc revised 03/02/11