09120036 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11550 LAKE SPRING CT CONTRACTOR:CASTILLO'S ROOFINGtPERMIT NO:09120036
OWNER'S NAME: OMKAR SURYADEVARA
1703 CATHAY DR SSUED: 12/04/2009
SAN JOSE,CA 95122 NO:(408)251-3565
/. ER'S PHONE: 4082523826
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT f— PLUMB
223o S�
License Class Date� J Lic.# MECH I— RESIDENTIAL� COMMERCIAL
—•--- -_._ �� d
Citractor._- JOB DESCRIPTION:RE-ROOF TEAR OFF EXISTING WOOD SHAKE.INSTALL
I hereby affirm th t I am licensed under the provisions of Chapter 9 430LB FELT,INSTALL GAF GRAND CANYON COMP SHINGLES
(commencing wit Section 7000)of Division 3 of the Business&Professions CLASS A 16SQ
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 Valuation:$7000
Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area:
permit is issued.
CERTIFICATION
APN Number:36654037.00
APPLICANT 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, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the
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 Dat 91/_Z—'y_0'7
9.18. r /a � p Issued
-
Date
Ag
[., OWNER-BUILDER DECLARATION RE-ROOFS:
Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
I hereby affirm that I am exempt from the
installed without first obtaining an inspection,I agree to remove all new materials for
the following two reasons:
I,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, - Date:
Signature of A licant:-
Business&Professions Code)
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 HAZARDOUS MATERIALS DISCLOSURE
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's
I have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the
California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this
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
for which this permit is
I certify that in the performance of the work 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 Ow �a orized agent: / 0
become subject to the Worker's Compensation provisions of the Labor Code,I mu;t
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.. Date:
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's
I certify that I have read this application and state that the above information is for which this emit is issued(Sec.3097,Civ C.)
correct.I agree to comply with all city and county ordinances and state laws relati ig Lender's Name
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address
in,' ,ify and keep harmless the City of Cupertino against liabilities,judgments,
e, nd expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.18.
Date Licensed Professional
Signature
t
CITY OF (L'UPERTINO
REROOF
CUPEkTINO PERMIT APPLICATION
APN #
Date:
Z � � � t,� v �-�I - `� v
Building Address:
0 LIC% ! S P
Owner's Name: CN� _Ck v_ !E�`Q V)ka LC&(-C1 Phone #:
HOA: Yes ❑ No E�( If yes, provide letter from HOA
Contractor: Phone #: �2
c;r,, 2 )0 i �lC- Fax #:
Cupertino Business License #: Contractor License #:
0
Type of hoof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ �uilt-Up roof
1 Asphalt Shingles
❑ Asphalt Shingles e
V Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
N tuber of existing coverings ❑ Provide I.C.C.E.S. Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: Te a t- o C-i:- �_x i c-
c
��,s-tV�I 1 ?,� I b. �'� I Il
Residential Commercial
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the fLpplication or if there are any restrictions:
applicable, include in plan set & the sheet in,3ex.
Valuation:
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signa e
Revised 02/05/09
ai7l_.
CITY OF CUPERTINO
REROOF
' OF FEE SCHEDULE
CUPEkTINO
N
umber of Fee ID Fee Description Fee Permit Type
Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICO Seismic Commercial B
1REROOFRES Re-roof Re;,,idential B 1SFDWLR00F
1BCBSC Cal Bldg Si:andards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Residential B
1 REROOFMRES Re-roof M-ilti-Family B 1MFDWLROOF
1BCBSC Cal Bldg gtandards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Residential B
B
1BUSLIC Business License
Community Development Department
Building Division
City of Cupertino
10300 Tone Avenue
Telephone: (408)777-3228
Fax: (408)777-3333
Building Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance,you must ag,ee to comply with 2007 IBC Standards
and manufacturers specifications on re-roofing.All roofs are Class "A"per Cupertino
municipal code 16.04.080.
2. New roof coverings shall not be applied without first obtaining all inspection
and written approval from the building inspector. A final inspection and
approval shall be obtained from the building inspector when the re-roofing
is completed.
3. All roofs shall be inspected prior to any roofing installation.
4. To receive a final sign off from the Ciiy,the following steps are
required:
1) Pre-inspection and/or tear off approval.
2) In-progress inspection approval.
3) Final inspection approval.
a) Spark arrester installation.
5. If plywood is installed,a plywood nail inspection is required.
6. Any roofing which is applied without:first obtaining an inspection,
will require the removal of all new material down to the sheathing,
so a proper City inspection can be performed.
7. NOTE: If you call for a plywood nail inspection and the job is not ready,
you will be charged a re-inspection fee of$176.18. The re-inspection fee must
be paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/ "per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O.report is required to be on the job site at the time on inspection.
I understand and will comply with the aboi,e stated policy on re-roofing.
Homeowner's Name: _r S L AP Va Lo
Job Site Address: 55-0 e— ' f� j 1 i Y?C
j'
Roofing Company Name:
Applicant's Si �� Date:
PP �a.
Greg Casteel
Building Official
Revi:;ed 07/30/08
Community Development
10300 Torre Avenue
{yam; Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
,UPEkTINO
Building Department
JOB ADDRESS: PERMIT #,3)91 Z v
OWNER'S NAME: �_Zi,l 166AMPHONE #
GENERAL CONTRACTOR: FAX # ,.,.�
I am not using any subcontr -
i mature Date
Please check applicable subcontractors and comiAete 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
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date