09120037CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11511 WELLSPRING CT
CONTRACTOR: CASTILLO'S ROOFING
PERMIT NO: 09120037
OWNER'S NAME: BATES DAVID L ET AL
1703 CATHAY DR
DATE ISSUED: 12/04/2009
ER'S PHONE: 4085298439
SAN JOSE, CA 95122
PHONE NO: (408)251-3565
❑ LICENSED CONTRACTOR'S DECLARATION
PLUMB
License Class Lic. #
BUILDING PERMIT INFO: BLDG ELECT
'�
Cont r, t � ate �— d
MECH RESIDENTIAL COMMERCIAL
I hereby affirm at 1 am licensed under the provisions of Chapter 9
JOB DESCRIPTION: RE -ROOF TEAR OFF WOOD SHAKE, INSTALL #30LB FELT,
(commencing with Section 7000) of Division 3 of the Business & Professions
INSTALL GAF GRAND CANYON COMP SHINGLES CLASS A
Code and that my license is in full force and effect.
17SQ
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
Sq. Ft Floor Area:
Valuation: $7600
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APN Number: 36651039.00
Occupancy Type:
APPLICANT CERTIFICATION
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.
w� C
Q/
Issued b y', Date:/2 +r+
Srgnat ure Dat
❑ 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 f Akan : 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:
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
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 pen -nit 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, [
_
become subject to the Worker's Compensation provisions of the Labor Code, I must
Ow er o a rprized agent: / �y Q
Date: l/
forthwith comply with such provisions or this permit shall be deemed revoked.
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
i nify and keep harmless the City of Cupertino against liabilities, judgments,
Lender's Address
L;. . and expenses which may accrue against said City in consequence of the
granting 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
NO
1
CITY OF
CUPEkTINO
CITY OF CUPERTINO
REROOF
PERMIT APPLICATION
() � 120 31
APN # ,..
Date:
Building Address:
Owner's Name. ' jDa v i a `6aie S
Phone #: 2cl _ � y 39
HOA: Yes ❑ No 21 If yes, provide letter
from HOA
Contractor:
Phone #: 02 5-1- 3576j-
Qv
Fax #:
Cupertino Business License #:
Contractor License #:
30856
Type of Roof Covering:
Existing:
Proposed:
❑ Built -Up Roof
❑ quilt -Up roof
Asphalt Shingles
Asphalt Shingles
Wood Shakes
❑ Wood Shakes
❑ Wood Shingles
❑ Wood Shingles
❑ Other (Specify)
❑ Other (Specify)
Number of existing coverings
❑ Provide I.C.C.E.S. Report #
aiTo be Removed
❑ Provide Mfgr. Installation Specs.
Job Description: l en e- b p F V\lDocl hak_e. ( ThsT� 11-44 3� b . Fe �-�-
vrsJ�CIDP zrcn(A Carvpn
c6atp. sht►-Lle"N . 1 iS6,
Residential
Commercial
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, include in plan set & the sheet ind zx.
Valuation:
on
I Have Read, Understand and Will Comply with Cupertino's Tear -Off Policy:
Signa
Revised 02/05/09
aFT-.
CITY OF C'UPERTINO
REF:OOF
CUPE}�T]NO FEE SCHEDULE
Number of
Squares
Fee ID
Fee Descr iption
Fee
Group
Permit Type
1REROOFCOM
Re -roof Co=ercial
B
1COMMLROOF
1BCBSC
Cal Bldg S,undards
Commission Fee
B
ALL PERMIT TYPES
1BSEISMICO
Seismic Commercial
B
l REROOFRES
Re -roof Re ;idential
B
1SFDWLR00F
/
1BCBSC
Cal Bldg Slandards
Commission Fee
B
ALL PERMIT TYPES
1BSEISMICRE
Seismic Re3idential
B
1 REROOFMRES
Re -roof ML lti-Family
B
1MFDWLROOF
1BCBSC
Cal Bldg Standards
Commissio.l Fee
B
ALL PERMIT TYPES
1BSEISMICRE
Seismic Re,>idential
B
1BUSLIC
Business License
B
Community Development Department
Building Division
City of Cupertino
10300 Torre 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 agg-ee to comply with 2007 IBC Standards
and manufacturers specifications on r: -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 b-- lding inspector when the re -roofing
is completed.
3. All roofs shall be inspected prior to ar.y roofing installation.
4. To receive a final sign off from the City, 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 mz.terial 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 ca i be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/4 " 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 above stated policy on re -roofing.
Homeowner's Name: GV)
Job Site Address: L I f=% T,�:Q r N1,6,2
Roofing Company Name: cl st,
Applicant's S�at�ue• _,...._ � �^ Date: 1 2J L � O
Greg Casteel
Building Official
Revised 07/30/08
;-�� un
CITY OF
�MkTINO
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
Building Department
JOB ADDRESS: PERMIT #� (� c> v
1151 I l�� n C
OWNER'S NAME: G 1/ir PHONE # S/-3,5& 5—
GENERAL
S&J—
GENERAL CONTRACTOR: L C D'S Udicird FAX # S �.
I am not using any subconaeters. c _ /�
Sii;nature Date
Please check applicable subcontractors an comvlete the following information:
Owner/ Contractor Signature
Date
60
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