The URL can be used to link to this page

11100041 (2)CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10852 ALDERBROOK LN I CONTRACTOR: CASTILLO'S ROOFING I PERMIT NO: 11100041 I OWNER'S NAME: PRAY- SILVER JANE TRUSTEE 1 1703 CATHAY DR I DATE ISSUED: 10/06/2011 OWNER'S PHONE: 6504655208 L LICENpS,ED CONTRACTOR'S DECLARATION License Class [ Lic. # Z4 •�C>4f5 � l Contractor C4�ti(l0 "5 �rx ,-,� Date tp- I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions 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. 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date /0� % -1 OWNER- BUILDER DECLARATION I ..creby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 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 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. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's 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 forthwith comply with such provisions or this permit shall be deemed revoked. 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, cots, and expenses which may accrue against said City in consequence of the 'ng of this permit. Additionally, the applicant understands and will comply all non -point source regulations per the Cupertino Municipal Code, Section 9.18. SAN JOSE, CA 95122 PHONE NO: (408)251 -3565 BUILDING PERMIT INFO: BLDG J_ ELECT f— PLUMB I- MECH f— RESIDENTIAL COMMERCIAL JOB DESCRIPTION: RE -ROOF TEAR OFF WOOD SHAKE INSTALL NEW ASPHALT SHINGLES CLASS A 18SQ Sq. Ft Floor Area: I Valuation: $7741 APN Number: 36920036.00 I Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 1 AYS OF PERMIT ISSUANCE OR 180 DA OM LAST CALLED INSPECTION. Issued by: V r� // Date: RE- ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. I -- Signature of Applicant: �.� ( Date: /C)_ _ l/ ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE 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 compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or Guth ed a en g „r - Date:�� el CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Signature Date I Licensed Professiona 3 ITEMS OF 3 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36920036.00 DATE ISSUED.......: 10/06/2011 RECEIPT # ......... BS000014969 REFERENCE ID # ...: 11100041 SITE ADDRESS 10852 ALDERBROOK LN SUBDIVISION ...... CITY CUPERTINO IMPACT AREA ...... OPERATOR: patg COPY # : 1 OWNER PRAY- SILVER JANE TRUSTEE ADDRESS 10852 ALDERBROOK LN CITY /STATE /ZIP ...: CUPERTINO, CA 95014 RECEIVED FROM CONTRACTOR ... COMPANY ...... ADDRESS ...... CITY /STATE /ZIP TELEPHONE .... CASTILLO'S ROOFING JOSE CASTILLO LIC # 2585C CASTILLO'S ROOFING 1703 CATHAY DR SAN JOSE, CA 95122 (408)251 -3565 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC ---- - - - - -- NEW BAL ---- - - - - -- ---- - - - - -- ------- - - - - 1BCBSC VALUATION -- ---- - - - - -- 7,741.00 ---- - - - - -- 1.00 ---- - - - - -- 0.00 1.00 0.00 1BSEISMICR VALUATION 7,741.00 0.77 0.00 0.77 0.00 1REROOFRES SQ FEET 18.00 252.00 0.00 - - -- 252.00 ---- - - - - -- 0.00 ---- - - - - -- TOTAL PERMIT ---- - - - - -- 253.77 ---- - - 0.00 253.77 0.00 METHOD OF PAYMENT --------------- -- CHECK TOTAL RECEIPT AMOUNT --------------- 253.77 --------------- 253.77 VOICE ID DESCRIPTION -- - - - - -- ---------------------- - - - - -- 309 EXTERIOR LATH 601 ROOF TEAR OFF REFERENCE NUMBER --------------- - - - -- #17375 VOICE ID DESCRIPTION -- - - - - -- ---------------------- - - - - -- 311 SCRATCH COAT 602 ROOF PLYWOOD NAIL 604 ROOF IN- PROGRESS 605 FINAL REROOF CUPERTINO REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building a cupertino.org PROJECT ADDRESS ! S (� y \ _ V_ r \�, APN # OWNER NAME �' ` . i, PHO E -MAIL STREET ADDRESS O CITY, STATE, ZIP U +) iJ / t / V�'�7 (> 1 .. FAX �1 APPLICANT NAME o►S�,�i,Q PHONE �. G� c S I -��b5- E -MA L STREET ADDRESS � b.7 ! l j \ r �❑ CITY, STATE, ZIP _ G Q CA �S i FAX ❑ OWNER ❑ OWNER- 1331J/ILDER OWNER AGENT 1 CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER Z ^ Li ` k LICENSE TYPE BUS. LIC. # COMPANY NAME C7V( 1 fl ++j E-MAIL lL � '745 ( l) ' C'(�jyl FAX STREET ADDRESS —7 ``__ 17 CJ�j ol%k �r CITY, STATE, ZIP (� /� ��17 (i(Z l '� �j51ZZ PHONE _ I �O�- Z SI `� � b ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC. # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF or Duplex ❑ Multi- Family STRUCTURE: ❑ Commercial ROOF AREA: ' s VALUATION: EXISTING ROOF TYPE: ❑ BUILT -UP ROOF 90ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE /REPLACE 9YFS El No I IF NO, ^ # LAYERS: °'� PLYWOOD ❑ W. ❑ THICKNESS: El /8 PLY WD ❑�, /OSB TYPE: lu CDX PITCR. ' i Z ROOF CLASS: A PROPOSED ROOF TYPE: ❑ BUILT -UP ROOF WAS.-HALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT # i, DESCRIPTION OF WORK T r 12- d Q —T_ cJ 1 1 ",b 2t "o 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 ' �authorize.representatives of Cupertino tc enter the above - identified propert; For inspection purposes. Signature ofApplicant/Age Date: SUPPLEMENTAL INFORMATION REQUIRED _ If building is associated with a Home Owner's Association, provide letters of approval from HOA., Provide Plannin g approval to verify if there any restrictions. Provide copy of Manufacturer's Installation Specifications. Lzt-lovide signed copy of Cupertino's Tear -Off Policy. .- -^ ReroafApp_2011.doc revised 03102111 ��,�� CITY OF CUPERTINO I CI FF.F ESTIMATOR — BUILDING DIVISION imlADDRESS: 10852 alderbrook In. FEE DATE: 10106/2011 REVIEWED BY: bobs. APN: BP #: "VALUATION: 1$7,741 'PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY USE: SFD or Duplex PENTAMATION 1 SFDWLROOF PERMIT TYPE: A WORK tear off wood shake install new asphalt shingles SCOPE FEE ID ROOF AREA s.f. 1 REROOFFRES 1,800 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School I)ictrirt_ Pte L ThvcP fees are haced on the nrelindnary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution I1-053 I . 7,'U11) FEE QTY/FEE MISC ITEMS Permit Fee: $252.00 f 1 _T__Ti Work Without Permit? 0 Yes 0 No $0.00 i Strom Motion Fee: IBSEISMICR $0.77 Select an Administrative Item Blda Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: > $253.77 $0.00 TOTAL FEE: $253.77 Revised: 10/01/2011 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 f JOB ADDRESS: og � b f ocl� i, �a,, PERMIT V OWNER'S NAME: �� ►lve _ PHONE # 6 GENERAL CONTRACTOR: a BUSINESS LICENSE # ADDRESS: `R03 ' a �r CITY /ZIPCODE: ' �►-�� `' S12Z *Our municipal code requires all Businesses working in the city to have a City of Cupertino nusmess ncense. 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. I am not using any subcontractors: r4g�- - ell Signature Date Please check applicable subcontractors and complete the following information: � 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 lumbing ' Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature /C) -(e---) - (( Date