13030108 (2) CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11703 SEVEN SPRINGS DR CONTRACTOR:CASTILLO'S ROOFING PERMIT NO:13030108
OWNER'S NAME: SHANGKUAN JOE AND JESSIE 1703 CATHAY DR DATE ISSUED:03/20/2013
OWNER'S PHONE: 4085066056 SAN JOSE,CA 95122 PHONE NO:(408)251-3565
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL
License Class '`j Lic. TEAR OFF(E)WOOD SHAKE,INSTALL 00LBS FELT,GAF
a l GRAND CANYON COMP(CLASS A)"EXISTING SOLID
Contract Date U SHEETING TO REMAIN" (r7 5V4
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. Sq.Ft Floor Area: Valuation:$8900
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 APN Number:36651064.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for.inspection purposes. (We)agree to save 180 DAY TION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Z�
granting of this permit. Additionally,the applicant understands and will comply Issue by: Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
n� RE-ROOFS:
Signa L Date 3 4� 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.
❑ OWNER-BUILDER DECLARATION /
Signature of Applic c `t Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I,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)
I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this,permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25 05,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authorized agent�'� Date 4l3
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 CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
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 I
ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
i
ELIR'EROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O
10300.TORRE AVENUE•CUPERTINO, CA 95014-3255 0�
CUPERTI'NO (408)777-3228•FAX(408)777-3333•building(cDoupertino.orp 1
PROJECT ADDRESS APN# 3 / / _ 5 06
/ L/
.OWNERNAME PHONE 7 E-MAIL
STREET ADDRESS O CITY,ST E,ZIP ' �j,�jR FAX
CONTACT NAME PHONE
s 8
STREET ADDRESS CITY,00
FAX
rCOM:PA ER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER TENANT
ACTOR NAME LICENSE NUMBER s�/n LICENSETYPE�J BUS:LIC.#NY NAME E-MAIL VK/ ` FAX
STREET ADDRESS CITY,STATE, IP
ARCHTTECT/ENGINEERNAME LICENSE NUMBER BUS.LIC.# (�
COMPANY NAME EMAIL FAX
STREET.ADDRESS CITY,STATE,ZIP PHONE
USE OF SFD or Duplex' El-Multi-Family ROOF AREA: ,/. VALUATION:
STRUCTURE: E] Commercial /
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE YES IF NO, (/y�`J PLYWOOD ❑ %:" ❑ PLYWD ❑ OSB PITCH: .12 ROOF A
❑NO #LAYERS v THICKNESS; ❑ 5/8" TYPE: ❑CDX CLASS:
ICC-ES REPORT#.,
PROPOSED ROOF TYPE:' ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER
n
DESCRIPTION OF WORK: /� /,u f �C� MA)
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 haveprovidSo 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 uilWcon ction. I authorize representatives of Cupertino to enter the above-i tife4 pro rty for inspection purposes.
Signature of licant/A Date: 4//i
SUPPLEMENTAL ORMATION REQUIRED
If building is associated with a Home Owner's Association,provide letter
of approval from HOA.
Provide Planning approval to verify if there any restrictions.
Provide copy of Manufacturer's Installation Specifications.:
Provide signed copy of.Cupertino's Tear-Off Policy..
ReroofApp_201 1.doc revised 03116111
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
*` ADDRESS: 11703 SEVEN SPRINGS DR DATE: 03/20/20137 REVIEWED BY: MELISSA
APN: 366 51 064 BP#: I *VALUATION: 1$8,900
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Repair
PRIMARY PENTAMATION
USE: SFD or Duplex PERMIT TYPE: 1SFDWLR00 i
WORK TEAR OFF E WOOD SHAKE INSTALL#30LBS FELT GAF GRAND CANYON COMP CLASS A
SCOPE **EXISTING SOLID SHEETING TO REMAIN**
w
kfech.Plan Check Plumb Plan Cheek Elec.Plan(..heck
:tech.
Permit Fee: Plumb.Permit Fee: Elec.Permit Fee:
rlf,,'h.
ilgech.Insp. Lather Plumb Insp. Other Elec.Insp. Lj Insp.Fee: Plumb, Insp.Fee: Elec.Inst.Fee:
NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc). Theseees are based on the relimina information available and are onlyan estimate Contact the Det or addn7 info.
FEE ITEMS(Fee Resolution 11-053 E . 7/1/12) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 = s.f, Re-roof
Suppl.PC Fee: Reg. ® OTT 0,0 hrs $0.00 $255.00 IRERooFRES
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl.Insp.Fe.019 Reg. 0 OT F0701hrs $0.00
PME Unit Feer $0.00
PME Permit Fee: T77 $0.00
Conswuction:Tax:
Administrative Fee:
Work Without Permit? ® Yes (E) No $0.00 E)
Advanced Planning Fee: $0.00 Select a Non-Residential
Travel Documentation ntutiort FeeyS: Building or Structure'
i
Strong Motion.Fee: IBSEISMICR $0.89 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
$1.89 $255.00 $256.89
Revised: 01/01/2013
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL
10300 TORREAVENUE•CUPERTINO, CA 95014-3255
CUPERTINO
.(408)777-3228•FAX(408)777-3333•buildingacupertino.org
PROJECT ADDRESS APN#
OWNER NAME • PHONE E-MAIL
STREET ADDRESS STATE,Z
CONTRACTOR NAME c ee CENSE NUMBER LICENSE TYPF BUS.tic.#
J
COMPANY NAME U E-MAIL FAX
STREET ADDRESSCITY, ,ZIP —[ap PHONE ����C'/ � ✓
- A" ), - I - 0
I UN11ERSTAND AND AGRE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable provisions of the 2010 California Codes.
2. An inspection request canbe scheduled up to one business day before the requested inspection date.
Please call(408) 777-3228 from 7:30-3:30pm(Mon-Thurs)or 7:30-2:30pm(Friday)to schedule
inspection: For Tear-Off and Nailing Inspections,you must also call on the day of the inspection only
after that phase.of the work is completed. The building inspector will be available within one hour.
Final Inspections will be given a two hour window.
3. 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.
4. If plywood is installed, a plywood Nailing Inspection is required.
5. Roofing shall not be applied without first obtaining all prior 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.
6. 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 1/4"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,vents painted, gutter/downspouts installed, debris removed.
7. 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. The re-inspection fee shall be paid before another inspection can be
scheduled.
By my sign" ow,I certify each of the following is true: I am the property owner or authorized agent to act on the .
property o er's be . I understand and agree to comply with the re-roof policy stated above. I also understand that
smoke detect d car b mo oxide de tors are required to be installed in accordance with Sections 14 and R315 of
the 2010 California en' Code ��► ��
Signature of Applicant/Age Date:
ReroofPolicy_2012.doc revised 10/7/12