11010118 CITU OF•CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11591 LAKE SPRING CT CONTRACTOR:CASTILLO'S ROOFING PERMIT NO: 11010118
OWNER'S NAME: TIEN TA K ET AL 1703 CATHAY DR DATE ISSUED:01/21/2011
"IWNER'S PHONE: 4084464079 SAN JOSE,CA 95122 PHONE NO:(408)251-3565
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
License Class L"n3 7 Lic.# .50
:Z Sl/o RE-ROOF 19 SQ TEAR OFF SHAKES,INSTALL#30 LB
Contrac Date
� hy
FELT INSTALL GAF GRAND CANYON CLASS A
I hereby affirl 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:$9000
1 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:36654026.00 Occupancy Type:
permit is issued. ;PecAPPLICANT 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 D ERMIT 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 DAYS FR ST ALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the c 1
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signatur Date / All roofs shall be inspected prior to any roofing materia 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 Appl � 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. I 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 25505 5533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
.Owner or authorized ager Date:
permit is issued. it
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 ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
is.and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
_ling 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
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333•buildinpna.cupertino.org
PROJECT ADDRESS APN# / _ n CV`06
OWNER NAME I-raTi Q PHONE4t4 (0 E-MAIL
=me
STREET ADDRESS SaVA6 �i CITY, STATE,ZIP FAX
CONTRACTOR NAME �S {� LICENSE NUMBER, 'y LICENSE TYKE BUS.LIC.#
COMPANY NAME I G- I E-MAIL V'f�Y�f�\ FAX
STREET ADDRESS ` CITY,STAT ZIP PHQNF- I��
I UNDERSTAND AND AGREE T THE FOLLOWING: fid
1. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code.
2. You must schedule all needed inspections a minimum of one day before the requested inspection date.
Please schedule inspections online or call (408)777-3228 between 7:30-3:30 (Mon-Fri).
3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof is torn off and all
the nails/fasteners have been removed. Any and all dry-rotted wood shall be replaced prior to this
inspection. A building inspector will be available within one hour.
There are special hours for this service: 7:30 — 10:30am and 1:00—3:30pm (Mon—Thurs);
7:30 — 10:30am and 1:00—2:30pm (Friday).
4. If plywood is installed, a plywood nailing inspection is required.
5. In-Progress roof inspection is required. Call for an in-progress roof inspection to verify building is
weather tight after installation of approximately 25% of the roofing material.
6. New roof coverings shall not be applied without first obtaining all inspections 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.
7. A final inspection and approval shall be obtained from the building inspector when the re-roofing is
complete. To receive a final sign-off, the following items will be verified:
a. Flat roofs shall have a minimum of'/4"per foot of slope and must 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.
8. 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. Iders and agree to co ply with the re-roof policy stated abov .
Signature of Apa _ Date: l �l
ReroofPolicy_2010.doc revised 05/17/10
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
ELI] Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: C5CI L, `f--S . PERMIT# t�[
OWNER'S NAME: '—�—� ir,--tJ PHONE# S-
GENERAL CONTRACTOR: CAS+j BUSINESS LICENSE#
ADDRESS: CITY/ZIPCODE:
*Our municipal code requires all business s working in the city to have a City of Cupertino sines�s license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY F CUPERTINO
BUSINESS LICENSE. � t r� / / I
I am not using any subcont pC
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
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36654026 . 00
DATE ISSUED. . . . . . . : 01/21/2011
RECEIPT #. . . . . . . . . BS000012541
REFERENCE ID # . . . : 11010118
SITE ADDRESS . . . . . : 11591 LAKE SPRING CT
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER TIEN TA K ET AL
ADDRESS 11591 LAKE SPRING CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5120
RECEIVED FROM . . . . : CASTILLO 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, 000. 00 1. 00 0 .00 1.00 0. 00
1BSEISMICR VALUATION 9, 000 .00 0. 90 0 . 00 0 . 90 0. 00
1REROOFRES SQ FEET 19. 00 247 . 00 0 . 00 247 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 248 . 90 0 . 00 248 . 90 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 248 . 90 16863
---------------
TOTAL RECEIPT 248 . 90
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
CITY OF CUPERTINO
FEE ESTIMATOR— BUILDING DIVISION
ADDRESS: 11591 lake spring ct. DATE: 01/21/2011 REVIEWED BY: bobs.
APN: BP#: "VALUATION: 1$9,000
;PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1SFDWLR00F
USE: PERMIT TYPE:
WORK tear off, install comp shingles.
SCOPE
FEE ID ROOF AREA
s.f.
1 REROOFFRES 1,900
a 1coli. Nun f 6c(k F f ,.;h, Alm)
;Lh>at. f't>�tttl P(>E: r t'r;rrzh. F7tt'ntit t�e: I:,•`�c }'crrni7 f�t-e
Ljt�tlrer ,lfercFi. Trst>. CJtitt�r t'r'unzb Irt=7. Utlt rI�f<�r.C�tsJ.
1h°ch. ltzs�. {�ee: t'hmih. hop, Insp. I'c'e:
NOTE: Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'l info,
FEE ITEMS (Fee Resolution 09-05I Elf. 7..%1%10) FEE QTY/FEE MISC ITEMS
Plan ("heck F(!c,:
slippl. P('Fee
Plztzrz/z.i.11cclz.;
CITY OF
CITY OF CUPERTINO
REROOF
CUPERTINO PERMIT APPLICATION
APN#� � Sq o�Lv` W Date: , r
If residential, is house an Eichler? Yes No If yes, needs planding approval.
Building Address:
Owner's Name: � � I eYl Phone #: 4f 1 . J u-7 9
HOA: Yes ❑ No 2r If yes, provide letter from HOA
Contractor: Phone #:
�l Fax#:
Cupertino Business License #: Contractor License #:
� S�O
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
VWood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
N�ber of existing coverings ❑ Provide I.C.C.E.S. Report #
e' To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: TSA SA 9-DPF— S iA- `V-3d lb Aq 0- 3�25,k7
614P �>�►� LAG,n Y� � � c< �r�-
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 index.
Valuation:
9. 6M. C�
Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: