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10120019I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 11572 SEVEN SPRINGS DR CONTRACTOR: CASTILLO'S ROOFING PERMIT NO: 10120019 OWNER'S NAME: SUTARDJA SEHAT AND DAI WEILI ( 1703 CATHAY DR I DATE ISSUED: 12/03/2010 1 OWNER'S PHONE: 4082034140 L. LICENSED CONTRACTOR'S DECLARATION 6/ < License Class Lic. # �y / ✓ (� Contnu Date I hereby a urm hat 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. Sig Date 1— OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the stricture 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 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, costs, and expenses which may accrue against said City in consequence of the �g of this permit. Additionally, the applicant understands and will comply v, .11 non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date SAN JOSE, CA 95122 PHONE NO: (408)251-3565 BUILDING PERMIT INFO: BLDG ELECT r PLUMB r MECH F RESIDENTIAL F COMMERCIAL r— JOB DESCRIPTION: RE -ROOF TEAR OFF SHAKES, INSTALL #30LB FELT, INSTALL GAF GRAND CANYON COMP CLASS A 19SQ Sq. Ft Floor Area: I Valuation: $9000 APN Number: 36654019.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by �<--.__� 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. Signature of App icant �„�� Date: 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 authorized agent: �'—'"�'�. Date•_,/D 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 Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36654019.00 DATE ISSUED.......: 12/03/2010 RECEIPT #.........: BS000012140 REFERENCE ID # ...: 10120019 SITE ADDRESS .....: 11572 SEVEN SPRINGS DR SUBDIVISION ...... CITY .............. CUPERTINO IMPACT AREA ...... OPERATOR: patg COPY # : 1 OWNER ............: SUTARDJA SEHAT AND DAI WEILI ADDRESS ..........: 11572 SEVEN SPRINGS DR CITY/STATE/ZIP ...: CUPERTINO, CA 95014-5125 RECEIVED FROM ....: CASTILLO'S 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 ----------------- CHECK TOTAL RECEIPT : AMOUNT --------------- 248.90 --------------- 248.90 VOICE ID DESCRIPTION -------- ---------------------------- 309 EXTERIOR LATH 601 ROOF TEAR OFF REFERENCE NUMBER -------------------- #16789 VOICE ID DESCRIPTION -------- ---------------------------- 311 SCRATCH COAT 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF 1. Use LowMo-VOC Paint 1 IAQ/Health pts 2. Use Low VOC, Water -Based Wood Finishes 2 IAQ/Health pts 3. Use Low/No VOC Adhesives 3 IAQ/Health pts 4. Use Salvaged Materials for Interior Finishes 3 Resource pts 5. Use Engineered Sheet Goods with no added Urea 4. Install Natural Linoleum in Place of Vinyl Formaldehyde 61AQ/Health pts 6. Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts 7. Seal all Exposed Particleboard or MDF 4 IAQ/Health. pts e. Use FSC Certified Materials for Interior Finish 4 Resource pts 9. Use Finger -Jointed or Recycled -Content Trim 1 Resource pts 1 D. Install Whole House Vacuum System 3 IAQ/Health pts N. Flooring 1. Select FSC Certified Wood Flooring B Resource pts y=yes 2. Use Rapidly Renewable Flooring Materials 4 Resource pts y—yes 3. Use Recycled Content Ceramic Tiles 4 Resource pts y --yes 4. Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 5. Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 6. Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes Total Points Available: Total Points Project Received: 1401 1301 57 01 01 0 G:data/progs/greenbuiidngguidelines/remodelerstgreenpointsfinal2.12.D4proteeted.xls REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 •FAX (408) 777-3333 •building a(�.cupertino.orq PROJECT ADDRESS ren APN # OWNERNAME e' a ,• �� PHONE 0;5 O E-MAIL STREET ADDRESS \ \ n n rt� CITY, STATE, ZIP , FAX CONTRACTOR NAME , ] 6 ENSE NU R O LICENSE TY E� BUS. LIC. # COMPANY NAME n E-MAIL FAX STREET ADDRESS I 7 0 3 �' J}_ / , CITY, SJ?.TE, ZIP PHONE I UNDERSTAND AND AGREE TO THE FOLLOWING: 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. 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., I und5rst3pA and agree to comply with the re -roof policy stated aove. Signature of App Date ReroofPo1icy_2010.doc revised 05/17/10 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST^ n JOB ADDRESS: . / -72- 4ff N S ,'nl /AELRM IT # OWNER'S NAME: S'= S�N PHONE # �fC�'• ,?C)3- GENERAL CONTRACTOR: r BUSINESS LICENSE # ADDRESS: -263 0 `71 CITY/ZIPCODE: e� 1Q. �•5f� *Our municipal code requires all businesses working in the city to have a City of Uupertmo business license. 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: Signature Date Please check applicable subcontractors and complete the following information: 6-5— r ner / Contractor Signature /r Date 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 r ner / Contractor Signature /r Date CITY OF CITY OF CUPERTINO REROOF CUPERTINO PERMIT APPLICATION APN # �� / f �, Date: c) Building Address: Owner's Name: Seha� 5 �.� Ph ne . 2(�3_ � ►.�(� HOA: Yes ❑ No E� If yes, provide letter from HOA Contractor: Plyone# OA11D'q VDp- Fax #: Cupertino Business License #: Contracto License #: WSJ Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles 2-`Xsphalt Shingles r�Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report # a� To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: .e ,QP_ 0 5 h -,=,)j' e_5 � .T Y15+A I 3O Ib To's M I 1 C-7 A i= 6� rck K CA (Oct -n q 0 -yl CCTY� . Residential - Commercial ❑ Green Building: Please complete relevant portion of the Confirmed -ith 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: q . 6co, 0o I Have Read, Understand and Will Comply with Cupertino's Tear -Off Policy: Revised 02/05/09