10110014 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11752 TRINITY SPRING CT CONTRACTOR:CASTILLO'S ROOFING PERMIT NO: 10110014
OWNER'S NAME: ELAINE CHAN 1703 CATHAY DR DATE ISSUED: 11/02/2010
1ER'S PHONE: 4088610569 SAN JOSE,CA 95122 PHONE NO:(408)251-3565
LICENSED CONTRACTOR'S DECLARATIONr
[.�5../ BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.# 30 / V
F F r
can MECH RESIDENTIAL COMMERCIAL
I or Date / /
I hereby affrrr hat I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OFF SHAKES,INSTALL#30 FELT.INSTALL
(commencing with Section 7000)of Division 3 of the Business&Professions GAF GRAND CANYON CLASS A 17SQ
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 Sq.Ft Floor Area: Valuation:$8000
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued.
APN Number:36653039.00 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 PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION.
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. Issued Date: / C
Srgna re Date
V OWNER-BUILDER DECLARATION RE-ROOFS:
All roofs shall be inspected prior to any roofing material being installed.If a roof is
I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for
the following two reasons: inspection.
1,as owner of the property,or my employees with wages as their sole compensation,
c
will do the work,and the structure is not intended or offered for sale(Sec.7044, Signature of pli ant: Date:
Business&Professions Code)
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
HAZARDOUS MATERIALS DISCLOSURE
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534.
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 Owner or aut ed
become subject to the Worker's Compensation provisions of the Labor Code must Date:
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's
I certify that i have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.)
correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address
nnify and keep harmless the City of Cupertino against liabilities,judgments,
and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.18.
Licensed Professional
Signature Date
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: DATE: REVIEWED BY:
APN: BP#: *VALUATION: 1$8,000—�
PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARYSFD or Du lex ' ;I. PENTAMATION 1SFDWLR00F
USE: P ��- -t�1 �'�_:�- PERMIT TYPE:
WORK
SCOPE
FEE ID ROOF AREA
s.f.
1 REROOFFRES 1,700
FT
P' ff7 r F" '
(4hcrAt""'I, Inv, Li b'%P Lj I
NOTE: Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'1 info.
FEE ITEMS (Fee Resohition 09-051 Ej'. 7/1;'10) FEE QTY/FEE MISC ITEMS
PIcor C hcc:k
Si plyl. PC f,'Ce
f'lilrrih.;'11�c11.:�1;Ic�c:I'luri C lre"c:-
Permit Fee: $221.00
P11111117 "Illec11.""Ei (" I"nil
IIII rrirh./11cic h—',Elcc° P,,I w?it 1='('c'
C on";11.11ction To:\
,1C0ieS1it:cl1 Rc vice v Vcc
Work Without Permit? 0 Yes No $0.00
li�cn c=I I)cx�trltrcirittrtir�rt f%c'c',4:
Strom;Motion Fee: IBSEISMICR $0.80 Select an Administrative Item
Bldg Stcis Commission Fee: 1BCBSC $1.00
SUBTOTALS: $222.80 $0.00 TOTAL FEE: $222.80
Revised: 10/17/2010
M. n oor it ua iiy an Ferns es
1.Use LowMo-VOC Paint 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y--yes 0
3.Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y--yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQ/Health pts y=yes p
0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes
7.Seal all dosed Particleboard or MDF 4 IAQ/Health. pts y=yes 0
B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0
1 1 1
N.Flooring Li
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0
2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
1 1 1
Total Points Available: 1401 1301 57
Total Points Project Received: 01 01 0
Matalprogs/gre ildingguidelineshemodelerslgreenpointsfina1212.D4protected.xls
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•building(d_)cupertino.org
PROJECT ADDRESS ' C�2 JaN
/
OWNER NAME PHO E-MAIL
G I
STREET ADDRESS CITY, STATE,ZIP FAX
CONTRACTOR NAME ` LICENSE NU R LICENSE TYPE BUS.LIC.4
COMPANY NAME �' E-MAIL FAX
STREET ADDRESS CITY,STATE, y PH014^6,2t
lJ1VI
1 -UNDERSTAND AND AGR E 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.
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 �g �
' I and tand and agr comply with the re-roof policy stated ab ve.
l Signature of!A!�ppicawn Date: �—
ReroofPolicy_2010.doc revised 05/17/10
CITY OF .
CITY OF CUPERTINO v Lf-
III
REROOF
CUPERTIN0 PERMIT APPLICATION
APN# 2 Date: /4 /lo
Building Address: >
Owner's Name: 1 a t none #: _ a S 1417
HOA: Yes ❑ No E�If Yes, provide letter from HOA
Contractor: Phone #:
Fax#:
Cupertino Business License #: Contractor License #`�
Type of Roof Covering: 7�
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
o/Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
N mber of existing coverings ❑ Provide I.C.C.E.S. Report #
el To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: 7�_�Pw_ v S yak�S� -ff� �� .3�. TP T, T- P
Gilr -
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:
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
i
Signature
Revised 02/05/09