10100056 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11593 FOREST SPRING CT CONTRACTOR:CASTILLO'S ROOFING PERMIT NO: 10100056
OWNER'S NAME: ALBERT HO 1703 CATHAY DR DATE ISSUED: 10/06/2010
YER'S PHONE: 4082573888 SAN JOSE,CA 95122 PHONE NO:(408)251-3565
❑ LICENSED CONTRACTOR'S DECLARATION (i
L� BUI LDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.#
9 / ` MECH F RESIDENTIAL F COMMERCIAL r
Contrac r Date `0 l0 0
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OFF EXISTING ROOF SHAKES INSTALL
(commencing with Section 7000)of Division 3 of the Business&Professions 16S#30 3 FELT,INSTALL GAF GRAND CANYON COMP CLASS A
Code and that my license is in full force and effect. 16SQ
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 Sq.F t Floor Area: Valuation:$8900
permit is issued.
APPLICANT CERTIFICATION APN Number:36651053.00 Occupancy Type:
I certify that I have read this application and state that the above information is
correct.I agree to comply with all city and county ordinances and state laws relating
to building constriction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expen$es which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. ---�
Issued by.� Date: ' �`U
Signature Date
OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All n ofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: instal led without first obtaining an inspection,I agree to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspe;tion.
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signs tyre of pli ar>r� , Date:
1,as owner of the property,am exclusively contracting with licensed contractors to _Z yU L'
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
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. Calif)rnia Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by com f liance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material.
Addi:ionally,should I use equipment or devices which emit hazardous air
permit is issued. conte minants as defined by the Bay Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Heah h&Safety Code,Sections 25505,25533,and 25534.
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 mus � o rized a er A
forthwith comply with suchprovisions or this permit shall be deemed revoked. Date: d
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is I here by affirm that there is a construction lending agency for the performance of work's
correct.I agree to comply with all city and county ordinances and state laws relating for w rich this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
-mnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
,and expenses which may accrue against said City in consequence of the
b.auting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. I and-rstand my plans shall be used as public records.
Signature Date Licer sed Professional
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTME�T•BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE•CUPERTINO, CA f 5014-3255
CUPERTINO
(408)777-3228-FAX(408)777-3333-buildirg(a�cupertino.org
PROJECT ADDRESS (� L APN#
r
OWNER NAME PH E� j�- E-MAIL
STREET ADDRESS CITY, TE,ZII r_ //�y v/J� 7 FAX
CONTRACTOR NAME ��C CENSE U B LICE P BUS.LIC.#
COMPANY NAME E_MAIL FAX
STREET ADDRESS ` ^ CITY,STATE,ZIP PHONE
_ ZSI 3S(�
I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable p•ovisions 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)777-3:?28 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 — 10:3 Oam and 1:00—3:30pm (Mon—Thurs);
7:30 — 10:3Oam and 1:00—2:30pm (Friday).
4. If plywood is installed, a plywood nailing inspection is required.
5. In-ProEress 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 )btaining 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 tie 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 per foot o 7 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. I i rsta and agree to comply with the re-roof policy stated ab ye. `
Signature of Applicant/Agent: Date:
ReroofPolicy_2010.doc revised 05/17/10
CITY OF CUPERTINO
3 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Iot:
APN . . . . . . . . : 36651( 53 .00
DATE ISSUED. . . . . . . : 10/06/ 2010
RECEIPT #. . . . . . . . . : BS000( 11667
REFERENCE ID # . . . : 10100( 56
SITE ADDRESS . . . . . : 11593 FOREST SPRING CT
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . . CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . . ALBERT HO
ADDRESS . . . . . . . . . . : 11593 FOREST SPRING CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : CASTILLO'S ROOFING
CONTRACTOR . . . . . . . : JOSE C:ASTILLO LIC # 25850
COMPANY . . . . . . . . . . : CASTILLO'S ROOFING
ADDRESS : 1703 C:ATHAY DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95122
TELEPHONE . . . . . . . . : (408) ,51-3565
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ----- ----- ---------- ---------- ----------
1BCBSC VALUATION 8, 900. 00 1 . 00 0 . 00 1 . 00 0 . 00
1BSEISMICR VALUATION 8, 900. 00 0 . 90 0 . 00 0. 90 0 . 00
1REROOFRES SQ FEET 16 . 00 ' 08 . 00 0 . 00 208 . 00 0 . 00
----- ----- ---------- ---------- ----------
TOTAL PERMIT ''09. 90 0 . 00 209. 90 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: DATE: REVIEWED BY:
APN: BP#: *VALUATION: 1$8,900
;�PERIMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY � 1� PENTAMATION 1SFDWLR00F
USE: SFD or Duplex �. ,� :,� =ref PERMIT TYPE:
WORK
SCOPE
FEE ID ROOF AREA
s.L
1 REROOFFRES 1,600
L!CC"r Pi, Lice_ Chc(k
FD
NOTE: Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn7 info.
FEE ITEMS(Fee Resolution 09-051 E.f. 7/1/10) FEE QTY/FEE MISC ITEMS
1/Oil C'hc�4 1'_C(1
SaP1 ti. PC.'Fcc
t'1=rrrzh. 11c, h. L'1c( I'lz tt 011 n
Permit Fee: $208.00
Pllwzlx IIc /7. Elc,. t'r=rt 1 cC.
Pcrmi! FCC'
Con�ijwfion 7_0A
JCMIWI'011' fl"vic�l Fc'
Work Without Permit? 0 Yes 0 No $0.00
P1L7i"tllttt�r 1'E'E',S:
11-�wcl 0oclunctitration Fu(%S:
I
Strong Motion Fee: IBSEISAECR $0.89 ' Select an Administrative Item
B1dpStds Commission Fee: 1BCBSC $1.00
SUBTOTALS: $209.89 $0.00 TOTAL FEE: 1 $209.89
Revised: 9/29/2010
INPUT ResDurres Energy ADIHealfh
M.Indoor Air Quality and Finishes
1.Use Low/No-VOC Paint 1 IAC,]Hsalth pts y=yes 0
2.Use Low VOID,Water-Based Wood Finishes 2 IAC(Health pts y=yes 0
3.Use Low/No VOC Adhesives 3 IAC,]Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Ra;ource pts y--yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AC,]Health pts y=yes 0
0
6.Use Exterior Grade Plywood for Interior Uses 1 IAC,]Health pts y=yes
7.Seal all dosed Particleboard or MDF 4 IAC(Health pts y=yes 0
8.Use FSC Certified Materials for Interior Finish 4 Fla;ource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Re,;ource pts y=yes 0
10.Install Whole House Vacuum System 3 IAO /Health pts y--yes 0
1 1 1
N.Flooring Mr
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 Mim"6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes
Total Points Available: i401 1301 57
Total Points Project Received: 01 01 0
<Mdatgs/greenbuildin 19uidelines/remodelers/greenpointsfinal2.12.D4protected.xls
Building Department
City Of Cupertino
LM 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
JOB ADDRESS: rj ED G' PERMIT# /490
OWNER'S NAME: eyt lin PHONE# 25 ' 5'&t
GENERAL CONTRACTOR: Clost ,s gwi,4q BUSINESS LICENSE#i SO I 5C
ADDRESS: CITY/ZIPCODE: S c)e P
*Our municipal code requi $ s all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INS'ECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE. e- C, �10I&I/Q
I am not using any subcontracto
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
a
Owner/Contractor Signature Date
CITY OF
CITY OF CUPERTINO
[M REROOF
C U P E RT I N O PERMIT APP=LICATION
APN # ( Date: Apho
Building Address: SD *
Owner's Name: � Phone #:
/ -�_ 3� �
HOA: Yes ❑ No Ej-__-If yes, provide letter f rom HOA
Contractor: Phone #: 140 2,51 5&5-
0
0 V� /�� S L� Fax #: S C>)-�
7
Cupertino Business License #: Contractor License License #:
t 56,V5-&
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Puilt-Up roof
❑ ,Asphalt Shingles V Asphalt Shingles
V Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other(Specify)
NNber of existing coverings ❑ Provide I.C.C.E.S. Report#
a� To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: T-e-a rc-f f oxi-y b" PW-
os
JJ J
ISQ
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 Cur ertino's Tear-Off Policy:
r
Signature
Revised 02/05/09