10080063 CITY OF CUPERTINO BUILDING PERMIT
CONTR4CTOR:CASTILLO'S ROOFING
PERMIT NO: 10080063
BUILDING ADDRESS: 11610 ORCHARD SPRING CT DATE ISSUED:08/09/2010
EEJ1703 CATHAY DR
OWNER`S NAME: NARENDRA PATIL PHONE NO:(408)251-3565
SAN JOSE,CA 95122
NER'S PHONE: 4083900172
SED CONTRACT R'S DECLARATION BUILT,ING PERMIT INFO: BLDG r ELECT PLUMB r
� LICEN ?�
/ Lic.# ✓� MECH r RESIDENTIAL r COMMERCIAL
License Class g q to
Contrac .C Date
JOB D ESCRIPTION:RE-ROOF TEAR OFF SHAKE,INSTALL#30LB FELT,
I hereby affirm t t I am licensed under the provisions of Chapter 9 INSTALL GAF COMP CLASS A 18SQ
(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. Valuation:$9000
1 have and will maintain Worker's Compensation Insurance,as provided for by FAPN
Floor Area:
Section 3700 of the Labor Code,for the performance of the work for which this Occupancy Type:
permit is issued. dumber:36654031.00APPLICANT CERTIFICATIONI certify that I have read this application and state that the above informaton is
correct.I agree to comply with all city and county ordinances and state laws relatingERMIT EXPIRES IF WORK IS NOT STARTED
to building constriction,and hereby authorize representatives of this city to enterWITHIN 180 DAYS OF PERMIT ISSUANCE OR
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 180 DAYS FROM LAST CALLED INSPECTION.
granting of this permit. Additionally,the applicant understands and will comply i" `,'
1 ,�: y ,.._- Date:
with all non-point sou a regulations per the Cupertino Municipal Code,Section Issued by:
��' '
9.18.
Date -
Signature
RE-ROOFS:
OWNER-BUILDER DECLARATION
_ All r mofs 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 insta lied without first obtaining an inspection,I agree to remove all new materials for
the following two reasons:
insp�xtion.
I,as owner of the property,or my employees with wages as their sole compensation, r of ��.�"-- Date:
will do the work,and the stricture is not intended or offered for sale(Sec.7044, Sigr ature Applicant
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three
HAZARDOUS MATERIALS DISCLOSURE
declarations: I have read the hazardous
1 have and will maintain a Certificate of Consent to helLabo re for Worker's Ca'forn a Health&Safety Code,Sect ons 25505,requirements25 25533,and andapter 25534.95 of the
I will maintain
Compensation,as provided for by Section 3700 of the Labor Code,for the col ipliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
performance of the work for which this permit is issued. Sal ety Code,Section 25532(a)should I store or handle hazardous material.
I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air
Section 3700 of the Labor Code,for the performance of the work for which this co►itaminants as defined by the Bay Area Air Quality Management District I will
permit is issued. me intain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
r which this permit is issued,I shall
He alth&Safety Code,Sections 25505,25533,and 25534.
1 certify that in the performance of the work to
the Worker'
not employ any person in any manner so as to become subject to s
Compensation laws of California. If,after making this certificate of exemption,Itl
vn or thorized agent: Date:
become subject to the Worker's Compensation provisions of the Labor Code,I mustforthwith comply with such provisions or this permit shall be deemed revoked.APPLICANT CERTIFICATION tereby 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 L-nder's Name
to building construction,and hereby authorize
rep senoseses of t isty to to enterave Lender's Address
upon the above mentioned property P PrP (We)agree
',xmnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION
and expenses which may accrue against said City in consequence of the
g canting of this ermit.Additionally,the applicant understands and will comply
psource regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
with all non-poi
9.18. —• Licensed Professional
Date
Signature
CITY OF CUPERTINO
OPERATOR: patg
3 ITEMS OF 4
PERMIT REC:sIPT COPY # � 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 36654031 .00
DATE ISSUED. . . . . . . : 08000010131
10
RECEIPT #• • " " . 100800E3
REFERENCE ID #
SITE ADDRESS . . . . . : 11610 ()RCHARD SPRING CT
SUBDIVISION • • • . . . : CUPERTINO
CITY . . . . . . . . . . . .
IMPACT AREA . . . . . . .
OWNER NARENDRA PATIL
ADDRESS 11610 ORCHARD SPRING CT
CITY/STATE/ZIP CUPERTINO, CA 95014-5122
RECEIVED FROM . . . . : CASTILLO' S ROOFING
CONTRACTOR JOSE CASTILLO LIC # 25850
COMPANY CASTIILO' S ROOFING
ADDRESS 1703 C'.ATHAY DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95122
TELEPHONE (408) ::51-3565
UNIT QUANTITY AMOUNT PD-TO-DT -THIS-REC- --NEW-BAL-
--FEE ID -----"----
0 .00
----------
----- ----------- ---------- 1 .00 0 .00 1.00
VALUATION 9, 000 . 00 0 .00 0 .90 0 .00
1BCBSC
9, 000 . 00 0 .90 234 .00 0 .00
1BSEISMICR VALUATION 18 . 00 234 .00 0 .00
-------
1REROOFRES SQ FEET -----3-
---
-"-----"--235 .90 0 .00 235.90 0 .00
TOTAL PERMIT :
-- VOICE ID DESCRIPTION
DESCRIPTION ----"---""
VOICE ID -- --"---"""---""---"
___ ----------
-- ------""-- 602 ROOF PLYWOOD NAI
601 ROOF TEAR OFF
605 FINAL REROOF
604 ROOF IN-PROGRESS
CITY OF
CITY OF CUPERTINO
Is
REROOF
CUPERTINO PERMIT APPLICATION
Date:
Building Address: (0(c)
r r
C Phone #C1403)
zr� M Q �Owner's Name: �Ctre oLN �,,, r3q
HOA: Yes ❑ No � If es, provide letter from HOA
Phone#: 2 5
Contractor:
Fax#: Vv
✓"`'v Contractor License #:
Cupertino Business License #: q S
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ sphalt Shingles o/Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Nu amber of existing coverings ❑ Provide I.C.C.E.S. Report#
a/To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: " . F 5�c-�f.� s J3 0 Jo.
Residential - Commercial
Green Building: Please complete relevant portion of the
Confirmed Yzith Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions:
a licable include in plan set & the sheet index.
Valuation: 11�
I Have ead, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signatur
Revised 02/05/09
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
Is ALBERT SALVADOR,P.E.,C.B.O., BUILDING CFFICIAL
10300 TORRE AVENUE•CUPERTINO, CA 950 4-3255
CUPERTINO (408)777-3228,FAX(408)777-3333•buildin cicupertino.orcl
�l aPN
PROJECT ADDRESS 1 ' �
E-MAIL
X /
OWNER NAME HOT�p\�\J► �
FAX
CITY. STATE,ZIP
STREET ADDRESS
LICENSE TYPE^ BUS.LIC.ri
t LICENSE NUM (-
CONTRACTOR NAME a
FAX
� E-MAIL
COMPANY NAME i O
CITY,STATE,ZIP
STREET ADDRESSJ 0 /
I/ I UNDERSTAND AND AGREF TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable previsions of the 2007 California Building Code.on date.
re luest,-d
2. You must schedule all needed inspections a minimum 228 betweenone day be30-3 30fore e(Mon-Fri). ><nsp
Please schedule inspections online or call (408)
3. Tear-off roof inspection is re uired. Please call for tear-off d Wof wood shall be replaced prior tothin
leall
the nails/fasteners have been removed. Any and all dry-r�tt
inspection. A building inspector will be available within one hour.
There are special hours for this service: 7:30 — 10:30am and 1:00=230p ( hurs);
7:30 — 10:30am and 1:00 pm (Friday).
4. If plywood is installed, a plywood nailing inspection is required.
5. In-Pro ress roof ins ection is re uired. Call fora r in-progress rom inspection to verify building is
weather tight after installation of approximately 25% of the roofing
6. New roof coverings shall not be applied without first obtaining
allin st obtaining an approved ections and written ovals tion
from the building inspector. Any roofing which is afplied without
will require the removal of all new material down to he sheathing so a proper inspection can be
performed.
7. A final inspection and approval shall be obtained fro n the wtll be building
ifiedtor when the re-roofing is
complete. To receive a final sign-off, the following -temthere is no
a. Flat roofs shall have a minimum of per foot,)f slopefacdemonstrate
used shall be a pailabll e
b. Listings from approved testing agencies for all Ire-manutored product
on-site to review at the time of the inspection.
c. Proper spark arrestor installation. p ou will
8. NOTE: If you call for atear-off or plywood nailing inept on fee shall be tion and the ork is not aid before another
be charged a re-inspection fee of$126.00. The re-it sr
inspection can be scheduled.
By my signin:below, I certify each of the following is tru coni am hththe re-roof p operty r oy authorizedtated gent to act
on the properner's beh f rs agree to p yDate:Signature of Ap /Agent:
ReroofPolicy_2010.doc revised 05/17/10
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
CUPERTINO
CONTRACTOR/ SUBCONTRACTOR LIST
MIT# c% `� U
JOB ADDRESS: 02 (�
OWNER'S NAME: Q PHONE#
GENERAL CONTRACTOR: BUSINESS LICEN E#
G .'l CITY/ZIPCODE:
ADDRESS: ss
*Our municipal code requires all businesses wor ng in the c ity to have a City of a eSCHEDULED1iUNTIL THE
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL
GENERAL CONTRACTOR AND ALL SUBCONTRACT QRS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE. (7:- W—
I am not using any subcontractors: Signature Date
Please check applicable subcontractors and complete the following information:
j/ 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
�U
Date
Owner/Contractor Signature
w1ndDDr r Qu !tY and FintshOs D
I.Use LOW)Do-V4E Pout 1 IAQ/Aealth pts yeses D
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ)-Iaatlth pts Yeses D
3.IlseLowid nVOCAdh sive 3IAaHealth pts Y--yes
4.Use Salvaged Materials for Interior Finishes 3 Resource pts yeses D
5.Use Engineered Sheet Goods with no added Urea 6 IAQ'Hsalth pts Y--Yes D
Formaldehyde D
1 IAQ Mea1th P Y--Yes6.Use Exterior Grade Plywood for Interior Uses D
7.Seal�l GODF ---- -- - 4IAC MBal tit s - es
4 Re::ource is y--yes D
B.Use FSC Certified Materials for Intenor Finish P. y�' D
9.Use Finger-Jointed or Recycled-Content Trim 1 Re source pts Y=Yes D
10.Install Whole House Vacuum System 3IAIWMealth pts Y--Yes
1 1 1
N.Flooring D
1.Select FSC Certified Wood FIDDring B Resource pts Y--Yes
4 Res ounce pts y=yeS D
.19sa er+emaahle#door+Vateria's D
3.Use Recycled Content Ceramic Tiles 4 Re:ource pts y=yes D
4.Install Natural Linoleum in Place of VinYl . 5 IAO/Health pts y_yes
4 Re:DUrCe is y=ye5 D
5.Use Exposed Concrete as Finished FiDDr p D
B.Install Recycled Content Carpet with Low VOCs 4 Re*urce'pts y=yeS
- 1 1 1
Total Points—Available:j—Available: 1401 130=
0 01 0
Total Points Project Received:
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