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10080210 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11762 PINE BROOK LN CONTRACTOR:CASTILLO'S ROOFING PERMIT NO: 10080210 OWNER'S NAME: MARATHE MUKUND V AND REKHA M 1703 CATHAY DR DATE ISSUED:08/27/2010 ER'S PHONE: 4082559485 SAN JOSE,CA 95122 PHONE NO:(408)251-3565 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT PLUMB r License Class Lic.# d / C MECH r RESIDENTIAL COMMERCIAL r Co cTr Date OJ _�7— r v JOB DESCRIPTION:RE-ROOF TEAR OFF SHAKE,APPLY#30LB FELT,INSTALL I hereby affirm th I am licensed under the provisions of Chapter 9 GAF GRAND CANYON COMP CLASS A 16.5SQ (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 Sq.F:Floor Area: Valuation:$8500 Section 3700 of the Labor Code,for the performance of the work for which s permit is issued. 1 APN Number:36655032.00 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 Date p L �� 9.18. Q Issued by /' Si Date ✓ ��G ROOFS: OWNER-BUILDER DECLARATION All r Hofs 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: insp xtion. I,as owner of the property,or my employees with wages as their sole compensation, Date: will do the work,and the structure is not intended or offered for sale(Sec.7044, Sigrature of),111 11 a1 �t?� Business&Professions Code) 2 r d 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 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 Cal tfornia Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. con ipliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Saf qty Code,Section 25532(a)should I store or handle hazardous material. 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 contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. ma ntain 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 He:dth&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 ONyer o ued agent: - Dater 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. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I h-;reby 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 Le ider'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 i- nify and keep harmless the City of Cupertino against liabilities,judgments, c 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 CUYERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: I:ATE: REVIEWED BY: APN: BP#: *VALUATION: 1$9,000 *PERMIT TYPE: Minor Building Permit PLAN CIIECK TYPE: Re-roof PRIMARY I't)"l-1I 7PENnTAMATION1SFDWLROOF USE: SFD or Duplex : tltah_,rt7__1. EIT TYPE: WORK RE-ROOF 16.5SQ TEAR OFF WOOD SHAKE IIJSTALL 30LB FELT INSTALL GAF GRAND CANYON SCOPE COMP FEE ID ROOF ARE A s.f. 1REROOFFRES 1,650 1'107t Chi(A t r r,,c lfs h 1'Ictt 1.<'iT; 11��- i riui%I-c Fermi,,Fcc l,", t..)lnerY r"t' I?tSJ'. kl r i? h1,,. f NOTE. These fees are based on the preliminary in ormation avai,able and are only an estimate. Contact the De t or addn'l info, FFEEITEMIS (Fee Resolution 09-051 Eff: 7/1%.10) FEE QTY/FEE MISC ITEMS I c�c�: q . cc Plrnnh..�11c�ch.-Z_`ic7 C'lzn� CTircck: Permit Fee: $221.00 Stappl. lttsp f°cc ,,1CONN[i(al hc5-icic Work Without Permit? 0 Yes No $0.01) Molartirtn 1 oc%: Tra c7I),wirrneInttItion 1�ccrs: Strong Motion Fee: IBSEISMICR $0.90 Select an Administrative Item Bldg Stds Conunission Fee: IBCBSC $1.00 SUBTOTALS; $222. 0 $0.00 TOTAL FEE: $222.90 Revised: 8/17/2010 CITY OF CUPERTINO 3 ITEMS OF 9 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 36655032 .00 DATE ISSUED. . . . . . . : 08/27/2010 RECEIPT #. . . . . . . . . BS000011320 REFERENCE ID # . . . : 10080210 SITE ADDRESS . . . . . : 11762 PINE BROOK LN SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . . OWNER MARA'IHE MUKUND V AND REKHA M ADDRESS . . . . . . . . . . : 11762 PINE BROOK LN CITY/STATE/ZIP . . . : CUPEFTINO, CA 95014-5111 RECEIVED FROM . . . . : CASTILLO'S ROOFING CONTRACTOR JOSE CASTILLO LIC # 25850 COMPANY CASTILLO'S ROOFING ADDRESS 1703 CATHAY DR CITY/STATE/ZIP . . . : SAN DOSE, CA 95122 TELEPHONE (408) 251-3565 FEE ID UNIT QUANTITY AMCjUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---- ------ ---------- ---------- ---------- 1BCBSC VALUATION 8, 500. 00 1. 00 0. 00 1. 00 0 .00 1BSEISMICR VALUATION 8, 500 . 00 0 .90 0 . 00 0 . 90 0 .00 1REROOFRES SQ FEET 17. 00 221 . 00 0 .00 221. 00 0 .00 ---- ------ ---------- ---------- ---------- TOTAL PERMIT 222 .90 0. 00 222 .90 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- - ------------------- CHECK 694 .70 4:16590 --------------- TOTAL RECEIPT 694 .70 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CITY OF CUPERTINO RER13OF CUPERTINO PERMIT APPLICATION APN# Date: ,�5(0 k;? L) Oji t Building Address: i Owner's Name: �`�1�wy1 yan1G Phone #: �5- HOA: Yes ❑ No If yes, provide letter from HOA Contractor: "o Phone #- �� J Fax#: Cupertino Business License #: Contractor License #: 30 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ ,Built-Up roof ❑ ,Asphalt Shingles of Asphalt Shingles g Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) N Mber of existing coverings ❑ Provide I.C.C.E.S. Report# o be Removed ❑ Provide Mfgr. Installation Specs. Job Description: 'F•e�ta v* r � --4' 3[) Residential Commercial Green Building: Please complete relevant portion of the Cort£rmed 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: Signature Revised 02/05/09 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTME IT•BUILDING DIVISION ALBERT SALVADOR, P.E.,C.B.O.,BUILDII`G OFFICIAL 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•build na(d)cupertino.orq PROJECT ADDRESSI.7, F APN# OWNER NAME PHONE :9!I E-MAIL MAr2 I `� /� STREET ADDRESS CITY, STATE, IP �_ _` / +4 9 aFAX .2_014 CONTRACTOR NAME LICENSE NUMBER `;0 LICENSE jlP .BU LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS _76 CITY,STATE,Z P /� �i�+-/� PHONE I UNDERSTAND AND AGR:E TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable irovisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimu n 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 z 11 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:m in-progress roof inspection to verify building is weather tight after installation of approximately 250/'o of the roofing material. 6. New roof coverings shall not be applied without fiat obtaining all inspections and written approvals from the building inspector. Any roofing which is z pplied without first obtaining an approved inspection will require the removal of all new material down t( 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 1/4"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-i ispection fee shall be paid before another inspection can be scheduled. By my signing below, I certify each of the following is trt e: I am the property owner or authorized agent to act on the property owner's behalf. I understand nd agree to comply with the re-roof policy s ed above. Signature of Applicag nt/A e — Date: r2--7 RerooJPo1icy_2010.doc revised 05/17/10 N!.Indoor Air Quality and Finishes 1.Use Low/No-VOC Paint 1 IACIHealth pts y--yes D 2.Use Low VOC,Water-Based Wood Finishes 2 IAC!Health pts y=yes D 3.Use LowMo VOC Adhesives 3 IACVH"th pts y=yes D 4.Use Salvaged Materials for Interior Finishes 3 Re source pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 6 IAC VHealth pts y=yes 0 6.Use Exterior Grade Plywood for Interior Uses 1 IACVHealth pts y=yes 0 7.Seal all Exposed Particleboard or MDF 4 IA(YHealth. pts y=yes 0 B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes D 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes D 10.Install Whole House Vacuum System 3 IAD/Health pts y=yes 0 N.Flooring 1.Select FSC Certified Wood Flooring 6 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 IACIHealth pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 Res ource pts y=yes0 6.Install Recycled Content Carpet with Low VOCs 4 Re:ource pts y=yes 0 M . ! E ! Total Points Available: 1401 130 57 Total Points Project Received: I — 0 0 0 G:datalprogslgreenbuilc noguidelineslremodelers/greenpointsfina12.12.04protected.xis Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Is Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUIo'CONTRACTOR LIST JOB ADDRESS: -�2, ` C.- 1 ,PERMIT# OWNER'S NAME: �,//�� `'�1 4a PHONE# 25- " J GENERAL CONTRACTOR: 04S T C vZCC'S A-4)a/A113USINESS LICENSE# 0 ADDRESS: 2-26>5 t!'.4 ,y CITY/ZIPCODE: ?oR *Our municipal code requires all busin sses working in the city to have a City of Cupertin4usiness 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. —� Sign iture Date Please check applicable subcontractors and completo 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 e � 27 Ower/Contractor Signature Date