10080209 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11782 PINE BROOK LN CONCRACTOR:CASTILLO'S ROOFING PERMIT NO: 10080209
OWNER'S NAME: ROBIN GEE 1703 CATHAY DR DATE ISSUED:08/27/2010
NER'S PHONE: 4082421792 SAN,IOSE,CA 95122 PHONE NO:(408)251-3565
❑ LICENSED CONTRACTOR'S DE/CLARATION BUILDING PERMIT INFO: BLDG r ELECT r- PLUMB r
License Class 0.2 qLic.# �✓ �
MECH r RESIDENTIAL F COMMERCIAL r
Con 6
Date � � � �"/C�
by affirm t t I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OFF SHAKE,APPLY#30LB FELT,INSTALL
I here
GAF CANYON 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.
I have and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$9000
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. /C�°
APN Number:36655034.00 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 1-80 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. Issw:d by: Date:v " 2
Signatu
Date
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 insta led without first obtaining an inspection,I agree to remove all new materials for
the following two reasons: inspc ction.
I,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044, Sign,sure of Applicarg. Date: 2f J Z7^/e
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 ha,,e read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the Cali-ornia Health&Safety Code,Sections 25505,25533,and 25534. I 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 Safe:y 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 Add tionally,should I use equipment or devices which emit hazardous air
cont iminants as defined by the Bay Area Air Quality Management District I will
permit is issued. main Main 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 Owi er or authorized agent. 2-7 -/ O
become subject to the Worker's Compensation provisions of the Labor Code,I mu � - Date:
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I her Eby 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 i,hich 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 Len ier's Address
i-,'-rnmfy 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
g._...ing of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section I um lerstand my plans shall be used as public records.
9.18.
Licc used Professional
Signature Date
CITY OF CUPERTINO
3 ITEMS OF 9 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 36655C34 . 00
DATE ISSUED. . . . . . . : 08/27/2010
RECEIPT #. . . . . . . . . : BS000011320
REFERENCE ID # 10080209
SITE ADDRESS . . . . . : 11782 PINE BROOK LN
SUBDIVISION . . . . . . :
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . . ROBIN ',EE
ADDRESS 11782 ?INE BROOK LN
CITY/STATE/ZIP CUPERTINO, CA 95014
RECEIVED FROM CASTILIO'S ROOFING
CONTRACTOR JOSE CASTILLO LIC # 25850
COMPANY CASTIL: O'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 18. 00 2. 4 . 00 0. 00 234 . 00 0 .00
TOTAL PERMIT225 .90 0 . 00 235. 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
DA7E: REVIEWED BY:
ADDRESS:
*VALUATION: $9,000
APN: #:
*PERMIT
PLAN CHECK TYPE: Re-roof
*PERMIT TYPE: Minor Building Permit PENTAMATION 1 SFDWLROOF
PRIMARY I PERMIT TYPE:
USE: SFD or Duplex � r.E�t� � �s����=T�
WORK RE-ROOF 18SQ TEAR OFF WOOD SHAKE INSTALL 30LB FELT INSTALL GAF GRAND CANYON
SCOPE COMP
FEE ID ROOF AREA.
s.L
1REROOFFRES 1,800
F'lw& Plan
N("c Pcrnld P0,
t".1"c. hasp Ice:
Act_ Irts'r',f.'t�
N
OTE: Thesefees are based on the prelimina in ormation available and are onl an estimate. Contact the
De t or addn'1 in o.
MISC
FEE ITEMS (Fee Resolution 09-05I Eff 7/1/10) FEE QTY/FEE
Plcaot rC`hcck f`f v:
)7117111. P
$234.00
Permit Fee:
slippl. jov)
Ph arab.-: 1cc/t. 1 1L r
Plt.aata/P.%:4cc h ]Jc( PE'7 Hlif
6)17srrtr( £iwl 14,tv
<Ic{iatsticxa7 l?cvww Fccc'.
�
Yes E) No $0.0(1
Work Without Permit.
I'ltartrtrarh l t'c'�:
7'rctvel 1>c�ctfarzc�rrlirtlorr 1�c'�'.�:
1 BSEISMICR $0.9) Select an Administrative Item
Strong Motion Fee:
Bld,,Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $235. 0 $0.00 TOTAL FEE: $235.90
Revised:8/17/2010
� «
CITY OF Zcq
CITY OF CU PERTINO
RERC►OF
CUPERTINO PERMIT APPLICATION
Date:
Building Address:
Owner's Name: b 1:11) Phone #:
HOA: Yes ❑ No E( If yes, provide letter -:rom HOA
Contractor: Phone #: 2,S-1 rJ 5-to
0aS Wr d t S X?O Fax#:
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: .Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ sphalt Shingles a-1 Asphalt Shingles
d Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Naber of existing coverings ❑ Provide I.C.C.E.S. Report#
a To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: Ten r O?r-,P 5ho%. � 4,o vlr( --'y 3 6//b -7ce -L 17,51WI
F C'Gfn ym
Residential Commercial
Green Building: Please complete relevant portion of the Con-firmed 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 Cu.3ertino's Tear-Off Policy:
Signature
Revised 02/05/09
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-buildinga�cupe__
r' �� _ APN#
PROJECT ADDRESS ' �[� i ��rv�
(� PHONE �I/I ' �Q 2 E-MAIL
OWNER NAME ]� y ��
V I FAX
CITY, STAT ZIP
AO W
STREET ADDRESS 5-a
�i � LICEN�� BUS.LIC.#
{{{ f LICENSE� `` t NUMBER
CONTRACTOR NAME /� ('..{� ( ,r'*J
FAX
E-MAIL
COMPANY NAME ^'M ///
CYI',• ///��� .� �.� CITY,STATE,ZIP /j ��/ Z PHONE
STREET ADDRESS / (/]�/ '
GRE E TO THE FOLLOWING:
I UNDERSTAND AND A
1. The re-roof project shall comply with all applicable p-ovisions of the 2007 California Building ton date.
2. You must schedule all needed inspections a mini X28 betweenone day be30-3 30fore e(Mon-Fri). msp
Please schedule inspections online or call (408)777-3
3. Tear-off roof inspection is re wired. Please call foi tear-off inspection
shall be replaced prior off
and all
the nails/fasteners have been removed. Any and all dry-rotted
his
inspection. A building inspector will be available within one hour. Mon—Thurs);
7:30 10:30am
There are special hours for this service: 7:30 = 10:30am and 1:00—2:30pm (Friday).
4. If plywood is installed, a plywood nailing ipWectio a is required.
5. In-Pro ress roof inspection is re uired. Call fora n in-progress rom inspection to verify building is
weather tight after installation of approximately 25/) of the roof
6. New roof coverings shall not be applied without firs t obtainingall
utifirst obtaini g an app o pections and written e d inspection
provals
from the building inspector. Any roofing which is applied witho
will require the removal of all new material down tc the sheathing so a proper inspection can be
performed.
7. A final inspection and approval shall be obtained from the
11 be gerified for when the re-roofing is
complete. To receive a final sign-off,the following item
a. Flat roofs shall have a minimum of per foot of slope dd oducts used shall be a emonstrate there is no vailabil g
b. Listings from approved testing agencies for all pre-manufacturedP
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 inet opn fee shall be econ and the ork is not aid before another
be charged a re-inspection fee of$126.00. The rc Insp
inspection can be scheduled.
zed
By my signing below, I certify each of the following is tr ie:o am the
tproperty
the re-roof policy statediabov gent to act
on the property owner's behalf. I understand and agree tic p y �r 2
Date:
Signature of Applica ent:
ReroofPo1icy_2010.doc revised 05/17/10
1-.101=111M i
M.IndDor Air Quality and Finishes
1.Use LowND-VOC Paint 1 IAO/Health pts y--yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IA(t/Health pts y=yes0
3.Use Low/No VOC Adhesives 3 IAO]Health pts y=yes 7 0
4.Use Salvaged Materials for Interior Finishes 3 Re source pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AO JHealth pts y--yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAI�/Health pts y=yes 0
7.Seal all Exposed Particleboard or MDF 4 IA()/Health. pts y=yes 0
B.Use FSC Certified Materials for Interior Finish 4 RE source pts y=yes 0
9.Use Fnger-Jointed or Recycled-Content Trim 1 RE source pts y=yes 0
10.Install Whole House Vacuum System 3 IP Q/Health pts y=yes 0
N.Flooring
1.Select FSC Certified Wood Flooring 6 Re:,ource pts y=yes 0
2.Use Rapidly Renewable Flooring Materials 4 Re;;ource pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Re;;ource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAO]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 Re source pts y=yes 0
! ! !
Total Points Available: 140 130 57
Total Points Project Received: 01 O=
�,2 -7
G:data/progs/greenbuil(6no.ui roes/remodelers/greenpointsfinal2.12.D4proteoted.xls
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
CU PERTI NO Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
MGENERAL
DRESS: t: v PERMIT#
R'S NAME: _ PHONE# J�
CONTRACTOR: ] S%/L-��S �'� BUSINESS LICENSE# a
SS: �} CITY/ZIPCODE: �z
*Our municipal code requires all busine ses working in the city to have a City of Cupertin business license.
NO BUILDING FINAL OR FINAL OCCUPANCYSUBCONTRACTORS INSPECTION(S)
OBTAINED AHCITY OF CUPERTINO
UNTIL THE
GENERAL CONTRACTOR AND ALL
BUSINESS LICENSE. �7- -,2 7 '-/16
I am not using any subcontractors: Date
Signature
Please check applicable subcontractors and complete :he following information:
&/ SUBCONTRACTOR BUSINESS '�iAME 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
2 7 / o
Owner/Contractor Signature Date