09120035 (2) CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11545 EVENING SPRING CT CONTRACTOR:CASTILLO'S ROOFING PERMIT NO:09120035
OWNER'S NAME: HUANG DAR-JEN AND DAH-YU 1703 CATHAY DR DATE ISSUED: 12/04/2009
ER'S PHONE: 4085699607 SAN JOSE,CA 95122 PHONE NO:(408)251-3565
❑
LICENSED CONTRACTOR'S DECLARATION 13UILDING PERMIT INFO: BLDG f— ELECT� PLUMB�
License Class -�/ Lic.# �7 S (CJ
MECH r- RESIDENTIAL� COMMERCIAL�
Co 55-r `` Date 7
I hereby affir that I am licensed under the provisions of Chapter 9—ZR/ JOB DESCRIPTION:RE-ROOF TEAR OFF EXISTING WOOOD SHAKE,INSTALL
1'30LB FELT,INSTALL GAF GRANDCANYON COMP SHINGLES
(commencing with Section 7000)of Division 3 of the Business&Professions CLASS A 16SQ
Code and that my license is in full force and effect.
1 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 3q.Ft Floor Area: Valuation:$7000
permit is issued.
APPLICANT CERTIFICATION APN Number:36652021.00 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 construction,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, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the
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 s�
9.18.
- - Issued by: Date:
Signafu`re Date /-2 d�
L OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed 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, inspection. ,
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signature o Date:
A l�.
1,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
declarations: HAZARDOUS MATERIALS DISCLOSURE
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 I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
1 have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
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
permit is issued. contaminants 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 Health&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 must Owner o an )orized�
Date:
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is I hereby 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 which 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
it •nify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
C and expenses which may accrue against said City in consequence of the
granting 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
I understand my plans shall be used as public records.
9.18.
Signature Date Licensed Professional
CITY OF C.UPERTINO 0 c( 12
RKROOF
COF
CUPERTINO PERMIT APPLICATION
APN !J� Date: ' ,2 � �� C
Building Address:
Owner's Name: bbi } �� Phone #: i-� C1 ( �
2�
HOA: Yes ❑ No 2""If Yes, provide letter from HOA
Contractor: Phone #:
t Fax #:
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof :,Zilt-Up roof
❑ Asphalt Shingles sphalt Shingles
V'�1 Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
&tuber of existing coverings ❑ Provide I.C.C.E.S. Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: \F�V"C�= e— 1 T-P 5tp 11
Residential Commercial El
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: -t)
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 02/05/09
aUT-1
CITY OF C-UPERTINO
REROOF
CUPEkTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Conunercial B 1COMMLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICO Seismic Commercial B
1REROOFRES Re-roof Residential B 1SFDWLR00F
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Re,,.idential B
1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
Fax: (408)777-3333
Building ]Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance,you must agree to comply with 2007 IBC Standards
and manufacturers specifications on re-roofing.All roofs are Class "A"per Cupertino
municipal code 16.04.080.
2. New roof coverings shall not be applied without first obtaining all inspection
and written approval from the buildin;;inspector. A final inspection and
approval shall be obtained from the b u.ilding inspector when the re-roofing
is completed.
3. All roofs shall be inspected prior to an-�roofing installation.
4. To receive a final sign off from the Cite,the following steps are
required:
1) Pre-inspection and/or tear off apprz)val.
2) In-progress inspection approval.
3) Final inspection approval.
a) Spark arrester installation.
5. If plywood is installed,a plywood nai] inspection is required.
6. Any roofing which is applied without first obtaining an inspection,
will require the removal of all new material down to the sheathing,
so a proper City inspection can be performed.
7. NOTE: If you call for a plywood nail Inspection and the job is not ready,
you will be charged a re-inspection feE'of$176.18. The re-inspection fee must
be paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/4 "per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O.report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: � � C
Job Site Address: S �= J C0 ' n \, 7( +
Roofing Company Name: � � O 20z)
Applicant's Signature: Date:
Greg Casteel
Building Official
Revised 07/30/08
Community Development
h 10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF
:UPEI�TINO Fax(408)777-3333
Building Department
JOB ADDRESS: PERMIT #
jj�
OWNER'S NAME: i C't PHONE # 15Ue
GENERAL CONTRACTOR: FAX # 5 a7V1�
I am not using any subcontra Z N U c
Signature Date
Please check applicable subcontractors and com Clete the following information:
21 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum/ Wood
Glass/ Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
�- LA C
Owner/Contractor Signature Date