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11070048 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11501 SUNRISE SPRING CT CONTRACTOR:CASTILLO'S ROOFING PERMIT NO: 11070048 OWNER'S NAME: FERGUSON CATHY 1703 CATHAY DR DATE ISSUED:07/08/2011 r ER'S PHONE: 2521117 SAN JOSE,CA 95122 PHONE NO:(408)251-3565 Q� LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIALE] �� C1_1 RE-RnOF 19 SQUARES TEAR OFF WOOD SHAKES,__Ln License Class l Lic.# Contrac Date l 30LB CLASS Pr I hereby affirmt at I am licensed under the provisions of Chapter 9 (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. Sq.Ft Floor Area: Valuation:$9800 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 APN Number:36652006.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION til I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 D M LA CALLED INSPE7;111 indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Date All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. OWNER-BUILDER DECLARATION -- 7 (/ / Signature of Applic Dale: / O I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(x)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized a �— Date 7749//-/ permit is issued. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION aemnify and keep hanmless the City of Cupertino against liabilities,judgments, s,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. 6,anting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 36652006 . 00 DATE ISSUED. . . . . . . : 07/08/2011 RECEIPT # . . . . . . . . . : BS000013998 REFERENCE ID # . . . : 11070048 SITE ADDRESS . . . . . : 11501 SUNRISE SPRING CT SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER FERGUSON CATHY ADDRESS 11501 SUNRISE SPRING CT CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5133 RECEIVED FROM . . . . : CASTILLO ROOFING CONTRACTOR . . . . . . . : JOSE CASTILLO LIC # 25850 COMPANY . . . . . . . . . . : CASTILLO' 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, 800 . 00 1. 00 0 . 00 1 . 00 0. 00 1BSEISMICR VALUATION 9, 800 . 00 0 . 98 0 . 00 0 . 98 0 . 00 1REROOFRES SQ FEET 19 . 00 266 . 00 0 . 00 266 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 267. 98 0 . 00 267 . 98 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 267. 98 chk --------------- TOTAL RECEIPT 267. 98 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ------------------- 309 EXTERIOR LATH 311 SCRATCH COAT 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF Building Department City Of Cupertino 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: S —( PERMIT# OWNER'S NAME: CK t. PHONE# 2 5t-3 S-- GENERAL CONTRACTOR: iNS �—i ` ` BUSINESS LICENSE # ADDRESS: k): J CITY/ZIPCODE: ' A R S(2Z *Our municipal code requires all bus in sses working in the city to have a City of Cupertino usiness 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. y / I am not using any subcontracto Signature Date Please check applicable subcontractors an complete the following information: V 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 -7- Owner/ ontractor Signature Date REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228- FAX(408)777-3333•buildingacupertino.org PROJECT ADDRESS ' s/ i APN# 2 I n r n rl �� f�L J�.[� v p OWNER k E MAIL Ee Lf/4 STREET ADDRESS Crry, STATE,ZIP 1 r' APPLICANT NAME S PHONE -y E-MAIL STREET ADDRESS CITY,STATE,ZIP 1 OA - 13 /❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR 13 CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAMEF LICENSE NUMBER LICENSE TY? j C BUS.LIC.# -y r COMPANY NAME E-MAIL FAX y j ca STREET ADDRESS CITY,STATE ZIP yl �1(f •�� PHONF 2E-/ � ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF FD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial 8 . EXISTING ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES 'U WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE YES IF NO, 0 PLYWOOD 13w, 13 _. PLYWD 13 OSB PITCH: ROOF 13 NO Al LAYERS: ` THICKNESS: ❑ 5/8" TYPE: 1:1CDX 12 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF Im ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK: I w 5. By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buding co ction. I authorize representatives of Cupertino tc enter the above-identifie prop rty for inspection purposes. r Signature of Appli Date: SUPPLEMENTAL tORMATION REQUIRED h. _If building is associated with a Home Owner's Association,provide letter T E a " 'ROUrt%tc sLl r ' of approval from HOA. 4 p ❑ BUu DING P AN xK1 vlEwr Provide Planning approval to verify if there any restrictions. EXERESS ❑ PLAg"GPLAWREVIER Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER Nj _ ' .. ReroofApp_2011.doc revised 03/02/11