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10080171 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11583 COUNTRY SPRING CT CON'CRACTOR:CASTILLO'S ROOFING PERMIT NO: 10080171 OWNER'S NAME: AFROZA RAHMAN 1703 CATHAY DR DATE ISSUED:08/24/2010 VNER'S PHONE: 4082576788 SAN.OSE,CA 95122 PHONE NO:(408)251-3565 LICENSED CONTRACTOR'S DECLARATION JOB )ESCRIPTION: RESIDENTIAL COMMERCIAL License Class C—�� Lic.# 7�3 T�� RE-ROOF 18 SQUARES TEAR OFF EXISTING WOOD �r SHAKES, Contra .C /L Date '� 'w INSTALL 30LB FELT AND GAF GRAND CANYON COMP I hereby affir hat I am licensed under the provisions of Chapter 9 SHINGLES (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.t t Floor Area: Valuation:$8900 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 whio this APN Number:36651052.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 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 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, j� —A— withand expenses which may accrue against said City in consequence of the Issued by: I/ `- Date: 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. RE-ROOFS: Signature U Date �? �U All i Hofs shall be inspected prior to any roofing material being installed.If a roof is instz Iled without first obtaining an inspection,I agree to remove all new materials for insp action. OWNER-BUILDER DECLARATION 7 U Signature of A i Date: c.. I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF CO INGS TO BE CLASS"A"OR BETTER 1,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 Cal fornia 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: Hea Ith&Safety Code,Section 25532(a)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 :ontaminants 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 agent Dat 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 he reby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. woj k's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Leiider'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 -idemnify and keep harmless the City of Cupertino against liabilities,judgments, its,and expenses which may accrue against said City in consequence of the I w►derstand my plans shall be used as public records. ..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 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 36651052 . 00 DATE ISSUED. . . . . . . : 08/24/2010 RECEIPT #. . . . . . . . . BS000011267 REFERENCE ID # 10080171 SITE ADDRESS 11583 COUNTRY SPRING CT SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER AFROZA RAHMAN ADDRESS 11583 COUNTRY SPRING CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5116 RECEIVED FROM . . . . : CASTILI,O ROOFING CONTRACTOR JOSE CRSTILLO LIC # 25850 COMPANY CASTILI,O' S ROOFING ADDRESS 1703 CiffHAY DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95122 TELEPHONE (408) 2!i1-3565 FEE ID UNIT QUANTITY AMOU14T PD-TO-DT THIS REC NEW BAL ---------- ----- ----- ---- 1BCBSC VALUATION 8, 900 . 00 1. 00 0 .00 1 . 00 0 . 00 1REROOFRES SQ FEET 18 .00 234 . 00 0 .00 234 . 00 0. 00 ----- ----- ---------- ---------- ---------- TOTAL PERMIT 235. 00 0 .00 235 .00 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- ---------------- CHECK 235 .00 16581 --------------- TOTAL RECEIPT 235. 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 REROOF CUPEkTINO PERMIT APPLICATION APN # Date: Building Address: 15S 3 Co o trkq n�W c/�- Owner's Name: Phone #: � "�1';;%yes, 1P--.�►hrnc � �S7 -0 18 HOA: Yes ❑ No provide letter from HOA Contractor: Phone #: 0 5 10 S j2ob ` YIrC. Fax #: Cupertino Business License #: ContraVi License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ ,Built-Up roof ❑ A phalt ShinglesAsphalt Shingles ood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Nypber of existing coverings ❑ Provide I.C.C.E.S. Report# To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: Acle-1 6,7/TP 9,revid0aliVen Comp . J Residential Er 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: 08 lot) I Have Read, Understand and Will Comply with Cup-Irtino's Tear-Off Policy: L r-',P Signature Revised 02/05/09 CITY OF CUFERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: *VALUATION: 1$8,900 91;PERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY TC)7�1L PENTAMATION 1SFDWLROOF USE: SFD or Duplex f��r_O R �1,}i<<f: PERMIT TYPE: WORK re-roof 18 squares SCOPE FEE ID ROOF ARE A s.f. 1 REROOFFRES 1,800 P(nrilh. N"'m Owc A 11 cJt 1'��trtrit fere_ ('I;rnzh. Perr til t�ac: fay r P��atr,zt t°t�f� F-1 I ?,''r•, 1f :h. iri,', f)tr, 1';'r:!rt1,Iri:, (fit tt L:<'t. hist NOTE: Theseees are based on the preliminatUy in ormation available and are only an estimate. Contact the De t or addn'1 in o. FEE ITEMS(Fee Resohrtion 09-051 Ef. 71,10) FEE QTY/FEE MISC ITEMS Man C'w"A Fcrc: Sir1 pl, PC l'ec P/mIlh.. Ile, /t. 'F/cc c I hol ("/'-A: Permit Fee: $234.00 slpp/. hl,sp 1'cc> Plztrtal. 11 <It. IIc{: (Jr,"it I'ec% F'Itrrrth.:":1dc�c h.:L'lec Pcrinit Fcc' ("onsirtrction 7-ax ,4couslicul Ice+t°wls -ec': Work Without Permit? 0 Yes No $0.00 Plctttr in" T-ave! A Strong Motion Fee: IBSEISMICR $0.89 Select an Administrative Item Bldg;Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $235.89 $0.00 TOTAL FEE: $235.89 1 IRevised: 8/17/2010 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENI •BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO,CA 9F014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•buildinc(Wcugertino.orq PROJECT ADDRESS `0n� �`��, / N# 00 5 1 O ;, 7� I/(� PHONE (' + ��••(/J// E-MAIL OWNER NAME zA �yil�Gyp-� -tea i ^ / � D STREET ADDRESS �'(/"� / ,.,,) ,r "l CITY, STATE,ZIP �L FAX CONTRACTOR NAME CENSE BER j i LICENS TYPE BUS.LIG?J COMPANY NAME � � 05`�`�p-� E-MAIL �L- FAX STREET ADDRESS 1.-� CI Y,STATE,ZIP PHONfg( I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable pr)visions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimum 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 :ear-off inspection after the roof is torn off and all the nails/fasteners have been removed. Any and all dry-rotted wood shall be replaced prior to this inspection. A building inspector will be available witl in 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 an in-progress roof inspection to verify building is weather tight after installation of approximately 25% of the roofing material. 6. New roof coverings shall not be applied without first obtaining all inspections and written approvals from the building inspector. Any roofing which is applied without first obtaining an approved inspection will require the removal of all new material down to the sheathing so a proper inspection can be performed. 7. A final inspection and approval shall be obtained frorr the building inspector when the re-roofing is complete. To receive a final sign-off, the following itcras will be verified: a. Flat roofs shall have a minimum of 1/4"per foot oi'slope and must demonstrate there is no ponding. b. Listings from approved testing agencies for all pr,.--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 i:ispection and the work is not complete, you will be charged a re-inspection fee of$126.00. The re-inspection fee shall be paid before another inspection can be scheduled. By my signing below, I certify pach of he following is true: I am the property owner or authorized agent to act on the property owner's beha n snd and agree to ccmply with the re-roof policy state above. Signature of Ap n ® Date: .� d ReroofPolicy_201 0.doc revised 05/17/10 pindoDr r Qualiny and Finishes �.11� Imo► .-__ 1 IAQ/Hec7 ith pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes. 2 IAQ/He�lth pts y-ye 0 *vM,MOM 31AQ/Hertth pts y--yes 0 41sai�D 4.Use Salvaged Materials for Interior Finishes 3 Resouns pts yeses 0 5.Use Engineered Sheet Goods with.no added Urea 0 Formaldehyde 5 IAQIHe filth pts Y--yes 6.Use Exterior Grade Plywood.for Interior Uses 1 IAQ/He filth pts Y--yes 0 4 IAQ/He Ah. pts yeses 0 8.Use FSC Certified Materials for Interior Finish 4 Resour;e pts y=yes 9.Use Finger-Jointed or Recycled-Content Trim 1 Resour;e pts y-yes 0 10.Install Whole House Vacuum System 3 IAQ/Hoalth pts y=yes 0 1 1 1 N.Flooring 1.Select FSC Certified Wood Flooring B Resourc a pts y--yes 0 4 Resource pts yeses 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts Y--yes0 4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Haalth pts yeses 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts y--yes0 6.Install Recycled Content Carpet with Low VOCs 4 Resourl:e pts y=yes 0 1 ! 1 Total Points Availa le: 140 130 57 Total Points Project Received: 0 0 0 Mdatalprogs/ nbuildngg iidelineslremodelers/greenpdintsfina1212D4protected.xls Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: '` L)i-) :�S- n ERMIT# OWNER'S NAME: �1 -� c PHONE# j. `� GENERAL CONTRACTOR: 6 12 ; BUSINESS LICENSE# t ADDRESS: �' CITY/ZIPCODE: 4,;1 l 3S *Our municipal code requires all businesses working in the city to have a City of Cupertino bu ness 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: 6�� - ��-/� Signature Date Please check applicable subcontracto s and complete tt a following information: SUBCONTRACTOR BUSINESS N AME 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 Date Owner/Contractor Signature