08080189'wCI'&Y
OF CUPERTINO
PERNIIT
CONT.RA.CTQRINFORMA"O�
BUILDING DIVISION
BUILDING ADDRESS:
PERMITNO..
IiB62 PLACER SPRING CT
CASTILLO'S ROOFING
08080189
NEWS NAME:
PERMIT ISSUE DATE
MATSUMOTO KEITH AND MICHELLE 0
1703 CATHAY DR
08/25/2008
PHONE:
SANITARY NO. CONTROL NO.
ARCHRECTMNGINEER:
BUILDING PERMfr INFO
TEAR OFF OLD ROOF, INSTALL
O O O O
i p
LICENSED CONTRACTOR'S DECLARATION
-pis Description
1 hereby affirm Wns
dust 1 em licensed under provisions or Chapmr 9 (Commencing
^ ^ - • -^ ^" • ^ • ^
g
with Section 7")of Division 3 oftie Business and Processions Code. and my licevc is
in full face seal ellen. 30 S�O
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ueeanmLic. x
i
Dm .3—Contrxmr
j
ARCHITECrs DECLA A] 01
d9
1 underrated my plans NJI W used as; public mrnNs
Licensed Pmfauianal
OWNER-BUILDER DECLARATION
y
1 hereby alErm that I am exempt from 1be Convenors Lieenm Law for the
o
following moon. (Sado. 7(111.7, Business and Proreadium Co": Any city err county
go!
which requires a permit to rnntuuct, alur. improve, demolish, or repair any suuctum
"y
$<
prior to its issuance. arm requires the applicant for such permit to file a signed statement
that ha is licensed pursuant to the provitlons of the Conmusr's license Law (Chapter 9
Sq. Ft. Floor Area
Valuation
exp
(commencing with S.W. 7000) of Division 3 of the Business and Profrsiana Code)or
..
that he u exempt Nerefmm and the Eula for the alleged exemption. My vioho n of
APN Number
Occupancy Type
Secdon 7031.5 by any applicant for a permit subjcCU the applicant 10 a civil Penalty of
out mom Nan five hundred doles. (55003.
0 Lu ownerofthe property, ormyemployces with wagesuth irsome mpenaadon,
Required Inspections
the wort, structure es Cos Bud^•••
Contractors Licensaoperean Out apply utD51,
and Pr The Law ansa eat apply lf rte owner of
ane Profnsdona Code:
ldsta stheren, cid who
propertylobobellroaimprotea thereon, and who acesouchwmk himselfar1luaagh Mf.
own employees,dovidnd Wmuchim orofferat faate IL
Is sold arc year of a the Owner.
b hath
however, tiro building m Impeen
a did Improve for
Wilder will have 1be bentan of purring Nat he did rot be1W m improm for purpose of
of pouring
sale.).
0 I, as owner of the property, aro exclusively convening with licensed com casts, to
construct site project (gee. 71344. Business and Rafessions Cade) The Convectors U-
cerme Law don not apply m an owner of property who bell" or improv Ihemon, and
...
who contracts fe ouch projeces with a convummuato
r(s) licensed prnt time Convector.'
License Law.
IaneaempsunderSee .Bg:PCfarthhseuon
ner Data
WORKERS COMPENSATION DECLARATION
I thereby of i m tae"r penally of perjury one of the fallowing declamations:
0 1 have and will maintain a Certificate of Courant m self-imune fur Workers Curet
station. as provided for by Section 3700 of the Iaba Cade, for 1be performance of the
work for which this permit is issued.
0 1 have ar d will maintain Workers Compensation Irimnnce, as required by Section
3700 ofte Labor Code, fa the part.. ee of the wart fawhlch this Permit is issued.
'
My Workers Compensation Irtaunaa carries and Policy number am:
Cartier. Poliry NC,]CA�!'
CERTIFICATE OF MEMPrION FROM WORKERS'
COMPENSATION INSURANCE
(ThesecUw recd wtbecampleud if ibe permit Is Inatome hundred dollars (SIM)
or less)
I comfy that in the performance of the work for which this Permit is Issued. I shall not
employ any person In my mmwran as to become subject to the Wahcrf Compensation
laws or Caliraroic Dam
Applicant
NOTICE TO APPLICANT`. IL aMr making this Certificau of Exemption, you should
become subject m the Workers Compensation provisions or Out Liber Cade yen most
Oforthwith
comply with such provisions Of Nu Permit Nall the deemed mveked.
y
CONSrRUCnON LENDING AGENCY
I hereby aff. this Oars h s eoummdrm lending agency for the perfarmarta of
i
the work for which Wer Permit is issued (Sea 3097, Civ. C.)
0
Lenders Name
,
Landers Aaama
2
0
I mtify that hove mad Ws application W sum Lou the above information is
Caroli I agme, m empty with all city and county centimeters and sum laws gelating m
E
building construction, and hereby tuchoden mpmmnutives or this city to Cour upon Ne
W
abeve-amot aned property for impaction purposes
gy
(We) agree to save, indemnify and keep harmless the City of Cupertino against
r,7
IiNilities, fragments, cores and expenses which may In my way uciva against said City
in coeequence of the granting of this permia
-
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT
Issued by: Date
SOUR REG S.
S
Re-roofs
Si of Applican r part
HAZARDOUS MATERIALS DISCLOSURE
Type Of Roof -
III ties or forum ocupanl atom or Lundie huartlom material
Curscrt I Co
defmN OY tie CupeNro Munro 1 Code. Chapter 9.1; and she Health seal Safety
Peak. Section 25!32()7
All roofs shall be inspected prior to any roofing material being installed.
0Yes No
If a roof is installed without first obtaining an inspection, I agree to remove
Will that applicant or future building Occupant um equipment or devices which
emit hvallous air cmuminanu u seed by f Bey Arra Air Guaiity Management
all new materials for inspection. '
District]
0 Yes u
I have rend the hmaNtusmaariabrequi ermads underChapter6.95 oftle Califor.
nia Hcedtha Sxfcly Cade.Seedms 25705.25333 and25534.1 underamb thatlftbe building
does not currently have a utam, that Is u my responsibility to Codify tie occupant Of the
mre
regeswan , bemet prior to issuance anCannes toa a perry.
�'?
Signature of Applicant Date
All roof coverings to be Class '%" or better
oruthamatl agent Dau'
a
CITY OF CUPERTINO
REROOF
10
•CUPERTINO PERMIT APPLICATION
r
L.
Art ME smra=
APN #
(ou 55 0��%D�
[date:
Building Address:
I Cer ,Sr -
n
Owner's Name:
Phone #: <95-1- 0&_'
1 � i C:')G' t [ e
Contractor:
Phone #:
ad ` S qOa -PN6
Fax #:
Cupertino Business License #:
Contractor License #:
6 Flo
Type of Roof Covering:
Existing:
Proposed:
a Built -Up Roof
❑ Built -Up roof
❑ /Asphalt Shingles
t( Asphalt Shingles
c� Wobd Shakes
❑ Wood Shakes
❑ Wood Shingles
o Wood Shingles
❑ Other (Specify)
❑ Other (Specify)
Vtuber of existing coverings
❑ Provide I.C.B:O. Report #
To be Removed
a Provide Mfgr. Installation Specs.
Job Description: eea.r v i� 01d- QCp F .
�1 ^� iA I ( 3d I b . ri i+ , n5i f1 1
GAF GrGnd Cann .
Residential
Commercial
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:
GI U00.C-0
• I Have Read, Understand and Will Comply with Cupertino's Tear -Off Policy:
Revised 6/16/08
CITY OF CUPERTINO
REROOF
CUPEI,TINO FEE SCHEDULE •
Number of
Squares
Fee ID
Fee Description
Fee
Group
Permit Type
1RER00FCOM
Re -roof Commercial
B
1COMMLROOF
1BSEISMICO
Seismic Commercial
B
(�
1RER00FRES
Re -roof Residential
B
1SFDWLROOF
I
1BSEISMICRE
Seismic Residential
B
1RER00FMRES
Re -roof Multi -Family
B
1MFDWLROOF
1BSEISMICRE
Seismic Residential
B
1BUSLIC
Business License
B
Revised 6/16/08
•
Community Development Department
Building Division
. City of Cupertino
10300 Torre Avenue
Telephone: (408) 777-3228
Fax: (408) 777-3333
Building Department
REROOF TEAR OFF POLICY
1. You must schedule an inspection for the tear off the day before
you wish the inspection to be made. The procedure is to call the
Building Division (408) 777-3228 between the hours of 7:30 a.m. and
3:30 p.m. to request a next -day inspection.
• 2. When the roof is torn off, the nails have been removed or driven in,
and all of the dry -rotted wood has been replaced, you must call the
City Building Division. An inspector will be there within one hour.
There are special hours for this service: from 7:30 a.m. to 10:30 a.m.
and 1:00p.m. to 3:30 p.m., Monday through Thursday and from
7:30 a.m. to 10:30 a.m. and 1:00 p.m. to 2:30 p.m. on Friday. (Note:
Building inspectors are on lunch break from 11:30 a.m. to 12:30 p.m.
and will not be called during that time. City Hall is closed between
12:00 and 1:00 p.m. daily.)
3. If you call for a tear -off 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.
Greg Casteel
Building Official
Revised 8/13/04
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
Building De artment
JOB ADDRESS:
c� s �-f .
PERMIT #
OWNER'S NAME: Jze i 4-h e
BUSINESS NAME
PHONE # 57 - 7
GENERAL CONTRACTOR: Q S"T 1 tA6S grW?
FAX # g5I -3S�.S
I am not using any subcontra D�
Signature Date
Please check applicable subcontractors and complete the following information:
Owner C� o tractor Signature
5-d
Date
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
Owner C� o tractor Signature
5-d
Date
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 building inspector. A final inspection and
approval shall be obtained from the building inspector when the re -roofing
is completed.
3.
All roofs shall be inspected prior to any roofing installation.
4.
To receive a final sign off from the City, the following steps are
required:
1) Pre -inspection and/or tear off approval.
2) In -progress inspection approval.
•
3) Final inspection approval.
. a) Spark arrester installation.
5.
If plywood is installed, a plywood nail 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 Raid before another inspection can be scheduled
IMPORTANT:
1. Flat roofs must have a minimum of I/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�/ i i 4`/� /M t ��`e a,1-1 111)7y
Job Site Address: O/�/Gl Ge% j /)1"i`n j C�
Roofing Company Name:
• Applicant'sSignatur .�( Date:
Greg Casteel
Building Official
Revised 07/30/08
•
•
•
2 ITEMS OF 2
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 36655004.00
DATE ISSUED.......: 08/25/2008
RECEIPT #.........: BS000005884
REFERENCE ID # ...: 08080189
SITE ADDRESS .....: 11862 PLACER SPRING CT
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA........
OPERATOR: SylviaM
COPY # : 1
METHOD OF PAYMENT
---------
CHECK
TOTAL RECEIPT :
AMOUNT
---------------
247.90
---------247.90
VOICE ID DESCRIPTION
-------- ----------------------------
601 ROOF TEAR OFF
604 ROOF IN -PROGRESS
REFERENCE NUMBER
--------------------
15300
VOICE ID DESCRIPTION
-------- ----------------------------
602 ROOF PLYWOOD NAIL
605 FINAL REROOF
OWNER ............:
MATSUMOTO KEITH AND MICHELLE 0
ADDRESS ..........:
11862 PLACER SPRING CT
CITY/STATE/ZIP ...:
CUPERTINO CA, 95014-5102
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
---------
I_BSEISMICR
-------------------
VALUATION 91000.00
---------- --------------------
0.90 0.00 0.90
----------
0.00
IREROOFRES
SQ FEET 19.00
247.00 0.00 247.00
----------
0.00
TOTAL PERMIT
---------- ----------
247.90 0.00 247.90
----------
0.00
METHOD OF PAYMENT
---------
CHECK
TOTAL RECEIPT :
AMOUNT
---------------
247.90
---------247.90
VOICE ID DESCRIPTION
-------- ----------------------------
601 ROOF TEAR OFF
604 ROOF IN -PROGRESS
REFERENCE NUMBER
--------------------
15300
VOICE ID DESCRIPTION
-------- ----------------------------
602 ROOF PLYWOOD NAIL
605 FINAL REROOF