08110084 CITY OF CUPERTINO `. -
13UILDING DIVIFION
PERMIT 9tCOZ R A"TOR N U N�� ' �'', N
BUILDING ADDRESS: PERMff NO.
11618 BIRCH SPRING CT CASTILLO' S ROOFING
OWNER'S NAME: PERMTI SUE DATE
ONE:
A O. CONTROL NO.
(408) 251-3565
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
�O' LICENSED CONTRACTOR'S DECLARATION lob Description
U I Acme,alt rse Nat 1 am licensed under provisions,of Chapter 9(commencing
with Section 7(100)Of Division 3ef the,Budrrs•and Professions Cad,aad my license I, RE—RF T/O EXT WDSHK INSTL 30LB FLT NEW COMP
n�s in fail forceaMeffm ys�
Lieertc Class 5 Lie.. .
r Date I y / Coruscmr SHNGLS
ARCH=S DECLARA CLS A 19S
Ig6 1 maturated ted my plans shall be used as public record 4
s G Licensed Perfessiana
5 OWNER-BUILDER DECLARATION
a� f I hereby from that 1 am exempt from the ConuactoYs license Law far f
COO following reason.(Section 7931.5.Business and Professions Code:Any city or county
which requites a Permit m construct,neer.improve.demolish,or repair any euummu
LZ prior in its issuance,also requires the applicam for such permit to file.signed.1 me mt
< that heis licensed pursuant Wfpnevismetofthe Common's LiccnmLaw(Chapter 9 Sq.Ft.Floor Area Valuation
at a (commencing with Section 7000)of Division 3 of the Business and Professions Code)or 9500
that he u exempt therefrom and f basic for the alleged exemption.Any violation of
Section 7071.5 by any applicant fa a permit subjects tiro applicant m•CMI Penalty of APN Number Occupancy Type
not fame don five hundred dollers($500). 36654075 . 00
❑1,u owner of tW property,or my employees with wages as their sole oompensxdon,
will de the work and the Sanctum W not intended or Offered for sale(Sec.7061,Business, Required Inspections
and pnefesaans code:Tie Contractors License Law des,not appy e an owmmi e of q P
Property who build or improves thereon and who does such work himself or toc ugh his
owo amplaycs,provided that such impmvemenss are am intended oraffucd for sale.If.
however,the building or impmcement is sole wi hie can year of completion.Ne owner,
Wilder will base th burden of proving that he did not Wild or improve far purpose of
al.j.
I.as owner of tie property,w eseluse al,contracift with licensed conuusors W
cortsuun due project(Sec.7014,Busine s and Professions Cod:)The Contractor's Li-
cense Law dors not apply to an owner of property who Wiles or imposes thereon,and
wW contracts far such projects with a conuanar(s)licensed pursuam as de Conucme,
License law.
❑IamaemptundrSoc. ,B&PCiends. amn
Owner Dam
WORKERS COMPENSATION DECLARATION
I hereby affirm under pnWty of perjury am of f following declantiow
I Aute and will maintain a co,Iincateaf Conant tosel6insum for Workere.Campm
tion,at provided far by Section 5700 of ase Luther Cad,far the performance of the
wort for which this permit is issued.
❑1 love and will maintain Worke(a Compensation Insurance,as required by Section
1700 of the Labor Code.far the performance often work far which this permit ulsoed. '
My Wortr s orop�e�s�auen a and policy number art:
Grrier r � ��4 PWicy Ha.:�3o � 9�
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
CrnW section need not bucompleeJ if tie permit Is forum hundred dollars($100)
or ins)
1 ceNfv that In f performace of the work for which this Permit W issued,l shall not
employ any person in my manner se sm to become subject to tW Workers'Compensation
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If,after making this Certificau of Eicmption,you should
become Subject m the Woher's Compensation provision of the labor Code you muss
�O forthwith comply with such provisions rev
ovisions or this permit mall W doemoked.
'Z Di CONSTRUCTION LENDING AGENCY
F+� IWrebyaffum that Jere isacmad
tsuunn lending.gmcY for Jeperfmmancoof
CC .�-, Ne wart for which this permit is iamd(Sce.3097.Civ.C)
0 Lemes' Name
=,z Landeh Address
U Q I ramify Na I have mad Nu application and sum than the above OfermaWn W
tf.!' comm I signs to comply with all city and county ordinances and sure laws relating te
.O Wilding con LIOCEmn,and Wreby induction representatives of this city to enter upon the
W above-mendoxd property for impaction purposes.
gy (We)agme to ave.indemnify and keep homeless the City of Cupertino against
ti rq liabilities,judgmcnb,costs and expenses which may in any my amore againsImid City f,//
U Z in consequence of the granting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOUR R UL Ns,
Re-roofs
ow,u of AFit II=dContacwr Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
B tie applicant or furore Wilding occupant score or Media haardous materia
as dclined by the Cupertino Municipal Code.Chapter 9.13,and f Ha1N and Safety
Cede.Section 25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yes N"
veil the applicant or future Wilding acmpanl um equipment or devices which If a roof is installed without firs[obtaining an inspection,I agree to remove
it hvvdnns air mn.m.nu ode toad by due Bay Ata Air ouaby Management all new materials for inspection.
u ct7
Ayes
I have mad Lou haamrars materials requirements andcrchapmr6.95 ofthe Califor_ /�
nia Health&Saety Code.Seedoms2550.5,25533 and 75534.I understand matiftite baarag / D
does not currently haw a tenant.that it is my responsibility to notify f=want of ihc7
reyulrementsw' m met pier toe' vancc oft Certifmae of cu $I nater Of Applicant Date
All roof coverings to be Class'A"or better
et utherimdagent Dam
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: pdtg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . . 36654075 . 00
DATE ISSUED. . . . . . . : 11/21/2008
RECEIPT # . . . . . . . . . : BS000006673
REFERENCE ID # . . . : 08110084
SITE ADDRESS . . . . . : 11618 BIRCH SPRING CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER POON KA L AND VIVIENNE W
ADDRESS . . . . . . . . . . : 11618 BIRCH SPRING CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5138
RECEIVED FROM . . . . : CASTILO' S 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
---------- --- -------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 9, 500 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1REROOFRES SQ FEET 19 . 00 247 . 00 0 . 00 247 . 00 0 . 00
---------- ---------- ---------- ----
TOTAL PERMIT 248 . 00 0 . 00 248 . 00 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
-- --- -- --------------- ------------
CHECK 248. 00 #15504
---------------
TOTAL RECEIPT 248. 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------- -- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
Ism
Community Development
10300 Torre Avenue
i' Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
.4UPEkTINO
Building De artment
JOB ADDRESS: PERMIT#
I - tr r 'n C .
OWNER'S NAME: ("I PHONE # - 251-3 oS
GENERAL CONTRACTOR 0— -h (js ii FAX #
I am not using any subcontractor; \'
Signature Date
Please check applicable subcontractors and complete the following information:
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/Contractor Signature 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 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:
Job Site Address:
Roofing Company Name: C/S g ` 4 S ��
Applicant's Signature 4_-21 Date: /a
• Greg Casteel
Building Official
Revised 07/30/08
CITY OF CUPERTINO o of q
Jaw
REROOF
Of
:CUPERTINO PERMIT APPLICATION
APN # _ / 6' / 0� U Date:
/
Building Address: "�
i rC 'llolivC'
Owner's Name: Phone #:
Contractor: Phone #:
�Zsi-3s�s
0 ASTI I I0 Fax #: S 2.
Cupertino Business License #: Contract q�License
Type of Roof Covering: L�
Existing: Proposed:
o Built-Up Roof ❑ Built-Up roof
❑ *phalt Shingles a--?Vsphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) o Other (Specify)
Nuryber of existing coverings o Provide I.C.B.O. Report #
er To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: TeAr d f rac,�Fi Wood S ha►ce b( ft it 36 1 b.
NeU,3 Cowl Sh,
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: 506
-tel
I Have Rea , Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
am?
CITY OF CUPERTINO
REROOF
CUPEkTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
1REROOFRES Re-roof Residential B 1SFDWLR00F
/ 1BSEISMICRE Seismic Residential B
1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08
•