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12040162CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11757 PINE BROOK CT CONTRACTOR: CASTILLO'S ROOFING PERMIT NO: 12040162 OWNER'S NAME: SIMON CHENG 1703 CATHAY DR DATE ISSUED. 0427/2012 OWNER'S PIIONE: 4087251111 SAN JOSE, CA 95122 PHONE NO: (408)251-3565 ❑ LICF:NSF.DD CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COti1MERCIAL ff- 3 RE 17 SQ- REMOVE SHAKEROOF, INSTALL 30 LB License Class / Lic, a -ROOF FELT, GAF GRAND CANYON COMP Contra Date 7 0�- I hereby affirm that 1 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. 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 whichthis permit is issued. Sq. Ft Floo rea: tion: $9000 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 60405 0 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 F LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Date: granting of this permit. Additionally. the applicant understands and will comply Issued by: with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Sign Date 7 .�- RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without First obtaining an inspection, f agree to remove all new materials for inspection. r �i L��' ❑ OWNER -BUILDER DECLARATION Signature of Appli C� �a Date: 1 hereby affirm that 1 am exempt from the Contractor's License Law for one of or the following two reasons: ALL ROOF C VERINGS 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 (Sce.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. 1 will 1 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(a) should I store or handle hazardous l 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 whichthis 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 dee performance of the work for which this Owner or authorized Dale: permit is issued. 1 certify that in the performance of die work for which this permit is issued, I shalt not employ any person inany manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, l must l 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. w'ork'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 fix inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, AR('IIITF:CT'S DF:C'I.ARATION costs, and expenses which may accrue against said City in consequence of the I understand my pians shall be used as public records. granting 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 BUILDING PERMIT BUILDING ADDRESS: 11757 PINE BROOK CT CONTRACTOR: CASTILLO'S ROOFING PERMIT NO: 12040162 OWNER'S NAME: SIMON CHENG 1703 CATHAY DR DATE ISSUED: 04272012 OWNER'S PHONE: 4087251111 SAN JOSE, CA 95122 PHONE NO: (408)251-3565 ❑ LICENSEDCONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL 3 50 n RE 17 SQ- REMOVE SHAKEROOF, INSTALL 30 LB License Class / Lic, q -ROOF FELT, CAF GRAND CANYON COMP Conlm Dalc 7 ri- 1 hereby aRrm that 1 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 Sq. Ft Floor Area: Valuation: $9000 performance of the work for which this permit is issued. 1 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: 36604055.00 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 properly for inspection purposes. (We) agree to save 180 DAYS F LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the iL 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. n �1 / RF --ROOFS: Sign tZurc�.0 l Date �` .� i' All roofs shall be inspected prior to any roofing material berg installed. If a roof is installed without first obtaining an inspection, 1 agree to remove all new materials for inspection. / ' ❑ OWNER -BUILDER DECLARATION Signature of Appli Date: 1 hereby affirm that 1 am exempt from the Contractor's License Lew for one of the following two reasons: ALL ROOF C VERINGSTO 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) 1, 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. 1 will I hereby affirm under penally 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 whichthis 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 25531. Section 3700 of the Labor Code, for Ate performance of the work for which this Owner or authorized Dale permit is issued.: I certify that in the performance of die work for which this permit is issued, I shall not employ any person many manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I CONSTRII('f10N LENDING ACF.NCI' 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 slate 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 properly for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting 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 Dale CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36604055.00 DATE ISSUED.......: 04/27/2012 RECEIPT #.........: BS000016648 REFERENCE ID # ...: 12040162 SITE ADDRESS .....: 11757 PINE BROOK CT SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OPERATOR: SylviaM COPY # : 1 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT : AMOUNT --------------- 239.90 --------------- 239.90 VOICE ID DESCRIPTION -------- ---------------------------- 309 EXTERIOR LATH 601 ROOF TEAR OFF REFERENCE NUMBER -------------------- 177772 VOICE ID DESCRIPTION -------- ---------------------------- 311 SCRATCH COAT 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF OWNER ............: SIMON CHENG ADDRESS ..........: 11757 PINE BROOK CT CITY/STATE/ZIP ...: CUPERTINO, CA 95014 RECEIVED FROM ....: CASTILLO 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 9,000.00 -------------------- 1.00 0.00 ---------- 1.00 ---------- 0.00 1BSEISMICR VALUATION 9,000.00 0.90 0.00 0.90 0.00 1REROOFRES SQ FEET 17.00 238.00 0.00 238.00 0.00 TOTAL PERMIT ---------- ---------- 239.90 0.00 ---------- 239.90 ---------- 0.00 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT : AMOUNT --------------- 239.90 --------------- 239.90 VOICE ID DESCRIPTION -------- ---------------------------- 309 EXTERIOR LATH 601 ROOF TEAR OFF REFERENCE NUMBER -------------------- 177772 VOICE ID DESCRIPTION -------- ---------------------------- 311 SCRATCH COAT 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT 2SALVADOR, P.E., C.B.O., BUILDING OFFICIAL oo� _jr. cLlnrovMA. N 050149255 CuPERTINO (408)777-3228-FAX(408)777-3333` building(dcuperlino.org PROJECT ADDRESS I I%5-7 19, r /n\ (J(J APN° •TIq(� ^-. h a �y i/ OWNERNAME ` PHONE- IV E-MAILj STREETADDRESS I 1-7:S_7 ITV. STA fly • CONTRACTOR NAME I r J rZIP LICENSE NUMBER r/ _ J((f LICENSE PE BUS. LIC. u COMPANY NAME E-MAIL FAA J STREET ADDRESS I� O3 CITY,S E. ZIP .qn PHONE o8- I UND RSTAND AND AGREE TO THE FOLLOWING: The re -roof project shall comply with all applicable provisions of the 2010 California Codes. 2. An inspection request can be scheduled up to the day before the inspection date. Please call (408)777- 3228 from 7:30 - 3:30pm (Mon-Thurs) or 7:30 - 2:30pm (Friday) to schedule the next day inspection. For Tear -Off and Nailing Inspections, you must also call on the day of the inspection only after that phase of the work is completed. The building inspector will be available within one hour. Progress and Final Inspections will be given a two hour window. 3. Tear -Off Inspection is required. Any and all dry -rotted wood shall be replaced prior to this inspection. Unless new plywood roof sheathing is proposed throughout, all the nails/fasteners shall be either completely knocked -down or removed prior to this inspection. 4. If plywood is installed, a plywood Nailing Inspection is required. 5. Roofing shall not be applied without first obtaining all prior inspection 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. 6. Progress Inspection is required when approximately 50% of roof covering is installed. 7. A Final Inspection and approval shall be obtained from the building inspector when the re -roofing is completed. To receive a final sign -off, the following items will be verified: a. Flat roofs shall have a minimum of 1/0 per foot of slope and demonstrate there is no ponding. b. Listings from approved testing agencies for all pre -manufactured products used shall be available on-site to review at the time of the inspection. c. Proper spark arrestor installation, vents painted, gutter/downspouts installed, debris removed. NOTE: If you call for a tear -off or plywood nailing inspection 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 each of the following is true: I am the properly owner or authorized agent to act on the property owner's behalf. I understand and agree to comply with the re -roof policy stated above 1 also understand that smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sectio s R314 and R315 of the 2010 California Residential ode - (' �I SienatureofADolican Date: 1 �� (�oc- ReroolPolirr 2011. dor ww.wd 02/16// / CUPERTINO REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO. CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building0cuoertino.orn IN -IT-7 I2&40)(Qa. PRO=ADDRESS I I'7S7 A( ,, APNa 1p(p (-JT OS OWNER NAME 1 PHONE las I I B -MAB. STRFFf ADDRESS S� P Cf1Y STA'tf,Z@ �fjOl q FAX . APPLICANT NAME. PHONE E-MAIL STREET ADDRESS I CRY ST ffi (A' 95 I2 % FAX ❑OwNFJt ❑OWNER-BNIDEA ❑OWNFAAOFM CONT0.ACIOR ❑COMRACTOR AGENT ❑ AR❑ifiFlT ❑ENGQ.E'E7711 ❑ DEYFIOPF]t ❑TFNAM CONTRACTOR NAME LICENSENUMBER LICENSETYFE�f` v I BUS. UCa COMPANY NAME •� E-MAIL FAX STREET ADDRESS CRY, STATE, PHONE /J 6 "+ �--t R ARCH'EC IENGMER NAME LICENSE NUMBER BUS. LIC. a COMPANY NAME E-MAIL FAX STREET ADDRESS CrrY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi -Family ROOF AREA: VALUATION: ❑ Commercial1-7 .-- V •+A.� STRUCTURE: , EXISTNO ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHMOLES WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE IRiPLACE IF NO. PLYWOOD ❑ N"❑ PLYD OS PTC1 ❑ N a 13 SR" SF 2 S. A PROPOSED ROOF TYPE: ❑ BUILT-I)P ROOF & ASPHALT SMNGLES ❑ WOOD SHAKES ❑ W00D SFBNGLES ❑ OTHER ICC -ES REPORT N DESCRIPTION OF WORK RRM• rw S1 agz om 36 / . By my signature below, I certify to each of the following I am the property owner or authorimd 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 ordinanvs and state laws relating to uildie nstruqXp I authoria repres ntatives of Cupertino tc enter the abov id tified pm, . ; fo: inspection purposes. Signature of App Neon Date: SUPPLEMENT INFORMATION REQUIRED , :-`"--< FnTce''DS's'."EomYA- -_•— If building is associazed wi a Home Owner's Association, provide letter �BI:AN'rDE^`'"'°� � o"�-��RtutrtNc,•sl�'=->r�: _ of approval from HOA. a� � 34 'hsr -" '=��-'P � -;-.. �r f. VER rEZCMUNIETt ..� $9®1NG P}NAti'I W Provide Planning approval to verifyif there any restrictions. Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cupertino's Tear -Off Policy.��. ReroofApp_2011.doc revised 03/02111