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10080208 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11772 PINE BROOK LN COr TRACTOR:CASTILLO'S ROOFING PERMIT NO: 10080208 OWNER'S NAME: SANGAMESWARA SHANUBHOG G AND R 1703 CATHAY DR DATE ISSUED:08/27/2010 YER'S PHONE: 4087251492 SAN JOSE,CA 95122 PHONE NO:(408)251-3565 LICENSED CONTRACT/ORB'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r License Class Li,# 7 c' MECH r RESIDENTIAL F COMMERCIAL r Contractor Date c�/'�d I hereby affirm t t I am licensed under the provisions of Chapter 9 JOU�DESCRIPTION:RE-ROOF TEAR OFF WOOD SHAKE,INSTALL 30LB FELT, INS]ALL GAF GRAND CANYON COMP CALSS A 18SQ (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. I have and will maintain Worker's Compensation Insurance,as provided for by Sq, :t Floor Area: Valuation:$9000 Section 3700 of the Labor Code,for the performance of the work forwhich this permit is issued. � APPI Number:36655033.00 Occupancy Type: APPLICANT CERTIFICATION 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. 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. Issiied _ Date: '7 ..� Date OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of instilled without first obtaining an inspection,I agree to remove all new materials for the following two reasons: incl ection. I,as owner of the property,or my employees with wages as their sole compensation, / will do the work,and the stricture is not intended or offered for sale(Sec.7044, I-- Sigt re of Applicant: Date: Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the Ca ifornia Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain performance of the work for which this permit is issued. cot apliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Salety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Ad Ationally,should I use equipment or devices which emit hazardous air cot taminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's C Compensation laws of California. If,after making this certificate of exemption,I Owner r auth gent: - //�� �U become subject to the Worker's Compensation provisions of the Labor Code,I _ - --'" Date: forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I h;reby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address 'inify and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION graining of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I u aderstand my plans shall be used as public records. 9.18. Li--ensed Professional Signature Date CITY OF CU?ERTINO 3 ITEMS OF 9 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: mot: APN 36655033 . 00 DATE ISSUED. . . . . . . : 08/27/2010 RECEIPT #. . . . . . . . . BS000011320 REFERENCE ID # . . . : 10080208 SITE ADDRESS 11772 PINE BROOK LN SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER SANGAMESWARA SHANUBHOG G AND R ADDRESS 11772 PINE BROOK LN CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5111 RECEIVED FROM . . . . : CASTILLO'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 AMCUNT 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 18 . 00 234 .00 0. 00 234 . 00 0 .00 ---- ------ ---------- ---------- ---------- TOTAL PERMIT 235. 90 0.00 235. 90 0 .00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CUPE,RTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: *VALUATION: $9,000 PLAN CHE ZK TYPE: Re-roof *PERMIT TYPE: Minor Building Permit ����ENTAMATION 1SFDWLROOF PRIMARY > RMIT TYPE: USE: SFD or Duplex F t.� ��it �� 1'�. USE: 18SQ TEAR OFF WOOD SHAKE INSTAU 30LB FELT INSTALL GAF GRAND CANYON WORKSCOPE COMP FEE ID ROOF AREA s.L 1REROOFFRES 1,800 7, ( 11"hq.Pleat 'herb F't�,w� 1'!arr t l�cck T_ s7c�rh I'I;rr, C:hc'�f t_Irc. Pcrrt7aN F,'tr- ifcj Zheit. 1 �rrrprl=et' C?ti,c°�°Pit;ltil'>firs,>>. Ills(?_ Pit�rrtf�. T;s1� Ftre: t 1 c.losp tee: -------- tie,f. 'r s�- t�x' NOTE: These fees are based on the preliminaryin ormation availa 5le and are only an estimate. Contact MISC ITEMS or addn'l into. FEE ITEMS (Fee Resolution 09-051 Fff. 7/1/102 FEE QTY/ pjI p7 ('1wck Vcc>: STfE PI1 PC/1'(1,". 1'ltrrrzh.'i1�h�,�rrr.�I,1�.°c' t'1<rrr {'her:k: Permit Fee: $234.00 StapJ 1. I l'y 1�cc I'lz�lrzh ;'11erlr..Isle c (;�}rii VO , 1'lurarl>.-�1���°i�.'lyh�c'Per`fltrt I�G�c': C't)trsFJ`trc ttc�ft �l'r.r.� Work Without Permit. Yes No $O.00 Pltrrtrrirtn f't'c'.�: 7'rc�i>c�i L�r�czrrnc:�lr�iiot� lt'c�.c: I BSEISMICR $0.90 Select an Administrative Item Strong,Motion Fee: Bldg Stds Corarnission Fee: 1BCBSC $1.00 —77 SUBTOTALS: $235.90 $0.00 TOTAL FEE: $235.90 Revised: 8/17/2010 CITY OF CITY OF CUl'ERTINO 2REROOF CUPERTINO PERMIT APPLICATION APN # F -� �� Date: Building Address: Phone # Owner's Name: ;Warq �2- 10 � ,1�-t� �l 11 !1 ' rom HOA HbA: Yes ❑ No If es, provide letter f phone #: Contractor: -2�l 'qS� ��a 5 ����7�� Fax#: Cupertino Business License #: Contractor ic�e�nse � Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ ,Asphalt Shingles u.--<sphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Nwber of existing coverings ❑ Provide I.C.C.E.S. Report# ulTo be Removed ❑ Provide Mfgr. Installation Specs. Job Description. ,eCt l2 L) W U C) h i�� � l I `� Ire �Th S4-R J6 Residential 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: D� I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signa re Revised 02/05/09 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPAPTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BLILDING OFFICIAL CUPERa] TINO 10300 TORRE AVENUE•CUPERTINC, CA 95014-3255 (408)777-3228•FAX(408)777-3333•building(c�cupertino orp PROJECT ADDRESS ' �'�/'1 G/.�. I APN# NER NAME 7 ` PHO'JE -�S _1q i q �� E-MAIL EET ADDRESS - • ���� CITY, ST.ATE,ZIP/� FAX CONTRACTOR NAME _ j LICENSE NUMBE 2 LICE/NJSC�TY/PJ1 C BUS .LIC# COMPANY NAMEJ � f EMAIL FAX TRAj7e3 / CITY,STA fE,ZIP�ji 'bONE •[��r�`I`:N I UNDERSTAND AND AGREE TO THE FOLLOWING: `J I. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimum of one da_y 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 tear-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 within 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 Yo 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 Ipplied without first obtaining an approved inspection will require the removal of all new material down t.) the sheathing so a proper inspection can be performed. 7. A final inspection and approval shall be obtained fr)m the building inspector when the re-roofing is complete. To receive a final sign-off, the following items will be verified: a. Flat roofs shall have a minimum of/4"per foot of slope and must 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. 8. 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-ir spection fee shall be paid before another inspection can be scheduled By my signing below, 1 certify each of the following is true: I am the property owner or authorized agent to act on the property 's behalf. unders and and agree to comply with the re-roof policy stated above. Signature of Applicant/Agent: Date: ,� 2 7 •-/C) ReroofPolicy_2010.doc revised 05/17/10 .Indoor Air Quality and Finishes _., ._. __ . 1 IAQ/l lealth Pts es 0 2.Use Low VOC,Water-Based Wood Finishes 21AQ/Ilealth pts y--yes.the 0 � 3IAQ/liealth pts y--yes 4.Use Salvaged Materials for Interior Finishes 3 Resc urce pts Y--yes0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 6IM-lealth pts y=yes 0 5.Use Exterior Grade Plywood.for Interior Uses 11AQ/-lealth pts y--yes0 - 41AQ/lealth. pts Y--Yes0 B.Use FSC Certified Materials for Interior Finish 4 Resource pts Y--yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Res,)urce pts y=yes 0 10.Install Whole House Vacuum System 3 IACMealth pts y--ye s 0 1 i 1 N.Flooring 1.Select FSC Certified Wood Flooring_ 6 Resoirce pts Y--yes f= 0 0 2. - !9 4 Resc irce pts y=yes 3.Use Recycled Content Ceramic Tiles 4 Resc urce pts Y--yes 4.Install Natural Linoleum in Place of Vinyl 5 IAQ/-Iealth pts .Y--yes0 5.Use Exposed Concrete as Finished Floor 4 Resc urce pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resc urce pts y=yes 0 1 1 1 Total Points Available: 140 130 57 Total Points Project Received: 0 0 0 i G:datalprogs/gresnbullcHi 5erinesfremodelersigreenp6intsfinaJ2.12-04prolectedxls Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 CUPERTINO CONTRACTOR/ SUBCONTRACTOR LIST PERMIT# JOB ADDRESS: i rGZ. - ; IV OWNER'S NAME: v� rn �YtSii�C.1� PHONE# ' GENERAL CONTRACTOR: ` I[O S Y+ �S' ` BUSINESS LICENSE# c © _ ADDRESS: 7V A'i +�3 CITY/ZIPCODE: JQ *Our municipal code requires all busi sses working in the city to have a City of Cupertino siness license. EULED UNTIL THE NO BUILDING FINAL OR FINAL OCCUPANCYINSPECTION(S) HAVE OBTAINED AHCITY OF CU ERTINO GENERAL CONTRACTOR AND ALL SUBCONTRACTORS BUSINESS LICENSE. F-o-7 10 I am not using any subcontractors: Signal ure 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 / oodGlass / Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile 2 7 -16 jd Owner/Contractor Signature Date