12050154 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11623 BRIDGE PARK Cf CONTRACTOR:CASTILLO'S ROOFING PERMIT NO: 12050154
OWNER'S NAIVE: YANG MICHAEL M AND JULIE Y 1703 CATHAY DR DATE ISSUED:0512112012
OWNER'SPHONE: 4089967837 SAN JOSE,CA 95122 PHONE NO:(408)251-3565
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL.Ll COVINIERCIAL
EI
License Class 39 Lic.4 RE-ROOF 17 SQ-TEAR OFF,WOOD SHAKES, INSTALL
30LB
Contmcto Date FELT APPLY CAF GRAND CANYON,CLASS A
1 hereby affirm LI I 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:
1 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
perfomtance of the work for whichthis permit is issued. Sq.F1 Floor Area: Valuation:$9500
1 have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for Ste performance of(he work for which this
permit is issued. APN Number:36652060.00 Occupancy Type:
APPLICANT CERTIFICATION �
1 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 complywith all city and county ordinances and state laws relating WITHIN 0 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 DAY M LAST CALLED INSPE TION.
indemnify and keep harmless the City of Cuperiiho against Iiabilities,judgmenls,
costs,and expenses which may accrue against said City in consequence of the !! ZI 2
granting of this permit. Additionally,the applicant understands and will comply Issued by: V Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
of G RF.-ROOFS:
Signal Date All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,I ages to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Signature of Applicant: ! Date:
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF 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(Sce.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). 1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. I will
1 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
performance of the work for whichthis permit is issued. will maintain compliance with The Cupertino Municipal Code,Chapter 9.12 and
1 have and will maintain Worker's Compensation Insurance,as provided for by the IIeallh&Safety Code,Sections 25505,25533,and 255}1.
Section 3700 of the Labor Code,for fie performance of the work for which this
Owner or authorized♦gen Dale:
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 my manner so as to become subject to the Worker's
Compensation laws ofCalifomia- If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must 1 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 state that the above information is
correct. 1 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
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.
Signa Date
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36652060. 00
DATE ISSUED. . . . . . . : 05/21/2012
RECEIPT #. . . . . . . . . : BS000016866
REFERENCE ID # . . . : 12050154
SITE ADDRESS . . . . . : 11623 BRIDGE PARK CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : YANG MICHAEL M AND JULIE Y
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5100
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
---------- ----- ---------- ---- ----- --------- --'
1BCBSC VALUATION 9, 500 . 00 1. 00 0. 00 1 .00 0 . 00
1BSEISMICR VALUATION 9, 500 .00 0. 95 0. 00 0 .95 0. 00
1REROOFRES SQ FEET 17.00 238. 00 0. 00 238.00 0. 00
-------- ------ ----------
TOTAL PERMIT 239. 95 0. 00 239 .95 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 239. 95 17813
---------------
TOTAL RECEIPT 239. 95
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ---- ---------- ----
309 EXTERIOR LATH 311 SCRATCH COAT
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO
(408)777-3228•FAX(408)777-3333•buildingC@cuoertino.org
PROJECTADDRF.SS -1 / APNH
OWNER NAME e� 1^ ,- ,t I i _ „lam- .1 ON , (1 � E-MAIL
STREET ADDRESS 23 g(&� �/1 CITY STATE.ZIP 4i / FAX
li
exj
CONTRACTORNAME l._(/ L ILJ (LICENSE NUMBER .1, LICENl3ElYYPPr BUS,LICA
COMPANY NAME E-MAIL .J FAX
STREET ADDRESS I Z �I Jy, CITY.STASE.ZIP J �+�/ ') PHO
J (� _III UNDERSTAND AND AGREE TO THE FOLLOWING:
1. 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. Proaress 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'/." 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.
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-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 property 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. I also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 Cali formentia Code
Signature of Applicant/Ag Date:
Krrnn/Poh(v 2011elor wvi.vrd 02116111
IR
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CU P ERTI N O (408)777-3228•FAX(408)777-3333•building D(�cuoertino.org
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PROTECT ADDRESS �rl f �/�r APN a ( 2, ^, '5 2—
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OWNERNAME A I Pd V / PHONE / lY—r lQ.V2'� E-MAIL W l/
STREET ADDRESS f V a 1 C . STATE,ZIP (� In.o J- ��Jl/ FAX
CONTACT NAME ST/ • PHO �J�(-� (lGL7F lEE--MAA1L
&4n IAL STREET ADDRESS I ��`j ,2 Y:STA IP �l] 7 FAX
❑OWNER ❑ ONNFR^.BUimm ❑ Ow,E AGENT co,
❑CONtRACFOR AGENT ❑ ARCHOELTVT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTORNAME A...br -h 0's �J..,,rF/., C LICENSE NUMBER �j6 /JJ LICENSE TYPE n BUS,LIC.k
COMPANYNAME � KU(q 7O`� E-MAIL L/(/i`Jf0 (- FAX
STREET ADDRESS/_ CRY,STATE. IP - 2/_3(��
/ (S
ARCHITELVENGINEER NAME LICENSE NUMBER BUS.LIC.k
COMPANY NAME E-MAIL FAX
STREET ADDRESS CRY,STATE,ZIP PHONE
USE OF 00`SFD or Duplex ❑ Multi-Family. ROOF AREA: VALUATION
STRUCTURE, ❑ Commercial I
EXISTMG ROOF TYPE//Jj/J,,,,, 11 BUILT-UP ROOF - 11 ASPHALT SHINGLES WOOD SHAKES ❑WOODSHINGLES 13 OTHER(SPECIFY,
REMOVE IREPLAC YPS IF NO. O PLYWOOD ❑ K" 13PLYWD 11 OSB PITCH: (2 ROOF
❑ NC NLAYER K 13sB" VP 13 Cox CLAS.
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC
//r-ES REPORT a
DESCRIPTION OF WORK:i 6 EE I �O� / �Il/ &
By my signature below,I certify to each of the following: 1 am the property owner or authorized agent to act on the property owner's behalf. 1 have read this
application and the information 1 have provided is correct. 1 have read the Description of Work and verify it is accurate. 1 agree to comply with all applicable local
ordinances and sate law 'ng to buddin - coon. 1 authonze mpresenatives of Cupertino to enter the above-iden Pied pro �n-ylfor inspection purposes.
Signalureof ApplicanUAgen. Data: L� �•
SUPPLEMENTA6hNFORMATION REQUIRED OFFICE USE ONLY
_ if building is associated with a Home Owners Association,provide letter PLAN CHECK TYPE ROUTING SLIP
of approval from HOA. ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
Provide Planing approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
_Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD - .❑ FIRE DEPT
Provide signed copy of Cupertinos Tear-OR-Policy. ❑ OTHER,-
Reroofdpp_I011-doc revised 03.76!11