10050112CITY OF CUPERTINO FUILDING PERMIT
BUILDING ADDRESS: 18860 LOREE AVE
CON'rRACTOR: CASTO ROOFING
PERMIT NO: 10050112
OWNER'S NAME: CELIA LA RIVIERE
1938 QLD MIDDLEFIELD WAY
DATE ISSUED: 05/12/2010
TR'S PHONE: 4082524609
MOUNTAIN VIEW, CA 94043
PHONE NO: (650)961-8922
LICENSED CONTRACTOR'S DECLARATIONF
L_ � � l � L
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic. # `
r— F f—
ContractorC : rl•\'}U&JAt',,,X-T-,C- Date 2_1 r b
MECH RESIDENTIAL COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: RE -ROOF REMV EXISTING TAR & GRAVEL & REPLACE
(commencing with Section 7000) of Division 3 of the Business & Professions
W/SA VIE CLASS A 18SQ
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.
Sq. V Floor Area:
Valuation: $6100
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
permit is issued.
APN Yumber: 37515017.00
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,
`'VITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
180 D YS FROM ST CALLED INSPECTION.
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Issued by. L �� Date:
Si ature Date
RE -ROOFS:
V OWNER -BUILDER DECLARATION
All ro >fs 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
install:d without first obtaining an inspection, I agree to remove all new materials for
the following two reasons:
inspection.
I, 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,
Signal ure of Applicant: Date:
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
I hereby affirm under penalty of perjury one of the following three
declarations:
HAZARDOUS MATERIALS DISCLOSURE
I have and will maintain a Certificate of Consent to self -insure for Worker's
I havi read the hazardous materials requirements under Chapter 6.95 of the
Compensation, as provided for by Section 3700 of the Labor Code, for the
Calif(rnia Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
performance of the work for which this permit is issued.
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
I have and will maintain Worker's Compensation Insurance, as provided for by
Safety 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
Addit onally, should I use equipment or devices which emit hazardous air
permit is issued.
contaminants as defined by the Bay Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is issued, I shall
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If, after making this certificate of exemption, I
Own / / �L )
become subject to the Worker's Compensation provisions of the Labor Code, I ust
4 Date: 5`
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I herel,y affirm that there is a construction lending agency for the performance of work's
I certify that 1 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
Lend(r'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
Lend(r's Address
mnify and keep harmless the City of Cupertino against liabilities, judgments,
, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
ARCHITECT'S DECLARATION
with all non -point source regulations per the Cupertino Municipal Code, Section
I unde -stand my plans shall be used as public records.
9.18.
Licen: ed Professional
Signature Date
CITY OF
CUPERTINO
CITY OF CUPERTINO
REROOF
PERMIT APPLICATION
c,
APN # 7 1
Date:
Building Address: .-.
Al
Owner's Name: y, •K&D
Phone #
�jZ,
HOA: Yes ❑ No If es, rovide letter from HOA
Phone #: '<
Contr(act_on,, �jj"j
(,"J (
Fax #: i
Cupertino Business License #:
`-Z 21
Contractor License #:
Se) Z3
Type of Roof Covering:
Existing: Proposed:
Built -Up Roof Built -Up roof
❑ Asphalt Shingles
Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.C.E.S. Report #
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
Residential l Commercial ❑
Green Building: Please complete relevant portion ,)f 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:;
I Have Read, Understand and Will Comply with Cup-_rtino's Tear -Off Policy:
Sign e
Revised 02/05/09
CITY OF
CITY OF CUPERTINO
2 REROOF
CUPERTINO FEE SCHEDULE
Number of
Squares
Fee ID
Fee Description
Fee
Group
Permit Type
1REROOFCOM
Re -roof Commercial
B
1COMMLROOF
1BCBSC
Cal Bldg Standards
Commission Fee
B
ALL PERMIT TYPES
1BSEISMICO
Seismic Commercial
B
1RER00FRES
1BCBSC
Re -roof Residential
Cal Bldg Standarc s
Commission Fee
B
B
1SFDWLROOF
ALL PERMIT TYPES
1BSEISMICRE
Seismic Residential
B
1REROOFMRES
Re -roof Multi -Family
B
1MFDWLROOF
1BCBSC
Cal Bldg Standards
Commission Fee
B
ALL PERMIT TYPES
1BSEISMICRE
Seismic Resident:.al
B
1BUSLIC
Business License
B
3 ITEMS OF 3
CITY OF CUPEPTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lo=:
APN ........: 37515017.00
DATE ISSUED.......: 05/12/2010
RECEIPT #.........BS000010389
REFERENCE ID # 10050112
SITE ADDRESS 18860 LOREE AVE
SUBDIVISION ......
CITY CUPERTINO
IMPACT AREA ......
OWNER CELIA IA RIVIERE
ADDRESS . 18860 IOREE AVE
CITY/STATE/ZIP ...: CUPERTINO, CA 95014
OPERATOR: patg
COPY # : 1
RECEIVED FROM LINDSEY D CASTO
CONTRACTOR CASTO, LINDSEY LIC # 21324
COMPANY CASTO ROOFING
ADDRESS 1938 OLD MIDDLEFIELD WAY
CITY/STATE/ZIP ...: MOUNTA::N VIEW, CA 94043
TELEPHONE (650061-8922
FEE ID UNIT
QUANTITY
AMOU.�TT
PD -TO -DT
----------
THIS REC
----
--NEW-BAL
-----------------------
1BCBSC VALUATION
1BSEISMICR VALUATION
1REROOFRES SQ FEET
----------
6,100.00
6,100.00
18.00
----------
1.00
0.70
234.00
0.00
0.00
0.00
------- ---
1.00
0.70
234.--
----------
0• 00
0.00
--- -0_00
TOTAL PERMIT
----------
235.70
0.00
235.70
0.00
METHOD OF PAYMENT
-----------------
CREDIT CARD
TOTAL RECEIPT
AMOUNT
---------------
235.70
---------------
235.70
VOICE ID DESCRIPTION
-------- ---------------------
601 ROOF TEAR OFF
604 ROOF IN -PROGRESS
REFERENCE NUMBER
--------------------
VISA
VOICE ID DESCRIPTION
-------- ------------------------
602 ROOF PLYWOOD NAIL
605 FINAL REROOF
CUPERTINO
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
(408) 777-3228 - FAX (408) 777-3333 - buildincCaDcupertino.org
PROJECT ADDRESS
APN #
OWNER NAME d` j
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PHi- �& " '7 Z _ L�(sC?
V 1
E-MAIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
CONTRACTOR NAME
LICENSE R
BUS. LIC. #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS -5 _. `� (�
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CITY, STATES ZIP{�(� e � �� 94 J at
PHO
I UNDERSTAND AND AGRE`3 TO THE FOLLOWING:
1. The re -roof project shall comply with all applicable provisions of the 2007 California Building Code.
2. An inspection request shall be scheduled the day before the inspection date. Please call (408)777-
3228 between 7:30 - 3:30pm (Mon -Fri) to schedule the next day inspection.
3. After the roof is torn off and the nails/fasteners have been removed and all the dry -rotted wood has
been replaced, you must call for a roof inspection. A building inspector will be available with one hour.
There are special hours for the service: 7:30 — 10:30 im and 1:00 — 3:30pm (Mon — Thurs);
7:30 — 10:30 im and 1:00 — 2:30pm (Friday).
4. If plywood is installed, a plywood nailing inspection � s required.
5. New roof coverings shall not be applied without first obtaining all 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. 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 item will be verified:
a. Flat roofs shall have a minimum of/" per foot of slope and demonstrate there is no ponding.
b. A listing from an approved testing agency shall be available on-site to review at the time of the
inspection.
c. Proper spark arrestor installation.
7. NOTE: If you call for a plywood nailing inspection rind the job is not ready, you will be charged to a re-
inspection fee of $126.00. The re -inspection fee sha: l be paid before another inspection can be
scheduled.
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on
.ie property owner's behalf. I underst d agree o cors ply with the re -roof policy stated above. j p
ISignature of Applicant/Agent, Date:
ReroojPolicy_20 10. doe revised 04114110