13080004ph
CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 18900 STEVENS CREEK BLVD
OWNER'S NAME: LOUIS TSANG & LIU ZAU
OWNER'S PHONE: 4082211431
IB' LICENSED CONTRACTOR'S DECLARATION
License Class e 3 q Lic. # D o _q� -_ - _
Contractor =c7�L� Date /'/ ;/ %?
I hereby affirm that I am licensed under a 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
performance of the work for which this permit is issued.
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.
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
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
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.
Signatur weQlf V ate l
❑ OWNER- BUILDERDECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury 'one of the following three
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
Section 3700 of the Labor Code, for the performance of the work for which this
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 any manner so as to become subject to the Worker's
Compensation laws of California. If, after making this certificate of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
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
upon the above mentioned property for.inspection purposes. (We) agree to save
indemnify and keep harmless the City. of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
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.
CONTRACTOR: STATEWIDE ROOFING PERMIT NO: 13080004
INC
5542 MONTEREY RD DATE ISSUED: 08/01/2013
SAN JOSE, CA 95138 PHONE NO: (408)288 -8680
JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL El
(49 SQ'S) TEAR OFF (E) B.U.R ROOF SYSTEM & INSTALL
JOHNS MANVILLE 4GNC BUILT UP TITLE 24 COMPLIANT
ROOF SYSTEM
Sq. Ft Floor Area: I Valuation: $27000
APN Number: 37511073.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF T ISSUANCE OR
180 DAYS F AS LED INSPECTION.
ate:
RE- ROOFS:
All roofs shall be inspected prior to any roofing material being installed: ff a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applican ate: 0
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code Sections 5505, 25533, an 5534.
Owner or authorized agent: Date:,
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
I Signature Date ! I
CUPERTINO
REROOF PERMIT APPLICATION
�0
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014 -3255
(408) 777 -3228 - FAX (408) 777 -3333 - building0cuperfino.org \�
PROJECT ADDRESS 18900 Stevens Creek Blvd.
APN #
OWNER NAME
Louis Tseng
PHONE
408 - 221 -1431
E -MA
E-MAIL
louis.tseng @gmail.com
STREET ADDRESS
19220 Stevens Creek Blvd.
CITY, STATE, ZIP
Cupertino, CA 95014
FAX
CONTACT NAME
PHONE
E -MAIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
❑ OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT 121 CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME Allan Courtney
LICENSE NUMBER 803926
LICENSE TYPE C39
BUS. LIC. # 23509
COMPANY NAME Statewide Roofing, Inc.
E-MAIL E -MAIL mbotill @swroof.net
FAX 408 - 286 -7820
STREET ADDRESS 5542 Monterey Road, #201
CITY, STATE, ZIP San Jose, CA 95138
PHONE 408- 286 -7828
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC. #
COMPANY NAME
E -MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or Duplex ❑ Multi - Family
STRUCTURE: a Commercial
ROOF AREA:
49 squares
VALUATION:
27,000.00
EXISTING ROOF TYPE: IX BUILT -UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE /REPLACE L,�YES
❑ NO
IF NO,
# LAYERS:
PLYWOOD ❑ ' /:" ❑
THICKNESS: ❑ 5/8"
PLYWD ❑ OSB
TYPE: ❑ CDX
F : :12
ROOF
CLASS: A
PROPOSED ROOF TYPE: R BUII,T -UP ROOF ❑ASPHALT SHINGLES 11 WOOD SHAKES ❑WOOD SHINGLES ❑OTHER
ICC -ES REPORT #
DESCRIPTION OF WORK:
Tear off existing roof and replace with Johns Manville 4GNC built up Title 24 roofing system.
By my signature below, I certify to each of the following: I am the property owner or authorized 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
ordinances and state laws relating to buildin ct .Ian orize representatives of Cupertino to enter the above - identified property for inspection purposes.
Signature of Applicant/Agent: Date: 7/31/13
SUPPLEMENTAL INFORMATION REQUIRED
_ If building is associated with a Home Owner's Association, provide letter
of approval from HOA.
_ Provide Planning approval to verify if there any restrictions.
Provide copy of Manufacturer's Installation Specifications.
Provide signed copy of Cupertino's Tear -Off Policy.
oFFrCE USE ONLY
PLAN iC TYPE
ROUTING SLIP
VER -THE- COUNTER
❑ EXPRESS °'
❑' sTANDnitli:
❑ BUILDING PLAN REVIEW
❑ PLANNING PLAN RE W
❑ FIRE DEFT
❑ OTHER: `
'4�1111
ReroofApp_2011.doc revised 03116111
'11�
CITY OF CUPERTINO
fl�,�
FF,F. FRTIMATOR — RIMMING DIVISION
Xfec:h. Plan Check Phuub. Plan Check Elec. Plan Check
tblech. Permit Fee.: Plumb. Permit Fee: Elec. Permit Pee:
Other Allah. L-up. Other Plumb Insp, Other flee. Insp.
A,fech. Insp. Fee: Plumb. Insp. Fee: Elec. Insp. Fee:
NOTE. This estimate does.not include tees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc). These ees are based on the prelimina information available and are only an estimate Contact the De t or addn'l
ADDRESS: '18900 STEVENS CREEK BLVD
DATE: 08/01/2013
REVIEWED BY: MELISSA
QTY/FEE
APN: 37511073
BP #:
'VALUATION:
1$27,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration /Addition/ Repair
PRIMARY
USE: Commercial Building
hrs
PENTAMATION
PERMIT TYPE: 1COMMLR00
WORK
TEAR OFF E). B.Q.R ROOF SYSTEM & INSTALL JOHNS MANVILLE 4GNC BUILT UP TITLE 24
SCOPE
COMPLIANT ROOF SYSTEM
Xfec:h. Plan Check Phuub. Plan Check Elec. Plan Check
tblech. Permit Fee.: Plumb. Permit Fee: Elec. Permit Pee:
Other Allah. L-up. Other Plumb Insp, Other flee. Insp.
A,fech. Insp. Fee: Plumb. Insp. Fee: Elec. Insp. Fee:
NOTE. This estimate does.not include tees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc). These ees are based on the prelimina information available and are only an estimate Contact the De t or addn'l
FEE ITEMS (Fee Resolution. 11 -053 E . 711112)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
4,900 s.£ Re -roof
$383.00 IREROOFCOM
Suppl. PC Fee: (E) Reg.. '0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee-0 Reg. Q OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction I'cax.-
Administrative Fee:
E)
Work Without Permit? ® Yes (E) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non - Residential 0
Building or Structure
i
Travel Docrtrnentutiorr Fees:
Strong Motion Fee: IBSEISMICO
$5.67
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$2.00
$7.67 $383.00 $390.67
Revised: 07/01/2013
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 - building(ED_cupertino.org
PROTECT ADDRESS 18900 Stevens Creek Blvd.
APN # 3 �- _ ( ^ f7 3
OWNER NAME
Louis Tseng
PHONE
408 - 221 -1431
E-MAIL
louis.tseng @gmail.com
STREET ADDRESS
19220 Stevens Creek Blvd
CITY, STATE, ZIP
Cupertino, CA 95014
FAX -
CONTRACTOR NAME
Allan Courtney
LICENSE NUMBER
803926
LICENSE TYPE
C39
BUS. LIC. #
23509
COMPANY NAME Statewide Roofing, nc.
9�
E -MAIL mbotill@swroof.net
@
FAX
408 - 286 -7820
STREET ADDRESS 5542 Monterey Road, #201
CITY, STATE, ZIP San Jose, CA 95138
PHONE 408- 286 -7828
I UNDERSTAND 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 I /4" 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. There- 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 California Residential Code.
Signature of Applicant/Agent: Date: 7/31/13
ReroofPolicy 2011.doc revised 02116111