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13120024 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22653 QUEENS OAK CT CONTRACTOR:IQV CONSTRUCTION PERMIT NO:13120024 INC OWNER'S NAME: SURESH MASURKAR:&LATA BHANDARKAR 820 CHARCOT AVE DATE ISSUED:12/03/2013 OWNER'S PHONE: 4082185727 SAN JOSE,CA 95131 PHONE NO:(408)582-9200 137 13 LICENSED CONTRACTOWS22DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class Lic.# ',X3 21 33 SQ'S(6 DETACHED GARAGES,ONE BLDG rr 11 22631,22633,22641,22643,22651,22653)REMOVE(E) Contractor TO V Date—(2= B.U.R.,INSTALL(N)CARLISLE 60 MIL TPO OVER 1/4 I hereby affirm that 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: 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.Ft Floor Area: Valuation:$917 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:34232062.00 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 property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, 1 I costs,and expenses which may accrue against said City in consequence of the Issued by: Date: 52 granting iof this permit. Additionally,the applicant understands and will comply with all on-point sour a regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signatur Dat All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first o4,,,mnngan' spection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION 2Signature of ApplicantDate: S 1 hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 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 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 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 which this 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 255 25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Dated �--11 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 CONSTRUCTION LENDING AGENCY 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 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 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, 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 Date REROOF PERMIT APPLICATION u� COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION. 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 Cl1PER-C'EhiO. (408)777-3228• FAX(408)777-3333•buildino(o1cupertino.org 2cx�vq PRO=ADDRESS ueQ� QCc C1 I APN OWNERNAME. � � A,�r PHONEZ �Z��j s" ADDRE53/�_-ss Dry . ` rhe FAX CONTACT NAME I I re e,, PH7 dg-- E MAIL STREET ADDRESS 7 7 C tti S� CITY,STATE ZIP !C GEt V' O J e CA FAX 13 OWNER ❑ OWNER-BUB-DER ❑.OWNERAGENT ❑ CONTRACTOR 11CONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONIRACfORNAMFT U ,lJa ,^c 4� Q 1 LICEI�SENUMBER%3Z/ LICET�TSETYPEBUS.LIC. COMPANY NAME 1/ c� 'V, E-MAIL FAX STREET ADDRESS 7/ I S, CITY,STATE,ZIPS PHONE ARCHTTECT/ENGINEER N(AME- LICENSE NUMBER BUS.LIC.4 COMPANY NAME EMAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: �J STRUCTURE: ❑ Commercial S 3_0 ' v` EXISTING ROOF TYPE: _ABUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE AYES IF NO, PLYWOOD �Si'/a" ElPLYWD ElOSB PITCH: ROOF ❑NO 9 LAYERS: A THICKNESS: ❑ 5/8" TYPE: ❑CDX 12 I CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT' DESCRIPTION OF WORK `ADS CG,t'�/�S D uec� S �©CK 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 cone 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 ons I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. S ignature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED — �? _If building is associated with a Home Owner's Association,provide letter � ERozITII` WEof approval from HOA. �I� R T cb. `TER =�tlrr� GFLAi� w Provide Planning approval to verify ifthere any restrictions. �: EvrE : Provide copy of Manufacturer's Installation Specifications.. Provide signed copy of Cupertino's Tear-OffPolicy. ReroofApp_2011.doc revised 03116111 REROOF TEAR-OFF POLICY IQ COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTIN0 (408)777-3228• FAX(408)777-3333-buildingecupertino.org PROJECT ADDRESS APN# OWNER NAMEW ^ n ! PHONE E-MAIL 112 STREET ADDRESS ��S C r /� C1TY�L'( ,,i STATE,Z1Pbe-8 sQQ FAX CONTRACTOR"! Lao ST SE NUMB%3 ,/7 LI Q63 z 1 C 3 BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS Crr �B S-J O PHONE O G_ 7 o / I UNDERSTAND AND AGREE TO THE FOLLOWING: o 1. The re-roof project shallcomply with all applicable provisions of the 2010 California Codes. 2. An inspection request can be scheduled up to one business day before the requested inspection date. Please schedule inspections online or call (408) 777-3228 from 7:30-3:30pm(Mon-Thurs) or 7:30- 2:30pm(Friday)to schedule 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. The hours for this service are: 7:30-10:30am and 12:30-3:30 (Mon-Thurs) and 7:30-10:30am and 12:30-2:30 (Friday). 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. 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 1/4"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. 7. 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. 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 ar equired to be installed in accordance with Sections R314 and R315 of the 2010 California Residential Code.- I Signature of Applicant/Agent: Date: ReroofPoligy_ 013.doc revised 10/20/13 COMMUNITY MANAGEMENT SERVICES October 1, 2013 City of Cupertino Building Department 10300 Torre Avenue Cupertino, CA 95014 Re: Westridge Country Club Homes Association Gentlemen: This office is the management company for the above homeowners association and the Board of Directors requests your assistance in obtaining a Permit for the installation of new roofs at this complex in Cupertino, CA 95014. Please be advised that IQV Construction, Inc. or Jim Lyons of Construction Services,Inc. will be obtaining the permits on behalf of the Board of Directors. Thank you for your anticipated cooperation. Sincerely, COMMUNITY MANAGEMENT SERVICES Pauline M.A.Moore, Senior Association Manager Westridge Country Club Homes Association cc: IQV CSI Board of Directors 1935 Dry Creek Road, Suite 203■Campbell, CA■95008-3631 ■voice (408) 559-1977 ■fax (408) 559-1970