14030028CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10083 AMADOR OAK CT
CONTRACTOR: IQV CONSTRUCTION
PERMIT NO: 14030028
INC
OWNER'S NAME: YAO KO-CHIANG ET AL
820 CHARCOT AVE
DATE ISSUED: 03/10/2014
OWNER'S PHONE: 4084483080
SAN JOSE, CA 95131
PHONE NO: (408) 582-9200
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL 0
7 /
3
(4 SQ'S) TEAR OFF (E) BUR, INSTALL SECURE ROCK,
License ClassLic. #C 1
60MIL CARLISLE ROOF SYSTEM
/
Contractor
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
Sq. Ft Floor Area:
Valuation: $2715
performance of the work for which this permit is issued.
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: 34232026.00
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 F LED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
_
costs, and expenses which may accrue against said City in consequence of the
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granting of this permit. Additionally, the applicant understands and will comply
Date:
with all non -point sourf a regulations per the Cupertino Municipal Code, Section
9 18.
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RE -ROOFS:
Signatu4 Date
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an ins ction, I agree to remove all new materials for
inspection.
❑ OWNER -BUILDER DECLARATION
/a
Signature of Applican Date^ / t-/- l7
I 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. I 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
Section 3700 of the Labor Code, for the of the work for which this
the Health & Safety Code, Sections r,
", 25533, and 25534.
performance
Owner or authorized agent: Date:
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
CONSTRUCTION LENDING AGENCY
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
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
918.
Signature Date
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION.
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 A�
(408) 777-3228 • FAX (408) 777-3333 - building a1cupertino.orq 1 v
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❑ OWNER ❑ OWNER -BUILDER ❑ .OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME /
LICENSE NUMBER
LICENSE TYPE
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USE OF ❑ SFD or Duplex ❑ Multi -Family
ROOF AREA:Jl
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VALUATION:
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STRUCTURE: ❑ Commercial
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EXISTING ROOF TYPE: , 'W BUILTAJP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE /REPLACE ®YES
IF ERS
PLYWOOD ❑ �%" ❑
PLYWD ❑ OSB
PITCH:
ROOF
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THICKNESS: ❑ S/6"
TYPE: ❑ CDX
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CLASS:A
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PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF. ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES OTHER
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DESCRIPTION OF WORK
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By my signature below, I certify to each of the following: I am the property owmer or authorized agent to act on the property owner's behalf. I hav1%01-4
application and the information I have provid id is correct. I have read the Description of Work and verify it is accurate. I agree to comply with alloc
ordinances and state laws relating to bui struction. I authorize representatives of Cupertino to enter the above-identifiedperty for inspection purpose .
,
Signature of ApplicandAgent: Date: ��
SUPPLEMENT INFORAATIONREQUIRED
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If building is associated with a Home Owner's Association, provide letter
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❑pk BUILDII G'PL'AT RE\'Ilya
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_ Provide Pliinnino „ approval to verify if there any restrictions.
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Provide copy of Manufacturer's Installation Specifications..
Provide signed copy of Cupertino's Tear -Off Policy,
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ReroofApp_2011.doc revised 03/16/11
REROOF TEAR -OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISIO
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
CUPERTINO (408) 777-3228 - FAX (408) 777-3333 - building aQcupertino.org
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I 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 one business day before the requested inspection date.
Please 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.
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.
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 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.
7. NOTE: If"you call for a tear -off or plywood nailing inspection and the work is not complete, you Mll 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 det tors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code. _
Signature of Applicant/Agent: Date: /
Reroo)Tohcy_2012.doc revised 10/7/12