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14010034 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22692 LIBERTY OAK LN CONTRACTOR:IQV CONSTRUCTION PERMIT NO:14010034 INC OWNER'S NAME: ZE SHU QI-BAO 820 CHARCOT AVE DATE ISSUED:01/07/2014 OWNER'S PHONE: 4085591977 SAN JOSE,CA 95131 PHONE NO:(408)582-9200 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL 11 COMMERCIAL E] G� — / C� RE-ROOF 4 SQ-REMVOE EXISTING BUR INSTALL License Class �3 ( Lic.# �C� �/ 1 SECURE Contractor �Q Date— l - ROCKS&60MIL CARLISLE ROOF SYSTEM 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:$2714 have and will maintain Worker's Compensation Insurance,as provided for by ection 3700 of the Labor Code,for the performance of the work for which this APN Number:34232041.00 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 WITIIIN 180 DA RMIT 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 ST CALLED 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 granting of this permit. Additionally,the applicant understands and will comply Is b with all non-point sourc regulations per the Cupertino.Municipal Code,Sectio 9 18. / RE-ROOFS: Signature Date `( � All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an' pection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: 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 the Health&Safety Code,Sections 25 33,and 25534. / Section 3700 of the Labor Code,for the.performance of the work for which this 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 he 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 918. Signature Date REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION. 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO. (408)777-3228• FAX(408)777-3333•building eupertino.org PROJECT ADDRESS• 265 Z l (� �C r , APN# 32 �I OWNER NAMP �_ _ e S STREET ADDRESS CITY,STATE,ZIP FAX CONTACT NAMEPHONF E-MAIL l '(, r r v xC.'S.S Z t 55 - S 7 c 7 STREET ADDRESSC11 Y,STATE,ZIP FAX • � ( S X. ! a ❑ oNxwm ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME / LICENSE NUMBER LICENSE TYPE BUS,LIC.B� COMPANY NAME E-MAIL FAX 4- h s: , STREET ADDRESS �- CITY,STATE,ZI PHONE ARCIIITECT/ENGINEERNAME LICENSE NUMBER BUS.LIC.Il COMPANY NAME EMAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: STRUCTURE: ❑ Commercialt� . `t-�� EXISTING ROOF TYPE: ,RIIUFLT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE ®YES IF NO, PLYWOOD ❑ %i' ❑- PLYWD ❑ OSB PITCH: ROOF NO A LAYERS: THl iO' S ❑5/8" TWE: ❑ CD 'l 2 LASS: A - -- -- PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ElWOOD SHAKES ❑WOOD SHINGLES OTHER ]CC•ES REPORT fI DESCRIPTION OF WORK-� � r �Ll 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 providedei =4t. I haveread the Description ofWork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildi on. I authorize representatives of Cupertino to enter the above-idened property for inspection purposes. Signature of ApplicantlAgentt Date; —6 "r SUPPLEMENTAL 1TIFORI\4ATION REQUIRED ��. w imn o'r..r•"ictixu�oiz r K Y r At\aCHL{LC ]I� ' � G 'r _If building is associated with a Home Owner's Association,provide letter '0, f�tANi-RK 7t0t terse , of approval from HOA. 0now J` : 4YJ-.RTS�rcgu[�r1R+ i �Ct1�I;�TLnI'�Crr�yy 4N it VI 1�+..0 Provide Planning approval to verify if there any restrictions. +6.b'1 ( '�/� J. '.s,•°•"'M,',,5 -},ail, _^Provide copy of Manufacturer's Installation Specifications. u❑: ' .t r,,n 'rzn + �(� r�Rr J?El z' _ Provide signed copy Of Cupertino's Tear-Off Policy, Rero0fApp_2011.doc revised 03/16/11 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 (408)777-3228- FAX(408)777-3333-building(c-)-cupertino.org PROJECT ADDRESS APN# OWNERNAME, ^ PHONE E-MAIL STREET ADDRESS (� �(�� /� C �CL✓�l ZIP( e / / C� S� )a- FAX CONTRACfORNA u LICENSENUMBER }� /f LICENSETYPE BUS.LIC. QU 4 93 2/7 Q63 z 1 G3 COMPANY NAME / E MAn. FAX STREET ADDRESS Q J � CrrY� 'i d S-/ O PHONE 10 �'s-S7 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 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 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 will be charged a re-inspection fee. The reinspection 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 o Signature of Applicant/Agent: Date: RerooJPo11cy_2013.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