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14010040 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10033 LONG OAK LN CONTRACTOR:IQV CONSTRUCTION PERMIT NO:14010040 INC OWNER'S NAME: LAKSHMI PARTHASARATH 820 CHARCOT AVE DATE ISSUED:01/07/2014 OWNER'S PHONE: 4085591977 SAN JOSE,CA 95131 PHONE NO:(408)582-9200 CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL F] COMMERCIAL LICENSED CONTRACT c R' RE-ROOF 4 SQ-REMVOE EXISTING BUR INSTALL License Class G--5 7 Li,.# 7 Z SECURE /� ROCKS&60MIL CARLISLE ROOF SYSTEM Contractor� I.SL V Date � ��—/ 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 �hav formanceof the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$2714 e and will maintain Worker's Compensation Insurance,as provided for by tion 3700 of the Labor Code,for the performance of the work for which this APN Number:34232053 00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the aboveinformation is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHEN 180 DAYS OF REPUT 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 A LED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, /1// costs,and expenses which may accrue against said City in consequence of the Iss Date Y granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 918. 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 inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Date/`�r/4( Signature of Applic I hereby affirm that I am exempt from the Contractor's License Law for one of V.0 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 0 25533,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 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 918. Signature Date REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION. 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERI"tNO. (408)777-3228• FAX(408)777-3333•buildingt7a.cupertino.org �\ PROJECT ADDRESS `Cos OS 1 /JIAPN# 2� �2 �/�✓ OVVNERNAMF Sh m i (�� / PH � 5V./� _' E-MAIL STREET ADDRESS r /, CITY,STATE,ZIP iJ Fp X CONTACT NAME • L< '' ♦^ <'V PHONE,�C SS Z(�S - S 7 Z.7 E-MAIL STREET ADDRESS CITY,STATE,`ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑.OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME //' LICENSE NUMBER LICENSE TYPE BUS.LIC.R Vie e,,u I 2.1( L- j C, 3 COMPANY NAME E-MAIL FAX STREET ADDRESS / CITY,STATE,ZI PHONE s A ARCHITECT/ENGINE ERNAME LICENSE NUMBER BUS.LIC.N COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex ❑ Multi-Family ROOFAREA: VALUATION: STRUCTURE: ❑ Commercial EXISTING ROOF TYPE: ,RI-BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE ISI YES IF NO. PLYWOOD ❑ %" ❑ PLYWD ❑ OSB PITCH: ROOF ❑NO I u LAYERS: THICKNE • ❑ 5/8" TYPE: ❑ COX 12 CL,4S5: A- PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES 11WOOD SHAKES ❑WOOD SHINGLES OTHER ICC-ES REPORT t! - - DESCRIPTION OF WORK:-) h • 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 b ' g construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature ofApplicant/Ager Date: SUPPLEMEN AL INIFOR14ATION REQUIRED_If building is associated with a Home Owner's Association,provide letterPL�aE rn�rsn :?ou >fics I� � of approval from HOA. Q 5.„ � R UII DJI�GPI REVS _Provide Planning approval to verify if there any restrictions.. �•� - ❑ r, c:_I:nN'REVIDw ; �, _Provide copy of Manufacturer's Installation Specifications.. ^'�•$• �'� � ' � �x�, .�.EIRE;PEPT' , _Provide signed copy of Cupertino's Tear-Off Policy, 'OT 19 ReroofApp 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 10300TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333-buildin4Ca.cupertino.org PROJECT ADDRESS APN# OWNER NAME. ^ PHONE E-MAIL STREET ADDRESS 9 3�.+ C c c k 0 CITY��V ZIP L�/ / C� s-oo FAX CONTRACTOR NAMF.y.a u u _S�MG4c� m LIC ENSE NUMBERn� Z/7 LICENSE �1 BUS.LIC.# COMPANY NAME L / EMAIL c� FAX STREET ADDRESS8 77 C -jJ S•� CrrYg n 1 B PHONE Q ` 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 fro in 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 detequired to be installed in accordance with Sections R314 and R315 of the 2010 California Residen��J22; Signature of Applicant/Agent: Date:_' 1 64'! ReroojPolicy_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 414-4-- , 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