14080169 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10104 LIBERTY OAK LN CONTRACTOR:IQV CONSTRUCTION PERMIT NO: 14080169
INC
OWNER'S NAME: DANNY YU 820 CHARCOT AVE DATE ISSUED:08/18/2014
OWNER'S PHONE: 4085591977 SAN JOSE,CA 95131 PHONE NO:(408)582-9200
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL E]
CARPORT-TEAR OFF(E)SHAKE,INSTALL(N)CLASS A
License Class1 Lic.# 10-7 COMP ROOF SYSTEM(7 SQ'S)
Contractor Too Xy 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
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$3250
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:34232049.00 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 0 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 ;77;7ED INSPE TI N.
indemnify and keep harmless the City of Cupertino against liabilities,judgments, (Y n�
costs,and expenses which may accrue against said City in consequence of the Issued by: Date: a G
granting of this permit. Additionally,the applicant understands and will comply
with all non-point sourc regulations per the Cupertino Municipal Code,Section
918. �j�� ��'� cL RE-ROOFS:
Signature �/ Date— fl-- /�f 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:
�
I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applican
the following two reasons: ALL ROOF COVERINGS TO BE CLASS' OR BETTER
1,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)
HAZARDOUS MATERIALS DISCLOSURE
I,as owner of the property,am exclusively contracting with licensed contractors to
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
Safety h&S
l
Heataty Code,Sections 2 5 5,25533,and 25534.
I have and will maintain Worker's Compensation Insurance,as provided for by the 4
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date:O—'Z
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
I hereby affirm
become subject to the Worker's Compensation provisions of the Labor Code,I must firm 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
-- ;-PERMIT�A__PLF ATI0N _---
- -
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION.
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 qb
VJ
CUPERT`INO. (408)777-3228 FAX(408)777-3333•building Cftupertino.org
PROJECT ADDRESS- • //� /r'r+---L%�/ /���3Z 6 _Ia
y
OV'NERNA1viP
STREET ADDRESS CTTY, ST�A/TE,ZIP J r FAX
!/ l
CONTACT NAMEE-MAIL
'- ,�t,
� 0 ?;v PHONIy rt5� Z7i'7
STREET ADDRESS CITY,STATE,ZIP
FAX
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,1
❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEL•R ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS,LIC.N-
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZI
PHONE
ARCHITECT/ENGINE ERNAME LICENSE NUMBER BUS.LTC.t!
COMPANY NAME E-MAIL
FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE of ' ❑ SED or Duplex ❑ Multi-Family Rr-- VALUATION:
STRUCTURE: ❑ Commercial 7
EXISTING ROOF TYPE: -BUILT-UP ROOF ❑ASPHALT SHINGLES P WOOD SHAKES ❑WOOD SIUNGLES ❑OTHER(SPECIFY)
RL-.MOVE/REPLACE IRYES IF NO, PLYWOOD El %" 13PLYWD ❑ OSS F
/ ROOF
❑NO f11.AYERS: THECIOdESS El 5/6" TYPE ❑ CDX — —'12 CLASS: A
PROPOSED ROOF TYPE; BUILT-UP ROOF ❑ASPHALT SHINGLES ,❑WOOD SHAKES ❑WOOD SHINGLESI OTHER ICC-ES 2tEP6RT!t ---
DESCRIPTION OF WORK:
'rr lti %.;;C .� -C �� ,LL L✓- `C' <> C�l ,;'�L,s� ��•
\�U \ ..---- �1. _�.j F�e,/ i ._ 1)C` `�l /`--' �(�L- r.Crl 1. Cl -
i
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 provide 's 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 p u' nstruction. I authorize representatives of Cupertino to enter the above-iideentifircl prop"for inspection purposes.
Signature of Applicant/Agent: Date: /( ' / /
SUPPLFI,ENTAL INFORMATION REQUIRED 1 XEctius�:oni�,�1�� ., `; R
YPK' y
�ytiay* �� °? 1'; t'1�4, ) rr ,r stsM
—If building is associated with a Home Owner's Association,provide letter - `. z.r>— sr3Lcrlr,ce a4�a>,4s
1,s v _ � r7tour c si ri =,
of approval from HOA. 0Map
� ,
"�QYLR 7I�]'CO7Jr fL'R s�s' - ❑4 I3�IILD G I'LAi`it 5���„�8�
_Provide Planning approval to verify if there any restrictions. '+ r` 11.- t r x
i�r'rai less �y���
—
Provide copy of Manufacturer's Installation Specifications.. �®�-"_�n.�. � �� 4 L�,�� ❑ rIR�nnl�T--' `� � - � ; '�;
—Provide signed copy of Cupertino's Tear-Off Policy. g9
Reroofilpp_2011.doc revised 03/16/I1
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: DATE: 08/11/2014 REVIEWED BY: Mendez
APN: BP#: "VALUATION:
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof 32
PRIMARY SFD or Duplex PENTAMATION 1 SFDWLROO
USE: PERMIT TYPE:
woRK CARPORT-TEAR OFF E SHAKE INSTALL N CLASS A COMP ROOF SYSTEM 7 SQ'S
SCOPE
FEE ID ROOF AREA
(s.L)
1REROOFFRES 700
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i lef:r:•I';rr?€.,;.rc I'ikrr,i).Plan C,ie.ck E_ec,f'.;rt;;t rr:cF
rFC'C•r i.. Perin Fee: Z'=;Fina•. ft'f"?tia:�£'�: L•r•!' rtf?t.rii%'s
0,-,Ter iverk fmv,”. F-1 I 01--"r plvfmb 17,15:11% Orhc-r Elec,
,Mled,%/uln f et" F'.7adlg?.f:.1:7.5p. Ff'.e:
NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Seiner District,School
District,etc.). These fees are based on the prellininar•y information available and are only an estimate. Contact the Det for addn'I info.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS
Plan Check f_ee:
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Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $1.00
;zx 4 F z � Si BTOVAL $120.50 $0.00 TOTAI;FEE $120.50
Revised: 07/08/2014
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A01"10d :1=10-UV31 X0021321
August 11, 2014
City of Cupertino
Building Department
10300 Torre Avenue
Cupertino, CA 95014
Re: Westridge Country Club Homes Association
Gentlemen:
This office is the mariagement 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