14080140 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10017 SPANISH OAK CT CONTRACTOR:IQV CONSTRUCTION PERMIT NO: 14080140
INC
OWNER'S NAME: PALMER 820 CHARCOT AVE DATE ISSUED:08/15/2014
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 Class,,�^^ r Lie.# Y�3 219 COMP ROOF SYSTEM(7 SQ'S)
_!
Contractor nL 0 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 Valuation:$2167
performance of the work for which this permit is issued. Sq.Ft Floor Area:
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:34232082.00 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 DA 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 FRO L T CALLED INSP CTI N.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Issued by: Date:
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section
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 inspection,I agree to remove all new materials for
inspection. f /
❑ OWNER-BUILDER DECLARATION Date:
Signature of Applicant:
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) 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
will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
performance of the work for which this permit is issued.
the Health&Safety Code,Sections 25505, 53 ,and 25534.
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 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
--- -
- An
REROOF CATION �\
COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION.
P. 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255
li's , N
(408)777-3228• FAX(408)777-3333•buildingna.cupertino.org
CUPERTINO. \
PROJECT ADDRESS •/j;C//� G6�4f/ - �3yz32 ora
OVIIJERNAMF � / 1 PHt5� /7� E-1,iAQ..
STREET ADDRESS CITY, STATE,ZIP FAX
CONTACT NAME PHON1y r E-MAIL
STREET ADDRESS CITY,STATE,ZIP
FAX
❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAMELICENSE NUMBER/ LICENSE TYPE BUS.LIC.H
d1
k(l G .'e
COMPANY NAME E-MAIL
FAX
STREET ADDRESS C CITY,STATE,ZI pF�pq�
776
ARCIMCT/ENGINEER NAME LICENSE NUMBER BUS.LIC.U
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP
PHONE
USE or ❑ SFD or Duplex ❑ Multi-Family Rr-- /Q 5 VALUATION: /
STRUCTURE: ❑ Commercial / 2
EXISTING ROOF TYPE: • 'BUILT-UP ROOF ❑ASPHALT SHINGLES IP WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE ®YES IF NO, PLYWOOD ❑ w, ❑ PLYWD ❑ OSB PITCH- ROOF
❑NO 1 A LAYERS: THICKNESS: ❑ 518" TYPE: ❑ CDX —�'12 CI ASS: A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES 13 WOOD SHAKES ❑WOOD SHINGLES OTHER ICGES REPORT it
DESCRIPTION OF WORK-J f
T( f
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property ov mer'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 tp u' nstruction. I authorize representatives of Cupertino to enter the above-iideentifipd property for inspection purposes.
S ignature of ApplicandAgent: Date: `/( —Z
SUPPLEMENTAL 114FORMATI0N REQUIRED ��� ��` �'�� t - "" "`
Q rti..�_ v;ciriicLusD:onL� 1ga-MRPry
_If building is associated with a Horne Ale Owner's Association,provide letter T ax�P CULCI a .k 79NN" [o ,srTl
of approval from HOA. ON
R1I Oji\JR4}+t rte B'MDLgGP-T K-t$1-rr5�'�a E�
a •��y, '� `-t2,
_Provide Planning approval to verify if there any restrictions. ' I sfi
I r = Ph G;P ANRE�1 �i� g e
_Provide copy of Manufacturer's Installation Specifications.,
Provide signed copy of Cupertino's Tear-Off Policy, 4 .f �{GTrfi Ra_ 1
Re)-oofApp_2011.doc revised 03116111
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 10017 SPANISH OAK CT DATE: 08/13/2014 REVIEWED BY: MELISSA
APN: 342 32 082 BP#: *VALUATION: 1$2,167
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION 1 SFDWLROOF
USE: I I PERMIT TYPE:
WORK CARPORT-TEAR OFF E SHAKE INSTALL N CLASS A COMP ROOF SYSTEM 7 SQ'S
SCOPE
FEE ID ROOF AREA
s.f.
1REROOFFRES 700
f c'r,. f'Iwl C.h,;Cr 1'ar.rrrir�..f'u;t Chet:k ter.. r?
<rr C,fatxt.
anit Fee:
()M,,r /_'i'k iJ'sp, 01 her 111"wrib In'sp, C11idc' E e'C,hip,
<' ,1'Y{t%h.12,>;. ',e¢e, t'rc...13:t:,
NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc.). These ees are based on the prelimina information available and are only an estimate. Contact the De t or addh 7 in o.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/132 FEE QTY/FEE MISC ITEMS
1:11an Check Fee:
Permit Fee: $119.00
T.—F
Fee:
Work Without Permit? O Yes No $0.00
Strong Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
M,4 s $120.50 $0.00 $120.50
S TOTAL FEE
Revised: 07/10/2014
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO
(408)777- 28•FAX(408)777-3333•building
Q)cupertino.org
PROJECT ADDRESS /y 7 APN hl
OWNER NAME f PHONE E-MAIL
STREET ADDRESS CITY,STATE,ZIP FAX
Q r [CA Ro
CONTRACTOR NAME LICENSENUMBEWS2/q LICENSE TYPE BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
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 un 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 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 monoxidd tectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential e.
Signature of Applicant/Agent: Date:
ReroofPolicy_2013.doc revised 10120113
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 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