15090167 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 8123 PARK VILLA CIR CONTRACTOR:FOUR SEASONS ROOFING PERMIT NO: 15090167
OWNER'S NAME: LEE I-TING ET AL PO BOX 1668 DATE ISSUED:09/24/2015
OWNER'S PHONE: SAN JOSE,CA 95109 PHONE NO:(408)278-0330
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
"`��# UNITS#8123,#8125,#8127-REMOVE(E)ROOF TILES
Gf72 AND UNDERLAYMENT,INSTALL 2 LAYERS OF 40#FELT AND
License Class C Lic.# �Q (N)BORAL OS CLAY"S"TILE-16 SQUARE'S
Contractor AAP-Se 5;16 /�-aoj/A-4 /A,-Date 94-V/310
1 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: Sq.Ft Floor Area: Valuation:$6465
r. 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. APN Number:35610057.00 Occupancy Type:
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
permit is issued.
PERMIT EXPIRES IF WORK IS NOT STARTED
APPLICANT CERTIFICATION WITHIN 180 DAYS OF PERMIT ISSUANCE OR
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 180 DAYS FROM LAST CALLED INSPECT ON.
to building construction,and hereby authorize representatives of this city to enter
q/%
L_uupon the above mentioned property for inspection purposes. (We)agree to save r� V1gq I�'
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Issued by:^ � C�L�U'I`r ' Date:INSPECTION.
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply with
all non-porn o r lations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS:
Signature %iii 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 Signature of Applicant: f Date: y do/S
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
t. 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 HAZARDOUS MATERIALS DISCLOSURE
sale(Sec.7044,Business&Professions Code)
2. 1,as owner of the property,am exclusively contracting with licensed contractors to I have read the hazardous materials requirements under Chapter 6.95 of the
construct the project(Sec.7044,Business&Professions Code). California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I hereby affirm under penalty of perjury one of the following three declarations: Safety Code,Section 25532(x)should I store or handle hazardous material.
t. I have and will maintain a Certificate of Consent to self-insure for Worker's Additionally,should I use equipment or devices which emit hazardous air
Compensation,as provided for by Section 3700 of the Labor Code,for the contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
performance of the work for which this permit is issued. Health&Safety Code,Sections 25505,25533,and 25534.
2. 1 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 r o aut orized agent:
permit is issued. Date:�0/5
s. I certify that in the performance of the work for which this permit is issued,I shall 61
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 that there is a construction lending agency for the performance of work's
become subject to the Worker's Compensation provisions of the Labor Code,I for which this permit is issued(Sec.3097,Civ C.)
must forthwith comply with such provisions or this permit shall be deemed Lender's Name
revoked.
Lender's Address
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is ARCHITECT'S DECLARATION
correct.I agree to comply with all city and county ordinances and state laws relating I understand my plans shall be used as public records.
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Licensed Professional
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 with
all non-point source regulations per the Cupertino Municipal Code,Section 9.18.
Signature Date
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t,C;�dl=�UNI + C' JELL 'N EN; EP r'r.R- 1�-E�N" �-��Ji 1P�1 DiVISiOt
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t+❑OMER ElMNER-GUiLDL•R ❑ OW;N RAGE) - CONTRACTOR ❑C(NIMC-10R GE1:T C) A'RC:xi'rECi 11UNGINiTR 1:10INFLOPER LI rt:NA'
CCNI'RACTORN ME t \S£.I. `}'ft BUS t.Jt,'0 ..
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USE OF ❑ SFD or Duplex Multi-Farnity Roar ARIV% VAI,;ATIG t:
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SDE-SCRn'rta\'OF WORK:
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By my signature below,I certify to each of the following: I am the property o}vner or authorized agent to act on the property owner's behalf. [have read this
application and the information I have provided is correct. I have read the Description of Work and verily it is accurate. I agree to comply with all applicable local
ordinance,and state laws relating to building construction. I authon-re representatives ot'Cttpenino to enter the abovtlidenlifie property f�spection purposcs
5igttature of ApplicanVAgent:-' ._. �_' '- — ,Date !
SLIP.PLEMENTAL INFORMAL ION REQUIRED �= FFIC F Lst QNLY
k
If building is associated Avith a Flame Owner's Association,provide letter PL V\CHEc'K INPe�— � _Rr)t UN :;t,tP`
of approval front I10A. ov}.R-t nf.-cnt-N-rcii: BUILDING DING t t to ttt;A MMV
} _Provide Planning approval to verity if there any restrictions. u bxrr ss rt_AN Rrvievt` 1,
dProtide copy of Manufacturer's Installation Specifications. Sr-ANDARD �l ruti.
1 Provide signed copy of Cupertino s Tear-Off Policy.
a r
ReraofApp_2011-doc revised 03/16/11
CITY OF CUPERTINO I 50q D 167.
FEE ESTIMATOR— BUILDING DIVISION
ADDRESS: 8123, 2125, 8127 Park Villa Circle DATE: 09/24/2015 REVIEWED BY: PAUL
APN: 356 10 057 BP#: "VALUATION: 1$6,465
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY Multi-Family Dwelling Buildina is PENTAMATION 1 R2ROOF
USE: 1 >3 Stories 0 Yes E) No PERMIT TYPE.
WORK Units #8123 #8125 #8127 - Remove E roof tiles and underla ment Install 2 layers of 40#felt and
SCOPE (N) boral OS Clay "S"tile - 16 Square's
FEE ID ROOF AREA
s.f.
1REROOFMRES 1,600
A,Jech.Plan Check "iumb. Plan Checi, s aec. Pine Check
beech. Permit Fee: Plumb.Permit Fee: Elec. Permit Fee:
)rher,Pluinbltap. Other Elec. Imp Li L-1
NOTE: This estimate does not include fees due to other Departments(i.e. Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . These fees are based on the preliminar information available and are only an estimate. Contact the Dept for addn 7 info.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Suppl. PC Fee
Phirnb.likfech.%Flee
Permit Fee: $272.00
Suppl. In,sp I,Iee
Plumb./Mech.!Elec
Plumb.Ltllech./Elec Pertnit Fee:
Construction Tax:
Administrative Pec:
Work Without Permit? 0 Yes (D No $0.00
Advanced.Planning Fees:
Travel Documentation Fees:
Strong Motion Fee: IBSEISMICR $0.84 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $273.84 $0.00 TOTAL FEE: T $273.84
Revised: 07/02/2015
E
REROOF TEAR-OFF POLICY"
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P,E., C.B.U., BUILDING OFFICIAL
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
4-:UPERTINO i
(408) 777-3228 -FAX (408)777--3333•buildinyLacupertino.org
PROJECTADDRL 7 5 , 912 D /C /�� (//nC AI'N N
r puntrE } E-MAII.
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51�1 Vi� C 1 CITY STATE.ZIP A y� FAX/-
CONTRACTOR N '
,.---` ,� / LICENSE NUM73&RLI LyN, i f IT BUS.L, M
COMPANY NAME E-MAIL F
STREET TDRES CI] STATE,R PIIONG
I UNDERSTAND AND AGREE TO 'THE FOLLOWING:
1. The re-roof project shall comply with all applicable provisions of the 2013 California Codes.
2. An inspection request can be scheduled up to one business day before the requested inspection (late.
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 vvoa°la is eoanpletaql. The building inspector will be
available within one hour. The hours for this service are- 7:30.10:30aam and 12:30.3:30 (Mon•-Thurs)
and 7:30-10:30a in and 12°30-2:30 (Friday). Final Inspections will be given a two hour window.
3. Tear-Off lnspectao a i4 recixib eta Any and all dry-rotted wood shall be replaced prior to this inspection.
Unless new plywood roof sheathing is proposed throughout, aall the nails/fasleaaers shall be either
completely lmocked--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 Fiviaal fustoection avid aDDroval 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/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 deaf➢ be paid before another inspection can be
scheduled.
)3 m signing below,I certify each of the following is true: I am the property owner or authorized agent to act on the
Y Y� g g � Y g p P Y g
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 are required to be installed in accordance with Sections R314 and R315 of
i the 2013 California Residential Code. I
Signature of Applicant/Agent: /'"a :=' .� _____---- Date: rZ
Rerooflloltcy_2014.doc revised 01/15/14
WESTMONT PAP-K VILLAS I-10MILOWNBRS ASSOCIATION
WESTMOINIT PARK VILLAS 110A
c/o CONIMUNITY lvlAiNIAGE-NfFN'I'S'YR-VICES
1935 DRY CREEK ROAD
CAIMPBELL, CA 95008
(408) 559 - 1977
8/112015
City of Cupertino
Building Depait-ment
To the City of Cupertino;
Please notc, th6 Westmont Park ViHla-s HOA has conti-acted and approvers Four Seasons
Roofing to perform 57 re-roof-,of our homes,-a-,placing the currem Tile floofing.3ystem
with nev.,BORAL U.S. 1"ILE, ON13-91ECF,MISSION"S'CLAY THE SYSTE'M, We
ED to matei i o ur exi s I i 00f
pwie selected ib.z color C ng roots.
Diana k.Joluison
Vice-President
Community TM-aiaagemcnt Services
SEP 2 4 2015
BY�
OWNER-CERTIFICATE COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT-,BUILDING DIVISION
10300 TORRE AVENUE°CUPERTINO, CA 95014-3255
(408)777-3228 b FAX(408)777-3333•building(cDcuperlino;org
Address2 \cag 4,ot.Alar t, Smake: G'trboll -',& '1•
Ir
PER HT CA. IOT BE, FWALED AND COMPLETED UINTIL TTIIS CERTIFICATE
HAS BEES SNI1 AND HETLINUD TO THE BUILD 1C DIvISIO-N
PURPOSE
This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC Section 8314,2013 CBC Sections 420.6 and 907.2:112 where no interior access for
GENERAL INFORMATION
Existing single-family and multi-family dwellings shall be provided with Smoke Alarms'and Carbon
Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds
$1000.00, CRC Section 8314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon
Monoxide Alarms be installed in the following locations:
AREA SMOKE ALARM CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the X X
bedroom(s)
On every level of a dwelling unit including basements C X
Within each sleeping room X
Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that
do not have an attached garage. Carbon monoxide alarms' combined with smoke alarms shall comply with
CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal.
Power Supply:h--i dwelling units with no commercial power supply, alarm(s)may be solely battery operated.
---1rexis�rd-well'- rutits-aiarn2s-are--errrutte�to-be��le�y=biter o-erat�cl where�re a=1�s""or al�erafions d��-"
not result in the removal of wall and ceiling finishes or there is no access by means of attic,basement or crawl
space.Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2.An electrical permit is required for
alarms which must be connected to the building wiring.
As owner of the above-referenced property,I Hereby certify that the alarm(s) referenced above has/have been
installed in accordance with the manufacturer's instructions and in compliance with the California Buildhag
and California Residential Codes.The alarms have been tested and are operational, as of the date signed
below.
I have read and agree to comply with the terms and conditions of this statement
Her doe stir e.r`s)Na€e:
LEE I-TIN6 ET AL Signature............... 10/3o�yol
....... . ...-................................................Date:
ureter Name:
Sinature................................................................._LIc.#...................I..............,,..Date: .......-..._......
Smoke and CO.form.doc remised 03118/14
,
`CATER-CONSERVING PLUMBING FIXTURES -.
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
CLFPERTiNO 10300 TORRE AVENUE• CUPERTINO,CA 55014-3255
(408)777-3228,FAX(408)777-3333� bui1ding0_cupertino.org
OFvnerName L t �Ie-�IN45 ET HL Permit No 0�AQ
Address (a,2n'J
1. Is your real property a registered historical site?
El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and.sign bottom of form.
9 No Go to Question 2.
2. Does your real property have a licensed plumber certifying that,due to the age or configuration of the property or its
plumbing,installation of water-conserving plumbing Mures is not technically feasible?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply.
❑ The licensed plumber's certification has been provided to the Building Division.
b1UP me rest Ot tile lorni and sign bottom or lorm.
91 No Go to Question 3.
3. Is water service permanently disconnected for your building?
❑ Yes Civil Code Sections 1101.1 through 1101,8 do not apply. Skip the rest of the form and sign bottom of form.
R No Go to Question 4.
4. Is your real property built and available for use or occupancy on or before January 1,19942
No fly real property is built and available for use or occupancy after January 1, 1994.
Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
W] Yes My real property is built and available for use or occupancy on or before January 1, 1994.
Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign
bottom of form..
5. Please check O_NTE-of the following'.-
1771
My property is a single-family residential real property. See Civil Code Section 1101.4.
On and after January 1, 2014,building alterations or improvements shall require all non-compliant plumbing fixtures
to be replaced with water-conserving plumbing fixtures throughout the building.On or before January 1,2017,all non-
compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures -(regardless of whether
property undergoes alterations or improvements).
K My property is a multifamily residential real property. See Civil Code Section 1101.5.
On and after January 1, 2014,specified building alterations or improvements shall require non compliant
��314rTTb1I2bfT:ilLlr�b�Lo -.. -• , � z
On or before January 1,2019,all non-compliant plumbing fixtures shall be replaced with water-
conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or
improvements).
❑ My property is a commercial real property, See Civil Code Section 1101.5.
On and after January 1, 2014,specified building alterations or irnprovernents shall require non-compliant
plumbing fixtures to be replaced with water-conserving plumbing fixtures.
On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving
plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements).
1,as the owner or owner's agent of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be
replaced prior to date specified above with water-conserving plumbing fixtures in accordance with Civil Code Sections 1101.1
through 1101 8,the current California Plumbing Code and California Green Building Standards Code,and manufacturer's
installation requirements,and that the water-conserving plumbing fixtures comply with the requirements as indicated in the
table on the f<)Ilo)yiqg page.
Owner or Owner Agent's Signature: Date:
Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit.
SB4072015.doc revised 08126115