B-2016-3037 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT N i:B-2016-3037
10092 AMADOR OAK CT CUPERTINO,CA 95014-5606(342 32 016) STATEWIDE ROOFING
INC
SAN JOSE,CA 95138
OWNER'S NAME: ZHU QIAN AND ZHANG MENG DATE ISS I D:11/04/2016
OWNER'S PHONE: PHONE NO:(408)286-7828
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class BUILDING MOVING.DEMOLITION Lie.#803926
Contractor STATEWIDE ROOFING INC Date 02/28/2018 X BLDG _ELECT —PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing —MECH X RESIDENTIAL—C RMMERCIAL
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
BLDG 6 CARPORT-PARTIAL ' i-ROOF;TEAR OFF WOOD SHAKE;
I hereby affirm under penalty of perjury one of the following two declarations: INSTALL CDX;COMP ROOF S II GLE(MANSARD ROOF)(12 SQ'S)
1. 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.
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. Sq.Ft Floor Area: Valuation:$►3670.00
APPLICANT CERTIFICATION
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 APN Number: Occupancy ,e:
and state laws relating to building construction,and hereby authorize 342 32 016
representatives of this city to enter upon the above mentioned property for
inspection purposes. (We)agree to save indemnify and keep harmless the a
City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF ORK IS NOT STARTED
may accrionally against said City in consequencetds the ygranting of o this WITHIN 180 DAYS 0 PERMIT ISSUANCE OR
Additionally,the :pplicant understands and will comply with all non-point
source regulati I, s pert`e Cupertino M nicipal Code,Section 9.18. 180 DAYS FROM 4. LED INSPECTION.
-'--------- ------
Signature tt
Date �/ 1t16 Issued by:MELD �_'':-
Date: 11/04/201
OWNER-BUIT,DER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the t t I i •
following two reasons: All roofs shall be inspected prior to an :roofing material being installed.If a roof is
1. I,as owner of the property,or my employees with wages as their sole installed without first obta: 'i 1:•inspe tion,I agree to remove all new materials for
compensation,will do the work,and the structure is not intended or offered for ins•ection.
sale(Sec.7044,Business&Professions Code) J
2. I,as owner of the property,am exclusively contracting with licensed Signaturefof Applicant: 4
/`I/,a
contractors to construct the project(Sec.7044,Business&Professions Code). Date: i l // I
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS OBE CLASS"A"OR BETTER
1. 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. _I■• M' I - _ D f i
2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code, 'ections 25505,25533,and 25534. I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous
air contaminants as defined by the B Area Air Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Certino M 'cipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code ctions 5 5,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall (/P
be deemed revoked. Owner/ 7i'
athorized agent:' II /
APPLICANT CERTIFICATION Date: iia v
I certify that I have read this application and state that the above information is CONSTRUCT ' LENDING AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance
relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.)
to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments,costs,and expenses which may accrue against said City in Lender's Address
consequence of the granting of this permit. Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION
Code,Section 9.18. I understand my plans shall be used as public records.
Licensed
Signature Date
Professional
I\Nam I!V N/I I Nom 14I WI■ I Y--‘I I %ma I',NP!-'t I I Neas,I.Al
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISIONK.
4,4-,
IIS 10300 TORRE AVENUE I CUPERTINO,CA 95014-3255 '
(408)777-3228 e FAX(408)777-3333 I building(n7cupertino.org
CUPERTINO
13 Z ( � - 7o3 --
PROJECT ADDRESS 10092 Amador Oak Ct.(Carport) APN# 342-32.016
OWNER NAME Westridge HOA 0/0 CMS PHONE 408.559.1977 E-MAIL cs@communitymanagement.Conl
STREET ADDRESS 1935 DRYCREEK ROAD#203 CITY, STATE,ZIP
CAMPBELL,CA 95008 FAX 408,559.1970
CONTACT NAME Jim LyonsE=MAIL
(CSI) PHONE
Y 408.210.6344 Iim@csibayarea.cotn
STREET ADDRESS P.O.Box 54190 CITY,STATE, ZIP San Jose,CA 95154 FAX N/A
❑OWNER 0 OWNER-BUILDER 0 OWNER AGENT ® CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER ❑TENANT
CONTRACTOR NAME Jon Robertson(PM) LICENSE NUMBER 803926 LICENSE TYPE C-3s BUS.LIC.# 23509
COMPANY NAME Statewide Roofing,inc. E-MAIL )robertson@swroof.net FAX 408.286.7820
STREET ADDRESS 5542 MontereyRd.#201 CITY,STATE,ZIP PHONE
San Jose,CA 95138 40$.286.7828
I'
ARCHITECT/ENGINEERNAME LICENSE NUMBER € BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP
PHONE
USE OF ❑ SFD or Duplex IXC. Multi-Family ROOF AREA: VALUATION:
1,173 s.f, 23,670.00
STRUCTURE: 0 Commercial
EXISTING ROOF TYPE: 0 BUILT-UP ROOF 0 ASPHALT SHINGLES Il WOOD SHAKES 0 WOOD SHINGLES 0 OTHER(SPECIFY)
REMOVE/REPLACE ❑YES IF NO, PLYWOOD ® W' 0 PLYWD 0 OSB PITCH: ROOF
0 NO #LAYERS: THICKNESS: 0 5/8" TYPE: MI CDX 20 .12 CLASS: A
PROPOSED ROOF TYPE: 0 BUILT-UP ROOF MIASPHALT SHINGLES 0 WOOD SHAKES 0 WOOD SHINGLES 0 OTHER ICC-ES REPORT
DESCRIPTION OF WORK:
Tear off existing shake roof,install 1/2"CDX plywood,Install Certainteed Presidential
Shake TLT"'shingles over Certainteed Diamond Decks"underlayment.
[.00 6. Cad" po
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 buildi'g constr I/ion. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: 4 Date: I 11/03116
SUPPLEMENTAL INFORMATION REQUIRED t OFFICE USE ONLY
X If building is associated with a Home Owner's Association,provide letter PLAN CHECK TYPE 1 ROUTING SLIP
of approval from HOA. ,- ER-THE-COUNTER Cl BUILDING PLAN REVIEW
e
Provide Planning approval to verify if there any restrictions. 0 EXPRESS 0 PLANNING PLAN REVIEW
X Provide copy of Manufacturer's Installation Specifications. 0 STAND . 0 FIRE DEPT
X Provide signed copy of Cupertino's Tear-Off Policy. 0 OTHER:
II km IaevvI ■ Ma.r-aIa ' I.I I I �O i-4'WP I
COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION
ALBERT SALVADOR,P.E., C.B.O,, BUILDING OFFICIAL
UPERTI alt 10300 TORRE AVENUE CUPERTINO,CA 95014-3255
(408)777-3228 FAX(408)777-3333® buildinqacupertina.orq
PROJECT ADDRESS 10092 Amador Oak Ct.(Carport) APN# 342-32-016
OWNER NAME Westridge HOA C/O CMS PHONE 408.559.1977 E-MAIL CS@communitymanagement,com
STREET ADDRESS 19$6 DRYCREEK ROAD#203 CITY, STATE,ZIP CAMPBELL,CA 95008 FAX 408.559.1970
CONTRACTOR NAME Jon Robertson(RM) LICENSE NUMBER 803926 LICENSE TYPE C_39 BUS.LIC.# 23509
COMPANY NAME Statewide Roofing,Ina. E-MAIL irobertson@swroof.net FAX 408.286.7820
STREET ADDRESS 5542 Monterey Rd.#201 CITY,STATE,ZIP San Jose,CA 95154 PHONE 408 286 7828
I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable provisions of the 2013 California Codes.
1 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 Y4"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 paidbefore 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 complywith 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
the 2013 California Residential Code.
Signature of Applicant/Agent: A of• _ Date:
11/03/16
WESTRIDGE II0A
C/O COMMUNITY MANAGEMENT SERVICE
1935 DRYCREEK ROAD #203
CAMPBELL, CA 95008
November 3. 2016
City of Cupertino
Attn: Planning/Building Department
RE: Westridge HOA
Mansard Roof Replacement Project
To Whom It May Concern:
Please be advised that Westridge HOA retained the firm Statewi se,Roofing, Inc. to
act as our agent for the above referenced repair project for the Association.
Statewide Roofing, Inc. is authorized to work on our behalf and vith the City of
Cupertino on this project.
Please contact the undersigned, if you have any questions or neee additional
information.
Sincerely,
On behalf of the Westridge HOA.
Jim Lyons
Construction Manager, Construction Services, Inc.
cc: Board of Directors