B-2016-3033CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-3033
22659 WEEPING OAK CT CUPERTINO, CA 95014-5632 (342 32 034)
STATEWIDE ROOFING
INC
SAN JOSE, CA 95138
OWNER'S NAME: WANG AUDREY K J TRUSTEE
DATE ISS D: 11/04/2016
OWNER'S PHONE: 408-559-1977
PHONE NO: 408) 286-7828
LICENSED CONTRACTOR'S DECLARATION ATION
BUILDING PERNIIT INFO:
License Class 02 Lic. #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 _ COMMERCIAL
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
BLDG 4 CARPORT - PARTIAL -ROOF; TEAR OFF WOOD SHAKE;
I hereby affirm under penalty of perjury one of the following two declarations:
INSTALL CDX; COMP ROOF SHINGLE (MANSARD ROOF) (9 SQ'S)
i. 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: $ 7460.00
APPLICANT CERTIFICATION
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 pe:
and state laws relating to building construction; and hereby authorize
342 32 034
representatives of this city to enter upon the above mentioned property for
inspection purposes. (We) agree to save indemnify and keep harmless the
City of Cupertino against liabilities, judgments, costs, and expenses which
PERMIT EXPIRES IF ORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit.
Additionally, t applicant understands and will comply with all non-point
WITffiN 180 DAYS O PERMIT ISSUANCE OR
source regula i p ns per the Cupertino Municipal Code, Section 9.18.
180 DA LAS CALLED INSPECTION.
Signature a e 1/04/2016
Issued by:
R DER DECLARATION
Date: 11/041 6
I hereby affirm that I am exempt from the Contractor's License Law for one of the
'
following two reasons:
All roofs shall be inspected p ' or 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 obtain . an 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 (Sea7044, Business &Professions Code)
2. I, as owner of the properly am exclusively contracting with licensed
Signature of Applicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 11/04/2016
I hereby affirm under penalty of perjury one of the following three declarations:
ALI"ROOF COVERINGS 10 BE CLASS "A" OR BETTER
i. I have and will maintain a Certificate of Consent to se -ifor 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.
HAZARDOUS MATERIALS
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, E ection 25505, 25533, and 25534. I will
permit is issued.
maintain compliance with the Cupe o Municipal Code, Chapter 9.12 and the
3. 1 certify that in the performance of the work for which this permit is issued, I
Health, & Safety Code, Section 255 2(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 a uipment or devices which emit hazardous
air contaminants as defined by the Area Air Quality Management District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with th C I iertino Municipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Co e S cti s 25505, 25533 and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agen
APPLICANT CERTIFICATION
Date: 11/04/2016
certify that I have read this application and state that the above information is
EDNSTRUCHIOT41 LENDING
correct. I agree to comply with all city and county ordinances and state laws
I hereby affirm that there is a constru -,tion 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
LendeftAddress
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.
1 understand my plans shall be used as public records.
Licensed
Signature Date 11/04/2016
9
Professional
WR
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a+a«.alqkq & a a.eaLaVaa a @_%v Y &—a `Y 9 %a 9..61%
COMMUNITY DEVELOPMENT DEPARTMENT . BUILDING DIVISION
10300 THERE AVENUE . CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (4113) 777-3333 • building@cupertinc.org
13-Z06-7 `5
D
PROJECT ADDRESS 22659Weeping flak lit. (Carport)
APN# 042.32-034
OWNERNAME Westritlge MOA C/O GMS
PHONE 408.559.1977E
�,71
-MAIL
cs@communitymanagement.com
STREET ADDRESS 1936 DRYCREEK ROAD #203
CITY, STATE, ZIP CAMPBELL, CA 96008
FAX 408.6669.1970
CONTACT NAME im Lyons (CSI}
PHONE 408.210.6344
£;MAIL
jim@csibayarea.com
STREET ADDRESS P.O. Box 54190
CITY, STATE, ZIPSan Jose, CA 95154
FAX I1i/A
OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT MCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER
❑ DEVELOPER. ❑ TENANT
CONTRACTOR NAME Jon Robertson (PM)
LICENSE NUMBER 803926
LICENSE TYPE C-39
BUS. LIC. # 23509
COMPANY NAME Statewide Roofing, Inc.
E-MAIL jrobertson@swroof.net
FAX 408.286.7820
STREET ADDRESS 5542 Monterey Rd. #201
CITY, STATE, ZIP San floe, CA 9513$
(
PHONE 408.288,7$2$
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC.
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD Or Duplex Multi -Family
STRUCTURE: ❑ Commercial
ROOF AREA:
865 s.f.
VALUATION: F
17,460.00
EXISTING ROOF TYPE: ® BUILT-UP ROOF ❑ ASPHALT SHINGLES 0 WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER
(SPECIFY)
REMOVE /REPLACE ®YES
❑' NO
IF NO,
I # LAYERS:
PLYWOOD 19 -w, ❑
THICKNESS: ❑ 5/8"
PLYWD 13 OSB
TYPE:, ® CDX
PITCH;
20 :12
ROOF
CLASS: A
PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ® ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTH
R
ICC -ES REPORT
DESCRIPTION OF WORK:
'tear off existing shake root, install 1/2" CDX plywood, Install Certainteed Presidential
Shake TLTm shingles over Certainteed Diamond Deck"' underlayment.
I
By my signature below, l certify to each of the following: I am the property owner or authorized agent to act on the property o
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree
ordinances and state laws relating to build' g constr ion. I authorize representatives of Cupertino to enter the above-identifiec
Signature of Applicant/Agent: Date: I 11103/16
net's behalf. I have read this
to comply with all applicable local
property for inspection purposes.
SUPPLEMENTAL INFORMATION REQUIRED
X If building is associated With a Home Owner's Association, provide letter
of approval from HOA.
Provide Planning approval to verify if there any restrictions.
X Provide copy of Manufacturer's Installation Specifications.
X Provide signed copy of Cupertino's Tear -Off Policy.
I OFFI
EUSEONLY
PLAN CHECKTYPEj
ROUTING SLIP
❑ OVER-THE-COUNTER
❑ EXPRESS A
❑ STANDA
❑ BUILDING PLAN REVIEW
❑ PLANNING PLAT REVIEW
❑ FIRE DEPT
THER:
(� 7\1 6V—
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE a r O CA 950144255
(408) 777-3228 • FAX (408) 777-3333 • buiidinq(a.cupertino.org /
S. 33
PROJECT ADDRESS
22659 Weeping Oak Ct. (Carport)
-7
APN # 342-32-034
r
OWNER NAME
Westrltlge HOA C/O CMS
PHONE
408.559.1977
E-MAIL CS@COtrittlUPeHtyFltaheget7ierlt,CUtit
STREET ADDRESS
1935 DRYCREEi4 ROAD #203
CITY, STATE, ZIP
CAMPBELL, CA 95(30$
FAX 408.559.1970
CONTRACTOR NAME
Jori RobertSon (PM)
LICENSE NUMBER 803926
LICENSE TYPE
C4P
BUS. LIC. # 23509
COMPANY NAME
Statewide Roofing, Inc.
E-MAIL
1robe2rtSon@SWPOOf.net
i
FAX 4.08.286.7820
STREET ADDRESS
5542 Monterey RC1. #201
CITY, STATE, ZIP
San Jose, CA 95154
PHONE 408.2$6.7828
I UNDERSTAND AND AGREE TO'THE FOLLOWING:
I
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 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 Inspection, you must also call on the
day of the inspection only after that phase of the work is completed. The bjuilding 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 1/4" 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 monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2013 California Residential Code.
of Applicant/Agent: Date: 11/03116
WESTRIDGE IROA
C/O COMMUNITY MANAGEMENT SERVICES
1935 DRYCREEK ROAD #203
CAMPBELL, CA 95008
November 3, 2016
City of Cu
pertino
Attn: Planning/Building Department
RE: Westridge HOA
Mansard Roof Replacement Project
To Miom It May Concern:
Please be advised that Westridge HOA. retained the firm Statewide 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 with the City of
Cupertino on this project.
Please contact the undersigned, if you have any questions or need additional
information.
Sincerely,
On behalf of the Westridge HOA.
Jim Lyons
Construction Manager, Construction Services. Inc.
cc: Board of Directors