B-2017-1759 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1759
954 WESTLYNN WAY CUPERTINO,CA 95014-5854(359 27 017) WESTSHORE
ROOFING INC
SAN JOSE,CA 95131
OWNER'S NAME: CHUANG DAVID T AND NAN-SING TRUSTEE DATE ISSUED: 10/12/2017
OWNER'S PHONE:408-865-1815 1 PHONE NO:(408)456-0200
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C-39 Lic.#787221
Contractor WESTSHORE ROOFING INC Date 11/30/2018 X BLDG _ELECT _PLUMB
MECH X RESIDENTIAL_COMMERCIAL
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. JOB DESCRIPTION:
REROOF;TEAR-OFF;INSTALL OSB;COMP SHINGLES(25 SQ)
I hereby affirm under penalty of perjury one of the following two declarations:
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
erformaance olf,the work for which this permit is issued.
x, have and will maintain Worker's Compensation Insurance,asD
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:$27480.00 '
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 Type:
and state laws relating to building construction,and hereby authorize 359 27 017
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 Cu.= ino againstliabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue a.:'nst said CIty,in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionall�yy a a.•licant understands and will comply with all non-point
source regtl .ks p- he Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 10/12/2017 Issued by:Abby Ayende
Date: 10/12/2017
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS:
following two reasons: • • All roofs shall be inspected pt'iie to any 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 obtaini•t .11 ..ection,I agree to remove all new materials for
compensation,will do the work,and the structure is not intended or offered for I "_.ction.
sale(Sec.7044,Business&Professions Code) ,,4,'
2. I,as owner of the property,am exclusively contracting with licensed ` ` ignature of Applicant:
contractors to cohstruct,the project(Sec.7044,Business&Professions Code). Date:10/12/2017
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
t. 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 woik,for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE
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,Sections 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 ernploy'any person in any manner so as to become subject to the material. Additionally,should I use eq ip •nt or devices which emit hazardous
air contaminants as defined by the Bay•rea Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cup' no M icipal Code,Chapter 9.12 and
exemption,.1 become subject to the Worker's Compensation provisions of the the Health&Safety Code, :ectio's 2551.,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed,revoked.
Owner or authorized agent:
APPLICANT CERTIFICATION Date: 10/12/2017
I certify that I have read this application and state that the above information is CONSTRUCTION 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 mentiohed 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 ofithis 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.
Signature Date 10/12/2017 Licensed
Professional.
\ / CONSTRUCTION PERMIT APPLICATION
5-7-017 —(1_70 '
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
/„i.i ps, , 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•buildinq(a�cupertino.orq
0 NEW CONSTRUCTION 0 ADDITION 0 ALTERATION/TI 0 REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS q [''(i cs }1\1 n n r `l APN# -65q,
OWNER NAME J l/` r PHONE ,I E-MAIL l
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STREET ADDRESS `- h \- 'r_ I r �j, r
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CONTACT NAME VA]�. 1 v 11�_ J F h •451,—(/ �eU ,�`MAIL 0 /'i r I(Jrf i a niiii seem
STREET ADDRESS n1.7 /l54 F'n J.7 , rL� jJ CITY,S T .ZIP q 9 i I/�/ pvdr/¢sf �Jr /Gd 2
❑OWNER 0 OWNER-BUILDER 0 OWNER AGENT 0 CONTRACTOR ONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT
LICESE ✓ BUS.LIC#C r.\ `&S,J fRoo \i)i ,ouLICEN
COMPANYAME E \ ( ILloggS,‘ Oa3e.SiSr\CiQ, �00c Jfl✓ \11(._ Ie-J1SV?fQ `v 9N° (AlqyN STATE,S ETBSSc.,..,(\cT�hZ � Sn Jb.l 7. C>& „IV 13', PH UUti'S. — 5j
ARCHIT ECT/ENGINEER NAME LICENSE NUMBER BUS.Licit ,
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK I� , /, / ) A 0_1. pu-dtect 4 in
I x5 ) _/l i 8 W{v®���,c
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EXISTING USE PROPOSED USENSTR TYPE STOWS
STOS
'<`Q,� 004- `] USE TYPE OCC. ;SQ.FT. VALUATION($)
.
EXISTG NEW FLOOR DEMO TOTAL
AREA AREA AREA NET AREA ' DD 2.71 (�� )
BATHROOM KITCHEN OTHER �//N `�,' /
REMODEL AREA REMODEL AREA REMODEL AREA IK_ t�
PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑DETACH
❑ATTACH
#DWELLING UNITS: IS A SECOND UNIT qigs SECOND STORY ■ S •
BEING ADDED? ADDITION? ►� O
PRE-APPLICATION S IF YES,PROVIDE COPY OF IS THE BLDG AN YES RECE BY: '� x c,,,',.7-7.-4-,,, TOTAL VALUATION:
PLANNING APDL# NO PLANNING APPROVAL LE'I-17+R EICHLER HOME? NO '�
B m signature y y below,I certify to each of the following: I am the property owner or authorized agent to act on the p�perty owner's behalf. I have read this
1 application and the information I have provided is correct. I have read the Description'of Work and verify it is accurate. I agree to c mply with all applicable local
;ordinances and state laws relating t lding construction. I authorize representatives of Cupertino to'enter the abo v'e-ide 'leer° e/ inspection purposes.
Signature of Applicant/Agent: fr' Date: 6 0 -/
a '
2SUPPLEMENTAL INFORMATION REQUIRED r O• :IPGSLP - ,r.pTYP „_ I,T. ROUTPLAN CHECK
_New SFD or Multifamily dwellings: Apply for demolition permit for ❑°OVE'1,1,111E-,'"'---- COUNTER ❑ BUILDING PLAN REvtEW
existing buildmg(s). Demolition permit is required prior to issuance of building
permit for new building. ,❑,`EXPRESS § „.,,t,,,,,„77(7,77,,:,:\.6,,,,
PLANNING PLAN REVIEW
_Commercial Bldgs: Provide,a completed Hazardous Materials Disclosure ❑:'STANDARD ❑ ;PUBLIC WORKS 7”h}
form if any Hazardous Materials are being used as part of this project. '° '. " _ �' ` , '
❑ :LARGE s a a k ❑ FIRE DEPT i ,,
Copy of Planning Approval Letter or Meeting with Planning prior to ' „ ' f
submittal of Building,Permit application.
❑ MAJOR ❑ SANITARY SEWER DISTRICT ,
' •., • ❑�ENVIRONMENTAL HEALTH•
,..-,,, ,:-.`,,,,-"::7;':`,"--.-.7.:',';',:-,,,T.,,, tea.,'`y
BldgApp_2011.doc 'revised 06/21/11
140'7 REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
;' ALBERT SALVADOR, P.E.,C.B.O.,BUILDING OFFICIAL
CF .INQ 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408) 777-3228• FAX(408)777-3333.building( cupertino.org
P12)rECf.,E)OR,r,-.S't AI\ b5Ci
oS4'NERNME Pl C)\t,_ �MAEL
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c Irg Gn s 11)9 tl ob -4)65.
,DDRESS rI Y, S,TATQ ZIPv, i � L
FAX
CON] "TOR N ME L1f,E !S'NI'M�3ER LICENSE TYPE BUS.LIC.0
94 a
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5\-5\ e .,01`vcorn FAX DsJ KSf
S7r.;.0 ADDR —v o w\e, `.. iT.T:1Tl jEt' v ' t is an,
I UNDERSTAND AND AGREE TO TIDE FOLLOVr'ING:
1. The re-roof project shall comply with all applicable provisions of the 2016 California Codes..
2. An inspection request can be scheduled up to one business day beforethe.re€uested inspection date.
To schedule inspections call (408) 777-3228 from 7 30-3:30pirl.:(1SMon-Thurs).c r 7:30-2:30pin(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 out to the
job site within one hour. The hours for this service are: 7:30-1.0:30am.and 12:3073:30(Mon,Thurs).
and 1:30-10:30am.and 12:30-2:30 (Friday). Final Inspections will be given a tvo hour wiid:ow•,
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 nailslfasteners 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 NN_Titten approvals from the
building inspector. Any roofing which is appIied without first obtaining an approved inspection will
require the removal of all new material down to the slieathii g 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 sigil-off,the following items Will be•verified:.
a. Flat roofs shall have a minimum of/"per foot of slope and.demonstrate there is no ponding.
b. Listings from approved testing agencies for all pre-manufacturedproducts used shall be
available on-site to review at the time of the inspection.
c. Proper spark arrestor installation, vents painted, autterldownspouts 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 ins ection 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 tire.
property owner's behalf. I understand and agree to comply with the re-roof policy stated above. I also understand that
-smoke detectors and carbcn mo -xid. detectors are required to be installed in accordance with Sections.8314 and R3l 5 of
the 2016 California Resident'. Co • Irl /IJ f I n
Signature of Applicant!Agent: w....._ \,- _...,_._ Date: v/ / /.._..
RerooJPolicv-2014.doc revised 064)1.'7