B-2017-1868 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1868
10052 MOSSY OAK CT CUPERTINO,CA 95014-5615(342 32 109)110042 MOSSY STATEWIDE ROOFING
OAK CT CUPERTINO,CA 95014-5615(342 32 108)110032 MOSSY OAK CT INC
CUPERTINO,CA 95014-5615(342 32 107)110022 MOSSY OAK CT CUPERTINO,CA SAN JOSE,CA 95112
95014-5615(342 32 106)110012 MOSSY OAK CT CUPERTINO,CA 95014-5615(342
32 105)
OWNER'S NAME: VENTIMIGLIA JOSEPH A AND ESKENAZI JANET A T DATE ISSUED:11/01/2017
OWNER'S PHONE:408-559-1977 PHONE NO:(408)286-7828
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C-39 Lic.#803926
Contractor STATEWIDE ROOFING INC Date 02/28/2018 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:
UNITS 10012, 10022, 10032, 10042,10052-REROOF CARPORTS;
I hereby affirm under penalty of perjury one of the following two declarations: TEAR OFF;INSTALL CDX;COMP SHINGLES(8.56 SQ)
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.
1.... I have and will maintain Worker's Compensation Insurance,as provided for by
ection 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$17269.00
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 342 32 105
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 WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the a.plicant understands and will comply with all non-point
source regulation l per t : Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature !AA Date 11/1/2017 Issued by:AbbyAyende
Date: 11/01/2017
s .hl .- - 1_ . 1 .►
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 prior 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 obtaining an inspection, .gree to remove all new materials for
compensation,will do the work,and the structure is not intended or offered for ' .-c,
sale(Sec.7044,Business&Professions Code)
2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code).
Date:11/1/2017 /'
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE 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. 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 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 Bay Area Air Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cu'- tino Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,S .tions 2551 ,25 .- .
Labor Code,I must forthwith comply with such provisions or this permit shall ,�
be deemed revoked. Owner or authorized agent: P,
APPLICANT CERTIFICATION Date: 11/1/2017 /
I certify that I have read this application and state that the above information is CONSTRUCTIO 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.
Signature Date 11/1/2017 Licensed
?>10 CT i (413
J " COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
�St.„J�
(408) 777-3228 • FAX (408) 777-3333• buildinq ancupertino.orq
CUPERTINO
Ib 01-2-I ‘00122-1 10061, 100q 2- 10(36-2_
PROJECT ADDRESS 10012-10052S\.1 OaK Carport APN# 342-32-105
OWNER NAME Westridge HOA C/O CMS PHONE 408.559.1977 E-MAIL cs@communitymanagement.com
STREET ADDRESS 1935 DRYCREEK ROAD#203 CITY, STATE,ZIP CAMPBELL,CA 95008 FAX 408.559.1970
CONTACT NAME Jim Lyons(CSI) PHONE 408.210.6344 E-MAIL jim@csibayarea.com
STREET ADDRESS P.O.Box 54190 CITY,STATE, ZIP San Jose. CA 95154 FAX WA
❑ OWNER 0 OWNER-BUILDER 0 OWNER AGENT ® CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT
CONTRACTOR NAME Jon Robertson(PM) LICENSE NUMBER 803926 LICENSE TYPE C-39 BUS.LIC.# 23509
COMPANY NAMEStatewide Roofing,Inc. E-MAIL jrobertson@swroof.net FAX 408.286.7820
STREET ADDRESS 5542 Monterey Rd.#201 CITY,STATE,ZIP San Jose,CA 95138 PHONE 408.286.7828
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF 0 SFD or Duplex IX—1 Multi-Family ROOF AREA: VALUATION:
856 s.i. $17,269.00
STRUCTURE: 0 Commercial
EXISTING ROOF TYPE: 0 BUILT-UP ROOF 0 ASPHALT SHINGLES ll WOOD SHAKES ❑WOOD SHINGLES 0 OTHER(SPECIFY)
REMOVE/REPLACE 0 YES IF NO, PLYWOOD Di W' 0 PLYWD 0 OSB PITCH: ROOF
0 NO #LAYERS: THICKNESS: 0 5/8” TYPE: Di CDX 20 :12 CLASS: A
PROPOSED ROOF TYPE: 0 BUILT-UP ROOF ®ASPHALT 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 Deck"'underlayment.
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 build'gcons' i ion. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: I,GQI '�i Date: 10/31/17
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
X If building is associated with a Home Owner's Association,provide letter PLAN CHECK TYPE ROUTING SLIP
of approval from HOA. ❑ OVER-THE-COUNTER 0 BUILDING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
X Provide copy of Manufacturer's Installation Specifications. 0 STANDARD ❑ FIRE DEPT
X Provide signed copy of Cupertino's Tear-Off Policy. 0 OTHER:
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
,.Js ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTINO
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PROJECT ADDRESS 10012-10052 California Oak Wy.Carport APN# 342-32-105
OWNER NAME Westridge HOA C/O CMS PHONE 408.559.1977 E-MAIL cs@communitymanagement.com
STREET ADDRESS 1935 DRYCREEK ROAD#203 CITY, STATE,ZIP CAMPBELL,CA 95008 FAX 408.559.1970
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 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.
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 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 monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2013 California Residential Code.9c?jH4239—'-
Signature of Applicant/Agent: Date: 10/31/17