B-2017-2099 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-2099
7588 LOCKFORD CT CUPERTINO,CA 95014-5047(362 26 045) WESTSHORE .
ROOFING INC
SAN JOSE,CA 95131
OWNER'S NAME: CHEN RONG-FONG AND HUEI-SUEH H DATE ISSUED: 12/07/2017
OWNER'S PHONE:408-431-9425 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:
• RE-ROOF;TEAR-OFF;COMP SHINGLES-(23 SQ)
I hereby affirm under penalty of perjury one of the following two declarations:
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:$13700.00
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 362 26 045 •
representatives of this city to enter upon the above mentioned property for
inspection purposes. (We)agree tq 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 applicant understands and will comply with all non-point
source regulations.- -- upertino,Munibipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
• Signature /` Date 12-07-2017 Issued by:Kim Dunbar
Date: 12/07/2017
•
OWNER-BUILDER DECLARATION
I hereby affirm'tl atI am exemptifrom 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 ins.ection,I agree to remove all new materials for
l i pection.
'compenation,will do the work,and the structure is not intended or offered for
i sale(Sec.7044,Business&Professions Code)
2. ',I,as owner of the property,am exclusively contracting with licensed Signature of Applica
contractors to:constructtbe project(Sec.7044,Business&Professions Code). Date:12-07-2017
I hereby affirm undar penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1. !I haveiatid 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 haveiand'will maintain,Wdrker's Compensation Insurance,as provided for by I-have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labbr 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
a: 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
material. Additionally,should I use equipment or devices which emit hazardous
shall not employ any'person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation,l'aw§of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I exemption;I,become subject to the Worker's Compensation provisions of the the Health&Safety Code,S• -05,25533,and 25534.
Labor Code,.I must forthwith comply with such provisions or this permit shall 1111
be deemed revoked. Owner or authorized agen ;�'
APPLICANT CERTIFICATION Date:12-07-2017.
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 mentioned property for inspection purposes. (We)agree Lender's Name
to save indemnify and'keep harmless the City of Cupertino against liabilities,
judgments,cost's,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 12-07-2017 Professional
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION F
r 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
,�
- �A„ 'sr=` (408) 777-3228 • buil din Ocu pertin o.o rg PEMIT><B-
261 - IX) 9 c)
' CUPERTINO REVS DEFS
❑NEW CONSTRUCTION ❑ADDITION ❑;ALTERATION ❑T.1. ❑MEP / RE-ROOF ❑SWIMMING POOL/SPA
PROJECT ADDRESS WGk c1 ]APN# La- 1(-Lo - e VI-
OWNER NAME �O PHONE E-MAIL
ate n (,'o8 -"f3/-'7'1 -$
• STREET ADDRESS CITY, STATE,ZIP
S88 Go c_Pa�G L�-. G44-J�s- /-4 --
p-- rfr 9'. 61 — — ---
I ONTRACTOR NAME ❑OWNER-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE
Pat, tot ! Fd wile( I�f h
C Tore, 1�v�PI -1 4 G-3�
LSTREET ADDRESS ATE, ZIP I
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E-MAIL PHONE BUS.LIC F
Wes/540(e,roof 0,9mai'la 4108 `L/S6 VZo1 .
0 ARCHITECT 0 OWNER.❑OWNER A ENTtONTRACTOR AGENT ENGINEER 0 DEVELOPER 0 TENANT •
CONTACT NAME �J-to,e H �/� �� E-MAIL
STREET ADDRESS `Li l�iy''nG CITY,STATE,ZIP • P ONE
1D8 • y57 ozeo
DECRIPTON pen 3 la-?
'vI ✓5 C iS�r‘i2 Cova � jnw
Si if
. co vv, e rdvf— o ve( CSC' i-6 h' Ply wood
INGLE-FAMILY/DUPLEX ❑MULTI-FAMILY 0 INDUSTRIAL ❑COMMERCIAL
EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES F TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION(5)
• REMODEL REMODEL KITCHEN REMODEL OTHR GARAGE 0 ATTACHED -
BATHROOM SF SF SF SF ❑DETACHED
EXISING OYES EICHLEIS. 0 YES SECOND STORY ADDITION ONO
FIRE SPRINKLERS 0 NO 0 NO
DWELLING SECOND DWELLING ❑YES ❑ATTACHED DETACHED OTHER
UNITS x UNIT ADDITON: ❑NO S F .
POOLS • 0 FIBERGLASS 0 VINYL-LINED 0 GUNITE ❑PREFABRICATED
POOL-SF SPA-SF' I SPA ATTACHED OYES ❑ NO I TOTAL-SF _
RECEI D TOTAL VALUATION:
Conmiercial or Multi-Fain fly Bvifdinrs with Public 5winuning Pools reclaims DevnrtnFent of Envirorm:enIal Heath approval //` #27k----' I‘13/- 0 7
RE-ROOF EXISTING ROOF TYPE: E BUILT-UP ROOFX4SPHALT SHINGLES WOOD SHAKES❑WOOD SHINGLES❑TILE OTHER(SPECIFY)
REMOVE/REPLACE❑NO IF NO e, PLYWOOD F ❑3/8" ' PLYWOOD TYPE: PITCH: ROOF CLASS
' 5ayES F OF LAYERS ✓° THICKNESS❑5/B" OTHER 11 OSB %CDX OTHER 7 •12 A
PROPOSED ROOF TYPE:❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES❑WOOD SHINGLES 0 OTHER �j '
*Provide a signed copy of the CLipertino's Tear-Off Policy SF rot SQUARES v.
By my signature below I certifyto 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 ordinance -•• state laws r- - ' g ,s building construction. I authorize representatives of Cupertino to
enter the above-identified property for ii :•ection 'urpose . ackn• edge and authorize all information contained on this application form
to be made available for public recor.
Signa ture,of Applicant/Agent: i I — Date: ii— 7 , •
SUPPLEMENTAL INFORMATION REQUIRED ' •
*New SFD/Second Dwelling Units/Multifamily Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction.
'Commercial Buildings: Provide aicompleted Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project.
*Copy of,Planning Approval Letter:or Meeting with Planning prior to submittal of Building Permit application.
"HOA-Provide,a letter of approval'from the Home Owner's Association
BldgApp_2017.doc revised 08/01/17
\ i REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
��u`'KA9rr,
CUJPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333•buildino(c cupertino.orq
PROJECT ADDRESS v C J II c[ ��• APN# 3 SJ �q (/_c
OWNER NAME 'fF. „•y�/ e e n PIjO ice. If 3f,. /�)Y"cIt E-MAIL
STREET ADDRESS0,4_5J Oc CITY,�SCTTAUTEE IP , r%nO / FAX
CONTRACTOR NAME CA.
I �.w f Q LICENS`� LICEI�$E TYpT; BUS.LIC.#
COMPANY NAME; ,, S f r F IL L _ _ ^ I FAX
vl/(/ hd-r/F va VIC - n e koof,`�N u4?0t'/;Cep ys6 -az33
S E�. r 1 trove. C7c�A✓l DP
J J O-f ' ?S73I PH N --ti.56 -02'60
I UNDERSTAND AND AGREE TO THE FOLLOWING:
.1. The re-roof project shallcomply with all applicable provisions of the 2016 California Codes.
2. An inspection request can be scheduled up to one business day before the requested inspection date.
To schedule inspections call (408) 777-3228 from 7:30-3:30pm(MonTThurs),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 out to the
job site within one hour. The hours for this service are: 7:30-10:30am and 12:3013:30 (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/"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 acts 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 a- - s s are required to be installed in accordance with Sections R314 and R315 of
the 2016 California Residential C •
Signature of Applicant/Agent: / / Date: 12 —
Rerooff'olicy_ 014.doc reviised 06/01/7