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13100189
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10010 MOSSY OAK CT CONTRACTOR:IQV CONSTRUCTION PERMIT NO: 13100189 INC OWNER'S NAME: THAKURIA DIPANKAR AND JYOTI TRUSTEE 820 CHARCOT AVE DATE ISSUED:10/29/2013 OWNER'S PHONE: 4085591977 — 1111 SAN JOSE,CA 95131 PHONE NO:(408)582-9200 9 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL Lic.# yG 3 2- �` 33 SQ'S(6 DETACHED GARAGES,ONE BLDG License Class 10010,10020,10030,10040,10050& 10060)REMOVE(E) Contractorl a V eogfl _ Date / `Z`+" B.U.R.,INSTALL(N)CARLISLE 60 MIL TPO OVER 1/4 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. I hereby affirm under penalty of perjury one of the following two declarations: 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 Valuation:$21443 performance of the work for which this permit is issued. Sq.Ft Floor Area: 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 APN Number:34232104.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter CALLED INSPECTION. upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Issu y: Date: /0/09/3 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. RE-ROOFS: Signature C�✓ Date �0—z 4' 3 All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. 1 ❑ OWNER-BUILDER DECLARATION Signature of Applicant d Date: 30 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) HAZARDOUS MATERIALS DISCLOSURE I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(x)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and Health&Safe H he eaSafety Sections 25505'and 25534. Code, I have and will maintain Worker's Compensation Insurance,as provided for by t Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent:/'/!< Date: permit is issued. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued(Sec.3097,Civ C.) forthwith comply with such provisions or this permit shall be deemed revoked. Lender's Name APPLICANT CERTIFICATION Lender's Address 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 and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date REROOF PERMIT APPLICATION 1-21 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 �D CUPERTINO (408)777-3228• FAX(408)777-3333•buildingQCLlpertino.org PROJECT ADDRESS 10010 1(-060 J APN# 3 '[-(-2- � j OWNERNAME -rkm 4j C I S r PHONE �_ �, l E-MAIL STREET ADDRESS CITY, STAT ,ZI FAX c 3s \fir c, C c oe .( CONTACT NAME PHONE E-MAIL ' �` t' O� Z./�5 �7 Z 7 STREET ADDRESS ++ CITY,STATE, ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ILCONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE NUMBE LICENSE TYPE BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESSy ,C` s CITY STATE,ZIP r PHONE 5;T7 Cct� �N . c A i,e. 7 Z 7 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 ROOF AREA: VALUATION:: , STRUCTURE: ❑ Commercial EXISTING ROOF TYPE: (BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE P.YES IF NO, PLYWOOD W -/1" ❑ ___. PLYWD ❑ OSB PITCH: ROOF 13 NO #LAYERS: THICKNESS: 115/8" TYPE. ❑ CDX I •12 CLASS: PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES OTHER ICC-ES REPORT# DESCRIPTION OF WORK: .-) C - v i hs' I -,n ►�, l! 1 L"rc-LA P C O C, -.4 C ci►1o6zo 1 ,0030 ( 0090 to0S 0 ( ao �-o By my signature below,1 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 pr vi ed 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 b construction. 1 authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: j~ Date: SUPPLEMENfAL INFORMATION REQUIRED OFFICE USE ONLY _If building is associated with a Home Owner's Association,provide letter PLAN CHECK TYPE ROUTING SLIP of approval from HOA. ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW _Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER: ReroofApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10010-10060 MOSSY OAK CT DATE: 10/29/2013 REVIEWED BY: MELISSA APN: 342 32 104 BP#: "`VALUATION: 1$21,443 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY Building is PENTAMATION 1 R2ROOF USE: Multi-Family Dwelling >3 Stories 0 Yes G No PERMIT TYPE: WORK 33 0010J0020,10030,10040,10050 & SCOPE REMOVE (E)EB.UCR .,EINSTALL (N) CARLISLE 0D GARAGES, ONE BLDG 1 060 MIL TPO OVER 1/4 SECURE ROCK FEE ID ROOF AREA s.f. 1REROOFMRES 3,300 t.Fc,ht'lart C'FiE c k P!wnh. Pha? C/If 4,; Chack tleclr. L' fruit F�>�_ t)ther P,tt+rr7,IC>thef` lras� flttrcr' 1le,%t. h�p Phiodj his r;t, icc. in"", Fcc NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These fees are based on the prelinddna information available and are only an estimate Contact the Dept for addn 7 info. FEE ITEMS(Fee Resolution 11-053 Ef. 711/131 FEE QTY/FEE MISC ITEMS Ilan Chccic Fecr: S111J/77, PC Fee Permit Fee: $528.00 40 Sllhrlrl. hr�p I`ee Plrrnlla.:"11c c I1.illec: I''1tXrtrh:%ad�clr.-1"Icc Pcrinit Fcc. (_on'No.11clion TJV. fti11Y11r71ttJYX11tY'f'c't': Work Without Permit? © Yes Q No $0.00 ,lcfti°uru'��cl Plasmin Fccs: Trcn eI OoclrJrXcrJXtuti.on Fees. Strong Motion Fee: 1BSEISMICR $2.14 Select an Administrative Item Bid�mmission Fee: 1BCBSC $1.00 x{03 SUBTOTALS: $531.141 $0.00 TOTAL FEE: $531.14 Revised: 10/01/2013 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 ( d CUPERTIhEO (408)777-3228• FAX(408)777-3333 -buildinga(Dcupertino.org PROJECT ADDRESS Wi OSS APN� (� -2- _ � I b OWNER NAME akv r to PHO G l 7 E-7MAII STREET ADDRESS CITY, STATE,ZIP I FAX CONTRACTOR NAME 1 ,` �C N S r LlC[10/I LICENSE NUMBER LIC vff TAPE j BUS.LIC.k36 i COMPANY NAME V E-MAIL FAX l STREET ADDRESS t I CITY,STATE,ZIP G SC �j //� PHONE t I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2010 California Codes. 2. An inspection request can be scheduled up to one business day before the requested inspection date. Please 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. 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. _,_Roofing shall not be applied without first obtaining_all or 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 mon tectors are required to be installed in accordance with Sections R314 and R315 of the 2010 California Resid Signature of Applica gen - Date: !D ReroofPolicy_2012.doc revised 1017/12 COMMUNITY MANAGEMENT SERVICES October 1,2013 City of Cupertino Building Department 10300 Torre Avenue Cupertino, CA 95014 Re: Westridge Country Club Homes Association Gentlemen: This office is the management company for the above homeowners association and the Board of Directors requests your assistance in obtaining a Permit for the installation of new roofs at this complex in Cupertino, CA 95014. ^ Please be advised that IQV Construction,Inc. or Jim Lyons of Construction Services, Inc. will be obtaining the permits on behalf of the Board of Directors. Thank you for your anticipated cooperation. Sincerely, COMMUNITY MANAGEMENT SERVICES Pauline M. A. �rM�T��TGG000re, Senior Association Manager Westridge Country Club Homes Association cc: IQV CSI Board of Directors 1935 Dry Creek Road, Suite 203■Campbell,CA■95008-3631 ■voice (408) 559-1977 ■fax (408) 559-1970