B-2016-3036 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-3036
10112 AMADOR OAK CT CUPERTINO,CA 95014-5606(342 32 017) STATEWIDE ROOFING
INC
SAN JOSE,CA 95138
OWNER'S NAME: GOPALASETTY MANO7 AND SARALA TRUSTEE DATE ISSUED:11/04/2016
OWNER'S PHONE:408-559-1977 PHONE NO:(408)286-7828
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C39 Lic.#803926
Contractor STATEWIDE ROOFING INC Date 02/28/2018 X BLDG _ELECT _PLUMB
MECII 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:.
BLDG 6 PARTIAL RE-ROOF;TEAR OFF WOOD SHAKE;INSTALL
I hereby affirm under penalty of perjury one of the following two declarations: CDX;COMP ROOF SHINGLE(MANSARD ROOF)(36 SQ'S)
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.
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: '72757.00
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 pe:
and state laws relating to building construction,and hereby authorize 342 32 017
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 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. WITHIN 180 DAYS 0 ' PERMIT ISSUANCE OR
Additionally,the applica t understands and will comply with all non-point
source regulations per a Cupertino , nicipal Code,Section 9.18. 180 DAYS FROM LAS PECTION.
Signature n Date 11/04/2016 Issued by:MELISSA N S
Date: 11/04/2016
I hereby affirm that I am exempt from the Contractor's License Law for one of the 'OOFS:
following two reasons: All roofs shall be inspecte .rior 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 obta'."•g an insp.etion,I agree to remove all new materials for
compensation,will do the work,and the structure is not intended or offered for ection.
sale(Sec.7044,Business&Professions Code) y
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:11/04/2016 `
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS 10 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 MA ERIALS DISCLOSURE
2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materia•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, ections 25505,25533,and 25534. I will
permit is issued. maintain compliance with the Cupe )o 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 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 e uipment or devices which emit hazardous
air contaminants as defined by the B.y Area Air Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the C o ertino Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code, 'ections 25505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agent: 411
APPLICANT CERTIFICATION Date:11/04/2016
I certify that I have read this application and state that the above information is CONSTRUCT/9' LENDING AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a cons r ction lending agency for the performance
relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issu-d(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 ARCIUTECE S DECLARATION
and will comply with all non-point source regulations per the Cupertino Municipal
Code,Section 9.18. I understand my plans shall be used as public records.
Licensed
Signature Date 11/04/2016 Professional
II%r..I 6iiIliI f lima l'4t V Nl I t•-. I s*I' t t I IV I!
• COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
4 .,.„ 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
UPCt 't ![°� (408) 777-3228•FAX(408)777-3333•building( ,cupertino,orq
. 1- r6 - 3036
PROJECT ADDRESS 10112 Amador Oak Ct. APN# 342-32-017
OWNER NAME Westridge HOA CIO CMS PHONE 408.559.1977 E-MAIL CS@communitymanagement.com
STREET ADDRESS 1935 DRYCREEK ROAD#203 CITY, STATE,ZIP CAMPBELL,CA 95008 FAX 408.5,59.1970
CONTACT NAMEchill Lyons I PHONE EMAIL
(CBI) 408.2101.6344 jim@esibayarea.com
STREET ADDRESS P.O.Box 54190 CITY,STATE,ZIP San Jose,CA 95154 FAX N/A
0 OWNER 0 OWNER-BUILDER 0 OWNER AGENT El CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 :NGINEER 0 DEVELOPER 0 TENANT
CONTRACTOR NAME Jon Robertson(PM) LICENSE NUMBER 803926 LICENSE TYPE c-3,, BUS.LIC.# 23508
COMPANY NAME Statewide Roofing,Inc. E-MAIL jrobertson@swroof.net FAX 408.286.7820
STREET ADDRESS 5542 MontereyRd.#201 CITY,STATE,ZIP PHONE
San Jose,CA 9513 408.296.782$
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP
PHONE
.,
USE OF 0 SFD or Duplex ® Multi-Family ROOF AREA: VALUATION:
3,607 s.f. 72,757.00
STRUCTURE: 0 Commercial
EXISTING ROOF TYPE: 0 BUILT-UP ROOF 0 ASPHALT SHINGLES IY WOOD SHAKES 0 WOOD SHINGLES ❑OTH:R(SPECIFY)
° REMOVE/REPLACE ❑YES IF NO, PLYWOOD Il %" 0 PLYWD 0 OSB PITCH: ROOF
0 NO #LAYERS: THICKNESS: 0 5/8" TYPE: l CDX 20 :12 CLASS: A
PROPOSED ROOF TYPE: 0 BUILT-UP ROOF ®ASPHALT SHINGLES 0 WOOD SHAKES 0 WOOD SHINGLES ❑OTH:R - ICC-ES REPORT
DESCRIPTION OF WORK:
Tear off existing shake roof,install 1/2"CDX plywood,Install Certainteed Presidential
Shake TLm shingles over Certainteed Diamond Decktm underlayment.
By my signature below,I certify to each of the following: l am the property owner or authorized agent to act on the property o ner'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 buildi'g constr1/ion. I authorize representatives of Cupertino to enter the above-identifie I property for inspection purposes.
1
Signature of Applicant/Agent: ,1/ _,..s, - Date: i 11 3x16
SUPPLEMENTAL INFORMATION REQUIRED I OFFI I E USE ONLY
X If building is associated with a Home Owner's Association,provide letter PLAN CHECK TYPE l ROUTING SLIP
of approval from HOA. ER-THE-COUNTER ❑ BUILDING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. p EXPRESS ° 0 PLANNING PLAN REVIEW
X_. Provide copy of Manufacturer's Installation Specifications. 0 STA I- •; 0 FIRE DEPT
X Provide signed copy of Cupertino's Tear-Off Policy. _...., _ ❑ OTHER:
0
I'i 11.x.1 3,1133 31333 i C Y13-.M b Yi/I I I 4a Io I`1•P I
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
I9 ALBERT SALVADOR,P.E., C.B.O., BUILDING OFFICIAL
LEPRI ill 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408) 777-3228• FAX(408)777-3333•buildinq(a)cupertino.orq (27 ?/�l h f /_t7 / n 7 v 31
PROJECT ADDRESS 10112 Amador Oak Ct. APN# 342-32-017
OWNER NAME Westridge HOA CIO CMS PHONE 408.559.1977 E-MAIL cs@communitymanagentent.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_ 9 BUS.LIC.# 23509
COMPANY NAME Statewide Roofing,Bite E-MAIL irobertson@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 FOLLOW G:
1. The re-roof project shall comply with all applicable provisions of the 2013. C.lifornia Codes,
2. An inspection request can be scheduled up to one business day before the r:quested inspection date.
Please schedule inspections online or call (408) 777-3228 from 7:30-3:30pm lMon-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 b ilding 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 give a two hour window.
3. Tear-Off Inspection is required. Any and all dry-rotted wood shall be repla ed prior to this inspection.
Unless new plywood roof sheathing is proposed throughout, all the nails/fast•ners 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 w 'tten approvals from the
building inspector. Any roofing which is applied without first obtaining an a'proved inspection will
require the removal of all new material down to the sheathing so a proper inssection can be performed.
6. A Final Inspection and approval shall be obtained from the building inspe,tor 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 IA" per foot of slope and demons irate there is no ponding.
b. Listings from approved testing agencies for all pre-manufactured pro a ucts used shall be
available on-site to review at the time of the inspection.
c. Proper spark arrestor installation, vents painted, gutter/downspouts i I stalled, debris removed.
7. NOTE: If you call for a tear-off or plywood nailing inspection and the work i. not complete,you will be
charged a re-inspection fee. The re-inspection fee shall be paid before anot er inspection can be
scheduled.
By my signing below,I certify each of the following is true: 1 am the property owner or aut orized agent to act on the
property owner's behalf. I understand and agree to comply with the re-roof policy stated abo e. I also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and 8315 of
the 2013 California Residential Code.
Signature of Applicant/Agent: ,�i ;j Date: 11to 116
4),
WESIRIDGE HOA
C0 COMMUNITY MANAGEMENT SERVICE",
1935 DRYCREEK ROAD #203
CAMPBELL, CA 95008
November 3, 2016
City of Cupertino
Attn: Planning/Building Department
RE: Westridge HOA
Mansard Roof Replacement Project
To Whom It May Concern:
Please be advised that Westridge HOA retained the firm Statewi•e Roofing, Inc. to
act as our agent for the above referenced repair project for the A.sociation.
Statewide Roofing, Inc. is authorized to work on our behalf and ith the City of
Cupertino on this project.
Please contact the undersigned, if you have any questions or neer additional
information.
Sincerely,
On behalf of the Westridge HOA.
\-71- - -
Jim Lyons
Construction Manager, Construction Services, Inc.
cc: Board of Directors