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14080232a/ CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1131 ELMSFORD DR CONTRACTOR: BUCK'S ROOFING PERMIT NO: 14080232 OWNER'S NAME: VICTOR HUANG 6853 W RIVERSIDE WAY DATE ISSUED: 08/22/2014 OWNER'S PHONE: SAN JOSE, CA 95129 PHONE NO: (408) 313-3429 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL E] RE -ROOF 27 SQUARES; REMOVE EXISTING ISNTALL 1/2 License Class/L7— 3 � Lic.#� 7� 011 /� OSB CLASS A Contractor XVC./C fjt�)/h n 1 Date Z 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 performance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $13000 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 36208013 00 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMITE S IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 80 AYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAVS AOM LAST CALLED INSP CT N. indemnify and keep harmless the City of Cupertino against liabilities, judgments, City in consequence of the / costs, and expenses which may accrue against said Issued by:W Date: granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section RE -ROOFS: If is 9 18. /Z Z Signature ate All roofs shall be inspected prior to any roofing material being installed. a roof installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature Appli Date: Z Z / ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of of the following two reasons: ALL ROOF ERINGS 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) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE 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(a) 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 I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized age Dat 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 forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C ) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that 1 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 u REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 '(408) 777-3228 • FAX (408) 777-3333 • buildingecupertino.org PROJECT ADDRESS .1131 /3/ APN # OWNERNAME J `t _% _ 0 V "vim1 PHONE 3 � (1 q 6 U GJ E-MAIL STREET ADDRESSv /�_ ZIP CITY, STATE, / ` �u FAX CONTACT NAME r � SL,' PHONE L/�� ` 7 2 C/� 3J%/ EMAIL STRE DTE S W ZIP {� C Gam-✓( 7C 11 OWNER❑.OWNER-BUILDER ❑OWNER AGENT CONIRACYOR ❑ CONrRACTORAGENT ❑ ARCHrrFcT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME V� J��S _ p O i h /C LICENSENUMBER 7 _3 Q �3 LICENZ _ BUS. LIC. # COMPANY NAME �_/� U 1�CT "T E-MAIL/ - FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHTTECr/ENGINEER NAME LICENSE NUMBER BUS. LIC. # COMPANY NAME F, FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi -Family STRUCTURE: ❑ Commercial ROOF AREA: VAL TION: ' EXISTING ROOF TYPE:. ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES WOOD SHAAK`ES' ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE /REPLACE YES ❑ NO ff NO, / #LAYERS: PLYWOOD h" ❑ A J 1 THICKNESS: PLYWD OSB TYPE: ElCDX FUCH: / / .12 ROOF A CLASS: PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT # DESCRIPTION OF WORK©S ( 1 , Ut 13 -r% / L-6 _I r By my signature below, I certify to each of the following: I ain 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 lavas relating to, buildin tru tiorL I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature ofApplicant/Agen Date: SUPPLEMENT TION REQUIREDIIQ — If building is associated with a Home Owners Association, provide letter of approval from HOA. Provide Planning approval to verify if there any restrictions. — Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cupertino's Tear -Off Policy. 11M F, a In�I li t - _ ReroofApp 2011.doc revised 03/16/11 CITY OF CUPERTINO FFIF ESTIMATOR — BUILDING DIVISION ADDRESS: 1131 elmsford 'h.k DATE: 08/22/2014 REVIEWED BY: larrys APN: I BP#: *VALUATION: 1$13,000 �PERMIT TYPE: Minor Building Permit Othe�, I'luinb 1ru'r, PLAN CHECK TYPE: Re -roof PRIMARY SFD or Duplex inib. hip. F,.,e: ENTAMATIO PENTAMATION 1SFDWLR00F USE: - Permit Fee: .' MIT TYPE: PERMIT TYPE: WORK roof 27 sq �re SCOPE FEE ID ROOF AREA (S.L) - 1REROOFFRES 2,700 M 'h.k QTY/FEE Y_,k"v, �Pio�i Chv,�-,,.,� Fee: 1,11wmh /'erozif Ne, rOf-'eT` v InT Othe�, I'luinb 1ru'r, il, h?")" Fn,I1 inib. hip. F,.,e: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Pubfic Works, Fire, Sanirarysewer vistriciachout r% A dn_fha i"fnrmadan available and are onlv an estimate Contact the Dept for addn'l info. CL, el" I. — UU, "I I L FEE ITEMS (Fee Resolution 11-053 E 711113) ..... FEE QTY/FEE I MISC ITEMS "I'a'n Clw"'k P'ee: Sl,ipfol, PC F71 Ah"'o?h "'.14ech- Elel­ - Permit Fee: $459.00 F Work Without Permit? 0 Yes 0 No $0.00 A 7'1--ovel 1)('1"v!1/'wW(_111 . Orl F(?(?S., Strony, Motion Fee: IBSEISMICR $1.69 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 %69 $461.69 $0.00[,_ TOTAL FEE Revised: 07/10/2014 CUPERTINO 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 (408) 777-3228 - FAX (408) 777-3333 - buildincJna.cupertino.org PROJECT ADDRESS / / "j /� !moi-!� ✓ i /' Y APN # OWNER NAME v �' / I l✓ H PHONE 3 G E-MAIL STREET ADDRESS / Ca FAX CONTRACTORNAME v� LICENSE ,N*FR_ S LICENS� TYP� ` Cl BUS. LIC. # COMPANY NAME C �C S E-MAM FAX STREET ADDRE� ( CITY, STS` 9,T J/ PHONE _3/ 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/" 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 14 and 8315 of the 2013 California Residential Co Signature of Applicant/Agent Date:,,,,,4A 2 ReroofPolicy_2014.doc revised 01/15/14 Address • SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingacupertino.org 1151 r M s -l* -RR -�>6zk CO-k7lon Ft PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314, 2013 CSC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On every level of a dwelling unit including basements X X, Within each sleeping room X, Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section 8314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. 1 have read and agree to comDJy wiffi the terms and conditions of this statement Owner (or Owner Agent's)Nam : VVIC�r � � �`��� 1 Signa ure ........ Date: ................... Contractor Name: Signature................................:.................................. Lic.#...................................... Date: ..::............... Smoke and CO form.doc revised 03/18/14 /�4