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15070087IR CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10790 PENINSULAR AVE CONTRACTOR: PETERSEN-DEAN INC PERMIT NO: 15070087 OWNER'S NAME: BROWN THOMAS AND JAYME 7980 ENTERPRISE DR DATE ISSUED: 07/13/2015 OWNER'S PHONE: 6502106048 NEWARK, CA 94560 PHONE NO: (510)494-9982 �r LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL TEAR OFF WOOD SHAKE, INSTALL (1) OSB, 30 # FELT, License Class n---3 Lic. # 16 (,,//7 CLASS A COMP ROOF SYSTEM (26SQ'S) Convactor/dc 'lZfc�� dE�1J� Date Z 7- /f - f 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 Sq. Ft Floor Area: Valuation: $13900 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 APN Number: 32603049.00 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 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 18 INSPEC ION. indemnify and keep harmless the City of Cupertino against liabilities, judgmen costs, and expenses which may ccrue against said City in consequence of th �ALLED granting of this pe Ad ' onally, the applicant understands and will comply Iss Date: /� with all non -poi sour a gulations per the Cupertino Municipal Code, Section 9.18. Signature Date_a7 - �� RE -ROOFS: All roofs shall be inspected prior to any r fing material being installed. If a roof is installed without first obtalni an ins ction, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION p� Signature Applicant: Date: �f%- / 3 1 hereby affirm that I am exempt from the Contractor's License Law for one of 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) 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. 1 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 u rti eMunicipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Secti s Z55 , 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date r 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 Compensation laws of California. If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY 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 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION 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 CUPBRTINQ REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95019-3255 (408) 777-3228 •FAX (408) 777-3333 • buildlnnCcllcttpertino.ora PROTECT ADDRESS I I� \ 1G ]�v APN H -3Z4Oy �j OWNER NAA1E .� PHONE _ �'Ot(!L �- � � STREET ADDRESSi' 1'] f A il� /1 tyl t�\ 1��^v-lv, ��1r 1 ,^`v CITY, STATE. Z 0; FAX CONTACT NAME PHONP '\ ei-` I ► _ , IL kCCA STREETADDRESS'�( j G/� ii CITY. STATE, 7.IXrl - (� Q OWNER El�i� OWNER -BUILDER Q OwNPRAOENT CMTRACTOR ❑COMRACTORAOUNT ❑ ARCHITECT C3ENOINEBR iA DEVELLOJPE.R ❑ TENANT CONTRACTOR NA LICENSENUMBER l n� (� `•I\✓ 1�..^ LICENSETYP BUS.LIC.H `•/' ^8 f I1 CO\1PANYNA ��`� E•�1hIL � �-��1 �((�( STRERTADDRESS' �`�\ CITY,STATF,ZIP V j, (�'Yrl Il/ ( Tom\ oqm e5Lr - (J `\j j�l� F_ �� �' ARCHITECT/ENOINEFR NANIH LICENSF.IRMIDE.R DUS. LIC. N COMPANY NAME 13 -MAIL FAX STREETADDRRSS CITY,STATE,ZIP PHO: H USE OF ❑SPD or Duplex (_} A'tultl-ralllll}' ROOFARL'.1:� VALUATION: STRUCTURE; ❑ Commercial Z � C), EXISTINO ROOF TYPE: ❑BUR.T•UPROOP ❑ASPHALTSHINOLES VOODSFIAKES �"OODSHINOLES 1'OTHFR(SPECIFY) RES10Y6/REPLACFY[S lFNO, PLYWOOD O PLYWD OSB I'EXPE: PITCH: : 12 ROOP , A ❑ N N L E 1 ',' • ❑ Sir, ❑ C X CLASS4 PROPOSED ROOF TYPE: ❑BU1LT•UPROOF IJASPHALTSHINOLE$ QWOODSIIAKm ❑\%'OODSHINULES 11 OTHER tCC•ESREPORT H DESCRIPTION OF\VORK:/ G�( <- -I "0' G `J wood <�V lJ �x i,J\ 13y my signature beton, I certify to tach of Ie olloe' g: I am the properly owner�®ratilharlzcd appltea(lon and Tho information i have p>5`'ide is c recL i have read Ute Dascrlplof e. ree to comply with all applicablelocal ordinances and scale laws relating Io b ldiag n u on. I atllhorizc representatibo entified property for inspectlon purposes. Signature of AppliennUAgent: Date: SUPPLFNIENTAL INFORMATION REQUIRED pt A GUtLKT1: 1; PUi 6�G sl tF ': If building is associated will) n Homo Owners Association, provide letter b OVER T)[��OU\TER I� pUELB1\C%Sn 1{E5'(£15' of approval tiom HOA, — Provide Planning approval to verit}' if there any restrictions. [j }�pnF$ ©FIrt1�11hGF1�1N);E11e11 Provide copy of Manufacturer's Installation Specitictltlolls, C1, ST.+ru,�iiu Q Fl,R4DkPT Provide signed copy of Cupertino's'1'ear•OR Policy. I oxttt tir' Rer•oofrtpp 2011.door•cvlsec10311&11 CITY OF CUPERTINO Ili+l FEE ESTIMATOR - BUILDING DIVISION LMADDRESS: 10790 PENINSULAR AVE DATE: 07/13/2015 REVIEWED BY: MELISSA 9tech. Permil 1- APN: 326 03 049 BP#: Z,.Z ZXej *VALUATION: 1$13,900 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY SFD or Duplex USE: rhumb. hap. Fir PENTAMATION 1SFDWLROOF I PERMIT TYPE: WORK TEAR OFF WOOD SHAKE INSTALL N OSB 30 # FELT CLASS A COMP ROOF SYSTEM SCOPE (26SQ'S) FEE ID ROOF AREA s.f. 1 REROOFFRES 2,600 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 nreliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-033 Eff 7-'1.13) Mech. Plan Check Phusb. Plan Check Elec. Plan Check 9tech. Permil 1- Plumb. Permit Fee: F,lec i' Other Alech. Insp )/her Plumb Insp Other Elec. Insp. E3 I Asch. Insp. Fee: rhumb. hap. Fir iJec. 117,w 1,c( 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 nreliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-033 Eff 7-'1.13) FEE QTY/FEE MISC ITEMS Mun (_ {tesc: k P ce: suppl. P(." Iy."C Pl1mb.%11eeh.,B1ec Permit Fee: $442.00 Suppl. Inap Fee 1'hlntb. - ;11ec/l.%Flee Plumb./11e>ch.iElec Permit Fee: C"onslruction Tax: .-administrative Fee.- ee:Work WorkWithout Permit? C) Yes No $0.00 (Meed P' inning P A 1'ruvel Do(, "lir Strong; Motion Fee: IBSEISMICR $1.81 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $444.81 $0.00 TOTAL FEE: $444.81 Revised: 07/02/2015 REROOF TEAR -OFF POLICY OaMMUNr Y DEVELOPMENT DEPARTMENT - BUILDING DIVISION T ALBERT SALVADOR, P.E., C.B.O., BUILDING WI01AL �t3PE}t7f N0 '10300 TORRE AVENUE - CUPERTINO, CA9)W14-3256 (408) 777-3228 - FAX (408) 777-3333,,bulldinap_cupertino.orci rRo7Ect ADDRM� � MN L 0WN2R14AME t��J PHONE(�rMAIL L/�1 57REETADDRESS V � CONTRACTORNAr lJ 'v ` CttY, 5fA'fE,z�E[ Y) / jo FAX LFUNSUNUMBER 11�iilJ,LICeNSETTYP E M. V0. N � 1 COMPAt•NY NAM r L STREET ADDRE53.-�'�/r,�/ \ Q� ) j CRY, 31A7E, EIP I UNDERSTAND AND AURES TO TTR r,OLLOWING: 1. The re -roof project shall comply with all applicable provisions of the 2013 California. Codes. 2. .Axa inspection request can be scheduled ori to one business day_Inforp the requested inspection_ date Please schedule inspections online or call (408) 777-3228 from 7:30-3:30p�n (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 availablc 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 Jmoeked-down or removed prior to this inspeotiom 4. If plywood is installed, a plywood Nailing_luspection is required, 5. Roofing shall not be applied without first obtaining all prior inspection and written approvals from the buildhAg 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 Jusnecti,on 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 1/a" per foot of slope acid demonstrate there is no ponding. b. Listings from app3'oved'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 reinspection fee. The re-iznspection fee shall be 'paid before another inspection can be scheduled. . By any signing below, I certify each of the following is true: 1 alp the property owner or authorized agent to act on the property ow'ner's behalf, I understand mid agree to comply with the re -roof polioyr stated above. I also understand that smoke detectors and carbon monoxide detect are required to be installed in accordance with Sections R314 and IU 15 of the 2013 California Residentl�m - <--1 I Signature of, 4pplicant/ABcnt:A Date:_ '--f ReraofPo11cy_2014,doc revised 01/1S/14 CUPERTINO Owner Name Address WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildina(Dcunertino.ora 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. P— o Go to Question 2. 2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its plumbing, installation of water -conserving plumbing fixtures is not technically feasible? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the fonn and sign bottom of form. �No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ No My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 0 Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. Ple e check ONE of the following: My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non- compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ My property is a multifamily residential real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water - conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). ❑ My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). I, as the owner or owner's agent of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and that the water -conserving plumbing fixtures comply with the requirements as indicated in the table on the following page. / / / / i I Owner or Owner Agent's Signature: Date: 6 L/7//T 1 Upon completing and signing this Certificate, please return it to the Building Division in order to final your bfiildin� permit. SB407 2015.doc revised 08126/15 BUILDING PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN SIGNED AND RETURNED TO THE BUILDING DIVISION Ate_ 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB407 2015.doc revised 08/26115 Non -Compliant Water -Conserving Plumbing Fixture PlumbingFixture (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type Water Usage 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 /Flow Rate 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 Single -Family Multi -Family Commercial Residential Residential Water Closets Exceed 1.6 Single flush toilets: 1.28 gallons/flush (Toilets) Gallons/flush Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite, average flush volume of two reduced flushes and one full flush Urinals Exceed 1.0 0.5 gallons/flush Gallons/flush Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of gallons per minute U.S. EPA WaterSense Specification for Showerheads (A hand-held shower is considered a showerhead.) For multiple showerheads serving one shower, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. Faucets — Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets 0.8 gallons per minute @ per minute @ 60 psi; 20 psi minimum 0.8 gallons per minute @ 20 psi In common and public use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute 60 si Faucets — Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60 Kitchen per minute 60 psi @ 60 psi psi Faucets May temporarily increase May temporarily up to 2.2 gallons per increase up to 2.2 minute @ 60 psi, and must gallons per minute @ default to maximum 60 psi, and must 1.8 gallons per minute @ default to maximum 60 psi 1.8 gallons per minute Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are may be used to achieve unavailable, aerators or reduction. other means may be used to achieve reduction. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB407 2015.doc revised 08/26115 SMOKE I CARBON MONOXIDE ALARMS FIL OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building Mcupertino.org Permit No. / FO 7 0 0 S7 Address / (% % y'V /A/5 044 n- A JE # of Alarms Smoke: 4 Carbon Monoxide: Z PEIZ'1IIT CANNOT BE FINALED AND COTAWLETED UNTIL THIS CERTIFICATE HAS BEEN S ,NNE) AN -1) RF,Tt1RNFD TO THE BUILDING DIVISION 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 CBC 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 R314 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. l have read and agree to comply with_the terms and conditions of this statement Owner (or Owner Agent's) Name: jrtvrr`K....D.777U/...?�v.....#t.. Contractor Name: )0,evT_fe7-1 !/�J N /f /5ignature.... ..............................# Date:4 Z 7— ........... .. Smoke and COform.doc revised 03/18/14