15070184CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20875 VALLEY GREEN DR I CONTRACTOR: NEMMER ROOFING PERMIT NO: 15070184
I OWNER'S NAME: KORET FOUNDATION 15348 AUDUBON PARK CT I DATE ISSUED: 07/27/2015 1
OWNER'S PHONE: 6505923960 1 FREMONT, CA 94538 1 PHONE NO: (510) 919 -2930
LICENSED CONTRACTOR'S DECLARATION
License Classy Q
Lic. # -7 / ` 3<D
Contractor / " �""r ate
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: RESIDENTIAL ❑ COMMERCIAL ❑
BLG #73 -88 REMOVE (E) ROOFING AND INSTALL NEW
OSB
AND NEW COMP. ASPHALT SHINGLES
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: $32178
.1-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.
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 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,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -poi source regulations per the Cupertino Municipal Code, Section
9.18.
Signatur Date
❑ OWNER- BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
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.
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.
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
APN Number: 32609064.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 D YS FROMcLAST /CALLED INSPE TIO r..
Issued by: VLf.(Jc -fv o j "Date YV'
RE- ROOFS:
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. /I /A
Signature ofApplic./P Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sectiorycr25505, 25533, and 25534.
Owner or authorized agent: Date: %
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
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,
costs, and expenses which may accrue against said City in consequence of the
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.
Signature
Date
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
CUPERTINO
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014 -3255
(408) 777 -3228 • FAX (408) 777 -3333 • building a()cupertino.org
&I
PROJECT ADDRESS �<) Q 7S q, C _ ��� _/
APN #
-
OWNER NAME /< L
TAT
STREET ADDRESS/0J �
CITY, STATE,
SO AE T? E,, ZIP
Fx
CONTACT NAME
PHONE
E -MAIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
❑ OWNER ❑ OWNER- BUILDER ❑ ON1WE.R AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTO NAME
LIONS NU BE
LICENSE TYPE
BUS. LIC #
COMPANY AME - ,✓
E -MAIL
FAX
STD RES
/ 6
P&NE Q! A__;�� y
! 7 U
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
STRUCTURE: STRUCTURE: E] Commercial
ROOFAREA: 2�J
/
VALUATION-
3 ` 7 cl� "
EXISTING ROOF TYPE: ❑ BUILT -UP ROOF ❑ ASPHALT SHINGLES 1! (-WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE/REPLACE>-YES
11 NO
IF NO,
# LAYERS:
PLYWOOD ❑ y,•• ❑
THICKNESS: 13 5/8'•
PLYWD 14,0 SB
TYPE: 1:1 CDX
PITCH:
• 12
ROOF
CLASS: A
PROPOSED ROOF TYPE: ❑ BUILT -UP ROOF ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER
]CC-FS REPORT #
DESCRIPTION OF WORK:
By my signature below, I 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 ided is correct. I Ole the Description of Work and verify it is accurate. I agree to comply withal] applicable local
ordinances and state laws relating to b ng construction orize representatives of Cupertino to enter the above - identified /property for inspection purposes.
Signature of Applicant/Agent: Date: —�� ( 5
SUPPLEMENTAL INFORMATION REQUIRED
_ If building is associated With a Home Owner's 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.
OFFICE USE ONLY
PLAN CHECK TYTE
ROUTING SLIP
OVER- TAE - COUNTER
❑EXPRESS
❑ STANDARD
❑: BUILDING PLAN REVIEW
El PLANNING PLAN REVIEW
❑ FIRE DEPT -
❑ OTHER:
ReroofApp_2011.doc revised 03116111
CITY OF CUPERTINO +sQq_0 13L
FEE ESTIMATOR - BUILDING DIVISION �
FEE ID ROOF
f.
1REROOFMRES 9,300
ADDRESS: 20875 VALLEY GREEN DR
DATE: 07/27/2015
REVIEWED BY: PAUL
lleela. Permit Pere
APN: 326 09 064
BP #:
'VALUATION: 1$32,178
zPERMIT TYPE: Minor Building Permit
PLAN CHECK TYPE: Re -roof
PRIMARY Multi- Family Dwelling
Building is
1
PENTAMATION 1 R2ROOF
USE:
>3 Stories Yes ® No
PERMIT TYPE:
WORK
BLG #73 -88 Remove E roofing and Install new OSB and new comp. asphalt shingles
SCOPE
FEE ID ROOF
f.
1REROOFMRES 9,300
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District eta ). These fees are based on the prelimina in ormation available and are onlv an estimate. Contact the Dept or addn'1 info.
FEE ITEMS (Fee Resolution 11 -053 Eff 71.13)
Mech. Plan Check
Plumb. Plan Check
L:lec. Plan Check
lleela. Permit Pere
Plumb. Permit Fc
Elec. Permit 1 :
Other Alech. hi.st,
Other Plumb /nsp
)rher Glec- Insp. Lj
!nsp. Pee:
Plumb. hasp. Tee:
06c. b ? "', F,,c
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District eta ). These fees are based on the prelimina in ormation available and are onlv an estimate. Contact the Dept or addn'1 info.
FEE ITEMS (Fee Resolution 11 -053 Eff 71.13)
FEE
QTY /FEE
MISC ITEMS
Plan Check Fee:
Suppl. PC Fee
Plumb. Ale cch.!EIec
Permit Fee:
81.00
SupP1. InsP Fee
Plumb. Alech.;Elec
Plunib.11fech.%Elec Permit Pee:
Cor:struction Tax:
Administrative Fee:
Work Without Permit? ® Yes Q No
$0.00
Advanced Planning Fees:
Travel Documentation Fees:
Strong Motion Fee: IBSEISMICR
$4.18
Select an Administrative, item
'IC7
Bldg Stds Commission' Fee: IBCBSC
$2.00
SUBTOTALS:
$1,587.18
$0.00 TOTAL FEE:
$1 .18
Revised: 07/02/2015
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 •,KX (40 )�7-333 3 • b 'Idin ertino.ora
PROJECT ADDRESS; Q U 7S /� 1�
APN N
t 3 V / 1 % 4 .
tIL
OWNERNAME '5 4F �/ -M Ar
E
STREET ADDRE A uc `A �, / SEQ 0
CONTRACTOR NAME A ENSEE NUMBER IJCENSE TYPE BUS. L IC #
COMPANY NAME
E -MAIL
FAX
STREET ADDRESS��
STATE ZIP 457
I1�F� Q / _ il
Q7 J
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 %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 monoxide detectors are required to be installed in accordance with Sectionfi R3 and R315 of
the 2013 California Residential Code �y�/�n� �,Q
Sienature of ADDlicant/Aeent: i ✓1' (1� [T . Date: �&QW15 q
f0k,p0l �t (" �5UU^ ' ` -/ 7Zeroo olicy_2 P,, sed 11)J4
CUPERTINO
Address ;.o 97 5 1`
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 • buildincia-cuoertino.orct
A -� 3 —0-g Pern
# of Alsrmc gmnke:
r!®70 /Sy
PURPOSE
/6
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.
I have read and agree to comaly with the terms and conditions of this statement
Owner (or Owner Agents) Name:
6 e I
Si nature....... .. .. .G....... .�CXI! ............ ............................... Date:L. ...
Contractor Name:
Signature... ... .................. ... .... Lic. #. ?.1...v. /..........Date: 0.- .2..../
Smoke and COform.doc revised 03118114
5,
WATER- CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION�`�'
CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
(40p) 777-:g28 • FAX -3333 • building (d)cupertino.orp
Owner - Name' Y%L J !
Address
FERM1"1 CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE
HAS BEEF �` A�DB TURNED TO THE BUILDING DIVISION
Please refer to the attached California Civil Code Sections 1101.1 - 1101.8 which are part of this Certification form.
1 Is your real property a registered historical site?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form.
/Owner' Signature:
No Go to Question 2.
Date: Ol,C451 �-
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.
Sign below and skip the rest of the form.
Owner' Signature: Date:
/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. Sign below and skip the rest of the form.
Owner' Signature: Date: Qj
No Go to Question 4. 8/ 1 t c ,-
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. Sign below and skip the rest of the form.
Owner' Signature: Date: l Lit l
X ly" es My real property is built and available for use or occupancy on or before January 1, 19 4. l q.
Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached.
❑ 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
Yf whether property undergoes alterations or improvements).
My property is a multifamily residential real property. See Civil Code Section 1101.5.
M
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.
SB407 2015.doc revised 02104115
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).
UWe, the owner(s) 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 110 1. 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 plumb' g fixtures comply with the requirements as indicated in the table below.
'Y- - "- -b �--- -- "- 5 ---- -15 -uO FICYISC ICIU.rI1 IL LO we r5unaing llivision in order to final your permit.
A. 11 LUQ CRIJIIIIg plulnoing rixttire water usage /tlow rate is equal to or lower than the figure shown, it is not required to be upgraded.
SB407 2015. doe revised 02104115
Non - Compliant
Water- Conserving Plumbing Fixture
Plumbing Fixture
(Fixture Complying with Current Code Applicable to New Construction)
Fixture Type
Maximum Water Usage/Flow Rate
2013 CPC Ch. 4
2013 CPC Ch. 4
2013 CPC Ch. 4
Water Usage
/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
Gallons /flush
0.5 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 on! 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 psi
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
I Tr -L_ _
reduction.
A. 11 LUQ CRIJIIIIg plulnoing rixttire water usage /tlow rate is equal to or lower than the figure shown, it is not required to be upgraded.
SB407 2015. doe revised 02104115