15050098 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11259 LA JOLLA CT CONTRACTOR:WESTSHORE PERMIT NO: 15050098
ROOFING INC
OWNER'S NAME:
SAN JOSE, CA 95131 PHONE NO:(408)694-0060
❑ LICENSED CONTRACTOR'S DECLARA"TION r F
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.# F F J
MECH RESIDENTIAL COMMERCIAL
Contractor Date JOB DESCRIPTION.REMOVE 1 LAYER EXISTING ROOF&INSTALL COMP
OVER
I hereby affirm that I am licensed under the provisions of Chapter 9 NEW OSB SHEATHING-33 SQRS
(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:0 Valuation:$19000
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:35621047 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
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION.
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 Issued by: Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9 18.
RE-ROOFS:
Signature Date 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.
❑ OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date:
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. 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
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 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
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 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
CUPERTI
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVIS
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building 5)-cupertino.org
a
Address
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 X X
bedroom(s)
On ever level of a dwellin .unit includingbasements 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.
natur .... :............ #..?.a...2.Z.........Date: ........ ..j
Smoke and CO form.doc revised 03118114
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/We, 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 1101.1 through
1101.8, the current California Plumbing Code and Califox'mia Green Building Standards Code, and manufacturer's installation` ;
_ e-gements, and that the water-conserving:.pTuinir gv�tures om Ty'i e requirements as indicated, ti-alhhetable below-
Qwneris (or Owner Agent's) Signature:
T T.-,.« .....Y., -.l n+i -A cionina thic r.P.rtif CAte please return it to the'Buildmg Division in order to final your permit.
All
n-Compliant
FixturIld
VoNmbine O}
Water -Conserving Plumbing Fixture
(Fixture Complying with Current Code Applicable to New Construction)
p
Fixture Type f
Maximum
2013 CPC Ch. 4
Water Usage/Flow
2013 CPC Ch. 4
Rate
2013 CPC Ch. 4
Water Usage �
2013 CALGreen Div. 4.3
2013 CALGreen Div. 4.3
2013 CALGreen Div. 5.3
/Flow Rate Ve i
Single -Family
Multi -Family
Commercial
i
Residential
Residential
Water Closet'
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!
'11),
Exceed 1.0
Gallons/flush '
0.5 gallons/flush
Showerheads
Exceed 2.5 k ,1
2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of
gallons per minutd
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
11
showerheads and/or other shower outlets controlled by a single valve shall not
t
exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to
it?5
allow only one shower outlet to be in operation at a time.
Faucets - "D
Exceed 2.2 gallons 4`
Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60
Lavatory 4
per minute, -
�`'
minute @ 60 psi; minimum Maximum 1.5 gallons psi
Faucets jj
0.8 gallons per minute @ per minute @ 60 psi;
0.8
j
20p si minimum gallons
per minute @ 20 psi
<,
In common and public
f
use areas: 0.5 gallons
i per minute @ 60 psi
1.8 gallons per minute
g
I
Faucets -
t±�
Exceed 2.2 gallons f
t 60 psi
} 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60
Kitchen
Faucets
per minutes
�3<;
60 psi @ 60 psi psi
May temporarily increase May temporarily
tS
€ 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
ff�
60 psi 1.8 gallons per minute
k
�
Where faucets meeting @ 60 psi
the above are unavailable, Where faucets meeting
aerators or other means the above are
E
' may be used to achieve unavailable, aerators or
reduction. other means may be
used to achieve
reduction. ,
N J
_ 1 ___.__ aL ...- aL,. i:..... -o nLriTr'CZ �I'k 'P �.11'� k "�• s .. r
nrn P!I-i'f.1 h'P 1.1T14TA G�P,CI.
111POIithe existing plumbing nxnzre water usuguiuuw ia« a �Lju �- ��• �- --�-- ---� - b _ ___ ..__, _ ,� ,� _
SB407 2015.doc revised 02/04/15