15050150 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7920 FALL CT CONTRACTOR:SECURITY ROOFING INC PERMIT NO: 15050150
OWNER'S NAME: JOANNE SMARTT 406 EL CAMINO REAL DATE ISSUED:05/26/2015
OWNER'S PHONE: 4082531247 SAN CARLOS,CA 94070 PHONE NO:(650)595-1213
0 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL
REROOF-REMOVE EXISTING WOOD SHAKES,INSTALL
License Class Lic.# 1/2
�
Q, OSB PLYWOOD,#30 UNDERLAYMENT CLASS A COMP(27
Contractor w7C � Dat ,� .rel` SQS)
I hereby affirm that I a licensed uftller 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:$12500
I hand will maintain Worker's Compensation Insurance,as provided for by
ection 3700 of the Labor Code,for the performance of the work for which this APN Number:36213008.00 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 YS FROM LAST CALLFiD INSP CTI N.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Z
granting of this permit. Additionally,the applicant understands and will comply Issued by. Date: V
with all non-point source re ulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signatur, — Dat All roofs shall be inspected prior to any roofing material being installed.If a roof is
ti installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Signature of Applicant: Date: ?";�' /
I hereby affirm that I am exempt from the Contractor's License Law for one 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. 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, d 25534. t
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date�y's' f
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
918.
Signature Date
15050 lc'50
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•building(a)cupertino.org
PROJECT ADDRESS y/�//e A APN# `_p 006
OWNER NAME a�* s i PHONE /V A, E-MAIL
2
1/7
STREET ADDRESS ® CITY, STATE,ZIP (�j' FAX
CONTACT NAME PHONEE s E-MAIL
STREET 4DDRESS CITATE, ZIP � f� FAX
❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT P40NTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONT `OR �A � r'� LICENSI U BERLICEi ETP BUS.LIC.#
COMPANY .AME E-MAIL FAX
STREET ADDPh CITY,S TE,ZIP PHO
tlff� �d✓yt u S 7;f�'�Cj ' 'S�
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF �9_SFD or Duplex ❑ Multi-Farnily ROOF AREA: VALUATION:
STRUCTURE: ❑ Commercial Z17(/z'9 /7 vv s
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES XWOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE)25�1'ES IF NO, PLYWOOD �4%, ❑ PLYWD 99&SB PITCH: ROOF
❑NO #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX /-:12 CLASS: A
PROPOSED ROOF TYPE: ❑BUILT-UP ROyOF ' ASPHALT SHINGLES 11 WOOD SHAKES El WOOD SHINGLES ❑OTHER ICC-ES REPORT#
DESCRIPTION F WORK:
0A////r / d-w-'F__ S 3.�// /"� f s 'f�' v�,� ��•d��/..a_✓°�/yJ G,G
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 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 relatin�ding c coon. authorize representatives of Cupertino to enter the above enti`i"�fied operty for inspection purposes.
Signature of Applicant/Agent: a Date:
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLl,s2 7}, _,-,s t
If building is associated with a Home Owner's Association,provide letter uyGSLIP
of approval from HOA. ❑aOVER THE COiSNTER "cs �ti 3UILDINGPLANREVIE�y ;,
Provide Planning approval to verify if there any restrictions. 'D EXPRESS# F�; " ,�xPLrANNII�GPLANREVIE\i' '
Provide copy of Manufacturer's Installation Specifications. t❑FIRE
Provide signed copy of Cupertino's Tear-Off Policy. � �� �� `� ❑ oTiR : �v �x
U51,
Rer•oofApp_2011.doc revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 7920 FALL CT DATE: 05/26/2015 REVIEWED BY: PAUL
APN: 362 13 008 BP#: `VALUATION: 1$12,500
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY PENTAMATION
USE: SFD or Duplex PERMIT TYPE: 1SFDWLR00
WORK REROOF- REMOVE EXISTING WOOD SHAKES INSTALL 1/2 OSB PLYWOOD #30
SCOPE UNDERLAYMENT CLASS A COMP (27 SQS)
FEE ID ROOF AREA
s.f.
1REROOFFRES 2,700
Ifech.flan Check Plumb.flan Check 1'lec..Plan Check
Lleclr. Permit fee: Plumb. Permit Fee: Glee. Permit lee:
Other Alech.Insp. Other Plumb Insp. Li Other 151ec.Insp. Li
Alech.Insp. he:e: 1'Ittrrrb. Insp.I'ee: Elec.Insp I'ee:
NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc). Theseees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 11-053 Ef. 7/1/13) FEE QTY/FEE MISC ITEMS
Plan Cheep 1%ee:
Suppl. PC Fee
Plumh,,"iVech./Elec
Permit Fee: $459.00
Suppl. Insp Fee
Phtnab./tllech./Elec
Phtm.bA,Vlech.lElec Permit Fee:
Construction lax:
Adininistrative Fee:
Work Without Permit? 0 Yes (j) No $0.00
Advanced Planning Fees:
7iravel Doeumentation Fees:
Strom Motion Fee: IBSEISMICR $1.63 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $1.00
SUBS OTAL$: ` $461.63 $0.00 :.TOTAL-FEE:,
Revised: 05/07/2015
,f-
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
CUPERTINO
(408)777-3228• FAX(408)777-3333•buildingQcupertino.orQ
PROJECT ADDRESS . / / 'u `J� 7APN#
OWNER Nr) AV,-)-e_`' yam. J PHONE `D `� E-MAIL
STREET Z,) CITY, ATF,ZIP f 7 • l,> FAX
CONTRACTO AME • `/ r / LICENSE B6,W+ C� LICENeTYP� / BUS.LIC.9
tfc
COMPANY NAME E-MAIL 5 FAX
STREET ADDRESSyA /l l / CITY,STATE,ZIP j /�� _�
PHON,,
I UNDERSTAND AND AGREE TO THE FOLLOWING: c�
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/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 Sections R314 and R315 of
the 2013 California Residentia ode.
Signature of Applicant/Agent: Date: Z212,
2L /SJ
ReroofPolicy_2014.doc revised 01/15/14
CUPERTINO
Address.
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
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.
Tn 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.
1 have read and a ree to comply with the terms and conditions of this statement
Owner or Owner ent'sNa
_ r
>-� ?K
5. T
a 0...
Signature ... .. ...... .. ...... .......... Date
C�rctorFNarnL!1:xL
r},. �//.
i ^, .-Y,'
Si nature ............. # c�........................ Lic.# ...... .... y................ Date: J�...
Smoke and CO fbmi.doc revised 03/18/14
MAWATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT ^ BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
G.UPERTINO
(408) 777-3-2-2-8- FAX (408) 777-3333 building
(a)cupertino.org
Owner Name GF t �N ' '3 ermit No. )EVOK
Address
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.
,I
N: Owner' Signature: r - r 3 J Date:
47
Go to Question 2. - � �CL/Y✓]TMA/�/ _ - `�� �+
2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the propertyor 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:
r % ate: =
yi�Po Go to Question 3. �S
3. Is water sei vice 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:T� 4 ,. Date:
o"- Go to Question 4. 2 _
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 fonn.
Owner' Signature: Y : Date: -�;
0% My real property is b d av
anailable for e or occupancy.2 or before January 1, 1994.
Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached.
,K-° Myprop city is a single family residential real property. See Civil Code Section 1101.4.
Qnandafter 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
�. f whethe>property undergoes alterations or improvements).
❑ Mypioperty is a multifamily 7-eside7ldal 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-conseiving 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 coniniercial real property. See Civil Code Section 1101.5.
On and after Januaiy.1, 2014, specified building alterations or improvements shall require non- compliant
- - plumbing fixtures to be replaced with water -conserving plumbing fixtures.
SB4072015.doc revised 02/04/15
-- On,,or*bdfore January 1, 2019, all non=compliant plumbing fixtures shall be -replaced with water- conserving
phhnbmg 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 fixtureQ139 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
reauirements. and that the water-conservii plumbing fixtured comply with t1A re uirements as, indicated in thq table -below. _
Owner's (or Owner Agerat:s y:S g.n�ature' i.'� : , la � % ¢ ��r � 1� Date:
Upon completing and signing thus Certificate, please return it to the Building Division in order to final your pen -nit.
Y!Non
-Compliant
li� Plumbin Fixtur �'�
I Water -Conserving Plumbing Fixture
(Fixture Complying with Current Code Applicable to New Construction)
'
! Maximum Water Usage/Flow Rate
Fixture, I ypg,.---
Water Usage
2013 CPC Ch. 4
6,013
2013 CPC Ch. 4
2013 CPC Ch. 4
/Flow Rate
CALGreen Div. 4.3
2013 CALGreen Div. 4.3
2013 CALGreen Div. 5.3
Single -Family
Multi -Family
Commercial
Residential
Residential
Water Closets
e`d(6
` + Single flush toilets: 1.28 gallons/flush
flush
(Toilets);
allons/flush
c. i Dual flush toilets: 1.28 gallons/flush effective volume (the composite,
average flush volume of two reduced flushes and one full flush
Urinals .NJ
EXceed1=0
'k 0.5 gallons/flush
+r,
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
r
(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 — z� -
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 :;;
08 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
1.8 gallons per minute
@ 60 psi
Faucets — : i
Exceed 2.2 gallons
1:11;'8 gallons per minute @
1.8 gallons per minute
1.8 gallons per minute @ 60
Kitchen
per minute
1°60 psi
@ 6,0 psi
psi
Faucets ,; '
:May temporarily increase
May temporarily
E'up to 2.2 gallons per
increase up to 2.2
`
minute @ 60 psi, and must
gallons per minute @
'default to maximum6.0.,ps'.
anis must
:1.8 gallons per minute @
default ' to maximum
V160 psi
1-.8 gallons per minute
i
'Where faucets meeting
@ 60 psi
the above are unavailable,
.Where faucets meeting
,'aerators or other means
the above are,
ymay be used to achieve
unavaifable, aerators or
'reduction.
:other means may be
used Vachieve
reduction.
II' . If the existing plumbing`fixture water usage/flow rate is equal to or lower than the figure shown, t 1s�no�t xequiFe— to j¢ "e upgia„ e
SB4072015.doc revised 02/04/15