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15080188CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22406 SALEM AVE CONTRACTOR: R E ROOFING & PERMIT NO: 15080188 CONSTRUCTION INC OWNER'S NAME: WEST DENNIS L AND BARBARA J 15230 CLYDELLE AVE DATE ISSUED: 08/26/2015 OWNER'S PHONE: 4089810801 SAN JOSE, CA 95124 PHONE NO: (408)626-9320 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL TEAR OFF (E) WOOD SHAKE, INSTALL (N) PLY, 30# Livens lass Lic. # FELT, CLASS A ROOF SYSTEM (55 SQ'S) QJ Contrac o � � Date 0 II Ker y affiri 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: $33000 erformance of the work for which this permit is issued. 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: 32615018.00 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 L T CALLED INSPECT ON. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Issued by: Date: grantin of this permit. Additionally, the applicant understands and will comply i l non- nt source regulations per the Cupertino Municipal Code, Section with 9 8. �. 4 RE -ROOFS: Si afore Date All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspe ion, I agree to remove all new materials for inspe ❑ OWNER -BUILDER DECLARATION S afore of Applic Date: 0 l I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: OOF GS 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 contami defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by will m ' fain compli ce with the Cupertino Municipal Code, Chapter 9 12 and the ealth & Safety C ctions 2550 3, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Ow r or authorize age 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 k - -9 CUPERTINO REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingQcupertino.orq �gal- -r' R PROJECT ADDRESS +/ j1 i1 ( A^ �� APN #n '1 ( 1 f' 0 ' g OWNER NAME PHONE /' 1 �f (' VI C/ I _ (, G' , 1 E-MAIL bn STREET ADDRESS { V o V UwV �� CITY, STATE, ZIP - �I FAX l),� CONTACT NAME , J `� Tn PHONE (, � (� E-MAIL of ,�VC STREET ADDRESS r G� v & , IV`h,,/� CITY, STATE, ZIP `- lj❑(,0`.\j�NERRAGGENT FAX . ❑ OWNER ❑ OWNER -BUILDER CONTRACTOR CONTRACTORAGENr ❑ ARCHnECT ❑ ENGLNTEER ❑ DEVLLOPER ❑ TENANT CONTRACTOR NAME� +! I y I �V LICENSE NUMBER % -j U 1+ETNIAIL r ( LICE E YP BUS. LIC. # ' ^ G I LN V COMPANY NAME 1 �/ FAX STREET .ADDRESS ^ U � STATE, ZIP 4 Q �j ( l - \ PHONEARCHITECT/ENGINEER NAME ( LIICENSE NUMBER BUS. LIC. # COMPANY NAME I A E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ❑ SFD or Duplex ❑ Multi -Family ROOF AREA: VALUATION: USE OF ❑ Commercial IV 5 (jU /I `` 0 U U STRUCTURE: V. EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE /REPLACES IF NO, '" 131:1 PLYWOOD El/1 PLYWD OSB PITCH: ROOF ❑ NO # L.A1'ERS: THICKNESS:/8" TYPE: DX :12 CLASS A PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF PHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT # DESCRIPTION OF WORK:1^e-` i `^ e//l n !"�II�V`lGl• 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 inf ion ve 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 law's relating to uilding construction. I au representatives of Cupertino to enter the above.- i entified property for inspection purposes. Signature of Applicant/Agenv I% Date: 2-k SUPPLEMENTAL INFQL4AO REQUIRED oFP7cEASEONLI l ` If building is associated With a Home Owner's Association, provide letter Pini\ CHECK TYPE'M ROUTING sLrp= t' OVER THE COUNTER A ' BUIIDIAG PLANREVIE\V a _ of approval from HOA. PP❑ Provide Planning approval to verify if there any restrictions. -"]] E�PREss ❑ PLnxNu.GPinN:REVIEiV " ' _._ Provide copy of Manufacturer's Installation Specifications. ❑ sTaI.DnRn FIREDEPT s Provide signed copy of Cu ertino's Tear -Off Policy. Y k ❑ OTHER it P 3 i �> w _ n Xeroof,4pp_2011.doc revised 03/16/11 U �� CITY OF CUPERTINO ID��/JJI FEE ESTIMATOR - BUILDING DIVISION FEE ID ROOF AREA s.f. 1REROOFMRES 5,500 22406 SALEM AVE DATE: 08/26/2015 REVIEWED BY: MELISSA JimADDRESS: APN: 32615 018 BP#: 'VALUATION: 1$33,000 xPERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY Multi -Family Dwelling USE: Building is 1 >3 Stories O Yes Q No PENTAMATION 1 R2ROOF I PERMIT TYPE: WORK TEAR OFF E WOOD SHAKE INSTALL N PLY 30# FELT CLASS A ROOF SYSTEM 55 SQ'S SCOPE Plumb.1-fech.;'Elec FEE ID ROOF AREA s.f. 1REROOFMRES 5,500 NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School Dictrict etc )_ These fees are hosed on the nreliminary information available and are onlv an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 E,ff. 7/1/13) ,Ltech. flan Check Plumb. Plan Check i:lec.Plan Check Fech. Permit Fee' Plumb- Pcrmir Fo F,lec Permir Fee Other Alech. Insp Ocher- Plumb Insi+ Islec. Insp. ET i4ech. Insp. F,. Plumb. hash. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School Dictrict etc )_ These fees are hosed on the nreliminary information available and are onlv an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 E,ff. 7/1/13) FEE QTY/FEE MISC ITEMS Plan C'hecl r.' Suppl. PC Fec Plumb.1-fech.;'Elec v Permit Fee: $9 .00 Suppl. Insp Fee Plumb.LAlech./Elec Plumb.;`,VIeeh./Elec Permit Fee: Construction Tar: Administrative Fee: Work Without Permit? O Yes Q No $0.00 -Idvanced Planning Fees. Travel Documentation Fees. Strong Motion Fee: IBSEISMICR $4.29 Select an Administrative Item �} 6M Bldg Stds Commission Fee: IBCBSC $2.001 SUBTOTALS: $941.29 $0.00 TOTAL FEE: 1 $941.29 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 - FAX (408) 777-3333 - buildinoacugertino.org PROJECT ADDRESS ;� L o b 1 A -,,o p - �N # 3 Z� ^ t9 OWNERNAME i' r� / v�V PHONE % f (�C( _ ak (�Of(/1) E-MAIL Aq ! `v STREET ADDRESS �% O IO CITY, STATE,_ZIIPVI)/i 1 f �7lUE'i�` IU�V FAX CONTRACTOR NAME LICENSrF NfBEI J l LICENSFCP£c � � D BUS. LIC. 9 COMPANY NAME /n v �/ I L / / IV (\�� EE -MAIL FAX /1� STREET ADDRESS(5 /I Q`� CITY, STATE, ZIPr`Ci PHONE 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/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 on Ino 'de de are requi be installed in accordance with Sect• ns R314 and R315 of the 2013 Califor a Residential Cod _ t_ Signature of Applic t/Agent: Date: �i Reroo)To1icy__2014.doc revised 01/15/14 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building aecuoertino.org p Permit No.% Address a� o� i (g �+'� �j J t C� 4 of Alarms Smoke: 7 Carbon Monoxide: 7� 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 I SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroorri(s) X X On every level of a dwelling unit including basements X X Within each sleeping room I 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 ase 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 hasihave 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 comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: c ISignature .... Date: .8..W ... I Contractor 'ame: Signature.......... ......................................................... Lic........................................ Date: .................... Smoke and CO form.doc revised 03118114 CUPERTINO 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 • buildino(dcupertino.org Owner Name �IIl/UlS ��GI(,hQi�n (,I�Q,St Permit No. Address 7 o d n 4au Q. PERMIT CANNOT BE FINALED AND COMPLETED Ul\7 L THIS CERTIFICATE HAS BEEN SIGNED AND RETURNED TO THE BUILDING DIVISION Please refer to the attached California Civil Code Sections 1101.1— 1101.8 which are part of this Certification form. Is your real property a registered historical site? ❑ Yes Civil Code Sections 110 1. 1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: o Go to Question 2. Date: 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: 4.No Go to Question 3. Date: 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: `)�No Go to Question 4. Date: 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: XYes 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. 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 of whether property undergoes alterations or improvements). 1) rA V S T- S 1 G A/ My property is a multifamily residential real property. See Civil Code Section 1101.5. (J 6�(,IC P 19 7 E 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 remised 02/04/15 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 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-conservingplumbing fixtures co ply wi the requiremeis as indicated in the table below. Owner's (or Owner Agent's) Signature: M0,111 �M Upon completing and signing this Certificate, please return it to the Building Division in order to final your permit. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower tnan ine nguic siiuwii, It •O uvL .11i,..11 urs SB407 2015.doc revised 02/04/15 Non -Compliant Water -Conserving Plumbing Fixture Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 Water Usage 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 /Flow Rate 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 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 reduction. 1 1. If the existing plumbing fixture water usage/flow rate is equal to or lower tnan ine nguic siiuwii, It •O uvL .11i,..11 urs SB407 2015.doc revised 02/04/15