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15090187 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10876 ALDERBROOK LN CONTRACTOR:M&S ROOFING CO. PERMIT NO: 15090187 OWNER'S NAME: TIRUMALA MARRI¢. T � � 208(OPCO LN DATE ISSUED:09/29/2015 OWNER'S PHONE: 4085056160 /7 7 SAN JOSE,CA 95123 PHONE NO:(408)314-0870 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ REMOVE TWO LAYERS OF ROOFING AND INSTALL NEW License Class `_� Li..#�.J-H' ���� O COMPOSITION ROOFING(1800 SQ FT). Contractor _, CoDate 1 hereby affirm Lt 1 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. 1 hereby affirm under penalty of perjury one of the following two declarations: Sq. 1'1 f lour.%rea: Valuation:$9700 m. 1 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 k P'\ `umber:36920034.00 Occupancy Type: 1 p rformance of the work for which this permit is issued. R07have 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. PERMIT EXPIRES IF WORK IS NOT STARTED APPLICANT CERTIFICATION WITHIN 180 DAYS OF PERMIT ISSUANCE OR I certify that I have read this application and state that the above information is 180 DAYS FROM LAST CALLED INSPECTION. 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 Issued by: ��-//1/ l I—,_Z7 G% Date: 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 RE-ROOFS: all non-point source regulations per the Cupertino Municipal Code,Section 9.18. All roofs shall be inspected prior to any roofing material being installed.If a roof is Signatureft, Date �� J� installed without first obtaining an inspection,1 agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Cr `� Date: �Z 1 hereby affirm that 1 am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS O BE CLASS"A"OR BETTER the following two reasons: m. 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 HAZARDOUS MATERIALS DISCLOSURE sale(Sec.7044,Business&Professions Code) I have read the hazardous materials requirements under Chapter 6.95 of the Z 1,as owner of the property,am exclusively contracting with licensed contractors to California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain construct the project(Sec.7044,Business&Professions Code). compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Safety Code,Section 25532(a)should 1 more or handle hazardous material. I hereby affirm under penalty of perjury one of the following three declarations: Additionally,should 1 use equipment or devices which emit hazardous air m 1 have and will maintain a Certificate of Consent to self-insure for Worker's contaminants as defined by the Bay Area Air Quality Management District I will Compensation,as provided for by Section 3700 of the Labor Code,for the maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the performance of the work for which this permit is issued. Ilealth&Safety Code,Sections 25505,25533,and 25534. z 1 have and will maintain Worker's Compensation Insurance,as provided for by Owner a horize gent: ,��C�� r Section 3700 of the Labor Code,for the performance of the work for which this Date:C�L �V permit is issued. 3 I certify that in the performance of the work for which this permit is issued,l shall CONSTRUCTION LENDING AGENCY not employ any person in any manner so as to become subject to the Worker's 1 hereby affirm that there is a construction lending agency for the performance of work's Compensation laws of California. If,after making this certificate of exemption,I for which this permit is issue become subject to the Worker's Compensation provisions of the Labor Code,I d(Sec.3097,Civ C.) Lender's Name must forthwith comply with such provisions or this permit shall be deemed revoked. Lender's Address APPLICANT CERTIFICAI ION ARCHITECT'S DECLARATION I certify that I have read this application and state that the above information is I understand my plans shall be used as public records. 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 Licensed Professional 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 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 / CUPERTINO (408)777-3228 • FAX(408)777-3333 • building aacupertino.org PROIF-CT ADDRESS 0NWNER NAt,4E ` " nSS-0 E-MAIL STREET ADDRESS " CITY, STATE,ZIP FPX CONTACT NAME ' PHONE�tV_31 `©.R� E-MAIL STREET ADDRESS CITY,STATE,(ZIP I FAX ❑ OP'NER ❑ o%1-,ER-BLTLDER ❑ OWNER AGENT CONCRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER El DEVELOPER ❑ TENAN7 CONTR.ACTORNAME / LIC SE L I ^ 1 LICENSETYPt BUS.LIC,9 C COMPANYNAME — E-MAIL FAX STREET ADDRESSCITY,STAT ZIP C P U GG ARCHITF.CTIENGINEER NAME LICENSE NUMBER BUS.LIC.k C OMP ANY N AME E-MAIL FAX S rREET ADDRESS CITY,STATE,ZIP PHONE USE OF 5Q SFD or Duplex ❑ Multi-Family ROOF AREA: VALUA0 STRUCTURE: ❑ Commercial )8 S TIO 0 v EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVEMPLACE EYES IF NO, PLYWOOD ❑ 'A., ❑ PLYWD ❑ OSB PITCH: ROOF _❑ N'0 1 4 LAYER • THI KNE : El518"�L/ TYPE: ElCDX :12 CLASS APROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES oo Sd,�,S ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT DESCRIPTION OF WORK rJ� By my signature below,I certify to each of the following: I am the property owner or authorized azent to act on the property oNkmer'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 relating to building on, uction. I uthoriae representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Appl icant/A gent: Date: ! SUPPLEMENTAL INFORMATION REQU D OFFICE USE 0�LY _If building is associated With a Home ONvner's Association,provide letter ]'LAN CFIFCK TYPE 1,0I7ING SLIP of approval from HOA. OVER-THE-COUNTER vt-ILDI'`G PLAN REVIEW Provide Planning approval to verify ifthere any restrictions. ❑ EXPRESS FLAB REt-IDN Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT Provide signed copy of Cupertino's Tear-Off Policy. ❑ uI I1ER: ReroofApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10876 Alderbrook Ln DATE: 09/29/2015 REVIEWED BY: Sean APN: 13P#: "VALUATION: 1$9,700 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1SFDWLR00F USE: I PERMIT TYPE: WORK Remove two layers of roofing and install new composition roofing 1800 s ft . SCOPE 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 preliminarl information available and are only an estimate. Contact the De t or addh7 info. FEE ITEMS (Fee Resolution 11-053 E 7/1/13,/ FEE QTY/FEF. MISC ITEMS Plan Check Fee: $0.00 1,800 .f. Re-roof Suppl. PC Fee: Q Reg. O OT 0.0 Iirs $0.00 $306.00 1RER00FRES PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 l 'oil S/ruc/ioll I(Illiblisli'(7live Fcc: O Work Without Permit? O Yes (j) No $0.00 0 Advanced Planning Fee: $0.00 Select a Non-Residential 0 !i•uve11)oCrr117ewtvion Fees. Building or Structure O A Strong Motion Fee: IBSEISMICR $1.26 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: 1 $2.26 $306.00 TOTAL FEE: $308.26 Revised: 07/02/2015 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• buildina(a7cugertino.org PROJECT ADDRESS APN q OWNER NAME PHONE E-MAIL STREET ADDRESS CITY, STATE,ZIP I FAX CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE n BUS.LIC.d COMPANY NAME E-MAIL l F jd STREET ADDRESS ^ CITY, T�4TE,ZIP ^ ( PHONE 03t I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2013 California Codes. e 2. An inspection request can be scheduled un 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 (Kion-Thurs) and 7:30-1.0:30am 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 Sections R314 and R315 of the 2013 California Residential Code. f -t— Signature of Applicant/Agent: .� Date: Y Reroo)Tolicy_2014.doc revised 01/1.5/14 SMOKE / CARBON MONOXIDE ALARMS Q OWNER CERTWICATE OF COMPLIANCE 6-' COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CL)PERTIN® 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408) 777-3333• building(@cupertino.org (� cIiress �N # offAff3�Sxiok'°e: fry r :ealtp�cci PERMIT CANNOT BE FL\TALED ANT COMPLETED UNTIL THIS CERTIFICATE HAS BEEN SIGNED AND.RETITRNED TO THE BUILDING DWISION 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 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:Ili 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 a ree to comgly ith jheerms and conditions of this statement Qvmai<(6t-Owner Agent`s)-Name:: ---' ........ .............- J t ....... D Contractor Name: Saue. 9`I aue........... ..................................Lic:#' Date: Smoke and COforn:.doc remised 03118114 WATER-CONSERVING PLUMBING FIXTURES - OWNER CERTIFICATE OF COMPLIANCE - COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 1 (408)777-3228•FAX x(408)777-3333• building (d.)cupertino.org Owner Name I ) C�11 M Permit No. Uf ^ Address A I 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. N.No 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 110 1.8 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. l 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 form 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. lK 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.. 5. Please 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. Owner or Owner Agent's Signature: _w r Date:12�, ci— Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit. SB407 2015.doc revised 08/26/15