15100063CITY OF CUPERTINO BUILDING PERMIT I
13UILDING ADDRESS: 11092 CANYON VISTA DRI CONTRACTOR: ONSON & I PERMIT NO: 15100063 ASSOCIATES
OWNER'S NAME: CLAYTON J B 3 AND LINDA G I PO BOX 786 1 DATE ISSUED: 10/08/2015 1
OWNER'S PHONE: 4082579026 1 BRENTWOOD, CA 94513 1 PHONE NO: (925) 626-7682 1
LICENSED CONTRACTOR'S DECLARATION
License Class cf `i 3 Lic. #
1 I f
Contractor 4fc""-A_ � K!:4o to.Ta9ate 1p-F{'1�
I hcreby affirm that 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.
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.
have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700of 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 -point source regulations per the Cupertino Municipal Code, Section 9.18.
❑ OWNER -BUILDER DECLARATION
1 hcreby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
t 1, 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)
2 I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
1 hereby affirm under penalty of perjury one of the following three declarations:
1 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
performance of the work for which this permit is issued.
2. 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.
s 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, 1
become subject to the Worker's Compensation provisions of the Labor Code, I
must forthwith comply with such provisions or this permit shall be deemed
revoked.
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
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
(DUPLEX - 1/2 OF ROOF FOR UNIT 11092 ONLY) OVERLAY
B.U.R. WITH (N) DURO-LAST PVC MEMBRANE (16 SQ'S)
Sq. Ft Floor Area: I Valuation: $14421
k P N\ u in her: 35628031.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
;180 DAYS FROM LED INSPECTION.
Y: Date:
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.
Signature of -Date:
ALL R S �TOBE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should 1 store or handle hazardous material.
Additionally, should 1 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, Sections 25505, 25533, and 25534.
agent: I
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
I icensed 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(5),cupertino.org
0 l61) 6203
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PROJECT ADDRESS 1091 �G
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❑ OWNER ❑ OUT'ER-BUILDER ❑ 01NR.ER AGENT CONTRACTOR ❑ CONrrRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR ' .14E
LICENSE NUMBER
14-113
LICENSE TYPE
BUS. LIC.
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COMPANY NAME
E-MAIL
FAX
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STREET ADDRESS
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CITY, STATE, ZIP
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PHONE
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ARCHITECT/ENGINEER NAME LICENSE NUMBER
HUS. LIC.
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or Duplex Multi -Family
ROOF AREA:
VALUATION:
STRUCTURE: ❑ Commercial
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EXISTING ROOF TYPE: _9BIALT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES
❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE /REPLACE ❑ YES
IF NO,
PLYWOOD 1K 'h" ❑
El OSB
PITCH:
ROOF
N'0
KL.AYERS
THI KN S ❑ 5/B"
T>'PE ❑ CDX
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CLASS: A
PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES
❑ WOOD SHINGLES OTHER 1'& ICC -ES REPORT/9�
11
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DESCRIPTION OF WORK:
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Af D 10 Az C-55 [ ( 6 S 2
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 relatine to building cnosui ion. I au orize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature ofApplic een
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SUPPLEMENTAL INIFORNiATION REQUIRED
= oF£ice
usE'ontii
*t.rLAh` C=dk TYPE`
Rot7i�c SLIP '
_ If building is associated With a Home 0\N'neT s Association, provide letter
o " UNTE
❑ BUIJ Dr�G PLAN REVIEW -
of approval from HOA.
Provide Planning approval to Verify if there any restrictions.
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Provide copy of Manufacturer's Installation Specifications.
❑
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Provide signed copy of Cupertino's Tear -Off Policy.
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❑ orliER
XeroofApp_2011.doc revised 03/16/11
FEE ID ROOF AREA
s. f.
1REROOFFRES 1,600
vv r c: t ors esnmare apes not inctutte.lees clue to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, eta). These fees are based on the nreliminary infarnfatian avnilahlo and n►o nater .., nc�i... d . ! ..... d .6 . n _. _ l.t. n :._�_
FEE ITEMS (Fee Resolution 11-053 k'ft ' l 131
�i i T yr %_ rLK I live
FEE ESTIMATOR - BUILDING DIVISION
QTY/FEE
ADDRESS: 11092 CANYON VISTA DR DATE: 10/08/2015 REVIEWED Bl': MELISSA
l'1U77 ( 'hcc'k
APN: 356 28 031
BP#:
*VALUATION: $14,421
PERMIT TYPE: Minor Building Permit
PLAN CHECK TYPE: Re -roof
PRIMARY SFD or Du lex
p
TPERMIT
PENTAMATION
USE:
Permit Fee:
TYPE: 1 SFDWLROO i
WORKDUPLEX
- 1/2 OF ROOF FOR UNIT 11092 ONLY OVERLAY B.U.R. WITH N DURO-LAST PVC
SCOPE
MEMBRANE (16 SQ'S)
FEE ID ROOF AREA
s. f.
1REROOFFRES 1,600
vv r c: t ors esnmare apes not inctutte.lees clue to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, eta). These fees are based on the nreliminary infarnfatian avnilahlo and n►o nater .., nc�i... d . ! ..... d .6 . n _. _ l.t. n :._�_
FEE ITEMS (Fee Resolution 11-053 k'ft ' l 131
FEE
QTY/FEE
MISC ITEMS
l'1U77 ( 'hcc'k
I'hmth. _1 hrcl..
Permit Fee:
$272.00
Suppl. Insp Fee
Phurrh. :1lccl. Tlec
l'ltrrrrh. l rc h. /"I(rc• /'erre,r
�tc/mini�lr�tit•r / ,
Work Without Permit? Yes 0 No
$0.00
i
Select an Administrative Item
Strong Motion Fee: IBSEISMICR
$1.87
Bldp, Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$274.87
$0.00 TOTAL FEE:
$274.87
Revised: 10/01/2015
N
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 - buildino(aDcupertino.org
PROJECT ADDRESS
APN 4
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OWNER NAME
PHONE
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STREET ADDRESS
CITY, STAT , ZIP
FAX
CONTRACTOR NAME
LICENSE NUMBER
LICENSE T1TE
BUS. LIC.
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COMPANY NAME `
E-MAIL
FAX
STREET ADDRESSt
Crr1', STATE, ZIP
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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 begiven 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 ofI/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 d are required to be installed in accordance with Sections R314 and R315 of
the 2013 California Resid e.
Signature of Applicant/ gent: Date:
ReroofPolicy_2014.doc revised 01/1.5/14
Rancho (Deep C(iff
ffomeownersAssociation
October 8, 2015,
City Of Cupertino,
On the behalf of the Rancho Deep Cliff Board I as property manager of the Rancho Deep Cliff
Homeowners Association give Sorenson & Associates Roofing Inc. permission to re -roof (4)
units at 11092, 10922 Canyon Vista Drive, 10901 Kester Drive & 22315 Rancho Deep Cliff
Drive located in Cupertino, California 95014.
Jason Overhulse
Association Manager
Compass Management
77 Las Colinas Lane
San Jose, CA 95119
Unit file
Compass Management Group, Inc. 77 Las Colinas Lane San Jose, CA 95119 Phone: 408.226.3300 Fax: 408.226.3406
CUPERTINO
Address
PURPOSE
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 - building(cDcuaertino.om
-�a_ �jY-rW__#
PERMIT CANNOT BE FINALEll AND COMPLETED UNTIL TMS CERTIFICATE
HAS BEEN SIGNED :SNI) RETU NED TO THE BUILDING DIVISION
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
bedroom(s)
X
X
On ever 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 comply with the terms and conditions of this statement
Own, -.r (or Owner Agent'-) Na�,,mpr
i/ IQ c ((/�L--
t
Si nature ... ........... ........ ........ ......................... Date: l...
Contractor Name:
Sinature................................................................... Llc.#...................................... Date:...................,
Smoke and CO form.doc reilsed 03/18/14
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
C1JPr-RTIN0
Owner N
Address
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.
)1 CNo 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 1101.8 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.
'�(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.
YNo 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.
es 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..
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 it provements).
❑ 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).
1, 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. _ „ r, ,.,n /I _
Owner or Owner Agent's Signature.
Date:
Upon completing and signing this Certificate, pleas return it talthe Building Division in order to final your bdilding permit.
SB407 2015.doe revised 08/16/15