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15100160CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10613 N STELLING RD CONTRACTOR: ORTIZROOFING & PERMIT NO: 15100160 WATERPROOFING I OWNER'S NAME: VIKAS NAYAR*- VA -14M k k 1S 11699 PARKVIEW GREEN CIR DATE ISSUED: 10/20/2015 I OWNER'S PHONE: 4085053112 SAN JOSE, CA 95131 1PHONE NO: (408) 509-2032 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ TEAR OFF (E) WOOD SHAKE, INSTALL (N) OSB, 30 # q FELT, CLASS LIGHT WEIGHT TILE ROOF SYSTEM (32 License Class C- 3q Lic. # C SQ'S) Contractor &)r�Z 42aP 0 // -) Date ew, , 2e ` I hereby affirm that I 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: 1. 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. ?� 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 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 wit all non -point sour a regulations per the Cupertino Municipal Code, Section 9.18. Signature rr Date xe ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: �. 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) 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 1. 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. 2. 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 permit is issued. 3. 1 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 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 Sq. Ft Floor Area: I Valuation: $13000 APN Number: 32608052.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR ;18 F ALL ED INSPECTION. 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 Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I 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. Ownegr ayth1r �', � n °C.iC . Date: CONSTRUCTION LENDING AGENCY I 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. Licensed Professional 4 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 GUPERTtNO (408) 777-3228 • FAX (408) 777-3333 • building a(-cupertino.orq O PROJECT ADDRESS �,� �/• n Jj� i APN 9 -3 % 0_09 �D OWNER NAME t/Zf' „ s I PHON Og r,y,? _ _(A2 E-MAIL STREET ADDRESS CITY, STATE, ZIP I FAX COI\TACT NAME /? PHONEKegw n� 50 q - E-MAIL STREET ADDRESS I CITY, STATE, ZIP FAX ❑ OWNER ❑ ONk-NTER-BUILDER ❑ OWNTER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGL TEER ❑ DEVELOPER ❑TE NANT CONTRACTOR NAME /� y LICENSE NUMBER,�g� LICENSE TYPE I BUS. LIC. COMPANY NAME'�.- E-MAI FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGIINTER NAME LICENSE NUMBER BUS. LIC. R COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or Duplex ❑ Multi -Family STRUCTURE: ❑ Commercial ROOF AREA: VALUATION: EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES i4�100D SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE /REPLACE id YES IF NO, � PLYWOOD ',K "/1" ❑ PLYWD $;r -OSB PITCH: ROOF ❑ NO LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX ' 12 CLASS: `4 C/�vr PROPOSED ROOF TYPE: ElBUILT-UPROOF 13ASPHALT SHINGLES 13WOOD SHAKES ❑ WOOD SHINGLES ICC -ES REPORT n OTHER ►l�7 j'% DESCRIPTION OF WORK: �. ��f�rE �� %s ��� ..�j //.I��- moo• .,,� r�?LC ��. ©S`�S �- .� 3l� /`�� �-/r �i�/���-/�zl���,� . %irk' �� c� � ��`�'���- G�Cc• s� �" �%L� Reroof,4pp_2011. doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10613 N STELLING RD DATE: 10/20/2015 REVIEWED BY: MELISSA APN: 326 08 052 BP#: *VALUATION: 1$13,000 'PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY SFD or Duplex PENTAMATION 1 SFDWLROOF USE: P PERMIT TYPE: WORK TEAR OFF E WOOD SHAKE INSTALL N OSB 30 # FELT CLASS LIGHT WEIGHT TILE ROOF SCOPE SYSTEM (32 SQ'S) FEE ID ROOF AREA sl 1 REROOFFRES 3,200 t:lE'c{l. Plan Ch 1't`if1i2 ;, NOTE: This estimate does not include fees due to other Departments (i.e. rtanning, rumic worKs, rare, Sanitary fewer District, acnuul n-4.. ..fes. 1 Tt.nnn finno nrn l.ncnrl nrs fit" nrolir"irtnry irifnrsp»tyfinri mytyittyhto ""d tyro n"h7 an octim"to_ rnntart the I)Pnt fnr addn 'l info. FEE ITEMS (Fee Resolution 11-053 Ef : 7f /1/13) FEE Plan i, ilecji � lee, Pian (. heck .leech. Permit I-ec: Plumb. Permit Fec, EAT. Permit Fee.: Other .1fech. Insp. Other Plumb . asp. )ihe r Elec. Insp. ;ilecrh. Insp. Fee: Plumb. Insp. Fee: !.lee. SP. , _,�>, NOTE: This estimate does not include fees due to other Departments (i.e. rtanning, rumic worKs, rare, Sanitary fewer District, acnuul n-4.. ..fes. 1 Tt.nnn finno nrn l.ncnrl nrs fit" nrolir"irtnry irifnrsp»tyfinri mytyittyhto ""d tyro n"h7 an octim"to_ rnntart the I)Pnt fnr addn 'l info. FEE ITEMS (Fee Resolution 11-053 Ef : 7f /1/13) FEE QTY/FEE MISC ITEMS Phan Check Fee: supp/. P(" Fee Permit Fee: $544.00 Su 1. Insp P'ee 'lztr77l�.;'��le'c°1r. %/lc>c Phjmh.IM&4i.; E1ec Permit Fein: Construction 7"xx: tlir���ar,�lrrrfi�,£a T��l<}: Work Without Permit? O Yes No $0.00 Adwinced Planning fees: l tl(ivel Doeutnente l ao a Strong Motion Fee: IBSEISMICR $1.69 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $546.69 $0.00 TOTAL FEE: $546.69 Revised: 10/01/2015 LI! 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 olcupertino.orq ;7Z 124yo I APN 4 PROJECT ADDRESS 4f L /V O�TNER NAME w PHONE fj/ E-MAIL STREET ADDRESS CITY, STATE, ZIP I FAX CONTRACTOR NAME010� f n LICENSE NUMBER©��� LICENSE'PE� BUS. LIC. n�.�1 COMPANYAME �47GC-�✓� rC %/�./ E-MAIL 77Z !�(% �a• J• C. F�F-3 / �' f / STREET ADDRESS e' 7 �f� �`'✓� ��--' CITY, STATE, ZIP �' / � Q 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 7:30-3:30pin (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 7:3040:30am 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 Residential Code. �G��C�� �,�% Signature of Applicant/A11) _(Z Date: ReroofPolicy_2014.doc revised 01/15114 PURPOSE SMOKEJ CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 o FAX (408) 777-3333 o building (a�cupertino.org N S r -c -t 1 ? �-ls 1: I CattL�:o�nr-I1�Ic�n�:�ide: PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN S C TE ANI) RE11JRNFD TO THE BUILDING DIIrISION 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 su-igle-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. h -i 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. l have read and agree to ppmply with the terms and conditions of this statement Owner, .ir O.wnerAgent s,) Name, ° m Si ......................................................................... " nafure ..... ...`Date:> Cb fractai-Name: t _ --- Sii;atu— re .................................................. ..................gf.................................... Date:.................... Smoke and CO form.doc remised 03/18/14 Address 'WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE GE COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 a building(2�cupertino.org &,-i 17 f Permit No. Ci.L r<ptjJ t +n.ip C A FILE 617-7`* l6d ��O i y 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. ® 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 1101.8 do not apply. ❑ The,licensed plumber's certification has been provided to the Building. Division. Skip the rest of the forn and sign bottom of form. R 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. N 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. �= 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 irnprovernents). 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.w.., Owner or Owner Agent's Signatu� �Y .. e.vup uus allu J1r,11111r. L1113 l.GI LUIUCILG,�1Lca5c rcLurn it to ine nunarng lirvisron in order to trnal your building permit. SB407 2015.doe revised 08/26/15