15110163CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1019 NOVEMBER DR
CONTRACTOR: STONERIDGE ROOFING PERMIT NO: 15110163
OWNER'S NAME: PYTEL MARTIN AND JAHRSDOERFER ALISO
1672 RIDGETREE WAY DATE ISSUED: 11/23/2015
OWNER'S PHONE: 4082559626
SAN JOSE, CA 95132 PHONE NO: (408)729-5101
LICENSED CONTRACTOR'S DECLARATION
K_TEAR
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
L�-E
OFF (E) COMP SHINGLE, INSTALL (N) 30# FELT,
License Class``f��— C Lic. #,4'1 0
CLASS A COMP ROOF SYSTEM (28 SQ'S)
Contracto\C', Date.1 '-A-� "_ s
I hereby affirm that I am I'censed under4e 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: $12000
performance of the work for which this permit is issued.
15,4 ave and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 36213054.00
Occupancy Type:
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
PERMIT EXPIRES IF WORK. IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN 180 D DANCE OR
to building construction, and hereby authorize representatives of this city to enter
WED
upon the above mentioned property for inspection purposes. (We) agree to save
180 D INSPECTION.
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 com
ue e:
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
y ~j
RE -ROOFS:
Signature Date A11 413
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.
❑ OWNER -BUILDER DECLARATIONA—-
_� }
^
Signature of ApplicanDater %
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 (Sce.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 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, Sectionsr5 05, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent y Date: ri
permit is issued.
�y
1
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
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 •FAX (408) 777-3333 •building a(�.cupertino.org
PROJECT ADDRESSNr +
i () \ 9 L =(\I
APN #
�i VV
OWNER NAME\�
PHONE . -MAL AIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
CONTACT NAME
PHO1�E
E-MAIL
61
(MY D
STREET ADDRESS C
CITY, STATE, ZIP ,
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT El ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME �LICENSE
NUMBE '
LICENSE
BUS. LIC. #
COMPANY N /'
U 0 nr
E- AIL 1
"(. C�
FAX
STREET ADDRESS e01—C
Y, STATE,^IP
D
PHONE O _
ARCHITECT/ENGINEERNAME
LICENSE NUMBER
BUS. LIC. #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or Duplex ❑ Multi -Family
ROOF AREA:
VALUATION:
STRUCTURE: ❑ Commercial
cMasq�
c�
EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES El OTHER (SPECIFY)
REMOVE/REPLACE YES
IFNO,
PLYWOOD ❑ w, ❑
PLYWD ❑ OSB
PITCH:
ROOF
❑ NO
#LAYERS:
THICKNESS: ❑ 5/8"
TYPE: ❑ CDX
2
CLASS:
PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER
ICC -ES REPORT #
DESCRIPTION OF WORK:,
Le
� o
By my signature below, I certify to each of the following: lam the property owner or authorized agent to act on the property owner's behalf. 1 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 buildi c ns ction. I authorize representatives of Cupertino to enter the abovf -identified property for inspection purposes.
Signature of Applicant/Agent: _ Date:
SUPPLEMENTAL INFORMATION REQUIRED
oPFICE VSE -ONLY-
_ If building is associated with a Home Owner's Association, provide letter
PLS caEeI�;TYPE
ROUTnvc sLiP ._
❑ OVER -THE COUNTER
y' B DING PLAN REVIEW -
of approval from HOA.
Provide Planning approval to verify if there any restrictions.
ExPREss °
PLANNING PLAN REVIEW
Provide copy of Manufacturer's Installation Specifications.
❑ FIRE DEPT
Provide signed copy of Cupertino's Tear -Off Policy.
D f HER-
4VI revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
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Phimb_blsi..". Fee,-
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NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.). Theseftes are based on the preliminary information available and are only an estimate. Contact the Dept for adan 7
FEE ITEMS (Fee Resolution 11-053 Eff 7/1/132
ADDRESS: 1019 NOVEMBER DR —TDATE:.
11123/2015
REVIEWED BY: MELISSA
Plan ("heck 1`ee:
APN: 36213 054
BP#:
*VALUATION: 1$12,000
*PERMIT TYPE: Minor Building Permit
PLAN CHECK TYPE: Re -roof
PRIMARY
. SFD or Duplex
USE.
I
PENTAMATION
1SFDWLR00F
I PERMITTYPE: A
WORK
TEAR OFF (E) COMP SHINGLE, INSTALL (N) 30# FELT, CLASS A COMP ROOF SYSTEM (28 SQ'S)
SCOPE
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Phimb_blsi..". Fee,-
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NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.). Theseftes are based on the preliminary information available and are only an estimate. Contact the Dept for adan 7
FEE ITEMS (Fee Resolution 11-053 Eff 7/1/132
FEE
QTY/FEE
MISC ITEMS
Plan ("heck 1`ee:
Sul.y.1L PC.Fee
Permit Fee:
$476.00
("Onsiruclioll 7,61x;
Work Without Permit? 0 Yes No
$0.00
Advanc&l J�lanning, fi-ees:
es:
Strong Motion Fee: IBSEISMICR
$1.56
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
A
SUBTOTALS
$478.561
$ 0.00 TOTAL FEE:,
. . ...... .. .. .
$478.56
Revised: 10/01/2015
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
(408) 777-3228 • FAX (408) 777-3333 • building CcDcupertino.org
PROJECT ADDRESS
APN #
OWNERNAME �,� _
PHONE
'-
E-MAIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
CONTRACTOR NAME
\
LICENSE NUMB
LICENSE
BUS. LIC. #
COMPANY NP'C
w
E-MAIL
FAX
s
-
STREET ADDRESS 1
A,
CITY, STATE, ZIP
^O
PHONE _/�
` 1
�
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 carbon monoxide 4etectors are required to be installed in accordance with Sections R314 and R315 of
the 2013 California Residential Cod
Signature of Applicant/Agent: Date:
ReroojPolicy_2014.doc revised 01/15/14
�l
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF GOMPL. ANNE
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3 28 • Fra�
(408) 777-3333 o buildin-O'Dcupertino.ong
Owner Name ) ISL. —Ia s & Permit No. )5110!6
Address V v DV�f,I O k (.c /c'1� i Wit— T
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 fonn.
JR VA- 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 form and sign bottom of form.
t� 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.
4 C& 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.
Q 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:
[B 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 110 1. 1
through 110 1.8, 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 followine nage.
Owner or Owner Agent's Signatur=�� Date'�)rJ f
Upon completing and signing this Certificate, please r rn it to the Building Division in order to final your building permit.
SB407 2015.doc revised 08126115
B'TiB[LD'LNG PICT= CL1 OT BE FUIALED 1 CQIS!PLrTE' ul_1M. TJWS
CERTIF,I,CA HAS BT,11V Nt ,WANM . __EM i*iT'
1. If the existing plumbing fixture water usagdflow rate is equal to or lower than the figure sho wit, It to LLIJL I ULJULJ V U LU UP61 aU....•
SR407 2015.doc revised 08126115
Non -Compliant
Water -Conserving Plumbing (Fixture
Plumbing Fixturel
(Fixture Complying with Current Code Applicable to New Construction)
Maximum
Water Us a a/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 Osi.
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. If the existing plumbing fixture water usagdflow rate is equal to or lower than the figure sho wit, It to LLIJL I ULJULJ V U LU UP61 aU....•
SR407 2015.doc revised 08126115
tCUPERTTWO
l
PURPOSE
0MOKE / CARBON MONOXIDE ,LAR
OWKER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE o CUPERTINO, CA 95014-3255
(408) 777-3228,, FAX (408) 777-3333 • bull ding Ca.cupertino.org
PERIVUT CANNOT BE FINALED AND COMPLETED D IUNTIL TINS CERTIFICATE
HASBE ��' 7YJ'`� lel � ;.�? TO THE Bumpj NG
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
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
alanns 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 Califon -da Residential Codes. The alarms have been tested and are operational, as of the date signed
below.
C have read and agree to COMDIv with the dorms, and rnnrlitinn.c of thic sfatnmont
n�rtr; � or wlrmerLA rrE'�l filar
5inaiUre,.,,,...
Cbni��cfor Name:
............................................... D'ate:, .
L
si� _' .Lic,? S�I�.�. l
...... ................... Dail.' .N..,.. ....
Smoke and CO form.d6c revised 0311811.4,