B-2016-1236CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1236
11679 OLIVE SPRING CT CUPERTINO, CA 95014-5141 (366 54 096) (JIREH INC)
LOS GATOS, CA 95031
OWNER'S NAME: HUI EDWARD S AND BETTY O
OWNER'S PHONE:
LICENSED CONTRACTOR'S DECLARATION
License Class Lic. #e(L51 'Allip 91 0
Contractor ( JIREH INC ) Dated f 20 ) l 1Q
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:
r. 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 with all non -point source regulations per the Cupertino Municipal
Code, Section 9.18.
Signature /ate
OWNER-BUTIDFR ECLARATIONI
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
t. 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:
t. 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. 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 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
DATE ISSUED: 01/20/2016
PHONE NO:
BUILDING PERMIT INFO:
X BLDG —ELECT —PLUMB
_ MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
REMOVE (E) SHAKE/SHINGLE (NO NEW PLY), INSTALL CLASS A
COMP ROOF SHINGLES (26 SQ'S)
Sq. Ft Floor Area: I Valuation: $12000.00
"N Number: Occupancy Type:
366 54 096
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS F ALLED 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
ins iom
ll
Signature of Applicant:
t:
Date I l� 01 G /„ `
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, Section , 25533, and 25534.
Owner or au hor' ed agent/ j
Date;) -1tq'�
/ (((((( TR T E E Y
I hereby a rm that there is a constr ction 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
Profession
,REROOP PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • building(a-cupertino.org
(� -- Z 3
PROJECT ADDRESS i 7APN #
06,ue) A,00,w-) (�v
OWNER NAME JU) Q, PHONE % t , \ � 1&31 E-MAIL
STREET ADDRESS I I (0Gt F� v �V CITY, STATE,ZIP _ �y j�j f� FAX
CONTACT NAME, C C0 �q0 -&J4
&J4 � E-MAIL
STREET ADDRESS CITY, STATE, ZIP J FAX
❑ OWNER ❑ OWNER-BUILDEER. � ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER y❑ TENANT
CONTRACTOR NAME n/ LICENSENUMBER IC fE / -- BUS. LIC. #
COMPANY NAME �� 1 SPD E-MAIL W ( FAX
STREET ADDRESS, , PHONE
Wc a )Ls vm av,Zz6_ J � 5� Com) a9� -���
4CITYSTATEZIP
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC. #
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY, STATE, ZIP PHONE
USE OF ❑ SED or Duplex ❑ Multi-Family rt ROOF AREA: (n VALUATION:'
STRUCTURE: ❑ Commercial
EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES El 'OTHER (SPECIFY)
REMOVE /REPLACE -ELYES IF NO, PLYWOOD ❑ '%, ❑ PLYWD ❑ OSB PITCH: 1 ROOF
❑ NO #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX - ' 12 CLASS: A
'v ICC-ES REPORT #
PROPOSED ROOF TYPE: 11BUILT-UPROOF El ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER
DESCRIPTION OF WORK: pp
��,In�iO C/�J (�✓l.L' ,(� rJ' � lS�s �t.�"cT Y l.C.� � fiI-vii W
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 orrect. 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 bu' di t ction. I authoriz_e_representatives of Cupertino to enter the abore-ide Ell
ified property for inspection purposes.
Signature of Applicant/Agent: Date: 1 / �
SUPPLEMENTAL FORMATION REQUIREDx .,ocE usE oNi Y:`- ,
If building is associated with a Home Owner's Association, provide letter PLAN cHECK'TYPE RouTING SLIP,
of approval from HOA. ❑ ovER�couv ❑ BUILnINc PLAN REVIEW
Provide Planning approval to verify ifthere any restrictions. C]'ExPRESsi Dy PLANNINGPLANREVIE�V
_ Provide copy of Manufacturer's Installation Specifications. ❑ sT '' ' 'p-'' nPx '
Provide signed copy of Cupertino's Tear-Off Policy. oTxEx
ReroofApp_2011.doe revised 03/16/11
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 - bui[ding CcDcupertino.org
PROJECT ADDRESS / „ T q 11 v� ' ! /y TAPN
#
OWNER NAME
PHONE I'a(� 6�2 fes' (J��7ET
AIL
STREET ADDRESS (I� ��/ V `C 6`
I-OiCONTRACTOR
CITY, STATE, ZIP / J nryI '
vl
FAX
NAME I C
LICENSE NEij
l(j
LICE� S TYPE
J(�
BUS. LIC. #
COMPANYNAME
E-MAIL
FAX
STREET ADDRESS �j(, Pi �v I
CITY, STATE, ZIP
_5 04~
PHONE Ok)'*q-93 qq
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 %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 detecto required to be installed in accordance with Sections R314 and R315 of
the 2013 California Residential Cdae. J 9 %
Signature of Applicant/Agent: Date
1 /,;PQ/ 1
2014.doc revised 01/15/14
CITY OF CUPERTINO
FFF FSTIMATOR - BUILDING DIVISION
,
ADDRESS: 11679 OLIVE SPRING C DATE: 01/20/2016
REVIEWED BY: MELISSA
iksl APN: 366 54 096 BP#: B-2016-1236
'VALUATION: 1$12,000
*PERMIT TYPE: Minor Building Permit _FPLAN
CHECK TYPE: Re -roof
PRIMARY
SFD or Duplex
7
PENTAMATION
1SFDWLR00F
PERMIT TYPE: 14
WORK
TEAR OFF 2 LAYERS OF (E) ROOF, NO NEW PLY, INSTALL 30# FELT, CLASS A COMP ROOF
SCOPE
SYSTEM
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Hire, Sanitary Sewer District, )cfioo1
Tinirins ni, 1 Th- f- - h -d n" 0ho nrofimi . . . ; ;"fnrmadn" "vailahlo and ar,, onh) an P.vt;mat.-- Cnntart the Dent for aildnl info.
FEE ITEMS (Iee.Resolytion.1.1-053. U�"%;'1113)
FEE
QTY/FEEMISC
ITEMS
Play, ("lleck 1,`ee:
Pen -nit Fee:
$442.00
Perwii P,,,e:
hiistroih:,,! Fee:
Work Without Permit? 0 Yes Q No
$0.00
I'Fave!
Strong Motion Fee: IBSEISMICR
$1.56
Select an Administrative Item
---
Bldg Stds Commission Fee: IBCBSC
$1.001
UBTOTA
$444.561
$0.001' TOTAL. FEE.
.56
$4447
Revised: 01/01/2016
Address 11
FILE
SMOKE / CARBON MONOXIDE ALARMS �3�J
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(@cupertino.org
++ C* okwl�- Permit No. ,70110 —1 �%
0 (%-q �'F . ��. titA\ i�O # of Alarms Smoke: 2 Carbon Monoxide: 2
PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE
HAS BEEN STs AND RETURNED TO THE BUILDING DIVISION
PURPOSE
This affidavit is a self -certification for the installation of all required Smoke and Carbon' Monoxide Alarms for
compliarice 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
bedrooms)
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.
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
Owner (or Owner Agents) Name:
"G&0, Cd
Sf nature ................. ...................................................................... Date:.,2 ... (.6
Contractor Name:
C'1�o3
......................................... Lic.#...................................... Date:... i ....
Signature ...... .. '3
Smoke and CO form doc revised 03118114
WATER-CONSERVING PLUMBING FIXTURE
OWNER CERTIFICATE OF COMPLIANCE
IE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTCNO I
Owner Name
+ (408) 777-3228 • FAX (408) 777-3333 • building(o)cupertino.ora
Permit No
Address h � 1k h� i �� Cit �l
PERMIT CANNOT BE FINALE AND COMPLETED UNTILTHIS CERTIFICATE
HAS BEEN SIGNED AND RETURNED TO THE BUILDING DIVISION
��Tf.5.54iSiLiLiS•n�'ii.Qit I `.
r ..L_J
Please refer to the attached California Civil Code Sections 1101.1— 1101.8 which are part of this Certification form.
1. Is your real property a registered historical site?
❑ 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 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:
C�, 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:
%,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. 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).
❑ 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.
SB407 2014. doc revised 03/18/14
On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving
plumb,ihg 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 have been replaced
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 comms with the requirements as indicated in the table below.
Owner's (or Owner Agent's) Signature: is " � I � �. - Date: -"-14 11 10
TT___ —A c.;rrn fk;o O?rf;fle-n'P. rP.illm It Io the Building Division in order to final your permit.
1. If the existing plumbing fixture water usage/tlow rate is equal to or lower than the ngure snown, it is not required io oe up. -i
SB4072014.doc reidsed 03118114
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. If the existing plumbing fixture water usage/tlow rate is equal to or lower than the ngure snown, it is not required io oe up. -i
SB4072014.doc reidsed 03118114