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B-2016-1303 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1303 10571 STOKES AVE CUPERTINO,CA 95014-1239(326 49 024) (ROSSETTA'S ENTERPRISES INC) SAN JOSE,CA 95126 OWNER'S NAME: KELLEY JON W AND EMILY L TRUSTEE DATE ISSUED:02/04/2016 OWNER'S PHONE:408-821-1711 PHONE NO:408-294-4400 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class CC39 Lic.#743864 Contractor(ROSSETTA'S ENTERPRISES INC)Date 02/04/2016 X BLDG _ELECT _PLUMB MECH X RESIDENTIAL_COMMERCIAL 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. JOB DESCRIPTION: TEAR OFF(E)COMP&INSTALL(N)PLY/OSB,30#FELT,CLASS A I hereby affirm under penalty of perjury one of the following two declarations: COMP ROOF SYSTEM(28 SQ'S) 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. AvI 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. Sq.Ft Floor Area: Valuation:$17000.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN information is correct.I agree to comply with all city and county Number: Occupancy Type: 326 ordinances and state laws relating to building construction,and hereby 326 49 024 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 PERMIT EXPIRES IF WORK IS NOT STARTED expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal 180 DAYS FROM LAST CALLED SPECTION. Code,Section 9.18. Issued by:MELISSA Signature ' O� Date 02/04/2016 Date:02/04/2016 OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of the All roofs shall be inspected prior to any roofing material being installed.If a roof is following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1. I,as owner of the property,or my employees with wages as their sole inspection. compensation,will do the work,and the structure is not intended or offered for sale(Sec.7044,Business&Professions Code) Signature of Applican z. I,as owner of the property,am exclusively contracting with licensed Date:02/04/2016 contractors to construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the z. I have and will maintain Worker's Compensation Insurance,as provided for California Health&Safety Code,Sections 25505,25533,and 25534. I will by Section 3700 of the Labor Code,for the performance of the work for which maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the this permit is issued. Health&Safety Code,Section 25532(a)should I store or handle hazardous s. I certify that in the performance of the work for which this permit is issued,I material. Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I shall not employ any person in any manner so as to become subject to the will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and Worker's Compensation laws of California. If,after making this certificate of the Health&Safety Code,Sections 25505,25533,and 25534. 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 Owner or authorized agent: j _ �--- be deemed revoked. Date:02/04/2016 APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance correct.I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued(Sec.3097,Civ C.) relating to building construction,and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments,costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant ARCHITECT'S DECLARATION understands and will comply with all non-point source regulations per the I understand my plans shall be used as public records. Cupertino Municipal Code,Section 9.18. Licensed Professional Signature Date 02/04/2016 RER®®F PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 CUPERTItO (408)777-3228• FAX(408)777-3333•building(c�cupertino.org y7 _ 2v' I> - ( 3a3 PROJECT ADDRESS �S � �f 7APN# �/ A L OWNER NAME _;0 -,�,� ! PHQE STREET ADDRESS J n J� CITY, S A E,ZIP U �( FAX V /] � J t�V CONTACT NAME � PHONE 002 E-MAIL i V 1 I STREET ADDRESS V j CITY,SOT,E, ZI - FAX V I u ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME 1 LICENSE UM LICE E T BUS.LIC.# 2 0 COMPANY NAME t E-MAIL STREET ADDRESS CITY,STATE, �P �q� PHO � 21Ca ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS�� CITY,STATE,ZIP PHONE USE OF LT�rD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: STRUCTURE: ElCommercial -2,6 I I -©do EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES v'OTHER(SPECIFY) REMOVE-/REPLACE YES IF NO, PLYWOOD 0'-w, ❑ PLYWD [2 OSB PITCH: ;A ROOF ❑NO 1 #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX -:12 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF r ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK: A, 4L 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' ehal . ha 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 omply with a 1 applicable local ordinances and state laws relating to building con ctio I authorize representatives of Cupertino to enter the ab ve-'dentified property for inspection purposes. Signature of Applicant/Agent: > W�J�N Date: �� SUPPLEMENTAL INFORMATION REQUIRED „ ,w_ 2�.,o cE USE _If building is associated with a Home Owner's Association,provide letter CHECK TYPE RovTING sLiP' of approval from HOA. pP OVER THE COiJNTER ❑ BUILDING PLAN REVIEW. _Provide Planning approval to verify if there any restrictions. O ExPREss ❑ PLANNIlVGPLAN REVIEW R _Provide copy of Manufacturer's Installation Specifications. 0 sTnA>tn SEPT �' _Provide signed copy of Cupertino's Tear-Off Policy. ` �� ❑ oTaER ReroofApp_2011.doc revised 03/16/11 t REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL C0015-it-11"I'14610300 TORRE AVENUE-CUPERTINO, CA 95014-3255 (408)777-3228- FAX(408)777-3333-building aacupertino.org F ECT ADDRESS ON# � OF ERNAMEjo�, �� PHO ' JJbr] �� �� E-MAIL STREET ADDRESS CITY, TATE,qP FAX i'1 fJ v� CONTRACTOR NA LICENSE 1Iv , —7LICE `f]� BUS.LIC.# 0 ZS Q f ll C f> COMPANY NAME \ E-MAIL i , FAXCyo())ivy d �`JtSc2S (�u6 Cath U ��-7 STREET ADDRESS ` CIT TATE, PHON(yorib 01 CA 1qS_1 2 V '29�- Lmo 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 detectors are required to be installed in accordance with Sections R314 and R315 of the 2013 California Residential Code. Signature of Applicant/Agent: Date: -2h r� ReroofPo1icy_2014.doc revised 01/15/14 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10571 STOKES AVE DATE: '02/04/2016 REVIEWED BY: MELISSA APN: 326 49 024 BP#: B-2016-1303 *VALUATION: 1$17,000 �IPERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1 SFDWLROO WORKTEAR OFF E COMP & INSTALL N PLY/OSB 30# FELT CLASS A COMP ROOF SYSTEM 28 SCOPE SQ'S) FEE ID ROOF AREA s.f. 1REROOFFRES 2,800 i'f.'i?. tjJUt'd��l".•Li'�: Ahtfi"b,Int",,v%C?tr.'L't£ pe'r'nit7Y Fee: E'le':J'erniit j'V: hi: <:te`I' Lj 1=1Ji?1}s13.Zit.'sfl. 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 prelimina information available and are only an estimate Contact the De t or addn'l info. FEE ITEMS (Fee Resolution.1.1-053 Eff. 7%1/13) FEE QTY/FEE MISC ITEMS Permit Fee: $476.00 Work Without Permit? 0 Yes (E) No $0.00 li'(Zvei f7L" 111t:'STf%''70311. `£?t',5: Strong Motion Fee: IBSEISMICR $2.21 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS:': $479.21 $0.00 TO.TALFEE: $479.21 Revised: 01/01/2016 SMOKE I CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT nE;PARTMENT BUILDING DIVISION CU PERVIN4 10300 TORRE AVENUE CUPERTINO,CA 950143255 (408)777•-3228-FAX(408)777-3333►buildin i@cupertino.ora ( �c�?irvv C/-} 3 zoo 6- 13,03 u PERMxT CANNOT BE FINALED AND C()MpLETED UNTJY,TIHS CERTIRCATE MS BEEN SJOANI D. T ' UI11CL�1 NG DIVUION PURPOSE _ -. .... ._ 'Chis 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-jaznily and mulii4amily dwo0ngs shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions;alterations, or repairs to existing dwelling units exceeds $1.000.00,CRC Section 8314 and CSC 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 ALAliM Outside of each separate sleeping area in the ivamediate vicinity of the X X bedroorn(s) On every level of a dwelling unit including basements X X Within each slee in room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that do Rot 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 iat 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 tie 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 izr compliance with the California Building and Califormia Residential Codes.The alaxms hanre beets tested and are operational,as of the date signed below. t have react and a06 to cora, ly with.the terms and conalom of this s€atemant s�- ar�....... .. ..........•------._...................----�----......ff�e�:'..�`�,�8�. .............. Smoke and COfvrm.4c revised 03/!8/):'4 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERI tNp 10300 TORRE AVENUE•CUPERTINO.CA 95014-3255 (408)777-3228•FAX(408)777-3333-buildingCacuoertino.ora Owner Nam n r Ke t A—a 1'erxvit NoA :B—.2o/(o —1303 Address l(LS,7/ S-ruce_5 /vim 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, ja g 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? 0 Yes Civil Code Sections 110 1.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Divisions. Slap the rest of the form and sign bottom of form. No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ 'Y'es Civil Code Sections 1101.1 thorough 1101.8 do not apply. Skip the rest of the form,and sign bottom of fora►. ffia A No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1,1994? O 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. ; -N X 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. Cheek one of the three following statements and sign bottom of fbun., 5. Please check ONE of the following: �.t s a' My prop' asingle,family residential real property. See Civil Code Section 1101.4. On and after January 1,2014,building alterations or improvements shrill require all non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures throughout the building.On or before January 1,20I7,all non- compliant plumbing fixtures shall be. replaced with water-comserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ My property is amaltifamily residential real property. See Civil Code Section 1101.5. On and after January 1,2014,specified buildifag 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). ❑ Myproperty 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). J,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 foll2LV rn a e. Owner or Owner Agent's Signature oat 2/97/(o Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit. SR4072015.dvcrevised 08116115