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B-2016-1357 CITY OF CUPERTINO BUILDING PERMIT I BUILDINGADDRESS: CONTRACTOR: PERMIT NO:B-2016-1357 10362 GREENWOOD CT CUPERTINO,CA 95014-3343(369 14 031) (ROOF ROOFING INC) SAN JOSE,CA 95118 OWNER'S NAME: SEVILLAALBF.,RTO TRUSTEE&ET AL DATE ISSUED:02/12/2016 OWNER'S PHONE:650-520-4865 PHONE NO:408-265-9270 LICENSED CONTRACTOR'S DECLARATION BALDING PERMIT INFO: License Class CC-39 Lic.#668 Contractor(ROOF ROOFING INC)Date 02/12/2016 X BLDG —ELECT _PLUMB MECH X RESIDENTIAL T 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)WOOD SHAKE,INSTALL(N)OSB,30#FELT,CLASS A 1 I hereby affirm under penalty of perjury one of the following two declarations: 30 YR COMP ROOF SYSTEM(27 SQ'S)(6 UNITS,ONE BLDG) i. T 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. $q.Ft Floor Area: Valuation:$11000.00 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 APN Number: Occupancy Type: ordinances and state laws relating to building'construction,and hereby 369 14 031 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 1,80 DAYS FROM LAST CALLED INSPECTION. Code,Section 9.18. Issued by:MEL ISSME I Signatures � Date 02/12/2016 Date:02/12/2016 1 ONVNER-BUILDER DECLARATION RE-ROOFS: 1 All roofs shall be inspected prior to any roofing material being installed.If a roof is T hereby affirm that I am exempt from the Contractor's License Law for one of the installed without first obtaining an inspection,I agree to remove all new materials for following two reasons: 1. I,as owner of the property,or my employees with wages as their sole inspec n. compensation,will do the work,and the structure is not intended or offered for sale(Sec.7044,Business&Professions Code) Signature of Applicant: , z: 1,as owner of the property,am exclusively contracting with licensed Date:02/12/2016 contractors to construct the project(Sce.7044,Business&Professions Code). ALLROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: 1 1. 1 have and will maintain a Certificcite 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. 1 will m by Section 3700 of the Labor Code,for the performance of the work for which maintain compliance with the Cupertino Municipal Code,Chapter 912 and the Health&Safety Code,Section 25532(a)should I store or handle hazardous this permit is issued. 3. 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 shall not employ any person in any manner so as to become subject to the 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 Worker's Compensation laws of California. If,after making this certificate of the Health&Safety Code,Sections 25 ,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: be deemed revolted. Date:02/12/2016 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 Lender's Address to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in ARCHITECT'S DECLARATION consequence of the granting of this permit. Additionally,the applicant I understand my plans shall be used as public records. understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Licensed Professional Signature Date 02/12/2016 { REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CU RTINO (408)-777-3228• FAX(408)777-3333•building ancupertino.org P ? t1 PROJECT ADD b` tL�Y.®�„ry®fJ C-+' APN# �j f / r D .3/ ® nOWNER NAME q// fvL \' v� P 5_1 b q 4 �6 E-MAIL STREET ADD CIT TATE,ZI Q' ) FAX leoe CONTACT NAME. PH;Et_ gyp/ g 91 �----- E-MAIL _-_ --- - ,x-- ---- GIS STREET ADDRESS CITY,STATE,ZIP 11 ❑OWNER D'OWNER-BUILDER ❑ OWNER AGENT NTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER 11 TENANT 1Ij CONTRACTOR NA ,_ - ®V f (da LIC SE LICENSE LIICENSE TYPE BUS.LIC.# COMPANY NAME1r( f E✓-MAIL Cd/� FAX STREET ADDRESS_ ®� CITY,STATE,ZIP Oey" y - ARCHITECT/ENGINEERNAME LICENSENUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX I STREET ADDRESS CITY,STATE,ZIP PHONE j I USE OF ❑ SFD or DUpleX - ti-Family ROOF AREA: VALUATION: f STRUCTURE: ❑ Commercial 4-o-0l ® -J EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES tOOD SHAKES ❑WOOD SHINGLES El OTHER(SPECIFY) REMOVE/REPLACE YES. IFNO, PLYWOOD !" y PLYWD OSB PITCH: ROOF ❑NO #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑CDX 12 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOFHALT SHINGLES ElWOOD SHAKES 13WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK 1 X00 l 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 relating to building 15 authorize representa' of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED _If building is associated with aHome Owner's Association,provide letter r�ANca>eITPI T xotIPINGSLlra of approval-from HOA. dyE �oIz R �F� �vl Provide Planning approval to verify if there any restrictions. ❑i Egp 4 i Pjp ' Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cupertino's Tear-Off Policy. ` zoo- ReroofApp_2011.doc revised 03/16/11 i 'F b4 s REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL C U PIERT 114 0 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228- FAX(408)777-3333•building(a,cupertino.org f tz PROJECT ADDRESS G ti R-°�V A elAPN# OWNER NAME. V' L ���, ® _. PHONE 6 Nn -52®,- ( E-MAIL cs STREET ADDRESS CITY, STATE,ZIP J FAX CONTRACTOR NAME r ®t. LICENSENLLM JAG LIC SES�E BUS.LIC.# COMPANY NAME �a E-MAIL / FAX STREET ADDRESS {^� ) r CITY, TATE,ZIP 7-� 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. Ifplywood 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 wi h the re-roof policy stated above. I also understand that smoke detectors and carbon monoxide detector re tquir to be installed in accordance with Sections R314 and R315 of the 2013 California Residential Code. Signature of Applicant/Agent: Date: ReroofPo1iey_2014.doe revised 01/15/14 W ON HR� � COMMUNITY DEVELOPMENT DEPARTMENT>BUILDING DIUIS[ON dE1� fI3 10300TORREAVENUE CUPERTINO,CA 9501,4-3255' {408)177-3228, FAX(408)777-3333 a,bu€I dlna(acupertino.org lI�I .16 � u fake.. far-110 lMde: p Ri 1I —ckNNoT f31F r Nrki, D ANT D COI�lpI TE UNTIL TRIS-CEI2I ICATFj IA ':E1C11� C' AN'D ;THMT) t i DWIIi ' PURPOSE s This affidavit is a.self-certification for the installation of all requiredSmoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section 8314,2013 CBC Sections 420.6 and 907:2.11.2 where no interior access for inspections are required, _ GtNERA-L INF tV tM N'1C'.oN Existing single-family,and multi=family dwellings shall be provided:with Bmoke Alarrns';and"Carbon Monoxide alarms; When the valuation of addifions,alterations,or repairs to existing dwelling-units exceeds $1000.00,CRC Section 831:4 and CBC Sections 907.2.11..5 and 420.6 require that Smoke Alarms and/or Carbon onoxidelarInsbe installed in the following locations; AREA SMOKE ALARM CO A3l. Outsid of each separate sleeping area in the imnmediate vicinity of the X bedrooftt(s) On ever level of a dwelling unit including basements X }( Within each ileein room 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 ha, dwelling units.with.no commercialpower,supply,alar m(s,)maybe solely battery operated._ In exist ing,dwellitg,units,alarms are:permiit2d Lobe solely batteryoperated where-repairs or alterations do not result in the removal of wall and ce'ilin&finishes or there:is no access by means of attic;basement or crawl space.Defer to CRCSection 12314 and CBC Sections 907.2.11A and 420.6.2.An electrical permit is required far, alarms which rrtust be connected toz the building wiring: As owner of the-above-referenced property,I hereby-certify that tine alarm-(s)referenced above has/liaue been. instalCed%n accordance°with the rx anu acturer's ins[xuctiozls and ixt eoznpl once with the California BujIdtk a iJ.Califon-da,ReszdlerttdaZ Codes.The alarms have been tested and are operational, as at'the date signed, b�Io�v. f have reaGrEn-d Aelree fo eornP.l,wi�r ._ r:: ,:. , conova s of this,statement 61wv c r t � r , :SIafc�ie::. ........ .tsar: .. Cantrftit�l�la€��t Sniak�aJirl�O farrf:dae °e�isecG03/1311:¢ JOWN COMMUNITYt7 l�LUI' T.[���1�f 1�t�T>B�fLt�lclr�.t3#�/iStU�, ?� � ik_Pt 103U FORRE AVENUE­dUPI fRTlt�lt7,Ck�95004-32,55 I iQ8 777--3228 F'f�(4'08 777-3333,-bi it ar odino.or Owner Nam L ( Permit N o`= b Addres, 1, s your realproperty a registered historical site? El Yes Civil Code Sections 110 1.1 through 1301.8 donot apply: .Skip the"rest of Elie farm and sign bottom of form. F,z �❑ No Qo 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`11.01,8do,notapply. ❑ The 0censedpliutnber's certification has been provided to:the Building Di�iision: Skip`the rest of the form and sign bottom of form, ❑ No GotoQuestion3,, Is water-service,permanently disconnected for your°building? _ ❑ Yes Civil Code Sections 1101.1 through 1101,&do not apply. Skip the rest of the form,and sign bottom of form: } ❑ No Go to Quolion 4. 4 ls'your real propertyybult and available for use or occupancy on or before January 1,.1994 ❑ No Myreal property is built and available for use or occupancy after January 1,1994. Crvit ;ode Seottons 1101.1 tbrough 1101.8 do not apply, Skip the rest of'the foram and sign bottom of form,_ ` ❑ Yes Myreabproperty 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: 0 Mypropertyisa single family residential real property, See Civil Code Section 11014. _ On.and after January I,2014,building alterations or,,iniprovemeats shall require all non-com pliant�phu cubing fixtures to be replaced with water-conserving plumbing fixtures,throughout the budding..Cn or before January 1,2.017,all cion- compliant pl imbia fixtures.shall'be replaced wltl"wnter-conserving phurit rrrg fu ares. {regardless of whether rop#tyundergoes,alterations or iznproveftimts), y property is a_rn°Lrlt atnily r-es`iclen041 real property: See.Civil Code,Seetion 12411.5. On and after January I,2014,specified building alterations or improvements shalt require-tion-.cornphant plumbing fixtures to be replaced with water-conserving<plumbing fixtures, On or before;January 1,201-9,all non-compliant plumbing fixtures'shall-be replaced with water. conserving plumbing fixtures throughout the building{regardless of whether property undergoes alterations or irnprovemerfs). ❑ Myproperty is a commercial real property. See CivitCode"Section 110:1.5. Omand afterJanuary ,'2014;specified building alterations or improve nen glzaTl require non-compliant. plumbing fixtures to be replaced with water-conse-rvirig plumbing fixtures. On-or before,January 1,-2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures tluoughout 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 futures will be ; replaced,prior to date specified:above with waster-conserving plumbing fixtures in accordance with Civil Corte Sections 1101.1 through 1101.8,the current California Plumbing ode and lifomia Green,Building Standards Code,and manufaeturer's ins tallation.requireinents,,and that the water-con rving lu ing fix es comply with the requirements as indicated in the•••• table on the following,pa e. Other or©weer:Agent's:Signature Da _ Upon completing and signing this Ceitificah .p;ease r.t'rn it to Building 1?lvis'ior,in-order.to fnal your building perrnit, Y SB4072015.docrevised 08/26115