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B-2016-1373 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO:B-2016-1373 6664 CLIFFORD CT CUPERTINO,CA 95014-4554(369 24 053) (STONERIDGE ROOFING) SAN JOSE,CA 95111 OWNER'S NAME: MAI RIFENG AND QIAN WEI DATE ISSUED:02/16/2016 OWNER'S PHONE; PHONE NO:408-729-5101 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-39 Lic.#951530 Contractor(STONERIDGE.ROOFING)Date 02/16/2016 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: Remove composition roofing and install new 7/16"OSB with 301b paper and I hereby affirm under penalty of perjury one of the following two declarations: new composition roofing(2600 sq ft). 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. ^`. .z. I have and will maintain Worker's Compensation Insurance,as provided for 43 by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$16700.00 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 24 053 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 INSPECTION. Code,Se4'. Issued by:1V<1 f� ,Signature Date 02/16/2016 Date:02/16/2016 ER-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 r. 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 Applicant: 2. 1,as owner of the property,am exclusively contracting with licensed Date:02/16/2016 i contractors to construct the project(Sec.7044,Business&Professions Code). T hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER - 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 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 2. 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 shall not employ any person in any manner so as to become subject to the air contaminants as defined the Bay Area Air Quality Management District I will maintain compliance with the Cupettino Municipal Code,Chapter 9.12 and Worker's Compensation laws of California. If,after making this certificate of the Health&Safety Code,pleevons 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-, be deemed revoked. owner or authorized'agent: bate:02/16/2016 / 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 02/16/2016 r�S REROOF PERMIT APPLICATION NARROW COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ux 10300 TORRE AVENUE CUPERTINO,GA 95014-3255 (408)777-3228 FAX(408)777-3333•build ina(tupertino.org CLTPERTINO -7 PROJECT ADDRESS" i e APN n OV N'ERNAME PHONE E-MAIL STREET ADDRESSCITY,STATE,ZIP FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑ONNWERAGENT OI\'TRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPERS` 1:1 TENANT LICENSE TYPE , BUS,LIC. �J / COiv*IRACTORNAM LICENSE NUMBER ® {® COMPANY NAME s e E-MAIL FAX , . STREET ADDRESS ,s I C TY,STATE,ZIP I pqi y l�� ARCHITECT/ENGINEERNAME LICENSEN'UMBER I BUS.LIC. COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USEOF SFD or Duplex I-] Multi-FamilyROOF AREA: VALUATION: STRUCTURE: ❑ Commercial �. EXISTING ROOF TYPE: ❑BUILT-UP ROOF 7ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE Lq YFS IF NO, PLYWOOD ❑ '/:" ❑ i PLYWD OSB PITCH: ROOF ❑NO mLA- E THICKAESS: ❑'5/a" ' TYPE; ❑CDX :12 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF �ASPHALT SHINGLES ❑V'OOD SHAKES ❑WOOD SHINGLES El OTHER ICC-ES REPORT R DESCRIPTION OF WORK A ,r� 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 c r ruction. I authorize representatives of Cupertino to enter the above-identified prope for inspection purposes. Signature of ApplicantlAgent: Date: iC li SUPPLEMENTAL IN .. ATIO REQUIRED? oFFzcEsE ol\I IB ,.. If building is associated with a Home Owner's Association,provide letter Ai,CJ�Cx�YPE , �RouTII:c sL� of approval from HOA. `ovxTMu.cPLAa>xEu�� Provide PlaINN nning approval to verify if there any restrictions. Ex REss E ❑ ���I.nn.�r�Anxla«E5 Provide copy of Manufacturer's Installation Specifications. �J sT�� ��� �Y ❑ h Provide signed copy of Cupertino's Tear-Off Policy. ReroofARp_MJ.doc revised 03/16/11 REROOF TEAR-OFF POLICY T COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333• buildinona.cupertino.org PROJECT ADDRESS \ I .;PN OWNERNAMEPHOA'E E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS,LIC,n COMPANY NAME a. ` E-MAIL - FAX STREET ADDRESS !J 17 1CITY,STATE,ZIP O� PHOI y 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 un 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- 2:3 :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 V4"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 oil-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 monoxi d e tors are required to be installed in accordance with Sections R314 and R315 of the 2013 California Residential d +— Signature of Applicant/Agent: Date: ReroofPolicy_2014.doc revised 01115114 W RC IFICATE OF COMPLIANCE OWWRE ERT COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION FIL 10300 TORRE AVENUE o CUPERTINO,CA 95014-3255CUPEKTINO (408)777-3228 W FAX(408)777-3333•building6a0cupertino.or4 n 6 �6 I- C lc%q e: PFRMIT CAL NOT BE RNARJD AND COMPLETED UNTIL THIS CERIWICATE TUS DMANS t�„ � M WWOTNG WV j$ PURPOSE 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. ENEHAL 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 R-314 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: MtIEA SMOKE ALA1zM CO`ALARM Outside of each separate sleeping area in the immediate vicinity of the X X bedroom(s) On every level of a dwelling unit including basements X X Within each,sleeping in room X Carbon Monoxide alarms are not required iii dwellings which do not contain fuel-buming 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 co,runercial power supply,alarm(s)`may be solely battery operated. In existuZg dwelling,whits,alarms are permitted to be solely battery operated where repairs-or alterations;do not result irn the removal of wall and ceiling finishes:or there is:no access by means of attic,.basement or craw space..Refer tol CRC Section 8314 and CBC Sections 907.2.11.4 and 420'.6.2.Am,electrical permit is,required for- alar-in,s which must be connected.to the building,wiring. As owner 4.the above-refereiaced property,I hereby certify that the alarm(s)referenced above has/have>beeL-t= i.nnstaffed{in accordance with the m armfac{arer's instructions and in compliance s pli1ance with the California B;uzldmg and Calif nda Residential Codes.The alarms have Keen tested :n t id.are operational, as of the dale sigrtedk befow.: t have>read and a ree fa com l with tt%ei rm anrL�co�d�2i n of tli%s; tatemenC ,wy _ �r na�ur _.. __.......,................ Dat ...... COYIIT3CIOrIN9pT1.�?: • NCR.................. .... ....................... 2 c/ Shwke and CO)fbimi,dk Ke1dsed 031178%I.'4j WAFER-CONSE'R'VING PLUMBING FIXTURES OWNER CERTIOICATE OF COMPLIANCE F HL E COMMUNITY DE L0,PME "t pARTMENT-BUI_©iNG DtV4atOf CUk° 6t Y:INA 10300 TORR:E AVENWE-CUP RTINO,CA'950'14-3255 408)777-3228.FAX�408J'777-3333,buildirigmpert7ris,org Owner Name .lr �j' (�MA-I Permit No& Address 6664 a I'��� 0' C�teU�Q�`l�t�. �o I Y:: 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 110 1.1 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 form and sign bottom of form. No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do riot apply. Skip the rest of the form and sign bottom of form. �- 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. (,p Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil'Code Sections 1101.1 through-110I..8 apply. Check one of the three following statements and sign bottom of form.. 5. Please check ONE of the following: 14 Myproperty is,a single family residential real property. See Civil Code Section 1101.4. i 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- eornpliant, plurnbimg fixtures shall be replaced with water-conserving plumbing fixtures (regardless of whether property undergoes alterations ornprovements). ❑ Mypropertyis a.mirltifamily residential real property. See Civil Code Section 1101.5. On and after January 1,201,14,.specified building alterations or improvements shall require non-compliant plumbing,fixtures to.be replaced with water conserving plumbing:fixtures. On or before Ianuary 1,20M,all non-compliantplumbing.fixtures shall be replaced with water- conservingplutubing fixtures throughout the building(,regardless,of whetherpropertyurrdergoes alterations or improvements)r. ❑ My,property is a commercial real property. See Civil Code Section 1101.5. On and atter,January, 1,20,14,specified building,alterations or improvements shall require non-compliant plumbing fixtures to be replaced with watereanserving plumbing fixtures. On or before:Ianuary 1, 20119,; all non-compliant plumbing fixtures shall be replaced with water conserving plumbingfixtureslthroughout the building(regardless ofwhetherproperty undergo es alterations or improvements). 1„as the owner or owner's agent of this property,certify under penalty,of perjury that non-compliant plumbing fixtures will.be repl'acedprior,to date.specified above with water conserving plumbing fixtures' ixtures in accordance with Civil Code Sections 1101.1 } through{1 liO1.&,the current California Plumbing Code and Calilforn a Green:Building,Standards Code,and manufacturer's instelllation?requirements„and that the water-conserving plumbing.fixtures comply wrrth the requirements as indicated in the table on the,follbwin .page. e. Owneror Omer Agentis Signature - Dat " 2 Upon,completfngt amid signing this Cert-ifi ate,please return,it to the Building Division in order to final yourbuirding.per. SB407 2015.doc revised 08126/15