B-2016-1407 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1407
18816 TUGGLE AVE CUPERTINO,CA 95014-3626(375 32 030) (BUCKS ROOFING)
SAN JOSE,CA 95129
OWNER'S NAME: AYYAR MANI AND RAJESHWARI TRUSTEE DATE ISSUED:02/22/2016
OWNER'S PHONE:4082554161 PRONE NO:4083133429
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C39 Lie.#739593
Contractor(BUCK'S ROOFING)Date 2/22/2016 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(E)ROOF AND INSTALL(N)LIFETIME COMP ASPHALT
I hereby affirm under penalty of perjury one of the following two declarations: SHINGLES-20 SQ'S(NO NEW PLYWOOD)
s. 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.
y 2. I have and will maintain Worker's Compensation Insurance,as provided for
' ---vy Section 3700 of the Labor Code,for the performance of the work for which
this permit is issued. Sq.Ft Floor Area: Valuation:$6500.00
APPLICANT CERTIFICATION
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 375 32 030
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,Section 9.18.
Issued by:PAUL O'SULLIVAN
Signatur - Date 2/22/2016 Date:2/22/2016 "
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
2. I,as owner of the property,am exclusively contracting with licensed Date:2/22/2016
contractors to construct the project(See.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
a I have and will maintain Worker's Compensation Insurance,as provided for California Health&Safety Code,Sections 25505,25533,and 25534. 1 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
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 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:
be deemed revoked. Date:2/22/2016
APPLICANT CERTIFICATION CONSTRUCTIO L AGENCY
I certify that I have read this application and state that the above information is I hereby affirm that there N a constructi ta-I ding agency for the perform ce
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 1 understand my plans shall be used as public records.
Cupertino Municipal Code,Section 9.18.
Licensed
Professional
Signature Date 2/22/2016
REROOF PERMIT APPLICATION W016 -4p
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE CUPERTINO, CA 95014-3255
CUPIE t T (408)777-3228• FAX(408)777-3333-building okupertino.org
PROJECT ADDRESS1 66)83/6 AfL /e ,- APN#
OWNERNAME f PHONE _ y�//' E-MAIL
STREET ADDRESS td CITY, STATE,ZIP / / FAX
CONTACT NAME 1 A / VS PHONE v® -3/3
r°7 Y Y Z E-MAIL
STREET ADDRESS e J-.>)C C4,
, CITY,STATE,ZIP I FAX
El OWNER ❑ OWNEREl AGENT (�CO�yNTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT/❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME I �� LICENSE NUMBER LICENSE!I`YPE3 BUS.LIC.# -
COMPANY NAME U���• a / E-MAIL ``�s FAX
STREET ADDRESS 4 -,A w M1T/, CITY,STATE,ZIP PHONE
ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS.LIC.
COMPANY NAME E-MAIL FAX
STREET ADDRESS CTPY,STATE,ZIP PHONE
USE OF D or Duplex ❑ Multi-Family ROOF AREA: VALUATION�
STRUCTURE: ❑ Commercial 6 5
%
EXISTING ROOF TYPE: ❑BUILT-UP ROOF eo<PHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE�S IF NO, PLYWOOD ❑ 'w, ❑ PLYWD ❑ OSB PITCH: ROOF
ElNO _ #LAYERS: THICKNESS: El 5/8" TYPE: ElCDX :12 CLASS: A
PROPOSED ROOF TYPE: 11BUILT-UPROOF , ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT#
DESCRIPTION OF WORK: r � > ® s/
(NO- d V
_JWG)
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 bu' construction. I authorize representatives of Cupertino to enter the above id tified prope for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMEkTAk1<FOEUjW4 REQUIRED �o
s�..�...���� ff.����.� m
If building is associated With a Home Owner's Association,provide letter -'tet p_ g� ? E �otTuv�st i
s:
of approval from HOA.
pp OVER zooly >xL��tc�lArrRx
Provide Planning approval to verify if there any restrictions, ❑j ExPI�s D pANrLAN$cyEr
_Provide copy of Manufacturer's Installation Specifications. RE-
L] sTAr�tv ] F DP �,r
Provide signed copy of Cupertino's Tear-Off Policy. RW
oTrzi _ ,
ReroofApp_2011.doc 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
h` (408)777-3228• FAX(408)777-3333•building(ca)cupertino.org
PROJECT ADDRESS Au
� APN# U30
OWNER NAME 1 PHONE 2 /
Mel
el E-MAIL
STREET ADDRESS ,/j j j"�., CITY, STATE,ZIP FAX
CONTRACTOR NAME`w,J f' I ),ry �� LICENSE NUMBER 7 LICENSr�Y&E � BUS.LIC.#
COMPANY NAME (VC�J ��pE� E-MAIL "J G' FAX
STREET ADDRESS// (� , {pF�I CITY,STATE,ZIP ,r•%�f 'y
(,S)S f e V ti -`Y / JAj 21 PHONE
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. Z�
Signature of Applicant/Agent Date:
ReroofPolicy 2014.doc revised 01/15/14
CITY OF CUPERTINO t
I
FEE ESTIMATOR-BUILDING DIVISION ,
W!IVVRMIT
DDRESS: 18816 TUGGLE AVE DATE: 02/22/2016 REVIEWED BY:: PAUL
N: 375 32 030 BP#: *VALUATION: $6,500
PE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION
USE: p PERMIT TYPE: 1 SFDWLROO
WORK REMOVE E ROOF AND INSTALL N LIFETIME COMP ASPHALT SHINGLES -20 SQ'S `NO NEW
SCOPE PLYWOOD)
FEE ID ROOF AREA
(S.f.)
1REROOFFRES 2,000
Y.v'L'F J"i'm C 1„G:.%Z. Fj>d F':'3
-Y`,; tY, F_ z t. '�# �'?. ,;c lSaF ue,.
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,eta). 'These ees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l in o.
FEE ITEMS (Fee Resolution 11-053 Ef 77/1113) FEE QTY/FEE MISC ITEMS
Phi,"{."he k./'ee.
'lech""I"'fec
Permit Fee:' _ $340.00
( . .
pp yy `�C:�
Work Without Permit? 0 Yes No $0.00
3;3 V%: p.; rrwTd'''n`r?1 z
Stronf4 Motion Fee: 1BSEISMICR $0,85 Select an Administrative Item
Bld.r S tds Commission Fee: 1BCBSC $1.00
IBT $341.85
. 0
Revise 01/01/2016
w.P ma+o YY Pr�[y P YIr.�.P?YY aFYPJ A�
OWNER,CERTIFICATE OF COMPLIANCEFILE
1
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE Y CUPERTINO,CA 95014-3255 '` ,LC L�7 67
(408)777-3228-FAX(408)777-3333-building(alcupertino.oro
P IZl�IIT CANNOT BF I±NNIXAD AM COMPLETED Ut TIL ,
HM AOS,
THIS CI;l�1 IIt LCAT'
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.
GVNERA L IN FORMATION
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
$1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon
Monoxide Alarms be installed in the following locations::
AREA SMOKE ALAR' CO A:I ANRI
Outside of each separate sleeping area in the immediate vicinity of the X X
bedroorn(sl`
On every level of a dwelling,unit including basements X X
Within each sf eeping room (
Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that
do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with
CBC Section 420.6 and shall be approved by the Office of the State Eire Marshal.
Power'Supp y:In dwelling units with no carni eredal power supply, alarm(s)may be solely battery operated.
In existing,dwefthag.units;alarms are permitted to be solely battery cperated wh ere repairs or alterations do
not result in,the rem,oval of wall and ce l•<< g finishes or there is no.access,by means of attic,basement or crawl
space.Refer to,CRC Section 8314 and CBC Sections 907.2.11.4 and.420,6.2.An electrical perTxu•t is required for
alaxix2s which must be cons,ected to the buil'du1g wiring.
As owner- of the above-rete-renceel property,I hereby, certify that tl.e alar,m(s.)r=efeirenced abo3ive ha,&/lna.e beeLz
in,stalTvd,in=aecordlaxnce with the manufacturer's ms Actio-m and inns cam p)komce with the CaiINorz a Build"t9
amid C'ailtila-ndmR Reskde-vt al Codes.`Fhe allam<< s have,beein tested aSn?.d are aperat omall as,of the dates s gn�edt
b'elbw..
_Blame til eadandrmop!fb)carw•,I'�with.ffie,Berms=andlaw,Aim s,0thrisslate„en:h
_s Gc a ' �nftrll
R
Cb.r��r�cko��"�larriets �
Xf A IT e 0.1 l.�s t$i
.......Dat
Smoke and CO:fbrgiidoe reu1setj03/18/1:4'
OWNER CERTIFICATE OF C*MPUANCE
GOM4NUNITY DEVELOPUENT IMPARTMENT►iBUft-DIN x OVISioON LE
CUPERTINO 103W TORRE.AVEEMUE a CiUPERliMO,CA'95"014=32:'5 T
(09)7-3228•F 8)777-3333 4 buitdinq _ pq�trto org 1, r
Owner Nam f 1'errriit No tU t
Address
1. Is your real property a registered historical site
El es Civil Code Sections 1101,1 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 prop e
g � p p rty 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 not apply. Skip the rest of the form and sign bottom of form.
KNo Go for 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.
,^+'QA, WYes My.real property is built and available for use or occupancy on or before January 1,.199'4.
Cavil Code Sections-1101.1 through,1101..8 apply. Check one of the three following statements and sign
bottom.of form..
�5. Please check 02W of the following:
lvlyproperty is alsi glc ffirsri[�residen al real property. See Civil.Code Section 110'1.4,.
On and after January 1, 2014,building alterations or improvements shall require all ilii-compliant phoitibing fixtures
to be replaced with water conserving plumbing fixtures throughout the building On orbefore January 1,2017,all,non-
"'pliant pliant plumbing fixtures shall be replaced with. water-conserving plummUing frxterres (regazdless of whether
property unde`rgoes alterations or,inprovemenYs.
N1ypropertyisa:muZrfarrrityresdentiaGreadpro�eity. See Civil Code SectionlT'01.5,
air and afterJanuary 1,20'14,specified liarlding alterations or irnproverrreints shall require non-compliant
plumbing.fixtures,fo b e repFaced with.wafer conserving plumbing fixtures.
On or before January l,.20119;a}Ili non-com p plumbi fxtures ahaYl be replaced wird',,water-
conserving plumbing fixtures throughout,the bulid%tig.(regardless of whether, lmdergoes alterations or
improvements-1
❑! My property is a commercialreal property, See Civil Code Section 110'1.5.
Ozt and afrerJanuary 1,2014,spedfeedbur}lding alteratiois orimprovements shall requ2re non-compliant
plumbing fixtures to be replaced with water conserving;plumbing fixtures.
0n or before Januarys 1„ 2913;, all non—com ai�it p1btribing fx- res shall: be rep3laeed with water- conserving
plumbing fioxtares tliirxougFro-d the budding(regandl!ess of whether property und`ergots alterations or impro-serments)�
1,as the owner-or owner's agem of this property,certify under penalty of perjury that non eompliant plumbing fixtures w 11-lie
replaced prior.*to date specisfred above;with water-conserving plumbing fixtures in accordance with Civil Code Sections:110`'1.1
thruagh 11'N.S,the°euirent Californ aPlumbing Code and California Green;Bui+l'ding Standards:Code,,and manufacture-r"s,
insta=llation,requirements,and:that the:water-conserving plum bing fixtures comply with the requirements as indicated in the
table on the�fo11bwiii a_%e�:
OwnlerarE)WnwfAgentt"&Sizgnatu,rie,
Upon,coimpfeting�amd signing this,Ceitiffieat!e,please.return,it o the Building Di visiiati in:order for final:your,U.ui ding.permiat.
SB907201.5.d crevise&0812,61,15