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16010047 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10753 W ESTATES DR CONTRACTOR:A-1 ROOF PERMIT NO: 16010047 MANAGEMENT AND OWNER'S NAME: MALIK SANJEEV AND BHUVANA 14100 DOOLITTLE DR DATE ISSUED:01/07/2016 OWNER'S PHONE: 5102102854 SAN LEANDRO,CA 94577 PHONE NO:(510)347-5400 JOB DESCRIPTION:RESIDENTIAL COMMERCIAL LICENSED CONTRACTOR'S DECLARATION ❑ ❑ REMOVE(E)ROOF TILES;INSTALL 30#PAPER AND(N) License Class3,t-3�T Lic.# l ASPHALT COMP SHINGLES-8 SQ'S Contractor-A-1 ►-ai ma r.4- Date 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: 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. Sq.Ft Floor Area: Valuation:$4800 - � 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 APN Number:36923027.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPE TON. 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 Issued by: Date: ® with all non-point source regulations per the Cupertino Municipal Code,Section mqu 9.18. RE-ROOFS: Signature _R:: Date 1 '� 1 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 inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: % , Date: 1! 1(r I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(See.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent:�-T, Date:l/-7 permit is issued. 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 CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date ,k d REROOF PERMIT APPLICATION II! 2 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUP ERTIN0 (408)777-3228• FAX(408)777-3333•building(Wcupertino.org PROJECT ADDRESS r APN# 10-7 S 3 � � S5AockS b 6 v-e OWNERNAME PHONE E-MAIL __7STREET ADDRESS CITY, STATE,ZIP FAX CONTACT NAME PHONE E-MAIL Ica �Gf( !i�u STREET ADDRESSCITY,STATE,ZIP FAX �i+tcs� 7v t -1--jkZ"t>s . T"n Le-Are.A,-,0 C-A 1+-ts-77 ❑OWNER ❑.OWNER-BUILDER ❑OWNER AGENT LZ3-CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC.# atg iA 1 912-9ISI.1 BIC-3-1 I C-SI COMPANY NAME E-MAIL FAX A-1 ksraC t'yla rVu-.,-t- 1.if e nro� L-e✓ _S1 b 3w'7 SLI o I STREET ADDRESSCITY,STATE,ZIP Q '1-1 !9--7-7 PHONE t-11 o+t TIN-71Q, .'C`r4 -l*' c+J,n✓i L_@ 'eJ'.' '1-@ 5-7"7 S1© 3"x`7 S11 0D ARCHTTECT/ENGINEERNAM t t LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: wo STRUCTURE: ❑ Commercial - EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑.WOOD SHAKES ❑WOOD SHINGLES OTHER(SPECIFY)P-130,C 'T Lk REMOVE/REPLACE YES IIFNO,. PLYWOOD ❑ %/: ❑ PLYWD ❑OSB BITCH: �.. ROOF ❑NO #LAYERS: ( THICKNESS: ❑ 5/8" TYPE: ❑ CDX- '12 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT DESCRIPTION OF WORK: 1 r S4--"li u S 0 1 o 5 l i e x`I v -tl-;Le r-a v✓ ON-\-t5 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 construction. I authorize representatives of Cupertino to enter the above-identified roperty for inspection purposes. "i Signature of Applicant/Agent: `��_ Dater l tI SUPPLEMENTAL INFORMATION REQUIRED _10F ja ox�zc tsE pNI Yifi " K m t If building is associated with a Home-Owner's Association,provide lettere of approval from HOA. OVEi�I3E-�OIIIVTE� ' ���sITAv��Irt�tl�v�z�E ^` _Provide Planning approval to verify if there any restrictions. 4p E s a C p p� y y T OR r Provide copy of Manufacturer's Installation Specifications. p sTA�vnAxn p Frgi nurTt ' ENT z Provide signed copy of Cupertino's Tear-Off Policy. jj ReroofApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10753 W Estates Dr DATE: 01/07/2016 REVIEWED BY PAUL APN. 369 23 027 BP#: *VALUATION: 14,800 PERMIT TYPE: Minor Building Permit i PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex PENTAMATION USE: _ p PERMIT TYPE: 1 SFDWLROOF WORK Remove E roof tiles; Install 30# paper and N asphalt comp shingles - 8 S 's SCOPE FEE ID ROOF AREA 1REROOFFRES 800 > <ie'i'12, i�lirrg(f..c� 1' ee Alan CliecA, �ja,<." .n 711 - F .i>..f�Ct,SZ?L/i'>i'>. a ddd nb,P,w .n fi,. ce Ins" ''Raab Irs Fee: f ee: NOTE.This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These ees are based on the relimina information available and are only an estimate. Contact the De t or addh7 info, FEE ITEMS LFee Resolution.L1-053.Lf. 7/7,113 FEE QTY/FEE MISC ITEMS LJ Permit Fee: $136.00 Work Without Permit? 0 Yes (F) No $0.00 I ravel D, Strong Motion Fee: IBSEISMICR $0.62 Select an Administrative It 131da,Stds Commission Fee: IBCBSC $1.00 SUBTOTALS $137.62 $0.00 TQTAL FEE; $137.62 Revi d: 01/01/2016 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ALBERT SALVADOR,P.E., C.B.O., BUILDING OFFICIAL Gtl P IW dTCMiCd 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228-FAX(408)777-3333•building(cDcupertino.org PROJECTADDRESS # neA i(3'�S� WASE S -t S �b v 3 (1AC__1 OWNERNAME, PHONE E-MAIL ��� � ``/lw�`t� S1q 21C>• 2�� STREET ADDRESS CITY, STATE,ZIP FAX 10`7 S j W C 5 �teS eve Ciu -e+'}�yip cA '3 S-0 I�'1 CONTRACTOR N ME LICENSE NUMBER LICENSE TYPE BUS.LIC.# !za s 2-1 3 9 F, C-3-1 zC"33 COMPANYNAME _ E-MAIL FAX A—I I�--crop mA rr-�., 9 e r1� '� Q r -vy-2 f - C-a v--, V O 3-`7 SI--i o i STREET ADDRESS CITY,STATE,ZIP 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. $/ Signature of Applicant/Agent: Date: ReroofPo1iey_2014.doe revised 01/15/14 SMOKE/CARBON MONOXIDE ALARMS FILE OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPE I 0 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228-FAX(408)777-3333•buildin cU rfino.or Permllr Ivy, 1�c)jo0 Address ' '#of Alarms Smoke: Carbon Monoxide: PE.RI,IIT CANNOT BE,PINALED AND COMPLETED ED f ' 'IL TIHS CERTMCAT ITS BEEN51 .AND ELIWED,TOT I DING DIVISION PURPOSE This affidavit is a self-certification for the installation of all required Smoke 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. GENERAL INFORMATION Existing single-family dnd 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 8314 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 X X bedroom(s) I On every level of a dwelling unit including basements X X Within each sleeping rosin 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. Poorer Supply:In dwelling units with no commercial power supply, alar-(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 meats of attic,basement or crawl space.Refer to CRC Section 8314 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,l 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. 1 have read and agree to comply the terms and conditions of this statement Owner(or Owner Agent's Name: Signature................ ....Date. Gontractr Name: Lic. .....,... 2 Signature...... Date: Smoke arta C?form.doc revised 03115114 WATER-CONSERVING PLUMBING FIXTURES FILE OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTI NO 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 (408)777-3228-FAX(408)777-3333•buildingp_cupertino.org Owner Name See¢V I�c��',1,� Permit Noy o`� Address t 1 S 'b W 2S kS t 4-e S Dr. 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. C) ❑ 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 not 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. Ell ❑ 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. Check one of the three following statements and sign bottom of form.. 5. Please check ONE of the following: ropMyP eriYis a single-family residential real property.YSee 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). 0 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 shallbe 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 11.01.5. 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). 1,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-con ry plumbing fixtures comply with th'requirements as indicated in the table on the following page. Owner or Owner Agent's Signature:t 1 Data: r` S 1 l I b Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit. SB4072015.doc revised 08/26/15