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B-2016-1853 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1853 10582 STERLING BLVD CUPERTINO,CA 95014-3834(375 23 027) ROOF ROOFING INC SAN JOSE,CA 95118 OWNER'S NAME: GRIGGS ROBERT E TRUSTEE DATE ISSUED:04/29/2016 OWNER'S PHONE:714-906-0070 PHONE NO:(408)265-9270 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-39 Lic.#687568 Contractor ROOF ROOFING INC Date 07/31/2017 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;BUILT UP CAP SHEET(17 SQS) I hereby affirm under penalty of perjury one of the following two declarations: 1. 1 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 erformance of the work for which this permit is issued. 01-400 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. Sq.Ft Floor Area: Valuation:$6800.00 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 ordinances APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 37523 027 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 expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant gnderstands and will comply with all non-point source regulations p rtino M a Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. 1`natur Date 4/29/2016 Issued by:Abby Ayende 7,- � 0 dow Date:04/29/20162�N W J _ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. 1,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I a e o remove all new materials for compensation,will do the work,and the structure is not intended or offered for ins sale(See.7044,Business&Professions Code) 2. 1,as owner of the property,am exclusively contracting with licensed �I'' iVmture of Applic t: contractors to construct the project(Sec.7044,Business&Professions Code). Date:4/29/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. 1 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. HAZARDOUS MATERIALS DISCLOSURE 2. 1 have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. 1 certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous 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 Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Codg,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 2 0 5 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. 40 Owner or authorized ages . APPLICANT CERTIFICATION Date:4/29/2016 1 certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 4/29/2016 Professional REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333• build in4(51-cugertino.org PROJECT ADDRESS ?1 Z \f 1 r v APN O'ArNERNAME V Q C6 /� l .PHONE E-MAIL STREET ADDRESS `J {`J CITY STATE,ZI FAX �o d� v CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE, ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT COAIRACTORATAME LICENSE S-/ LICENSETYZE BUS.LIC. COMPANY NAME E-MAIL r FAX STREET ADDRESS �n�s 1' CITY,STATE,7';p (:_14 Q-3-1( S-- PHOiv'Fprd� � ARCHITECT/ENGINEERNAME 'i LICENSEI,'UMBERR BUS.LIC: COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF XSFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION:, STRUCTURE: ❑ Commercial 1 ('J C-7 �'40 EXISTING ROOF TYPE: UILT-UP ROOF ❑ASPHALT SHINGLES 11 WOOD SHAKES ❑WOOD SHINGLES El OTHER(SPECIFY) REMOVE/REPLACE' ES IF NO, PLYWOOD ❑ 'h" ❑ PLYWD ❑ OSB PITCH: / ROOF ❑NO m LAYERS: THICKNESS: ❑ 5/S" TYPE: ❑ CDX ` 12 CLASS: A PROPOSED ROOF TYPE: IILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT' DESCRIPTION OF WORK: ✓��(\ I 1 -f ,�J� L-- �xr��f r1r l.� �I� Y••�r 1 � �.l �� � AI o.✓L.�L- By my signature below,I certify to each of the following: I am the property ownCr or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is corre�c. I-hwlrread the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building s eta auth rize representatives of Cupertino to enter the above-identified property for inspection purposes. S ignature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED If building is associated with a Home Owner's Association,provide letter `` PLAA CHECKTYPE" y ROUTIIIG 5LIP3+ ' of approval from HOA. IIP © OVER THE CO�UIITER %i �t�UI1 bII�GP�Ah REVIE« ? r Provide Planning approval to verify if there any restrictions. T 4 E t x g. EXPRESSt]�PL �II�GPLAII RESiE�� { T _Provide cop),of Manufacturer's Installation Specifications. fl >iRFDEPT r x;a } ' m 48 WN Provide signed copy of Cupertino's Tear-Off Policy, z, �.. M, Reroof.4pp_2011.doc revised 03/16/11 REROOF TEAR-OFF POLICY IN., 14 COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERT[Pt0 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228 FAX(408)777-3333• building(d)cupertino.orq PROJECT ADDRESS f� � lI /� I aPN 4 t9gJ OWNER NAME PHONE E-MAIL STREET ADDRESS CITY, STATE,ZIP I FAX CONTRACTOR NAME LIC NSE NUM 4 EER LI y I SE TYPE BUS.LIC.m COMPANY NAME T E-MAIL J FAX STREET ADDRESS ^ {�0,55�� f� CITY,STATE,ZIP \�� fi/� PHONE rA 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- 2:30pm (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 w' h the re-roof policy stated above. I also understand that smoke detectors and carbon monoxide dete rs e q to be ' stalled in accordance with Sections R314 and R315 of the 2013 California Residential Cod � ��• , Signature ofApplicant/Age Date: ReroofPo1icy_2014.doc revised 01/15/14 SMOKE f CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION / CUPERTINa 10300 TORRE AVENUE•CUPERTINO.CA 95914-3255 (408)777-3228•FAX(408)777-3333•buildingCcDcuoertino.aT Permit No. Address ', ' '�'��^ --Aof.Alarms Smoke: Carbrnt Monoxide. PERMIT CANNOT BE FINALF,D AND COMPLETED UNTII,THIS CERTIFICATE ELAS BEEN SI ;f-E:t)AND HLj[iRNI'D TO THE BUILDING 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 R314,2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL.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 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 MX CO ALARM i Outside of each separate sleeping area in the immediate vicinity of theX 1 bedroom(s) on eve level of a dwelling unit includingbasements X Within each sleeping room Carbon Monoxide alarms are not required in 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 commercial power supply,alarm(s)may be solely battery operated. In existing dwelbng 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 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 permit is required for alarms which roust be connected to the building wiring. As owner of the above-referenced property,I hereby certify that the alarm(s)referenced above has/have been l' 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 s i## below. 1 d a ee to corn ! fh the terms and conditions of this statem wt 1 have read an s gfaerEo. ` ...Date 1... y � ` .2 � St tl8ttfrQ• f Can tpf Date: . ... -:.. .............. .tsC.7t.. .x.�..t....... - # t St.n Lure. Srnvi<e and CO jbrm.doe rei iced 03!18114 I WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPEX tfV® 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 / I ( 7 Owner\acne ( 7-3228-FAX(408)777-3333-buiidinatd�cupertino.orG Permit No. Address f C Z. S`�c �'-; � it 33 1. Is your real property a registered historical site? ❑ 'es Civil Code Sections 1101.1 through 1101.8 do not appy. Skip the rest of the form and sign bottom of form. Ole No Go to Question 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-consen•ineplumbing fixtures is not technically feasible? C 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. t 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 sib 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? D 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. dd Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Codi Sections 1 101.2 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. Please check ONE of the following: 17-1 My propem is a single-family residential real property. See 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). Aly property is a multifamily residential realproperty. See Civil Code Section 1101.5. On and after January 1,2014,specified building alterations or improvements shall require non-compliant plumbing natures 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 improverrients). 1Sy prop-rry 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). I,as the omier or owner's agent of this property,certify under penalty of perjury that non-compliant plurnbi4g fixtures will tie 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 iii tatlation requirements.and that the watt.consetvin�=plumbing -xtures comply with tl�requirements as indicated in tl�e table on the following Tage, Owner or owner Agents Signature: �` Date: Uly.)n completing and signing this Cert"ncate,please D&urn it to the Building Division in order to final your bui ding p nrtit. SB407 201526c reused 0$!26/15