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B-2016-2195 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2195 10136 ALPINE DR CUPERTINO,CA 95014-0939(326 15 104) CALIFORNIA RAINGUARD INCORPORATED SAN JOSE,CA 95112 OWNER'S NAME: LUMINA INVESTMENTS LLC,ET AL DATE ISSUED:06/23/2016 OWNER'S PHONE:650-444-1667 PHONE NO:(408)279-6116 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class ROOFING Lic.#943125 Contractor CALIFORNIA RAINGUARD INCORPORATED Date 02/28/2018 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 Codand that my license is in full force and effect. JOB DESCRIPTION: TEAR OFF;INSTALL OSB;INSTALL COMP SHINGLES(23 SQ'S) I hereby affirm under penalty of perjury one of the following two declarations: 1. I have and will maintain a certificate of consent to self-insu�.e for Worker's Compensation,as provided for by Section 3700 of the Labo 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 by 11 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$13500.00 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 countyrdinances APN Number: Occupancy Type: and state laws relating to building construction,and hereby auth�rize 326 15 104 representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep h rmless the City of Cupertino against liabilities,judgments,costs,and expenes which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City inconsequence of the granting of his permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all n�n-paint source regulations per the Cupertino Municipal Code,Section 918. 180 DAYS FROM LAST CALLED INSPECTION. Signature 4ZDate 6/23/2016 Issued by:Abby Ayende Date:06/23/2016 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License L rw 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 r. I,as owner of the property,or my employees with wages a their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting wi licensed Signature ofApplicant. contractors to construct the project(See.7044,Business&Professions Code). Date:6/23/2016 I hereby affirm under penalty of perjury one of the following threl declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. I have and will maintain a Certificate of Consent to self-in ure for Worker's Compensation,as provided for by Section 3700 of the Lab r Code,for the performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE z. I have and will maintain Worker's Compensation Insuranc ,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. I 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 shall not employ any person in any manner so as to becom subject to the material. Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after m g this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensatio provisions of the the Health&Safety Code cc'bns 05,25533,and 25534. Labor Code,I must forthwith comply with such provisio or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date:6/23/2b16 I 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 ar�d state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize represe9tatives 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 aga+nst liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the ap licant understands and will comply with all non-point source regulations per the C pertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 26/ 3/2016 Professional REROOF PEE? IT APPLICATION N JIM COMMUNITY DEVELOPIMENT DEPARTMENT• BUILDING DIV1510NRomw 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 CUPERT[PIO (408)777-3228• FAX( 08)777-3333• buildino o1cuoertino.orct PROJECT ADDRESSE o` r� A`� I N APN R �7/ pS ^q ON�WER NAME S +� I H .'E _ ( 6 E-MAIL STREET ADDRESS �) •7 � � �L��� `� CRY, STATEZIP5,4� � ��� W4 FAX CONTACT NAME o( PHONE E-MAIL STREET ADDRESS CITY,STATE, ZIP FAX OWNER ❑ OWNER-BUILDER ❑ 0\VNERAGr7P1' ❑ CONTRACTOR ❑CONrR.ACTORAGEN*r ❑ ARCHITHCT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME LICENSENUMBER( f�2`12 C" LICENSETYPEIc-37 BUS.LIC.m COMPANY NAME /`Y J L J FAX STREET ADDRESS q � . I CITY,STATE,ZIPjq,§.��� nA ' �I�� PHON n nci✓!b A-RCHITECTIENGTNL•ERNAAQE LICENSE NUMBER \Yi BUS.LIC:R 6 1 COMPANY NAME E-MPJL FAX STREET ADDRESS I CITY,STATE,ZIP PHONE USE OF SFD or Duplex ❑ Multi-Fami1 ROOF AREA: VALUATION: STRUCTURE: .I] Commercial // Z' 3 , P . EXISTING ROOF TYPE: ❑BUILT-UP ROOF El ASPHALT S 'GLES b OOD SHAKES ❑\VOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACEIfdi ES IF h'O, PLYWOOD D IYl I/i' ❑ PLYWD 2'OSB PITCH: ROOF ❑NO R LAYERS: THICKN S: ❑ 516" TYPE: ❑ CDX �� 12 CLASS'- -UP PROPOSED ROOF T1TE: ❑BUILT-UP ROOF 51PHALT SHI nGLBS ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER I ICC-ES REPORT m DESCRIPTION OF WORK ( �� �,I./�oU�' WnO� S��>a -Lt��T-�ZL-• Z �s� t� fs�.�.�� � By my signature below,l certify to each of the following: I arr 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 hare read the Description of Work and verify it is accurate. I agree to comply�vith all applicable local ordinances and state laws relating t6au ng traction. I a horize representatives of Cupertino to enter the above-idea,led property for inspection purposes. SignatureofApplicart/Aeent: Date: 7_3 SUPPLEMENTAL INIFO!AVIATION R.EQU=D 4 _ OFFICE USE OI�L3 _ s r t tiff: —If building is associated With a Home Ovorier's Association,provide letter PLaI. TSE ` S itou i*,GSLS of approval from HOA. © OVER THE COU\TER FC2r$ �I7�GPL�I��iEF1E�'J� a Provide Planning approval to verify if there any resti ictions. EXPREss fl� MP3...- T---_. REVIE�T�r -�-€: —Provide copy of h1anufacturer's Installation Specific tions. rt W STDARD m❑ � _Provide signed copy of Cupertino's Tear-Off Policy, ) Reroof4pp_2011.doc revised 03/16/11 `REROOF TEA OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERT[NO 10300 TORRE AVENUE- CUPERTINO, CA 95014-3255 (408)777-3228- FAX(408)777-3333•buildina(a.cuoertino.org PROIECTADDRESS I -9?N4- 32(p IS OWNER NAME /t ` PHO1 E .� 1'Qb 1 STREET ADDRESS CITY, STATE,Z1510 n- <;, I FAx J (Zte COv R9CT0RNAh4E LI CENSE NUMBER LICENSE TYPE BUS.LIC. COMPANY NAME /,_ip �� 1N E-1241L FAX STREET ADDRESS (�t CITY,STATE,ZIP( 7S ,ZS I UNDERSTA6 AND AGREE TO THE FOLLOWIT\TG: 1. The re-roof project shall comply wit all applicable provisions of the 2013 California Codes. 2. An inspection request can be sched ed up to one business day before the requested insnection date. Please schedule inspections online o� call (408) 777-3228 from 7:30-3:30pin(Mon-Thurs) or 7:30- 2:30pm (Friday) to schedule inspect on. 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 hou s 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. y 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 rem,ved prior to this inspection. 4. If plywood is installed, a plywood Nailing Inspection is required. 5. Roofing shall not beapplied withou first obtaining all prior inspection and written approvals from the building inspector. Any roofing w ch is applied without first obtaining an approved inspection will require the removal of all new mateial 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 t 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 lywood nailing inspection and the work is not complete, you will be charged are-inspection fee. The re-inspection fee shall be paid before another inspection can be scheduled. By my signing below, I certify each of the fol owing is true: I am the property owner or authorized agent to act on the property owner's behalf. I understand and agiiee to comply with the re-roof policy stated above. I also understand that smoke detectors and carbon monoxide detec s are required to be installed in accordance with Sections R314 and R315 of the 2013 California Residential Code. f Signature of AppIicant/Agent: Date: Z3z K Reroo1Po1icy_2014.doc revised 01/15/14 Fft, I R-CONSERV ING PLUM13ING FIXTURES MAMIER CERTIMCATS OF`COMPLIANCE r p r M,-3265 77 �*�. FAX ry i �q �`4 j`t � L +'a'P. 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