B-2016-2372 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2372
19711 BIXBY DR CUPERTINO,CA 95014-3324(369 09 045) JIREH INC
L05 GATOS;CA 95031
OWNER'S NAME: ART FREDERICO DATE ISSUED:07/25/2016
OWNER'S PHONE:408-341-577$ PHONE NO:(408)298-9399
LICENSED CONTRACTOR'S DECLARATION
. BUILDING PERMIT INFO:
License Class GENERAL BLfILDING CONTRACTOR Lic:#800707
Contractor JIREH INC Date 10/31/2017 X BLDG —ELECT —PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing —MECH X RESIDENTLAL_COMMERCIAL
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
I hereby affirm under penalty of perjury one of the following two declarations: RE-ROOF;TEAR OFF;INSTALL OSB;COMP SHINGLES(38 SQ'S)
i. 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.
�^ I have and will maintain Worker's Compensation Insurance,as provided for by
U „
Section 3700 of the Labor Code,.for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$13052,00
APPLICANT CERTIFICATION
certify that[-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 369 09 045
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 l this permit: WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant.understands and will comply with all non-point
source regulation pert e Cupertino Municipal Code,Section 9.18. 180 DAYS + 2 SPECTION.
Signature ` Date 07/25/2016 Issued by: ES MISSANAM
Date:07/25/2016
R-BI F ERDECLARATION
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. I,as owner of the property,or my employees with wages as 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 i, inspection.
sale(Sec.7044,Business&Professions Code)
2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant. -
contractors to construct the project(See.7044,Business&Professions Code). Date:07/25/2016
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF VERINGS TO BE CLASS"A"OR BETTER
x. 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. HAZARDOUS MATERIALS DISCLOSURE
2. I 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. 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 become 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 making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code; ections 25505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. 'i
Owner or authorized agent:' Arllv
APPLICANT CERTIFICATION Date:07/25/2016
certify that I have read this application and state that the above information is CON TRITC]dONLENDING AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a co struction 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 MunicipalARCHITECT'S DECLARATION
Code,Section 9.18. 1 understand my plans shall be used as public records.
Signature Date 07/25/2016 Licensed
Professional
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228• FAX(408)777-3333•buildin cu erHno.or
CUPERTEhC`3 — 20
PROJECT ADDRESS /e • i 9—z) - /
If
OWNER NAME /,/ / c (/
PRONE TOO l E-MAIL
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STREET ADDRESS CITY, TE,ZIP � FAX
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CONTACT NAME PHONE E-MAIL
STREET ADDRESS CITY,STATE,ZIP FAX
j ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT V ONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
60
CONTRACTOR NAME LICENSE VBER LIC NSE TY BUS.LIC.# -
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COMPANY NAME B.
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STREET DRE s CITY,STA ,ZIP ` J PHO
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ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF SFD Or Duplex ❑ Multi-Fatally ROOF AREA: VALUATION:
STRUCTURE: ❑ Commercial QS
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES - WOOD SHAKES ❑WOOD SHINGLE$ El'OTHER(SPECIFY)
A
REMOVE/REPLACE S IFNO, PLYWOOD ❑ '/:" ❑ PLYWD OSB PITCH: ROOF
❑NO #LAYERS: THICKNESS:. ❑5/8" TYPE: ❑ CDX 5—:12 CLASS: A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOFASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT
DESCRIPTION OF WORK:
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 mply.Ith all applicable local
ordinances and state laws relating to bui in strucf A I authorize repr sentatives of Cupertino to enter the above-identified p operty f inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMEN AL IN ORMATION REQUIRED o ,cE,usE t i z�� 5
If building is associated with a Home Owner's Association,provide letter K# PLANMelz YPExovT GSLip?s
of approval from HOA.
I _ ¢r
I�h RDECOIINTERr ❑yBIIITiD GELANREVIEW - +;
Provide Planning approval to verify if there any restrictions,
�X PRESSs`'
❑x STANProvide copy of Manufacturer's Installation Specifications.
❑ FIRE DEPT
_Provide signed copy of Cupertino's Tear-OffPolicy. ® oTIR:t
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
0 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228 FAX(408)777-3333-building aQcupertino.orq
PROJECT ADDRESS APN#
l 6
OWNER NAME �- PHONE E-MAIL
STREET ADDRESS CITY, STATE,ZIP FAX
CONTRACTOR NAME e.P-� LICENS BER LI NSE E B LIG
I /�
COMP
E-MAIL, 4s a FAX
STRE D SS CITY TATE, �"'
° `. Jly PHONE _Z
99
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-
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 7:30-3:30prn(Mon-Thurs)or 7:30-
2:30prn(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 1/4"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 detector are required to e installed in accordance with Sections R314 and R315 of
the 2013 California Residential o
Signature of Applicant/Agent: Date:
ReroofPolicy 2014.doc revised.01115114
Ff"
SMOKE / CARBON MONOXIDE ALARMS.
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•building(@cuperlino org
Address -71 l 13) }G b Per 't No. tlJ�
{ 4 of Alarms Smoke: Carbon mon
oxide:y`"" 7
PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE f
HAS BEEN ST4NtD AND RFT.IRNFD TO THE BUILDING DIVrSION
PURPOSE —-
This affidavit is a self-certification for the installation of allrequired Smoke and Carbo Monoxide Alarms for
compliance with 2013 CRC Section R314,2013 CBC Sections 420.6 and 907.2.11.2 when.e no interior access for
inspections are required.
GENERAL INFORMATION
Existing single-family, and multi-family dwellings shall be provided with Smoke Alar s and Carbon
Monoxide alarms. When the valuation of additions,alterations,or repairs to existing welling units exceeds
$1000.00,CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon
Monoxide Alarms be installed in the following locations:
AREA
-- SMOKE ALAI M CO ALARM
`Outside of each:separate sleeping area in the immediate v d ity of the X X
bedroom(s)
On every level of a dwelli n unit including basements X X
Within each sleeping room X
Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that
do not have an attached garage: Carbon monoxide alarms combined with smoke alar . s shall comply with
CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal.
Power Supply:In dwelling units with no commercial power supply,alarm(s)may be solely battery operated.
In existing dwelling units,alarms are permitted to be solely battery operated where repairs or alterations do
not result in the removal of wall and ceiling finishes or there,is no access by means of a tic,basement or crawl
space.Refer to CRC Section R314 and CBC'Sections 907.2.11.4 and 420.6.2.An electrical'r permit is required for
alarms which must be connected to the building wiring.
As owner of the above-referenced property,I hereby certify that the alarm(s)referenced above has/have been
installed in accordance with the manufacturer's instructions and in compliance with the California Building
and California Residential Codes.The alarms have been tested and are operational,as of the date signed
below.
1 have read and mply with the t r sada.&ions of this statE ment
Owner(or ,Owner age A'S)Name:
Signa ur .....:. ...... .."... .. >- ... Date. ...r/`$..
tt
o frac or Nam
Signature.V,,a�,. ...............Lic.#... i?f��. . ..................Date:
.r..L!?. ...,
Smoke an CO form.doc revised 03118114
„.
WATER-CONSERVING PLUMBING FIXTUR S �I
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•building(r�cupertino.org
jOwner Name A7 ��. fist �� � 772—
I� Permit No.
,Address q de c u
1. Is your real property a registered historical site?
EI-Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form nd sign bottom of form.
tr`ko Go to Question_2.
2. Does your real property have a licensed plumber certifying that,due to the age or configuratio of the property or its
plumbing,installation of water-conserving plumbing fixtures is not technically feasible?
❑ Yes Civil Code Sections 1101.1 through 110.1..8 do not apply.
❑ The licensed plumber's certification has been provided to the Building Division.
;i Skip the rest of the form and sign bottom of form.
/t�rNo Go to Question 3.
3. Is water service permanently disconnected for your building?
El--,Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form nd sign bottom of form.
X1^0 Go to Question 4.
�f
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.
s 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 Pleie check ONE of the following:
" My property 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 i
property undergoes alterations or improvements).
❑ 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 n n-compliant
plumbing fixtures to be replaced with water-conserving plumbing fixtures.
i
On or before January 1,2019,all non-compliant plumbing fixtures shall be replaced with wz ter-
conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or
improvements).
El My property is a commercial real properly. 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 vith water- conserving
plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements).
I,as the owner or owner's agent of this property,certify under penalty of perjury that non-comr liant plumbing fixtures will be
replaced prior to date specified above with water-conserving plurn.g fixtures in accordance .with Civil Code Sections 1101.1
through 1101.8,the cuixrent California Plumbing'Code and Cali rnia Green B ng�Standard Code,and manufacturer's
installation requirements,and that the water-corse g plum ung f
es-M/pl with t�e requirements as indicated in the
table on the followingage.
__
Owner or Owner Agents Signature:
Upon completing and signing this Certific-a-re—,pD-asd retuM it to he Buildm in der f final your bu' din permit.
SB407 015. c revised 08/26/15
BUILDII`�G PELT CANNOT BE FINAT,ED AND,CO�pLETE
CERTIFICATE HAS BEEN T N UNT1,L THIS
�'D RFTiTRED TO TH LDINGDI
EB
Non-Compliant
Water-Conserving Plumbi g Fixture
Plurnbin Fixture (Fixture Complying with Current Code Applic bleto New Construction)
Fixture Type
Maximum Water lJsa e/F ow Rate
Water Usage 2013 CPC Ch. 4
20.13 CPC Ch.4
/Flow 2013 Rate 2013 CPC Ch.4
2013 CALGreen Div. 4.3 2013 CALGreen Div. .3 2013 CALGreen Div. 5.3
Single-Family Multi-Family Commercial
Water Closets Exceed 1.6 Residential Residential
(Toilets) Gallons/flush Single flush toilets; 1.28 gall ns/flush
Dual flush toilets: 1.28 gallons/flush effective fl' shvolume(the composite,
Exceed 1 0
Urinals average flush volume of two reduced flushes and one full flush
Gallons/flush 0.5 gallons/flush
Showerheads Exceed 2.5
2.0
gallons per minute @ 80 psi., Also certified to th—e performance criteria of
gallons per minute U.S. EPA WaterSense Specification for Showerhea s
(A hand-held shower is considered a showerhead.)
For multiple showerheads serving one shower,the mbined flow rate of all
- showerheads and/or other shower outlets controlled y a single valve shall not
exceed 2.0 gallons per minute @ 80 psi, or the sho er shall be designed to
aucets
allow onlyone shower outlet Lobe in operation at a time.
F — Exceed 2.2 gallons Maximum 1.5 gallons per VI/ithin units:
Lavatory per minute O.Sgallonsper minute @ 60
Faucets minute @ 60 psi; minimum . M aximum 1.5`gallons psi
0.8 gallons per minute er minute @ 60 psi;
20 psi minimum 0.8 gallons
per minute @ 20 psi
In common and public
use areas: 0.5 gallons
per minute @ 60 psi
1.8 gallons per minute
60 si
Faucets Exceed.2:2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60
Kitchen per minute 60 psi
Faucets @ 60 psi psi
May temporarily increase May temporarily
up to 2.2 gallons per increase up to 2.2
minute @ 60 psi, and must gallons per minute
default to maximum 60 psi, and must
1.8 gallons per minute @ default to maximum
60 psi 1.8 gallons per minute
Where faucets meeting @ 60 psi
the above are unavailable, Where faucets meeting
aerators or other means the above are
may be used to achieve unavailable,aerators or
reduction.
other means may be
used to achieve
reduction.
1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown,it is not required to be upgraded.
i
I
a •
SB407 201 S.doc revised 08126115
i