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B-2016-2405 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2405 20640 RODRIGUES AVE CUPERTINO,CA 95014-2965(359 11 016) R E ROOFING AND CONSTRUCTION INC SAN JOSE,CA 95124 OWNER'S NAME: SULAVER MARLENE M TRUSTEE DATE ISSUED:07/28/2016 OWNER'S PHONE:510-516-8986 PHONE NO:(408)626-9320 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic.#727599 Contractor R E ROOFING AND CONSTRUCTION INC Date 09/30/2016 X BLDG _ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH X RESIDENTIAL_COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: RE-ROOF,TEAR OFF;NO PLY;INSTALL LIGHT WEIGHT TILE(ESR I hereby affirm under penalty of perjury one of the following two declarations: 1017)(35 SQ'S) 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 ch this t is a 2performance of the work for 2. 1 have and will maintain Worker's ompenssation1Insurance,as provided for by r Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$22000.00 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 ordinances APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 359 11 016 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 a_qainst said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additio F the ap licant�u nds a�dauilLcomply with all non-point sourc. regulations- .:The Cupertin unicipal Co e,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signatur ' /2 / 1 Issued by:M I77 /` ` Date:07/28/2016 OWNER-BUILDER DECLARATION v 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 insta a ou fir t obtain' an inspection,I a ee to remove all new materials for compensation,will do the work,and the structure is not intended or offered for rion. sale(Sec.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature ofApplic t: / contractors to construct the project(Sec.7044,Business&Professions Code). Date 07/28/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER r. 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 conta ' ants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will aintain co pliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Ileal &Sa Code, ec i ns 25505, 5533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. O er or authori a :age _ APPLICANT CERTIFICATION Date: 7 2 2 1 I certify that I have read this application and state that the above information is I EN Y 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 07/28/2016 professional REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTiNt (408)777-3228• FAX(408)777-3333•building&cupertino.org 13 Zo c) PROJECT ADDRESS OWNER NAME c 9 11A4NE �✓ /- ` E MAII STRFET ADDRESS CAA (: h�f ! 11 CITY,STATE;ZIP , I ) FAX tt CONTACT NAME PHONE E-MAIL �pL i� du @� �rJ _ �� 1 � ` f �Ifrf�Ol�11t C'tiyy.� STREET ADDRESS C � I i ITY,STATE,ZI _ v p,� ��t "9 FAX 44- 6,u110- of g 0 ❑OWNER ❑ OWNER-BUILDER OWNERAGENT / <INTRACTOR ❑:CONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME i �/ � t� / LICENSE NUMBER �q q q LICENSE TYPI BUS.LIC.# ( ( r COMPANY NAME ({��!' ( d v� L {{ yy Xry!Y pq i C �l>hA_,01 1 4 C EMAIL t 4rG6 FAX STREET ADDRESS ` CITY,STATE,ZIP S - °rt e PHONE K l fi o AAW LILLj ARCHITECT/ENGINEER NAME LICENSE NUMBER 7 BUS.LIC.'#� COMPANYNAME \ E-MAIL FAX — STREET ADDRESS \\ CITY,STATE,ZIP - �, PHONE list OF SF r Duplex ❑ Multi-Family ROOF AREA: VALUATION: 11 STRUCTURE: ❑ Commercial /J(� EXISTING ROOF TYPE: 11 BUILT-UP ROOF 1,ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACEe6YES IF NO, PLYWOOD 11w, ElPLYWD El OSB PITCH: ROOF ❑ NO #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑CDX { :12 CLASS: A, PROPOSED ROOF TYPE: El BUILT-UP ROOF El ASPHALT SHINGLES El WOOD SHAKES 11 WOOD SHINGLES /6QTHEI�I ICC-ESRE 0R� .. DESCRIPTION OF WORK: 47r^ _ ,/ �- �r 1,A ) d , r r q kc - 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 e vided is correc ead the Description of Work and verify it is accurate..I agr to comply with all applicable local ordinances and state laws relaf to build" c .frac on. I autho ' e r esentati'v spertino to enter the above-i entifi property for inspection purposes. Signature of ApplicanUAgent: ��' Date: SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE'ONLY _If building is associated with a Home Owner's Association,provide letter PLANciiECxTIF ,' ouT�Ncsi m of approval from HOA. H-COUNTER ❑ BUILDING PI AN REyzEi , Provide Planning approval to verify if there any restrictions. EXPRESS Raw. : ` Provide copy of Manufacturer's Installation Specifications. p sTA� iz� FM DEPT" Q- Provide signed copy of Cupertino's Tear-Off Policy. � OTH z ReroofApp_201Ldoe revised 03116111 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 CUPERTINO (408)777-3228-FAX(408)777-3333•building(cDcupertino.org PROJECT ADDRESS /t / -n At APN# f � (P �" OWNER NAME_�jk�;� { / 0 A- PHONE l U / i E-MAIL STREET ADDRESS V�((v CITY,STATE,ZIP euy ` r FAX CONTRACTOR NAME�a i i y s LICENSE NUMBER 17Z j I I LICENSE TYPE(ma'S� BUS.LIC.# 2_0( j{ COMPANY NAME �j l�r��y / (� / / c (r t✓ f !`1 L;.� E-�'n" ,�° STREET ADDRESS Q� L'` CTTY,STATE;ZIP �fi�J 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/"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 behalfnzler ttand and agree to comply with the re-roof policy stated above. I also understand that smoke detectors and carbon monk*de detecto r-e,.equ' o e installed in accordance with Sections 314 and R315 of the 2013 California R sldential Cod . Signature of Applicant/A�.t: � Date: � �-4 t ReroofPolicy_2014.doc revised 01115114 1 OKE JGA N" IFIL 1 COMMU'NITYDEVEL`O:RMENT.aEPARTMENT>-BUILD`ING DIVISION 10300 TO.RRE AVENUE,GUPERTINO =CA 55014-8255 (408)777-3228 FAX x 4`08)777-33331 h-,U diq-qA-guperk no org r 2q0*'( j*' FURPOS>✓ 'Ellis affidavit's 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 interi r access.for illzspecho-ns arerequi_red. GE RAL INFORMATION Existing single family and multi-family dwellings shall be provided with Smoke Alarms and Carbon Menwdde alarms Wien the valuation of additions, alterations,or repairs to existing dwelling units exceeds $10000,CIBC Section 8314 and CBC Sections 907.2.11.5 and:420.6 require that Srnolee Alarms m, id/or Carfio7 Mon vide Altar ns be installed in the following locatiof s: A SA SMOKE AtAFMACoF ALA GuEsnde of each separate sleeping area inlfik immediai e vicLnFty of the _ bedpggo ,(g, C7newer level,of a dwelii -unit includiri .kasemeni s - X fiNfthM each:slee Ing,roari� x X 6"o cars, l . 're C �- G�v Carboy Tvlon© Yde alar m r s a>e not requi,•e,<rn dwellings which do Mitt contain { el burning appl antes an hat do nflt Piave an attached garage. Carbon mo>to ide alarrnis combiined with sn robe alarms sTnlall dotn Cply vrth CBC Sec io i=42.0'6 ai d sl`lall b e atppT.oved by the Office of,the State Fire Ivlarshal. P'owe'r Svippliy::In dwel'1`u g units wiffiN no)commnercial power'supply,alar,, (0 inay ,-be salely B ery nperafecl.. In,,e-Afsfim%, <rwell'ing>Ut is alarms are s�errnrfted to be solely batfe>y operatedt where rep�a{{irs of afions do p r ter. i; nut res-ftik i0 the removal cd wa I'anid ceili2lg,finishes%;there;is mD a:.ccess by means of atfrc,braselu�ent or, crawl space.,Refer to CRC Sectiml R3,14 2 21d CBC Sections 9077.2..11.4 and 42<..6-2..Ant electrical per:m,"t r r ox �s� equi ed f t,, alarm&vd6e h irust be coruiecfed:tottrhE e huill d in.- wining;. As owner of the above referenced property,11,1,er eb, certify that fT1e alanin(s).r..e€erenced ab:orve Q 1as/,%6ave b-eeil; instal-Ted in ac:cordaLtce with the moirtufactixrer`s instructions,and iR co.,,mpDance with the Cal o>ni a=B.0 ld iib and C2ia:Residential.Coil==.es.. Me altal,mms Tuve been tested an-,id.are,op:erat, oi1}al,as of tkie d -,,t e:sighed Melo ., {- 1,taaver read and a ree om l'aF�auifh fh>: :t'er and coadifJ.cins,ar th sta(erraer�f r ` �FR. IT OV n rur' - Ute y L fit...,atCiFe. ..........;. � Det WATER-CONSERVING PLUMBING FIXTURES �� OWNER CERTIFICATE OF COMPLIANCE -, ✓t COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTIINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408) 77-322 (408_)777- 333•building(a-cupertino.org Owner Name,( Permit ll e r �T Address r , 40 1. Is your real property a registered historical site? El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. ID 0 No Go to Question 2. 2. Does your real property have a licensed plumber certifying that,due to the age or configuration of the p perty'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. IN No 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 and sign b ttom of form. D-9 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. E] R Yes— My real propertyis-built-and--available for-use-or occupancy-on-or before-Jauuary ,-1994-- --- -- Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statem nts and sign bottom of form.. 5. Please check ONE of the following: LlM roe is a single-familyresidential real roe See Civil Code Section 1101.4. �� � Yp property property. On and after January 1,2014,building alterations or improvements shall require all non-compliant lumbing 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 (reg ar ess of whether 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 non-compl ant 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 alter Ltions or improvements). ❑ My property 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-compl'ant 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 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 ode 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 wer-c ing plumbing fixtures comply with the requirements as indicated in the table on the following page. Owner or Owner Agent's Signature" D'al 1; - O 16 Upon completing and signing this Certificate,please return it to the Building Division in order to final you'building permit. SB4072015.doc revised 08126115