B-2016-2464 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2464
18640 CYNTIBAAVE CUPERTINO,CA 95014-3810(375 22 029) WINTER ROOFING
INC
MORGAN HILL,CA
95037
OWNER'S NAME: SCHMALENBACH UWE AND LENA DATE ISSUED:08/05/2016
OWNER'S PHONE:408-893-8566 PHONE NO:(408)363-8052
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class QENERAL BUILDING CONT TOR Lic.#752097
Contractor WINTER ROOFING INCDate 07/31/2018 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:
I hereby affirm under penalty of perjury one of the following two declarations: REROOF;TEAR OFF;INSTALL COOL ROOF SYSTEM-(19 SQ)
1. 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.
® z: !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:$7300.00
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 ATN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 375 22 029
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 l the granting this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant understands and will comply with all ll non-point
source regulations per th Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 8/5/2016 Issued by:Abby Ay—en—de
Y f Date:08/05/2016
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. 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 inspection.
sale(Sec.7044,Business&Professions Code)
2. I,as owner of the property,am exclusively contracting with licensed Signature ofApplicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:8/5/2016
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER.
1. 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-die 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 C e,Chapte 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 550,,255 ,and
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agent:
APPLICANT CERTIFICATION r Date: /8/5 2016
1 certify that I have read this application and state that the above information is C STRUC(Tk)N INEN Y
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a constructi n 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 8/5/2016 Professional
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228• FAX(408)777-3333•buildingPCUPERTINO —cupertino.org b2t�o-'Z -
—
LIU
PROJECT ADDRESS -7#
all 1/0
OWNER NAME
PHONEE-MAIL
STREET ADDRESS CITY,STATE,ZIP FAX
CONTACT NTAMEP ONE
OE
� E-MAIL.
STREET ADDRESS � CITY,STATE,ZIP FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENTCONTRACTOR El CONAGENT ElARCHITECT 11 ENGINEER ❑' DEVrE�LOPER -❑'TENANT
CONTRACTOR NA E LICENSE NUMBER LICEN TYPE BUS.LIC..-
IC.# s 1 1
COa 2 �Y NAME E-MAIL FAX G.
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STREET ADDRESS CI Y STATE,ZIP ISIS
ARCHITECT/ENGIN€ERNAAIE LICENSE NUMB R BUS.LIC,
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF )R-9FD Or Duplex ❑ Multi-Family ROOF AREA: VALUATION:
STRUCTURE: ❑ Commercial 1 ��� 7, 300
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ZASPHALT SHINGLES ❑WOOD SHAKES WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE RYES IFNO, PLYWOOD ❑ %" ❑ PLYWD ❑ OSB PITCH: ROOF
❑NO #LAYERS: THICKNESS: ❑5/8" TYPE: ❑CDX '12 CLASS:
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT 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 Ovide is correct. I have read the Desc 'tion of Mork and verify it is accurate.. I agree to comply ith all applicable local
ordinances and state laws relating t din onshuctioll. th eprese tives of Cupertino to enter the above-identifi property r •s ection purposes.
Signature of ApplicantlAgent: Date:
_.
' Ofi _ -�
SUPPLEMENTAL INRMATION REQUIRE F(CE,, SEONL�,,,{, „
If building is associated with a Home Owner's Association,p oxide letter PLAIYsxIEcYc rLPE ,, ,; iiouTlNG sTP
Of approval from HOA. {)VER THE COUIITER BUILDING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. I EaPREss n II PLANI�INGPLANREYIE«
Provide copy of Manufacturers Installation Specifications. sTANDARD I� FIRE DEPT
Provide sighed copy of Cupertino's Tear-Off Policy. r OTHER
ReroofApp_2011.doc 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• buildina(a)cupertino.org.
PROJECT ADDRESS APN# )
OWNER NAME PHONE F Lha �71t W E-MAIL
STREET ADDRESS CITY, STATE,ZIP �` FAx
Pei
CONTRACTON7E LICENSE NUMBER LICENSE TYPE BUS.LIC.
COMPANY NA E E-MAIL FAX
STREET ADD SS CITY STATE,ZIP OIQE
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 fiom 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/"per foot of slope and demonstrate there is no ponding.
b. Listvnlgs 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 monox' 7ec./ sare req ' e to be` talled in accordance with Sections R 14 an R315 of
the 2013 California Residential o .Signature Of Applicant/Agent: Date:
ReroofPo icy_2014.doc revised 01115114
3
I
WATER`-CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF.COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
�tIPE6�71`l�tf
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(409)777-3228•FAX(408)777-3333•buildirrrltx_cupectino.orq ��
OwnerNatne l) W S r, 1 U Permit No 4� o!
Address ' G D 6_4 14
1, Isyour real property a registered historical site?
El Yes Civil CodeSections 1101.1 through1101.8 do not apply. Skip the rest of the form and sign Bottom of form,
4it No Go to Question 2;
2. Does your real.property have a licensed plumber certifying that;due to the age or co, guration of the property or its.
plumbing,installation of water bnserving 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 formand sign bottom of form,,
P'No Go to Question.3.
3.. 'Is,water service permanently disconnected far 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.
J�P 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 occtupancy-after January-1 -i-994.---
Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
,'es IViy real propertyis 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:
'rMy 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
property undergoes alterations or improvements).
My property is a multifamily residential real property. See Civil CodeSeefWA 1101.5.
On and after January 1,.2014,specified building alterations or improvements shall require non compliant
l
plumbingfixturesto be replaced.with water-conserving plumbing fixtures.
g On or before January 1,2019,all non-compliant plumbing fixtures shall be replaced with Wvater-
conserving.pAumbivg fixtures throughout the building(regardless of whether property undergoes alteratco,s r �
improvements).
Myproperty .is a commercial real,property. See Civil Code Section 1101.5.
` On and after January 1,2014,specified building alterations or improvementsshall'require non-compliant
plumbing fixtures to Ile replaced with water-conserving plumbing fixtures;
On or before January 1, 2019, all icon-compliat t plumbing fixtures shall be replaced with water= cons- ' g
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 viconserving plumbing fixtures in accordance with Civil Code Sections 1101.1
through=1101.8;the current California-Plumbin ode-a California Green Building Standards Code,and manufacturer?s
installation requirements,and that fhe water- erviri lambing fixtures comply with the requirements as indicated in the
table on the followin e.
Owner orOwnsrAgent's Signature:
i -
Upon completing and signing this Certificate,please return it to the Building Division inorder to final your building permit:
SB407 2015.doe revised 0812611
SMOKE! CARBON MONOXIDE.ALARM
OWNER. CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPi ENT DEPARTMENT-BUILDING DIVISION
CtJPERTIN Ct 10300 TOkRE AVENUE•CUPERTINO,CA 95414-3255
{408)777-3228-FAX(408)777-3333•buildih.g0_crauertino.org
Permit No-6
Address {a L( Q CA4 / #of Alarms Smoke Carbon Monoxide: 1
PERMIT C,A1�OT BE FINAI.tED ANlr►COMPLETEI)'LINTIG THI�CEIt�TCATE
PURPOSE
This affidavit is a self certification for the installation of all required Smoke and Carbon Monoxide Alarms far
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 shallbe 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 Snmke Alarms and/or Carbon
Monoxide Alarms be installed in the following locations;
-<__ - _> = SMOKE AL .__ CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the 7C X J
bedrooms)
On every level of a dwelling unit including basements X _ X
Within each slee:in,room
_.
Carbon Monoxide alarms afenot 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,
I Bower Supply:Indwelling units with no commercial power sup]V __alb=s)maybe solely battery operated.
lit existing dwelling units,alarms are permitted to be solely battery operated-where repairs or alterations do
s 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 must be connected to the builcling.wiring-
As owner of the above=referenced property,I hereby certify that the alarm(s)referenced above k; , lies,
installed in accordance with the manufacturer's instructions and in compliance with the Callfo t �
and California Residential Codes.'The alarms have been tested and are operational,as of the date Ze
below..
1 have read`and agree to.comp&with the terms o diti ns 4t this statement
Owner(or owner Agent's)Name:
�J V ( S /"`9 P�0 P/�6 P' aM Si nature.. .... . .:... .
Contractor Name;
r � PoLl _.�`` _ Si nature......... ...... ......... ...4...........Lie.#. ...._: .. ....... ........Qate: ..>•-.. ........
Smoke and COform.doc revised 03118114