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B-2016-2627 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR; PERMIT NO:B-2016-2627 10092 MANN DR CUPERTINO,CA 95014-1138(326 19 004) JIREH INC LOS GATOS,CA 95031 OWNER'S NAME: WEST JOHN S AND JUDITH R DATE ISSUED:08/31/2016 OWNER'S PHONE:408-320-2390 PHONE NO:(408)298-9399 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B.C=39 Lic.#$9Q74Z X_BLDG _ELECT _PLUMB I herebyaffirm that I am licensed under the provisions o _MECH X RESIDENTIAL_COMMERCIAL Contractor JIREH INC Date 10/31/2017 p ' ' f 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: RE-ROOF;TEAR OFF;INSTALL OSB;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-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. ff TSection 3700 of the Labor Code,for theerform Insurance,as provided for by 2. 4 have and will maintain Worker's Com enation 6`'� performance of the work for which this permit is issued. Sq.Ft Floor Area; Valuation;$7643.00 APPLJCANT CERTIFICATION certify that i have read this application and state that the above APN Number: Occupancy Type: information is correct.I agree to comply with all city and county ordinances 32619004 and state laws relating to building construction,and hereby authorize 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 understands and will comply with all non-point source regulations per the upertino Municipal Code,,Section 9.18. 180 DAL SPECTION. � --" ate 08/31/2015 Issued by: N Signature Date:08/31/2016 oWNER B M DERDECLCLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of the All roofs shall be inspected prior to any roofing material being installed.If a roof is following two reasons; installed without first obtaining an inspection,I agree to remove all new materials for t. I,as owner of the property,or my employees with wages as their sole inspection. compensation,will do the work,and the structure is not intended or offered for sale(Scc.7044,Business&Professions Code) 2. 1,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(See.7044,Business&Professions Code). Date: 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 HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. 2. 1 have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 34of the California Health&Safety Code,Sections 25505,25533,and 25534.. I will Section 3700 of the Labor Code,for the performance of the work for which this maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the permit is issued. Health&Safety Code,Section 25532(a)should I store or handle hazardous 3. 1 certify that in the performance of the work for which this permit is issued,I 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 Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&z Safety Code,Sections 25505,25533,and 25534. Labor Code,I must forthwith comply with such provision or this permit shall 11 be deemed revoked. Owner or authorized agent:aQL-t�___ APPLICANT CERTIFICATION Date:Q$/31/2016 CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance correct.I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued(Sec.3097,Civ C,) relating to building construction,and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments,costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands ARCHITECT'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code,Section 9.18. Licensed Signature Date 08/31/2016 professional i REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•building6Zoupertino.org t IPERTIN© ° o ZG l 1 F0WaNERNAhffi APN#G1l�d✓ $ ' CJ �"'- � -„L_._ PHONE E-MAIL STREET T�nnrcc CITY TATE,ZIP / FAX f� /1, PHO / w� E-MAIL/j W CONTACT NAIQE e'✓ A(r �J'�*SIS rte' Y {� O /`. �'�`"f' � `l �% / ICA ri STREET ADDRESS gg� �-/_j - CITY,STATE,ZIP FAX 171 OWNER ,❑ OWNER-BUII..DER 1,5❑ OWNER? (A/GENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT :❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LIC SENfER LIC !SE TV BUS.LIC.# c COMPANY NAME E- AIL F LAS O CITY,STA ,ZIP -++" / PHO gi g STREET DIZ2E S t J os LICENSE NUMBER BUS.LIC.# ARCHITECT/ENGINEER NAME COMPANY NAME E-MAIL FAX CITY,STATE,ZIP PHONE STREET ADDRESS SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATIO -. d'�/// USE OF STRUCTURE: ❑ Commercial EXISTING ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑-OTHER(SPECIFY) PLYWOOD ❑ '/:" ❑ — PLYWD T OSB PITCH: 4 ROOF 5:�7/>Q � �IFNO, ❑ CDX :12 1, NLAYERS: THICKNESS: ❑ 5/8" TYPE: CLASS: ICC-ES REPOR # PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER DESCRIPTION OF WORK Fmysipaturebelow,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. Ihavereadthis e information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ate laws relating to bui din struct A. I authorize repr sentatives of Cupertino to enter the above-iden'feed operty for inspecti�o f purposes. Date � Signature of Applicant/Agent: SUPPLEMEN AL IN ORMATION REQUIRED u , _If building is associated with a Home Owner's Association,provide letter of approval from HOA. ElovER TicomvTEx ❑�BUIIDIlYGPLItEVIEWI _ om Provide Planning approval to verify if there any restrictions. ❑ Exr> ss ❑ PLArmIGPLAxr xr v�k _Provide copy of Manufacturer's Installation Specifications. ❑ TivDaxny 4 ,0; �,EPTf Provide signed copy of Cupertino's Tear-Off Policy. t � ReroofApp_2011.doc revised 03116111 REROOF TEAR-OFF 'POLICY COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CJPERT1t+I0 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 (408)777-3228 FAX(408)777-3333•building(5-)cupe±ag,orq2-0 PROJECT ADDRESS ' ON? 77NA r /' 3, 122&Am a . OWNER NAME. PHO . (�_ E-MAIL . dJ-3 o-, o STREET ADD SS ° CITY, S E,ZIP b FAX 62PA CONTRACTOR NAME j LICENSE E M Y? LICENS$TYPE BUS.LIC.# ce), 42 /dam - vt� ( 'y/2 Gj ry CO NAME S V G C� E-MAI; 1J ' !d I PAX S n"/R' t STRE ISS CITY TATE, 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/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 8314 and R315 of the 2013 California Residential Signature of Applicant/Agent: Date: _I ReroofPolicy_2014.doe revised 01/15114