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B-2016-2679
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2679 10955 DRYDEN AVE CUPERTINO,CA 95014-4785(356 14 019) DAN ELLIOTT'S ROOFING COMPANY SAN JOSE,CA 95159 OWNER'S NAME: HUANG CHINFU JAMES AND CHING-SHIUN TRUSTEE DATE ISSUED:09/08/2016 OWNER'S PHONE:408-215-8071 PHONE NO:(408)559-7327 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-3$ Lic.#611338 Contractor DAN ELLIOTT'S ROOFING COMPANY Date 01/31/2017 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: REMOVE;TEAR-OFF;INSTALL OSB;COMP SHINGLES-(31 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. 2. 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:$15346.00 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 356 14 019 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 Cupertino Municipal Code,Section 9.18, 180 DAYS FROM LAST CALLED INSPECTION. J { Signature, L Date 0918/2016 Issued by:Kim Dunbar Date:09/08/2016 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 I contractors to construct the project(Sec.70.44,Business&Professions Code). Date: 9/80 /2016• I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 2. l have and will maintain a Certificate of Consent to self-insure for Worker's Compensation,as provided for by Section 13700 of the Labor Code,for the performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. 1 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,Sections 25505,25533 a d 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. .Owner or authorized agent: APPLICANT CERTIFICATION Date:09/8/2016 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 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. Signature Date 09/8/2016 Licensed Si 9 Professional. REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 90300 TORRE AVENUE•CUPERTINO,CA 95014-3255 4t,lP'ERTIN4 (408)777-3228•FAX(408)777-3333•buiiding@cupertino.ora p � I PROJECT ADDRESS '+ a� $ �n APN# r35— - { q 11' t"' OWNER NAME'MI lM'7QI. 1`� - z tT• 1 L-90`7 1 1 I NIAM STREET ADDRESS CITY,STATE,ZIP c 5 D 1 FAX lam., `� °� CONTACT NAME � E—MAIL ' STREET ADDRESS j (� GTiY STATE ZIP FAX -7310-7 13 OWNER 0 owNER-BUILDER 0 OWNER AGENT M CONTRACTOR 13 CONTRACTOR AGENT 0 ARCHITECT 13 ENGINEER 0 DEVELOPER 11 TENANT CONTRACTORN ' i I t / LICENSENCIMB LIE ;TYPE BUS. p LIC: t li /t�tsd� n COMPANY NAME U E- /O /11Gt t/, 4> F - J; . 7-74 STREET ADDRESS ! ! `—K/I •STATEd C' G G J`+ !51 1c 4( !/v-s l `-3 ° ARC=CT/ENGIIEER NAME LICENSE NUMBER 13U&LIC.# COMPANY NAME E MAM FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF © SFD or Duplex 0 Multi-Family ROOF AREA:/� ViALUATION: g� STRUCTURE: [I Comm ercial � l 0 � \ - 3q 10 EXISTINGROOF TYPE: O BuiLT-UP ROOF 13 ASPHALT SHINGLES ®WOOD SHAKES 0 WOOD SH NGL ES 0 OTHER(SPECIFY) REMOVE/REPLACE 0 YES IF NO PLYWOOD ❑%„ 18 PLYWD EI OSB PTrCH: ROOF 13 NO #LAYERS: THICKNESS: 13 518- J TYPE: CS ASS PROPOSEDROOF TYPE: 0 BUILT-UP ROOF 0 ASPHALT SHINGLES 0 WOOD SHAKES 0 WOOD SH Nca F-s ©OTHER ICGES REPORT# DESCRIPTION OF WORK:�0to S-F ) i � I By my signature below,I certify to each of the following: I am the pro owner or authorized agent to act on the property owner's behalf I have read this application and the information I have vided is correct. I have read the cription of Mork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to nil nsttuction. a rize resentatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPI.EM.ENTAL INFORMATION a cs usE of x: " If building is associated with a Home Owner's Association,provide tetter Pr ANCHECK xor s of approval from HOA D 10,WW" 11 cath 13 su nlrr�P arl vri w provide plain g approval to verify if there any restrictions. Q y 1� �i rr�riAla v w Provide copy of Manufacturer's Installation Specifications. CQ-STA fAxu © a Provide signed copy of Cupertino's Tear-Off Policy_ omEx ReroofApp_2011.doc revised 113/16111 Re, e., .i"%-%` I, ? 7--i 9V21/2016 -,-•• , SMOKE I CARROH MONOXIOE ALARM OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT,BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014.3255 (408)737-3228•FAX(408)777-3333-bu+ldfmaO rSno ora /� � Permit No: c)I a Address 5 S �H h J''tJ #of Alarms Smoke.• Carbon Monoxide: PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE. HAS BEEN SMER AND RETURNED TO THE BUILDING DIVISION PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314,2013 CBC Sections 420.6 and 907.211.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi-family dwellings shall be 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 8314 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 ALARM CO ALARM Outside of each separate sleeping area ire the immediate Acinity of the X X bedroom s On ewry level of a dwelling unitincluding basements X X Within each sleeping.room X — 'I - - j 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 combinedwith smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply:Indwelling units with no commercial power supply,alarms)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 them is no access by means of attic,basement or crawl space.Refer to CRC Section R314 and CBC Sections 907.2.11,4 and 420.63.An electrical 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 Califomia Buildig below. n and California Residential Codes.The alarms have been tested and are operational,as of the date signed f have read and agree to with the terms and conditions d this statement Ow ver(or Oww nrs)Name: Vin.eS turati convaaor `h ......... .....:......:.....tom. _....... ......... ......._. axa oas. &-ke and€t)fonmdoc reined 03,,1811* iOVATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTiNO.CA 95014-.3255 (4088)777-3228•FAX(408)777-3333•�niildirxtCaat:u22 tino.org d Owner Name AAAA 3 Wu it yl C, Permit No i Address .�€�=1 s S (7Yvuo4, A>/e, 1. Is your real property a registered historical site? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. No Go to Question 2. 2. Docs your real property have a licensed plumber certifying that,due to the age or configuration of the property or its plumbing,installation of'water-conserving plumbing fixtures is not technically feasible? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. 0 The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. 9k No Go to Question 3. 3. Is,water service permanently disconnected for you building? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. X No Go to Question 4. 4. 1.s your real property built and available for use or occupancy on or before January 1,1994? 0 No My real property is built and available for use or occupancy afkcr 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. Yes My real property is built and available for use or occupancy on gr be 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 followings 14 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 fractures 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 (+egardlas of whether property undergoes alterations or improvements). 0 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 nem compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. On or before:January 1,2019;all non-comlt .liant plumbing fixtures shall be repheed with water conserving plumbing rhoures throughout the building(regardless of whether property underggoes alterations or improvements). 0 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-compliant plumbing fixtures to be replaced with water-conserving plumbing fixturm On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water-consenting plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements), • 1,as the owner or owner's went 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 Code Sections 1101.1 through 1101.8.the current California Plumbing Code and California Green Building Standards Code,and manufacturers installation requirements,and that the water-conserving plumbing fixtures comply with the requirements as indicated in the table on the following e. Owner or Owner Agent's Skjnature: f1a1e Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit, S84072015.doe rr►*m 087&Is cupertino permit docs-2 (1).jpg Page 1 of 1 9121/2016 I (2)11•'s3 5izF I Ng y J, s� T KE _N9 OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95094-3255 (408)j777-3228•FAX(408)777-3333•buiitiina martin am j Address 9 S S b r d�l7 A oz Permit Nin. vLB #of A I trtts moke Carbon oxide 1 PERi4f1T A1V114)T BE l lr1L AtAi L CUiit'LETEll Uiti"IIL T IS CERT'IHCtifTE . a� s PURPOSE __ ..s This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314,2013 CBC Sections 4220.6and 907.2.11.2 to h re na interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi-family dwellings shall be provided with Smoke Alarms and Car Monoxidenoxide alarms. I11hen the valuation bon of additions,alterations,or repairs to existing dwelling units exceeds. $1000.00,CRC Section 8314 and CBC Sections 907,2..11.$and 420.6 require that Smoke.Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA StrOKE ht AKAi Outside of each separate steeping area in the immediate vicinity of the X CO ALARM bedroom(s) X On evrrlt level of a dwelling unit includin basements Within each stee in room X_ X 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 alarms shall CBC Section 4.20.6 and shall be approved by the Office of the State Fire Marshal. comp[y'With Power Supply:In dwelling units with no commercial power supply,alarm(s In existing duelling units,alarms are permitted to be-solely rated}may be solely battery operated. not result in the removatof wall and ceiling finishes or there ist o access by means of attic,basement or crawl when!repairs or alterations do ction spare.Refer to CRC Section 11314 and CHC Se s 907:2.13.4 and 420.6.2.An electrical permit is inquired for alarms which must be connected to the building wiring, As owner of the above-referenced property,.1 hereby certify that the alarms}referenced above installed in accordance with the manufacturers instructions and in compiiance with the California Building e has/have been and California Isidential Codes.The alarms have been tested and are operational,as of the date signed below. LMmer(or ovmwrt's)Ctama; Ifi, read and ree to ca t with the terms and c SondttTans of arts statement 4tGt i t Corttfactat e�isrcei: _. Date. 54rzakg rnsrl Cfl fnr+n:,rinc rettisil3.+`!lt�l https://mail.google.com/, /scs/mail-static/ /js/k=gmail.main.en.RcTlakbpxBg.O/m=m i,t,it... 9/22/2016 cupertino permit does_l.jpg Page 1 of 1 1: F'1 9121/2016 tmage 4dpg q c WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 {408)777-3228•FAX(408)'777-3333•buikiinaft�cuDgrtirtp oro rlwnerName &IAes 4UCt 11 Permit No 6 ,- Address loq�s De,-4 .1— I Is your real property a registered historical site"? a Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the test ofthe form and sign bottom of fort. No Go to Question 2. 2. Does your=1 property have a licensed plumber certi6ing that,due to the age or configuration of the property or its plumbing,installation of water-conserving plumbing fixtures is not technically feasible? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. 0 The licenced plumber's certification has been provided to the Building Division. Skip the rest of the form and-sign bottom of form. Pk No Go to Question 3. 3. Is water service permanently disconnected for your building? Cl Yes Civil Code Sections 1101.1 through 1101:8 do not apply Skip the rest of the farm and sign bottom of form. K No Go to Question 44 4. is your real property buil and available for use or occupancy on or before January 1,;19947 0 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 farm and sign bottom of form. PYes My real property is built and available for use or occupancy on or befam January 1,1994. Civil Code Sections 1.101.1 through 1101,8 apply Check one of the three followitig statements and sign bottom of form., S. Please check QJ E of the following: ! My .property is a single family residential real property. See Civil Coale Section 1101.4. On and after January 1,2014,building alterations or improvvemems shall require all noncompliant plumbing 6xtmes to be replaced with vvatcr-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 (regangess of whether property undergoes shentions or improvements). 0 My property is a multifamily residential real property. Set Civil Code Section 1101.5. On and after January 1.2014,specified building alterations or improvements shall require tion compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. On or before January 1,2014,all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building(regardless of Whether property undergoes alterations or improvements). Cl rely .property is a cvmnter-sial rcal property. See Civil Code Section 1101.5. On and atter January 1,2014,specified building alterations or impitivements shall inquire non.compliant plumbing fixtures to be replaced with watts-conserving plumbing fixtures. On or before January 1, 2019, all tion-cornpfiant plumiiutg firnurrs shall be replaced with water-conserving plumbing fixtures throughout the building(regardless of wbetherproperty undergoes alterations or hul rovemnents). 1,as the owner or ovvticr's agent of this property,certify under penalty ofpequry that ton-compliant plumbing fixture,will be replaced prior to date specified above with tvaler{onservsmg plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101.6,the current California Plumbing Cote and California Green Building Standards Code and mm�ufactumes installation requmrem•rmts,and that the water-ectwerving plumbing fixtures comply with the tequirernents as indicated in the table an the followinge. Owner or Owner Agent's Signature: pee: Upon completing and signing this Certificate,plias return it to the Building Division in otlerto final your building permit, sev7 rats rr,,;s.�r os;zav�,s https:/lmaid google.txanftoMDMnboWI574e399d99101ig?tbrnpose=1570478lao3d73c8{no*cW--1 https://mail.google.com/_/ses/mail-static/ ljs/k=gmail.main.en.RcTlakbpxBg.0/m=m_i,t,it... 9/22/2016