B-2016-2842CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS:
CONTRACTOR:
PERMIT NO: 13-2016-2842
11043 CANYON VISTA DR CUPERTINO, CA 95014-5403 (356 28 043)
SORENSON &
ASSOCIATES
ROOFING INC
BRENTWOOD; CA
94513
OWNER'S NAME: PENG KERN GE AND PATRICIA TSAI TRUSTEE
DATE ISSUED: 09/30/2016
OWNER'S PHONE: 408-753-3728
PHONE NO: (925) 626-7682
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class C Lic. #949$40
Contractor SORENSON & ASSOCIATES ROOFING INCDate 06/30/2018
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:
REROOF; OVERLAY DURA -LAST SINGLE PLY MEMBRANE (22 St).
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
of the work for which this permit is issued.
t"tormance
ave an iil m intain Worker's Compensation Insurance, as provided for by
on 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
Sq. Ft Floor Area:
Valuation: $14132.00
APPLICANT CERTIFICATION
I 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
and state laws relating to building construction, and hereby authorize
356 28 043
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.
Additionally, the applicant understands and will comply with all non -point
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source regulationIs perthe perti o Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Date 9/30/2016
Issued by: Abby Ayende
O •R -B aUER DECLARATION
Date: 09/30/2016
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
ection.
sale (Sec.7044, Business & Professions Code)
2. 1, as owner of the property, am exclusively contracting with licensed
Signa
contractors to construct the project (Sec.7044, Business & Professions Code) �
Date: 9/30/201
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 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. 1 will
permit is issued.
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
of the
3. I certify that in the performance of the work for which this permit is issued I
Health & Safety Code, Section 25532(x) should I store or handle hazardous
shall not employ any person in or 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, Ibecome subject to the Worker's Compensation provisions of the
the Health & Safety Code, Sections 25505, 25533, and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
'���
be deemed revoked. _,,d
wner or authorize agent:
APPLICANT CERTIFICATION `-
Date: 9/30/2016
I 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 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 9!30/2016
Licensed
tUPERTINNO
REROOF PERMIT APPLICA ■ iON
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408) 777-3333 • building(ftupertino.orp
PROJECT ADDRESS
APN
OWNER NAME
PHONE
E-MAIL
n
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STRE ADDRESS
CITY, STATE, ZIP FAX
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CONTACT NAME
PHONE
E-MAII
STREET ADDRESS
CITY, STATE, ZIP
FAX
❑ 0"Aq-UR ❑ OWNER -BUILDER ❑ OWNER AGENT `CONITRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME .: j
LICEilNSCE, NUMB®
LICENSE TYPE
BUS. L
J
COMPANY NAME
E MAIL_1
FAX
STREET ADDRESS
CITY, STATE, ZIPA7
PHONE
UBd r CII r -i
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC.
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or Duplex Multi -Family
ROOFAREA:
VALUATION:
STRUCTURE: ❑ Commercial
EXISTING ROOF TYPE: BUILT-UP ROOF 11 ASPHALT SHINGLES ❑WOOD SHAKES ❑ WOOD SHINGLES E3 OTHER (SPECIFY)
REMOVE /REPLACE ❑YES
IFNO,
PLYWOOD �w, ❑
PLYWD ❑ OSBPITCH:
ROOF
NO
#LAYERS:
THICKNESS: El 51-
TYPE: ECDX
'12
CLASS: A
PROPOSED ROOF TYPE: ElBUILT-UPROOF ElASPHALT SHINGLES ElWOOD SHAKES ElWOOD SHINGLES 2 THER�
_
ICC-ES REPORT #
-.
DESCRIPTION OF WORK:
6
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 comply with all applicable local
ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-identified/property for inspection purposes.
Signature ofApplicant/Age Date: 9_`30 _/4-
SUPPLETAL INFORMATION REQUIRED
_ If building is associated with a Home Owner's Association, provide letter
of approval from HOA.
Provide Planning approval to verify if there any restrictions.
Provide copy of Manufacturer's Installation Specifications.
Provide signed copy of Cupertino`s Tear -Off Policy.
ReroofApp_2011.doc revised 03116111
CUPERTINO
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
(408) 777-3228 • FAX (408) 777-3333 • building(a cugertino.org
PROJECT ADDRESS s
APN
C� &C'Y e Sts r
OWNER NAME PHONE
STREIMADDRESS
CITY, STATF, ZIP
FAX
L Pi P -
CONTRACTOR NAME
LICENSE NUMBER
LICENSE TYPE
BUS. LIC. #
COMPANY NAME
E-MAIL
FAX
VL � _ �Ci• Sia,
S REET ADDRESS
ST TE, ZIP
PHONE
(CITY,
y
-to
12.5 u 99
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 7:30-3:30prn (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 perfonned.
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/" 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 detectors are required to be installed in accordance with Sections R314 and R315 of
the 2013 California Residential Code. p
Signatare of Applicant/ nt: — Date: q —ZD - t �o
ReroofPolicj 2014.doc revised 01/15/14
CUPERTINO
WATER-CONSERVINGWATER-CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE TE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT ® BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
`� (408)777-3228 - FAX (408) 777-3333 $ building(a)-cupertino oro
Owner Nam DZ .v"y� i , . c, Yermit No �' /
Address 'k .0 `z� G/' I�C.
1. Is your real property a registered historical site?
❑ Yes Civil Code Sections 110 1. 1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
No Go to Question 2.
2. Does 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?
❑ 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.
E31 I --
No Go to Question 3.
3. Is water service permanently disconnected for 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.
C),�a 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.
es 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. Please 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
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- 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 with water -
conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations 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- 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 with water- conserving
plumbing. fixtures throughout the building (regardless of whether property undergoes alterations or improvements).
1, 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 Code 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 water -conserving plumbing fixtures comply with the requirements as indicated in the
table on the following Daae. -------
Owner
-----
Owner or Owner Agent's Signature; -i '----�°�� -�-^ -� Dafe: 1 2-2. —f
Upon completing and signing this Certificate, please retur it
the Buildina)7ivi.Rinn in. nreler to finny vnnr bliiirl;na „P,,,,; f
SB407 2015.doe revised 08/26/15
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(afcupertino.org
'#iiftaSnc� Cinlrp r—!� 1 -tea r� tea= ?
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 907.2.11.2 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 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 ALARM
CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s)
X
X
On every level of a dwelling unit including basements
X
X
Within each sleeping room
X
Carbon Monoxide alarms are not required in d ellings which do not contain fuel -burning appliances and that
do not have an attached garage. Carbon monoxde 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
Power Supply: In, dwelling units with no commercial power supply, alarm(s) may be solely battery operated.
ha existing dwelling. units, alarms are permitted to be solely battery operated where repairs or alterations do
not result iia the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl
space. Refer to: CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for
alarms which must be cor ected to the building wiring.
As owner of the above -referenced property, i hereby certify that the alarm(s) referenced above has/have been
11 �' with the manufacturers instructions and Ili compliance 1_ Building
InSta' eu iia accordance wi pllance VWILIa Llle �a11folZala Bulldiiib
and California Residential Codes. The alarms have been tested and are operational, as of the date signed
below.
Smoke and CO fonn.doc revised 03118/14