B-2016-2871 f
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS; CONTRACTOR: PERMIT NO:B-2016-2871
10847 LINDA VISTA DR CUPERTINO,CA 95014-4748(356 07 036) JIREH INC
LOS GATOS CA 95031
OWNER'S NAME: KAU DERCHANG AND LIN ALICE HWEI-HWA TRUSTEE ; DATE ISSUED:10/06/2016
OWNER'S PHONE:408-533-5005 1 PHONE NO:(408)298-9399
LICENSED CONTRACTOR' RATION BUILDING PERMTT INFO:
License Class CM Lic.#800707
Contractor JIREH INC Date 10/31/2017 X BLDG ELECT _PLUMB
_MECH X RESIDENTIAL_COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing
with Section 7000)of Division 3 of the Business&Professions Code and that my l
license is in full force and effect. JOB DESCRIPTION:
RE-ROOF;TEAR OFF;INSTALL OSB;COMP ROOF SYSTEM(35
I hereby affirm under penalty of perjury one of the following two declarations: SQ-S) t
i. 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
l permit is issued. Sq.Ft Floor Area: Valuation:$15100.00
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 07 036 .
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 Muni ipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
6S'igriature _ Date 10/612016 Issued by:AbbyAm&
Date: 10/06/2016
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 ofElpplicant -
contractors to construct the project(Sec.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. 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
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 9.12and the
s. 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 dented 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 505,25533,and 25534
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. r Owner or authorized agent: l
APPLICANT CERTIFICATION Date:10/6/2016
certify that I have read this application and state that the above information is CON TR TION NDINAGENCY
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 fo�which this permit is issued(Sec.3097;Civ C.)
to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Nme
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 ARCHITECT'S DECLARATION
and will comply with all non-point source regulations per the Cupertino Municipal -
Code,Section 9.18, i understand my plans shall be used as public records.
Licensed
Signature Date 10/6/2016 Professional
x
I
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION,
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
el3PERTthtC3 (408)777-3228 FAX(408)777-3333•building(o)cupertino.org
PROJECT ADDRESS Q✓ V ,7 ��
I APN# i �/
OWNERNAME t' ! V PHONE _z 2 E-MAIL/L
STREET ADDRESS ` CITY, S TE,ZIP
U FAX
04
CONTACT NAME+t""N� .1 PHO E-MAIL�r� w4� coo F
STREET ADDRESS > . CTTYsTATE, g
❑OWNER ❑ OWNER-BUILDER. ❑ OWNER AGENT ! CONTRACTOR ❑CONTRACTOR AGO ❑ ARCHITECT ElENGINEER El DEVELOPER El TENANT
' ..
CONTRACTOR NAME r. I LICENSE VMBER770LIC NSE T - BUS.LIC.#
I
COMPANY NAME " IL E AFAX
J)AA 4-0 `1 j
STREET - DgEESS CITY,STA ,ZIP �, PHO py
-
® T
. ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS:.LIC.#
COMPANY NAME E-MAIL FAX
i
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF [? SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION:
STRUCTURE: ❑ Commercial > /d J !00._
EXISTING ROOF TYPE, BUILT-UP ROOF El ASPHALT SHINGLES WOOD SHAKES ❑WOOD SHINGLES ❑-OTHER(SPECIFY)
REMOVE/REPLACE 511 ES IF NO, PLYWOOD ❑�'/:" ❑ PLYWD I 5KOSB PITCH: 1 4L ROOF
❑NO #LAYERS: THICKNESS: 5/8" TYPE: ❑ CDX '12 CLASS: A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF 13/ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT#
DESCRIPTION OF WORK-
7
ORK��- _
q-12- ne:��6A�ZkES _M4 4& 06,6- ZZ"Mek
i
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 t co'
with all applicable local
ordinances and state laws relating to bui di struct, . I authorize repr sentatives of Cupertino tl enter the above-identified roperty or//inspection purposes.
Signature of Applicant/Agent: I Date:
i
SUPPLEMEN AL IN40RMATIONREQUIRED 3 AazcEusEorrLY ,u. ,
_If building is associated with a Home Owner's Association,provide letter h PLANcnEcxxYPE xovTIN�si�
ofa l from HOA. ) k ,
OVER TH)+rCOD1VTER+
approval ❑ BUILDINGPLANREVIEW
4,3
Provide Planning approval to verify ifthere any restrictions. ExPiu ss "MAPaER
Provide copy of Manufacturer's Installation Specifications. ❑ sTAvDARD ❑ DEPT �'
_ 2, x
r _ i
_Provide signed copy of Cupertino's Tear-Off Policy. ❑ oTaER k
V w �, r tea, z
ReroofApp 2011.doc revised 03/16/11
i
I
t
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIPL
Cups=ATIN0 1-0300 TORRE AVENUE CUPERTINO, CA 95014-3251I5
(408) 777-3228-FAX(408)777-3333•building a(�.cupei ino.orq
I
PROJECT ADDRESS
(� r LS APN#
OWNERNAME /( Ud PHONE (Ib E MAIL
d�7
STREET ADDRESS O ,�,_ f (/`� / \ _ CITY, ATE,ZIP f p FAX
C f{�[[t7 ) V (7ArCn/ F/�►\CAS (BGG, 6+,
+ `y,J`
CONTRACTOR NAMEj LICENSENUMBER (lLIC.NSETYPE BUS.LIC.#
CO NAME E-MAILFAX 10
�j
STRE _AIZ SSCITY TATE, PHONE
+ 3
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.
. f .
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 Haid before another inspection can be
scheduled.
i
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 R 4 and R315 of
the 2013 California Residential j'�
Signature of Applicant/Agent: Date: /
13
l
ReroofPo1icy_2014.doc revised 01115114
f
QFILE
SIMWATER-CONSERVING-PLUMBING FIXTURES J f Fab 11b
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPER`t INO 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255
(408)777-3228,FAX(408)777-3333•building(a�cupertino.org
� f ,Q
Owner Name o /�Ct� ` -A Permit No. //
Address 1 d 0 V 7 C►JN�t'9 L�ply
1. Is your real property a registered historical site?
❑ Yes Civil Code Sections 1101.1 through 1.101.8 do not apply. Skip the rest of the form and sign bottom of form.
09 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.
El The licensed plumber's certification has been provided to the Building Division.
Skip the rest of the form and sign bottom of form.
19 No Go to Question 3.
3. Is water service permanently disconnected for your building?
L-1 Yes Civil Code Sections 110 1.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
X No Go to Question 4.
4. Is your real property built and available for use or occupancy on or before January 1, 1994?
l 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.
C7 Yes My real property is built and available for use or occupancy on or before January 1, 1994.
Civil Code Sections1101.1 through 1101.8 apply. Check one of the three following statements and sign
bottom of form..
5. Please check ONE of the following-
1-1 My property is a single-family residential real property. See Civil Code Section 1101.4.
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).
'i
lt,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 110 1.1
through 1101.8,the current California Plumbing Code and California Green Building Standards Code,and manufacturer's
kinstallation requirements,and that the wate- ruing plumbing fixtures comply with the requirements as indicated in the
table on the following age.
Owner or Owner Agent's Signatur ' Date:
Upon completing and signing t rtificate,please return it to the Building Division in order to final your building.permit.
SB40 7 2015.doe revised 08126115 -
���' G T O�DE ' t LED AND COM�'LETED:UNTIL THIS
CETFCE'TE IFAS3EEN I NED STD 12ETUR1vED TO THE DUIIDING,DIVISTON i
Non-Compliant Water-Conserving Plumbing Fixture
Plumbino Fixturel i ;Fixture Complying with Current Code Applicable to New Construction)
ixture Type Maximum Water U------low Rate
Water usage 2013 CPC Ch. 4 2013 CPC Ch.4 2013 CPC Ch. 4
/Flow Pate 2013 CALGreen Div.4.3 2013 CALGreen Div.4.3 2013 CALGreen Div. 5.3
Single-Family Multi-Family Commercial
Residential Residential
Water Closets ffxceed 1.6 Single flush toilets: 1.28-gallons lush
(Toilets) Gallons/flush Dual flush toilets: 1.28 gallons/flush effective flush volume(the composite,
I
average flush volume of two reduced flushes and one full flush
Urinals Exceed 1.0
Gallons/flush 0.5 gallons/flush
Sowerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of
gallons per minute U.S. EPA WaterSense Specification for Showerheads
j (A hand-held shower is considered a showerhead)
For multiple showerheads serving one shower,the combined flow rate of all
showerheads and/or other shower outlets controlled by a single valve shall not
exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to
allow only one shower outlet to be in operation at a time.
Faucets Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute@ 60
Lavatory per minute minute @ 60 psi;minimum Maximum 1.5 gallons psi
Faucets 0.8 gallons per minute @ per minute @ 60 psi;
20 psi minimum 0.8 gallons
per minute @ 20 psi
In common and public
use areas: 0.5 gallons
per minute @ 60 psi.
1.8al
per er
minute
g
Faucets- 60 psi
Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60
Kitchen per minute 60 psi @ 60 psi psi
Faucets fi May temporarily increase May temporarily
up to 2.2 gallons per increase up to 2.2
P ( minute @n0 psi, and must gallons per minute @
default to maximum 60 psi, and must
l 1.8 gallons per minute @ default to maximum
60 psi 1.8 gallons per minute
Where faucets meeting @ 60 psi
the above are unavailable Where faucets meeting
aerators or other means the above are
may be used to achieve unavailable,aerators or
reduction. other means may be
used to achieve
reduction.
1. ff the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown,it is not required to be upgraded.
i
I
1
SB407 2015.doc revised 08/26115
SMOKE / CARBON MONOXIDE ALARMS �LFIL { '
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
GUPERTtNO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•building c)..cupertino.org
-t PERMIT CANLVOT BE FINAL D kV PIG, EMANIBEEN'
.y,�.� ,max
ffi
'C 0-
ST NI+n �ND RFT 7R,1V>K'b TOS HEIIILDTII�DZYS�ION �
r � €
URPOSE
i
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
�spections are required.
�ENERAL 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
i
$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 X X
the bedroom(s)
On every level of a dwelling unit including basements X X
Within each sleeping room 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 comply with
'CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal.
ower Supply:In dwelling unitswith no corm-rercal power supply,alarm(s)maybe solely battery operated.
--
Irn existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do
of result in the removal of wall and ceiling finishes or there is no access by means of attic,basement or crawl
$pace.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 connected to the building wiring.
i
As owner of the above-referenced property,I hereby certify that the alarm(s)referenced above has/have been
>nstalled in accordance with the manufacturer's instructions and in compliance with the California Building
and California Residential Codes. The alarms specified below have been tested and are operational,as of the
date signed below.
ylA1ddress: 00 e -1, "tii
pz Permit No. 4—2 6 °lam 71
Specify Number of Alarms: #Smoke Alarms: #Carbon Monoxide Detectors:
I have read and agree to comply with the terml and conditions of this statement
Owner(or(O�wner Agent's)Name:-
�C�d1Gt� UTAII,r Signatur .. .. .............Date:
...............................................................
Contractor Name_:
Signatu ..................................................................Lic.# ......................................Date:
Smoke and CO form.doc revised 09/2.7/16