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B-2016-3205 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-3205 942 BROOKGROVE LN CUPERTINO,CA 95014-4668(375 39 032) J E JOHNSON • ROOFING SAN JOSE,CA 95132 OWNER'S NAME: TSENG NIEN-HUNGAND CHEN''YUNG-FEN TRUSTEE DATE ISSUED:12/05/2016 OWNER'S PHONE:408-823-6179 PHONE NO:(408)876-9630 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C39 Lic.#998269 Contractor JE JOHNSON ROOFING Date 10/31/2018 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: -ROOF;TEAR OFF;INSTALL TPO MEMBRANE-(20 SQ) 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 6 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:$7000.00 APPLICANT CERTIFICATION 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 375 39 032 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 oflthis permit. itWITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,theapplicantunderst:nds and will comply with all non-point source regulations per the• pe no Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. SignatuDate 12/5/20.16 Issued by:Kim Dunbar Date: 12/05/2016 OWNER BUILDER DE( ARATION 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, agree to remove all new materials for for ins'-ctio-. sale(Sec.7044,Business property,Professions Code) g �'� compensation,will do the work,and the structure is not intended or offered 2. I,as owner of theam exclusivelycontracting with licensed �-Signature ofApplican• • contractors to construct the project(Sec.7044,Business&Professions Code). Date:12/5/2016 /• 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 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 9.12 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 Cod ,Sections 25505, 5533 and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall / be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date:12/5/2016 I certify that I have read this application and state that the above information is _ •UC ON LE I IN e AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is e.nstruction le g 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. I understand my plans shall be used as public records. Licensed Signature Date 12/5/2016 Professional REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 UP R FtT` (408)777-3228• FAX(408)777-3333•buildinq(aIcupertino.orq 110l —3 20 PROJECT ADDRESS Ct l �NJ V 3 OWNER NAME )r� PHO E-MAIL STREET ADDRESS t c� CITY,STATE,ZIP 9,"t rla 13( 6 O cd' Wel Cc re i c9 FAX CONTACT NAME y C�? PHO )irt�R2 NEf,� f i � E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑ OETEER ❑ ORX*ER-BUILDER 0 OWNER AGENT CJ CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGLO'EER 0 DEVELOPER 0 TENANT CONTRACTOR NAME _ { � LICENSE NUMBEI$8 9 LICENSE TYPE 9 BUS,LIC. y COMPANY NAl 7E L. j" , R4707-174, E-?4AII i L"`36 f -At S r 1 4 C O 4..0 di FAX CZ P 1 STREET ADDRESS STC. PHONE y/�"� ��„� CITY.STATE.ZIP ARCHITECT/ENGINEER NAME LICENSE NUMBER - BUS.LIC. COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF SFD or Duplex IT 14tiFama,ily ROOF AREA: • STRUCTURE: 0 Commercial aQd 0�UI EXISTING ROOF TYPE: ZJ BUILT-U-P ROOF 0 ASPHALT SHINGLES 0 WOOD SHAKES 0 WOOD SHINGLES —0 OTHER(SPECIFY) REMOVE/REPLACE i S IF NO, PLYWOOD 0 'A" 0 PLYWD ❑ OSB PITCH: ROOF 0 NO 4'LAYERS: THICKNESS: 0 5/8" .1 TYPE: 0 CDX :12 A CLASS: PROPOSED ROOF TYPE: 0 BUILT-UP ROOF 0 ASPHALT SHINGLES 0 WOOD SHAKES 0 WOOD SHINGLES 0 OTHER. PO ICC-ES REPORT r DESCRIPTION OF WORK: YYj.96/Q- ek-( d e` ur � ^ 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 corm t. 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 cons., c,'on. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: J+ Date: 6- – j- SUPPLEM,N/AL INFO° .r TION REQUIREDl 80'k isE;ONIVQ .M. 1. . 3 If building is associat-`e with a Home Owner's Association,provide Ietter ` PLANCxECKTYPE ,x .ROUTING sLIP of approval from HOA. VEri OVER THE COUPTER ❑ $UDIAG:PLAX REVI ILEW Provide Planning approval to verify if there any restrictions. � E3iPRESS �� fl PLA'\I�II�G PLA' RE�'IEW� Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTxER � Y F Reroof pp_2011.doc revised 03/16/11 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION s.ePin ALBERT SALVADOR, RE., C.B.O.,BUILDING OFFICIAL UFERT[NC3 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333• buildinq(a�cupertino.orq PROJECT ADDRESS n ��??? / f )h �"td 6Co0 ro c/e_ Celt �, APN a 79 OWNER NAME n J / E-MAIL IVVV - -e / 15 I �� /Ai iv/ PHorte^ go`tJ J eFIYI/lSonl2 r•t (t IYN- STREET ADDRESS / / CITY, STATE,ZIP /tJ //�T �� Q 67'1 fl' BP9oiej L/� �� it l c)1`e (Cn FAX CONTRACTOR NAME /LICENSE NUMBER LICENSE TYPE BUS.LIC,r / (42 Liz / COMPANY NAME � ` E-MAIL ' ' j57000 I"." n / � �? SLSc�a JCJ� N?" FAX STREET ADDRESS / ✓ -L CITY,�� STATE,ZIP S ��2> 2r�� I1►� say -� s e 3 - PHON s 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/"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 R3 15 of the 2013 California Residential Code. Signature of Applicant/Agent: Date: ReroofPolicy_2014.doc revised 01/15/14 • 1216/15,11:59 AM please sign it asap—pdf 1 /1 F srzoKE/CARBON-MONOXIDE ALARMS 11d" N.,14,4f OWNER CERTIFICATE OF COMPLIANCE COMMUNHYDEVF_LOPMENT DEPARTMENT*BUILDING*IVISION CLIPERTItid. 103e9 TORRE AVENUE*CUPERTINO.GA 95014-3255 (408)777-3228 4 FA)((408)7174333 buticHnotectaseninoorn 3() kos-Admoo,_ Itch Kt).:447,vww.14__Tail.-?1,:, PURPOSE affidavit n7.a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section re14,2013 CBC Sections 420.6 and 9072.11.2 whereno interior access for inspections are required. GENERAL INFORMATION Existing and muld-family dwellirsgs shall be provided with Smoke Alarms and Carbon • Monoxide alarms,'When the-Valuation of additions,alrations,or repairs to existing dwelling unift exceeds . $1000.00,ac Section R314 and CBC'Sectioris 907.2.11.5 and,420,6 requim that Smoke Alarms andior Carbon MonmddeAlarms beinitalled in the following Ioadloas: AlEA. SMOKE ALARM. CO MARK Outside of each separate sleeping area in the inan ediate vicmity of X X tile bedroom s On every level of a dwaitingunitincludin-basements X X _ Within each slee.in:zoom X Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burnMg appliances and that • do nothave an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 320.6 and shall be approved by dte Officeof the State Fire Marshal. • Power Supply:In dwelling tutits with no commeretalpower supply,alarm(s)may be solely battery operated. In existing dwellit%ttniti,alarms are pennitted to be solely battery operated where repairs or alterations do- not result in the removal of wail 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 connected to the building wiring. As owner of the above-referenced property,Ihereby certify that the alarm(s)referenced above has/have been installed in accordance with thomanufacturcer,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. Address• : 2 Ar 07 he 69 Alt ermit -3 e9 Specify Number of Alarms: if Smoke Maims: Carbon'Monoxide Detectors:11, have read and aurae to co.-vivo:the terms aril car:01ms of ihis stator:m-4 Omar lot Okyr,er Aganro i+1,me: 1 gma. , • ! Bate:pi/al& Si Carra-aciw Name: Vgnature - — .. – • n 7 smoke and CO fonndoc ratisa 09/271,16 about:btank Page 1 of 1