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B-2017-0083CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0083 7438 HEATHERWOOD DR CUPERTINO, CA 95014-5824 (359 28 053) JIREH INC LOS GATOS, CA 95031 OWNER'S NAME: MO LAWRENCE WAND SU LISA H IDATE ISSUED: 01/17/2017 OWNER'S PHONE: 408-470-0467 PHONE NO: (408) 298-9399 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class= Lie. #800707 Contractor JIREH INC Date 10/31/2017 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 license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: r. 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. z. 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. 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 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 may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 01/17/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: i. I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 2. I, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). X BLDG —ELECT —PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: RE -ROOF; TEAR OFF; INSTALL OSB; COMP ROOF SYSTEM (33 SQ'S) Sq. Ft Floor Area: I Valuation: $11233.00 APN Number: Occupancy Type: 359 28 053 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS XRO1�I I,A PECTION. RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature ofAppl Date: 01/17/2017 hereby affirm under penalty of perjury one of the following three declarations: I ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER r. 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. s. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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 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 may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 01/17/2017 HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should Iuse equipment or devices which emit hazardous air contaminants as defined, by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent:; , oe Date: 01/17/2017 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPEkTING REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION (408) 777-3228 • FAX (408) 777-3333 • building(a,)cupertino.org (3 - 261 -4-- , o0'9 '�> PROJECT ADDRESS 6 % G `ice APN � 2::2L OWNER NAME p! j P8 Jy / f t/ �f ✓ A . � MAIL \ STREET ADDRESS/ a CITY, ATE, ZIP FAX CONTACT NAME � �� PHONE �.�1� �� E-MAIL STREET ADDRESS CITY, STATE,, Z"IIPP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME LICENSEBER LIC NSET BUS. LIC. ' ry 1 f 0 ! ' <_ L COMPANY NAMEE- L) Is CDC j Lt' Lj FAX STREETMFy/ , CITY, STA ,ZIP PHO yg� ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS. LIC. # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF Duplex ❑ Multi -Family ROOF AREA: VALUATION: QSFDor A2 133 STRUCTURE: mercial EXISTING ROOF TYPE: 11BUILT-UPROOF ElASPHALT SHINGLES 00D SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE/REPLACE`YES ❑ NO IF NO, #LAYERS: PLYWOOD El '/." ❑ 5 ,� /THICKNESS: El 5/s ' PLYWD 1ZfOSB TYPE: ❑ CDX PITCH: '12 ROOF (//j^� CLASSY `� PROPOSED ROOF TYPE: 11BUILT-UPROOF ASPHALT SHINGLES ❑ WOOD SHAKES ElWOOD SHINGLES ❑ OTHER ICC -ES DESCRIPTION OF WORK: �•- �v 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 bui di strue ' ?i. I authorize repr entatives of Cupertino to enter the above-identi ed prop rty for inspection purposes. Signature of Applicant/Agent: Date: O SUPPLEMEN AL IN ORMATION REQUIRED l • oc usE.ozvi Y =,i' ,, _ ;_ If building is associated with a Home Owner's Association provide letter =❑ -OVER THE -COUNTER ,--,. ❑ BUII.DINGPLANREVIEw Of appIOVaI from HOA. Provide Planning approval to verify ifthere any restrictions. ❑ ❑ =rLANNIPIGYLANREVIEW _ ExrxEss - -, _ Provide copy of Manufacturer's Installation Specifications. ❑ srANnaxD x ❑ F7RR nErT - Provide signed copy of Cupertino's Tear -Off Policy. ❑ oiz . _ ReroofApp_2011.doc revised 03/16/11 VIM REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ---ALBERT-SALVADOR,-P-.E-.TC-.B.O.—, BUILDING-OFFICIA-E—_ 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 - FAX (408) 777-3333 - buildinqQcupertino.org, PROJECT ADDRESS 1A V4 APN 4 1 33 OWNERNAIvIE PHONE�7g AIL STREET ADDRESS CITY, STATE, ZIP FAX CONTRA,CTORNAME L 1=0d 0 rZ LlCrSETEq BUS. LlO� 3.4 CO NAME L A_ __6 S 6004, 1 6e j E-MAIL 4-k4'I 0 ql�,S f&Al Q CC FAX -9317 ) 9 R, - STREr 57 \J CITY TATE, PHONE ter 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. Pleaseschedule inspections online or call (408) 777-3228 from 7:30-3.30pm (Mon-Thurs) or 7:30- 2:30 -pm (Friday) toschedule,insp _ tion. For Tear -Off and N;3,:llingil-i—spec-tLons-,-yau must- also.calt 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 '/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. t 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 Vto e installed in accordance with Sections R314 and R315 of the 2013 California Residential c`9 I A/ /)__7 M61 Date: ,-2014.doc revised 01115114 ____S_M-OKE_/-CARBON_M-ON-OX-1D-E-ALARM-S--- OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION C U P E RTI N O 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 Address PURPOSE (4008) 777-32228 • FAX (408) 777-3333 • building(a.cupertino.org V11 , '�-� � . — Permit No. 1W/-` 0 PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIIS CERTIFICATE HAS BEEN 4 b AND RETURNED TO THE BUILDING DIVISION 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 --- $MOO QO,-CR-C_SectionR3,a- nd-CBC Sections -9-07.? 11.5 anal. 420,6--re-quire-that-Smoke .larms and/or -Car -ban- - - . ---- -. -- - - 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 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. Power Supply: In dwelling units with no commercial power supply, alarm(s) 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 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, 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 California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. I have read and agree to comply with the terms and cgvditions of this statement Owner (or Ownnerr�Agent's) Name: Signature... i t -C .Dat ... ..... .. :................: Contractor Name: Signature................................................................... Lic.##....................................:. Date:................... Smoke and COfonn. doe revised 03118114 cuol`IktI140 Owner Name Address WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION I.I UKKt AVtNUE - CUPERTINO, CA 95014-3255 Please refer to the attached California Civil Code Sections 1101.1-1101.8 which- are part of this Certification form. I. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: Date: M' 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? El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. -- -- --- - -- __ —. 0 -The licenses-plumher!s_certification-has-been-provided-to-tha$uJ1dinDivision-------- -- - -- - - Sign below and skip the rest of the form. Owner' Signature: Date: 5r 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. Sign below and skip the rest of the form. Owner' Signature: ❑ No Go to Question 4. Date: 4. Is your real property built and available for use or occupancy on or before January 1, 1994? 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. Sign below and skip the rest of the form. Owner' Signature: Date: ® Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 110 1. 1 through 1101.8 apply. Refer to the attached. My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or iunprovements 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 unprovements shall require non- compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. SB4072014.doc revised 03118114