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B-2017-0330CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0330 11871 PLACER SPRING CT CUPERTINO, CA 95014-5103 (366 55 015) KENT ROOFING COMPANY INC CAMPBELL, CA 95008 OWNER'S NAME: KOH KYUNG HO TRUSTEE OWNER'S PHONE: 408-507-8787 LICENSED CaNTRACTORIS DECLARATION License Class C=39 Lic. #957398 Contractor KENT ROOFING COMPANY INC Date 05/31/2017 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: n. 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. I have and will maintain Worker's Compensation Insurance, as provided for by Rt—tion 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. aW�?0?Z17iD hereby affirm that I am exempt from the Contractor's License Law for one of the illowing two reasons: n. 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 property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: n. 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. 3. 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 2/28/2017 DATE ISSUED: 02/28/2017 PHONE NO: (408) 971-4042 BUILDING PERMIT INFO: X BLDG —ELECT —PLUMB _ MECH X RESIDENTIAL T COMMERCIAL JOB DESCRIPTION: REROOF; TEAR -OFF; COMP SHINGLES - (25 SQ) Sq. Ft Floor Area: I Valuation: $17000.00 IAP550 Number: Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Abby Avende Date: 02/28/2017 RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. hire ofApphcan ALL ROOF COVERINGS TO BE CLASS "A" HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Ow er or authorized bate: 2/28/2017 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional `t�-10 R , 0'1 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT . BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildin 2cupertino.org PROJECT ADDRESS ® r (- �\ F -e �1 APN #`p ®, OWNER NAME g 1\ T ' �� j NE ��dJ E-MAIL STREETADD$E,S tr%�� ce-ry B� � �® i CITY, STATE, ZIP( n0 Iry FAX �J CONTACT NAME �"�so� %PHONE E-MAIL STREETDRF f � Cl2STATE(- IPWI n4 950 FAX El OWNER ❑ OWNER-BUrLDER ❑ OWNER AGENT CONTRACTOR CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME -F� c� LICENSEU v�IBER 20 LICENSE BUS. LIC. # }`J COMPANY NAME E-MAIL FAX STREET ADDRESS `� "1 ; C� r� e ` 9 (� ✓ Vw CITY, STATE, ZIP f L PHONE I- ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC. # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF FD or Duplex ❑ Multi -Family STRUCTURE: ❑ Commercial ROOF AREA: -Z, (� 1� VALUATION: 1 qf_� EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES J IOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE /REPLACE El YES ❑ NO IFNO, 4 -LAYERS: PLYWOOD ❑ %" ❑ THICKNESS: ❑ 5/8" PLYWD ❑ OSB TYPE: ❑ CDX PITCH: (�/y 12 ROOF CLASS: f1 PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF SPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT # DESCRIPTION OF i e I kq ® oo h` or— p� J 2-��tb fir--: C-nA[7- q_rn_,_PA 0Q.&I"M 67Law, �2d cowto 9k(q%-1ej 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 IATork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws build construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant nt: Date: ---7 SUPP'LEMENT7tRMATION 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. OFFICE USE ONLY " PLAN CHECK TYPE " -POUTlrc SLIP OVER-THE-COUNTER 'FXPR SS ❑ STANDARD, ❑- BUILDING;Pi REVIEW "PLANNING PLAN' REVIEW ". . ❑FIRE DEPT OTHER:'" ReroofApp_2011.doc revised 03116111 CUPERTINO 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 • buildingQcupetno.org PROTECT ADDRESS �pN OWNERNAME U dmo g�n? ErIvIAIL STREET ADDRE ) 0 �-1�' ZM Cry& 4!9 E, T1 N;_ 1 CJ C-4 �i�Ql - f FAX CONTRACT! AAME a i ^ n / LI T 5l LIC SE E BUS. LIC. # COMPANY NAME E-MAIL FAX STRE iS //��ey✓� E�R�/V �. Ave- CIy!�T�AT"EV e /ne, a ® (w,7 I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re -roof project shall comply with all applicable provisions of the 2016 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) 717-3228 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: 7:3040:30am. 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. 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 2016 California Signature of ADD1ical Date:-? r Z-19-- I ReroofPolicy_2014.doc revised 12/15116 CUPERTIF' O SMOKE i CARBON MONOXIDE ALARMS OWNER.CERTIF[CATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 FAX (408) 777-3333 • building(a)cupertino:org PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with..2016 CRC Section R314, R315, 2016 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 mots exceeds $1000.00, CRC Section R314, R315, 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 I SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedrooms) — (Smoke alarms shall not be located within 3 feet of bathroom door) X On every level of a dwelling unit including basements and habitable attics 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: lin 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. Ain electrical permit is required for alarms which nnust be corunected to the building wirinc, 01 As owner of the above -referenced property, I hereby certify that the alarm(s) refereznced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the Califorina Building and California Residential Codes. The alarms specified below have been tested and are operational, as of the date signed below. Address: 1 t -o) Permit No. 1�'��' Specify Number of Alarms: -747 Smoke Alarms: = 4 Carbon Monoxide Detectors: I have read and agree to comply with the terms and conditions or this statement Owner (or Owner Ag�e}nt's) Name: % BUKI ViD � v Signature......... .......:............................................................. Date:. �o/rector N me: Signa .............. Lic.# ..1 .. ................ Date:...4I . Smoke and COfbi7md.oc revised 01/10/2017 WATER -CONSERVING PLUI GING FIXTURES Ott NER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION � �. I 10INO 300 TORRE AVENUE m CUPERTINO, CA 95014-3255 �p (408) 777-3228 • FAX (408) 777-3333 • building(alcupertino.org 2, Owner Name i U KBO H Permit No 1�� Ql� 0 ✓� 0 Address vol )aatq In mr, . U(y XV\'f\o CCk�1 1. Is your real property a registered historical site? ❑ 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. j L 2. Does your real properly 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. 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. 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. Yes 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 fixturesthroughout the building (regardless of whether property undergoes alterations or improvements). I, 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 11.01.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and that the water-conserving-plurnbing fixtures comply with the requirements as indicated in the table on the following page. Owner or Owner Agent's Signature: % )/ dd.�fPa�� a Date: � / fir/ t 7 Upon completing and signing this. Certificate, please return it to the Building Division in order to final your building pen -nit. SB407 2015. doc revised 08126115