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B-2017-0525CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0525 10195 PARK CIRCLE W CUPERTINO, CA 95014-1965 (326 32 014) D & M QUALITY ROOFING SAN JOSE, CA 95112 OWNER'S NAME: PARK CIRCLE LLC OWNER'S PHONE: 408-7294818 LICENSED CONTRACTOR'S TF! i AusTTnN License Class C-39 Lic. #646795 Contractor D & M QUALITY ROOFING Date 06/30/2018 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: 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. fY 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 4/3/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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: 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 permit is issued. a. 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 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 4/3/2017 DATE ISSUED: 04/03/2017 PHONE NO: (408) 313-4408 BUILDING PERMIT INFO: X BLDG —ELECT —PLUMB _ MECH X RESIDENTLAL _ COMMERCIAL JOB DESCRIPTION: UNITS 1- 4; REROOF; INSTALL TPO; INSTALL (N) PIPE FLASHING - (20 SQ) Sq. Ft Floor Area: I Valuation: $7750.00 "N Number: Occupancy Type: 326 32 014 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Abby Ayende 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 ofApplicant:,�/" A Date: 4/3/2017 ALL ROOF COVERINGS TO BE CLASS "A" OR 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. Owner or authorized agent: Date: 4/3/2017 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 DE L R TION I understand my plans shall be used as public records. Licensed Professional CUPERTINO REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 FAX (408) 777-3333 s building(a)cupertino.org PROJECT ADDRESS / f�� l�S P&rk-c.i r APN # -c\L OWNER NAME r ' PHONE E-MAIL STREET ADDRESS�� p gg+ 99 CITY, STATE, ZIP (d° ` /_X CONTACT NAMEo� 4V � 91 V PHONE E-MAIL} STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT IJ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRAC OR�N � L 4W LICEI_�TSE NUMBER LIC�EjJSE E 'WVC, go COMPANY NAME ",-v m (aUa g Y1V €4` EMAIL FAFAXSTREET�DRESS ' J �- CITY, STATE, G pI®NEo ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS. LIICC. n COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF LJ/ SFD or Duplex [I Multi -Family STRUCTURE: E] Commercial ROOF AREA: 5Q, Z � c � VALUATION: 7 � Sc) EXISTING ROOF TYPE: E5BUII -UPROOF ElASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE /REPLACE ❑YES ❑ NO IF NO, PLYWOOD ❑ w, ❑ Y LAYERS: THICKNESS: 115/8" PLYWD ❑ OSB TYPE: ❑ CDX PITCH: 12 ROOF CLASS: A PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ElASPHALT SHINGLES 11WOOD SHAKES ElWOOD SHINGLES ❑ OTHER �- ICC -E$ REPORT # DESCRIPTION OF WORK: + f p� .� `y 6 In LIL 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 build' g construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date:—Y-3 SUPPLEMENTAL 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. oFI ICR DISE oNLY PLA CHECkTITE ROUTINGSLrr OVER rxl -COUNTER 0`'EXPRESS - ❑ STANDARD ❑.'BZIILviNGPLAr REvtE«+ Ej PLANNING. PLAN REVIEW �` FIRE, DEPT O OTHER ReroofApp 2011.doc revised 03/16111 SMOKE I CARBON MONOXIDE ALARMS OWNER CERTIMATE OF COMPLIANC=- COMMUNfTY DEVE-0MAIENT DEPARTM ENT, BUILDIN'o 01VISION CU}}*'FP-Ttt40 (4-08) 777-3228 - FAX 1408) 777-33RI h,,;Kmnn� _41— PTTPPr M'S affidavif� 1s aselt-certificati9n for -tie installationof Ali required Smoke and Carbon iVonoxide compliance with,00,16 CRC Section 1?314;�R315,2016- ' ')Ot6 a where no it for inspection$ arerequixed. C8CSections4. nd907.2.l'LZ'w GENERALINFORMAXION Existing single-family and multi-fainily dwel1mgs shall be provided with Sm -oke Alarms and Carbon Mb.noxide Alarms- Mhea the valuation of addi alterationsx or -repairs to e.J:sting dwelling its 1 $1000-0 0, CXC $ec U011 R314, R315, and C13CSectim is 9 07.2.11.5 and 420,6 require that Stfi&e, Alarms Ckbort Mono)dde Alamisfbe, iT -w astalled in tile folio, ing; locations: is for access ou tsdO - of ' each ARESli separate sleeping. hl the irarnediate vicinity Of the. LAR X' CO ALA te-clroom(s),—,(Sm,6kealarms shall; not ,lie located witldn3 feet cif bathroom door) -On e level o _f -a dwellinguqitjnciudln�� and hi�bftableattics XF_ Carboft-M-ono3dde alar is are not -required -in dwellings which do not contain fuel -burn ng appliances an I that do not have an attached, garage. Caxbon monoxide alarms 'combined Vft smokealanxis shall comply with -CBC-Section 4ZO,6 and shallbe approved by the Office of the St -ate FireMarshal. I Power S"PP'Y- In dwelling units with no cOn-Imercial power supply, alarm(s) may be solely battery ower z tea, sting hi e)d dwelling units, alarms are perp-dUeed to be solely battery operated where repairs or Alterations do not resLfff in the removal -of wall and ceiling finishes or there is no access by means of Attic, Yisaserzrent or c Fa space. Refer to CRC Section 8314 aimd CBC Sectigris 907-2.11.4 and 420.62. Ad'eectrical pennitis. rekyirea for alarms WI-dch rxlu$t connected. to the biffidin- g"WiP1100- As 0W.Uer Of the abolre-referenced property,, I hereby. certify that the alqrm(s) referenced above haAfhave installed -in accordance with the manufactures instrtictions, azdin compliance with (hp- California Build and Califon'da ResideAW Codes. Tae, alarms specified below have bem. tested and are ope'r4onal as. 0A dale,signed below, $-,Iyeq.ifY Namber of AlgrmN: read zand agrae to comply wkh the WATER -CONSERVING PLUMBING FIXTURES OVNER CERTIFICATE of COMPLIANCE COMMQN6 DEVELOPMENT DEPARTMENT a BUILDIN� DIV181ON -10300. TORRE AVENUE - CUPERTINO, CA 95014-3266 CUP, fl, r ; 8) 777 3998 = FAX (408) 777-8833 ii building (&cUoetfino.Dfd Garter Name lay — Permit No, Address J. Is rWrW property aregistered historical site? ves Civil Code Sections lj,0141thmigh!101-Sdonot,apply. Ski 'the Testof idle form and sign bottom -E,rXo GotoQaestio42. 2.. Do--syoir-real prcTertybay-ealicosed plmercer4f that; duo to the age or configuration ofthe property orits probing, ns,umbing 'i tallaticin OYes -Civil- Code Sections 1,101A through jl0L$dQnQtapply. 13 'The licensedplutriberg certificationlias beenproNided to the Building1livision, Skip. lh--jrestt)fthop;M=4-sip-bottomof,fornL 'ET"No Goto`Question3. 1 Ts water serVice permanently disconnected for yourBuilding? 0 'Yes, Civil C64o Sections 1101.1 through 1101,8 4o riot apply. Skip the rest ofthe form -andignbott si om ja'NQ Go to question 4. 4. ls'y6utroil property built and available ,foruseor occVancy cin or before. January 1, 19947 pro Cl No M, neat - a perty is built and available for use or occupancy.after. January 1, 1094, .Civil c-O&Sections !101.i.thro4g,hj,loi.g`46 not apply. Skip the rest of the form and sign bottom of form jal'yes My real property is built and available for use or occupancy on orbo January 1,1994, �ci-vilCode 9000oris Ii.614through 4101.8 apply, Check one cifthe ,three ,foII6.wiu$gtatehimtand sig. bodbih of form, ,5. -PI0a§edheck_!0a of the following: 0MLyproperty is a single-family residential real prqperty,, See Civil Code. Section 1101,4. On and after January 1, 2014, building alterations. or improvements shall require all non-oompImt plumbing fixt to replaced Withwater conserving plumbing fixturef, throughout the building, On or before January 1, 2017, -all i compliant- plumbing fixtures shall be replaced with water -conserving plurribing, fix4uts (regardless of whe ,,erppextyundergoes alterations or improvements). Code. Section 1161.5, Pr is a W" f7 On lair�ary 1, 2 14,specified revements shall require nba- -compliant urr _tur to be _ - laced'with ivater`conservang p, _"' gfixtures � Y 1 rep g fixtures. �m before ryl, 2019,all shall be replaced with water - or, fro s plumbing f Ixtures t hr of Whether, property undergoes 9teratiops or on crVIR.- ts in me El MypropeiVisa'continercia[Tealproperty- See QviJ Code-S'ecti(in 11OL5. Oji and afierlanuaty L,2014, specified Building aftevitions, ori- Improverrieats shall require non- compliant plumbing 'fixtures to be replaced with orate r-coiserynig, plumbing factures. ,on or fidote January 1, 2019, all nou-cpnipliant plumbing, fixtures- shall be replaced with water= const vin,, plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements) 1, a`s the o;viler or owiierls agent of fl-AserW, MeF;undcrpcnaltYof perjury that n0n_comP1ia&p1umbih4 i`ures be replaced: prior to date specified above %ith-w'ate'r-consdivirig plumbing fixtures in accordance, vftCiAl Code Sections A 101.1 tbrough 1101 Athe current CaliforniaPlunibingObde and California Green Building;Standards Code, and mattufacturefs installation requirements, andchatthe w.'ter.conser&g plumbing fixtures coniplywiffi ihe)tqpin!m=ts as indicated in the table on the j( �7in p tlwriaer or 51Owner -Agent's S' Date, XAMQk [,- UpPA completing and szgnlng Ibis: Cerdfi*ate, plea re it y0urb so nit t-Q,the Building, Division i ordertofin�!, S346726115roc -rev'ised 01/05/17