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B-2017-0666CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0666 21427 KRZICH PL CUPERTINO, CA 95014-4942 (362 05 039) GREG JONES ROOFING INC HALF MOON BAY, CA 94019 OWNER'S NAME: LINDLEY DALE C AND CAROLINE N TRUSTEE DATE ISSUED: 04/27/2017 OWNER'S PHONE: 408-482-4752 PHONE NO: (650) 726-1428 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-39 Lie. #669195 Contractor GREG JONES ROOFING INC Date 02/28/2019 X BLDG —ELECT _PLUME 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: RE -ROOF; TEAR -OFF; INSTALL OSB; COMP SHINGLES - (30 SQ) I hereby affirm under penalty of perjury one of the following two declarations: 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. 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: $20000.00 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 362 05 039 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 regul tions jor the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. g 0 27 20 7 Si natur Date Dunbar Issued by: Kim un Date: 04/27/2017 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 ani pecticn, 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 ofAppficant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 04/27/2017 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 Code, Sections 25505, 25533, 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: 04/27/2017 1 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 CONSTRUCTION LENDING AGENCY 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 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. 1 understand my plans shall be used as public records. Licensed Signature Date 04/27/2017 Si 9 Professional CUPEIRTINO REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinci a.cupertino.org PROTECT ADDRESSj qpN, OWNER NAME — /� P �/ lt/% E-NLSIL STREET ADDRE C .ykriid� Lefc� CITY> STATE, ZIP, l FF CONTACT NAME Z5 E-MAIL STREET ADDRESS CITY, STATE FAX ❑ OWNER ❑ OWNER-BUII,DER ❑ OWNERAGENT ❑ CONTRACTOR ❑ C0X1TRACCTyORAGEh*r ❑ ARCHITECT ❑ ENGwEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NA � � , CENSE E LI �E COMPANY NAIr� / ' E N AII. F` "t CITY ), �C✓�% r Cjt Cr' t / j�� 6•P ARCHITECT/ENGBgEFRNAME LICENSE NTUA.SER BUS. LIC. P' COMPANY NAME E-ivLAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF Q SFD or Duplex ❑ Multi -Family Y ROOF AREA:X STRUCTURE: Q Commercial VALUATION: Q EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES WOOD SHAKES ❑ WOOD SHINGL ❑ OTHER (SPECIFY) ^� REMOVE/RL-PLACEES IF NO, % PLYWOOD %z" ❑ _. PLYWD OSB PITCH: ROOP ❑ r10 Y LL YERS. ( THICKNESS: ❑ S/S" Ti PE: ❑ CDX ' 12 CLAS : A PROPOSED ROOF TYPE: ❑ BUILT' -UP ROOF ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES Q OTHER I ICC -ES RE - ORT r DESCRIPTION OF WORK�r^ By my signature below, I certify to each of the fo owing: I aIn the property ow er or authorized agent to act on the property owner's behalf. 'I have read this application and the information I have rovided is co ct. I have read the Des ription of Vdork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to ilding cos on. I authorize representatives of Cupertino to enter the above -identified roperty for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL 1AVORAATIONREQUIRED If building is associated with a Home Owns Association, provide letter Of approval frolm HOA. Provide Planning ae ro /al; to yerify if there any restrictions._ . _ _ Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cupertino's Tear -Off Policy.:° OFFICE'USEo>\Ly, ' Pim CHECK TYPE= iovrinc sL� I]. ,LIVER -THE -COUNTER - 'I IZEss IQ ,STANDARD:�."PIREDEPT BL3ILDdnGPL REQ IEw :: i�,uPLAi\ L G PLA 1 REViE4S' ._; - oTiIER ReroofApp_2011.doe revised 03/16/11 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 • building(d)cupertino.org PROJECT ADDRESS OWNERNAnfEz LC� APN #! _ EMAIL 17 STREET ADDRESI, CITYf TEm� Y `' (� � � J FAX CONTRA /// LIt ' $ L' ��� BUS. LIC. COMPANY N1AI � E-MAIL FAX STREET (-) 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) 777-3228 from 7:30-3:30pin (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 tlds 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 requiredY. 5. Roofing shall not be applied without first obtaining all prior inspection and written approvals fi-oin 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. property owner's behalf. I understand and agree to smoke detectors and carbon monoxide det�c ors a the 2016 California Residential Code. - of .AUtulicant/. I am -the property owner or- authorized agent to act on the - with the re -roof policy stated above. I also understand that i to be installed in accordance with Sections R314 and R315 of Date: Re7-oofPo1icy_2014.doc revised 12115116 tam I onoxide rn-'s for PURPOSE the installation of all required Smoke and carbon Where no interior access Trds affidavit is aself-certification for 8315, 2016 CBC Sections 420.6 and 907 compliance with 2016 CRC Section 8314, for inspections are required. GENERAL INFORMATION to existing dwelling units exceeds inti -family dwellings shall be provided with Smoke Alarms and Car on Existing single-family and m alterations, or repal Monoxide alarms. When the valuation of additions, $1000.00, CRC Section 8314, R315, and CBC Sections 907.2.11.5 and X0.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: SMOKE ALARM CO ALARM AREA X X Outside of each sepazate sleeping area in the immediate vicinity of the X X room s) — (Smoke alarms shall not be lucatedrW ntsana habitable attics door X bed ( g Unit including baz On every level of a dwelling ' Within eacl, sleep ina room g' appliances and that ot contain Carbon Monoxide ala rms are not required in dwellings WE, ch db ned with moke alarms shall comply with ayage.Carbon monoxide alarms com do not have a ��t6aWddhall be a pproved by the Office of the State Fire Marsha . CBC Section 4_ alarmO Y ercial ower supply s may be solely battery operated. Power Supply: In dwelling units With no comm p of attic, basement or crawl are ermitted to be solely battery operated repairs or alterations o In existing dwelling units, alarms por there is ermit is required for not result in the removal of wall and ceiling rig es 907 11.4 and 420 6.2 An electrical p space. Refer to CR the coion R.7DI4 and CBC nnected to the building wiring. alarms which mus d property, I hereby certify that the alarms) referenced above has/have been nl As ojveT of the above -reference pro p compliance Nvi$h the California Building installed in accordance �'Nrith the manufacturer's instructions and in been tested and are operational, as of the com iu and California Residential Codes. The arms specified below have � P � Permit N t t2 date signed below. n /r —, 1 f I ")'1 !� -/?A Address: Specify Number of Alarms: _ I have read and a Carbon Monoxide Detectors: Smoke_ Alm with the terms and conditions of this statement e to co Owner (or Owner Agent's) Name: Signature ... /C/o�nt�ra/c�tor �P Pn// Signature / -1 t --'Or' ,I lY)e ] .. ............................. �Qlt�.:.l� 1 ........... Date ...• ............. LIC..+ Smoke and CO form.doc revised 01/101'201; CUPERTINO Owner Name Address ;Z/ �n2 WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-322§r FAX (408) 777-3333 • building(dcupertino.ong Permit No,; 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. ANo 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 110 1. 8 do not apply. ❑ The licensed plurmber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of fonn. 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 fonn and sign bottom of fonn. )91 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 fonn and sign bottom of fonn. 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., 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-conseiving 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, 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 installation requirements, and that the water -conserving plumbing fixtures comply with the requirements as indicated in the table on the following nage. Owner or Owner Agent's Signature: ., �� , :�j Date: 7 Upon completing and signing this Certi Cate, please return it to the Buil _., Division in order to final vour building uermit. SB407 2015. doe revised 01/05117 1. If the existing plumbing fixture water usage/flod7 rate is equal to or lower than the figure shown, it is not required to be upgraded. SB407 2015.doc remised 08/26/15 Non -Compliant Water -Conserving Plumbing Fixture Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type Water Usage 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 (Flow Rafe 2013 CALGreen Div. 4.3 2013 CALGreen Div, 4.3 2013 CALGreen Div. 5.3 Single -Family Multi -Family Commercial Residential Residential Water Closets Exceed 1.6 Single flush toilets: 1.28 gallons/flush (Toilets) Gallons/flush Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite, average flush volume of two reduced flushes and one full flush Urinals Exceed 1.0 0.5 gallons/flush Gallons/flush Showerheads 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 (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 1.8 gallons per minute 60 psi Faucets — 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 May temporarily increase May temporarily up to 2.2 gallons per increase up to 2.2 minute @ 60 psi, and must gallons per minute @ default to maximum 60 psi, and must 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. If the existing plumbing fixture water usage/flod7 rate is equal to or lower than the figure shown, it is not required to be upgraded. SB407 2015.doc remised 08/26/15