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B-2017-0801CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0801 1101 KENTWOOD AVE CUPERTINO, CA 95014-5807 (359 30 018) COSMOS ROOFING INC MOUNTAIN VIEW, CA 94043 OWNER'S NAME: LEE WILLIAM WAI-LIT AND SUSAN DATE ISSUED: 05/19/2017 OWNER'S PHONE: 408-593-3737 PHONE NO: (650) 969-7663 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class �$ Lic. #785441 X BLDG —ELECT —PLUMB Contractor COSMOS ROOFING INC Date 04/30/2019 — 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: REROOF; TEAR -OFF; INSTALL COMP SHINGLES (27.5 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. I Sq. Ft Floor Area: Valuation: $11955.00 APPLICANT CERTIFICATION 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 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. Signatur atLsl75 T�017 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) 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: m. 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 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 05-19-2017 APN Number: Occupancy Type: 359 30 018 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Kim Dunbar Date: 05/19/2017 RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without fust obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant ' -- Date: 05-19-2017 ALL ROOF CO BE CLASS "A" OR BETTER 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: 05-19-2017 I hereby affirm that ttheere�isRaLcons ng -9§ ncy 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 CUPERTINO 5 No REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingQcupertino.org PROJECT ADDRESS I 0 r/ C _r, ) ♦orf 1,D A / r'^ N/ 11V APN # !� I bo — I� OWNER NAME O PHONFs r 6rq STREET ADDRESSU'S 2�?,p feVI FFAX CONTACT NAME ALEJANDRO OCEGUERA PHONE 650-969-7663 E-MAIL STREET ADDRESS 1901 Old Middlefield Rd CITY, STATE, ZIP Mountain View, CA 94043 FAX 650-584-3078 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT SI CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ALEJANDRO OCEGUERA LICENSE NUMBER 785441 LICENSE TYPE C39 BUS. LIC. # 18844 COMPANY NAME COSMOS ROOFING E-MAIL FAX 650-485-2314 STREET ADDRESS 1901 Old Middlefield Rd CITY, STATE, ZIP Mountain View, CA 94043 PHONE 650-969-7663 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC. # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi -Family STRUCTURE: Commercial ROOF AREA: 27 -56 5' F - VALUATION: )"95-5 —� / EXISTING ROOF TYPE: ❑ BUILT-UP ROOF .IBJ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE/REPLACE YES ❑ NO IF NO, #LAYERS: PLYWOOD ❑ vi" 11PLYWD THICKNESS: 115/8" C1 OSB TYPE: ❑ CDX PITCH: IZ ROOF CLASS: A PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF R ASPHALT SHINGLES 11WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT # DESCRIPTION OF WORK: 7 GfA35 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 building cons thorize representatives of Cue the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: ----V f 9 SUPPLEMENTAL INFORMATION RED _ 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 ROUTING SUP ❑ ovER-THE-couNTER ❑ EXPRESS ❑ STANDARD ❑ Run DING PLAN REVIEW ❑ PLANNING PLAN REVIEW ❑ FIRE DEPT ❑ OTHER: ReroofApp_2011.doc revised 03116111 CUPERTINO REROOF TEAR -OFF POLICY 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(cDcupertino.org PROJECT ADDRESS � ^ ) t #cA ?)a -, O 1 OWNERNAME .5v,4,i PHONE 73? E-MAIL 'O STREET ADDRESS d / F- t✓ ce!�A_PN C% / rLICENSEE FAX CONTRACTOR NAME ALEJANDRO OCEGUERA LICENSE NUMBER 785441 TYPE C39 BUS. LIC. # COMPANY NAME E-MAIL FAX COSMOS ROOFING 650-584-3078 STREET ADDRESS 1901 Old Middlefield Rd CITY, STATE, ZIP Mountain View, CA 94043 PHONE 650-969-7663 I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re -roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimum of one day before the requested inspection date. Please schedule inspections online or call (408)777-3228 between 7:30-3:30 (Mon -Fri). 3. Tear -off roof inspection is required. Please call for tear -off inspection after the roof is torn off and all the nails/fasteners have been removed. Any and all dry -rotted wood shall be replaced prior to this inspection. A building inspector will be available within one hour. There are special hours for this service: 7:30—10:30am and 1:00 — 3:30pm (Mon — Thurs); 7:30—10:30am and 1:00 — 2:30pm (Friday). 4. If plywood is installed, a plywood nailing inspection is required. 5. In -Progress roof inspection is required. Call for an in -progress roof inspection to verify building is weather tight after installation of approximately 25% of the roofing material. 6. New roof coverings shall not be applied without first obtaining all inspections 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. 7. A final inspection and approval shall be obtained from the building inspector when the re -roofing is complete. To receive a final sign -off, the following items will be verified: a. Flat roofs shall have a minimum of I/4" per foot of slope and must 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. 8. 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 of $126.00. 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 ee to compl roof policy stated above. Signature of Applicant/Agent: Date: / ReroofPoltcy_2010.d0c revised 03/17/10 CUPERTINO SMOKE I CARBON MONOXIDE -ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 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 units 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 SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) - (Smoke alarms shall not be located within 3 feet of bathroom door) X 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: 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 specified below have been tested and are operational, as of the date signed below. Address: � 0LAPermit No. }> � 00 Specify Number of Alarms: # Smoke Alarms:F-6-71 Carbon Monoxide Detectors: with the terms and conditions of this statement 9 — Smoke and CO forns.doc revised 0111012017 WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING. DIVISION CUF'ER.TiI~iQ 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinalcDcupertino.org�p Owner Name V sc.,Le-Q— Permit No y> ' ? —6F61 Address 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 fonn. ©- 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? ❑ 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. t2"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. VNo 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 fon-n.. 5. Please check ONE of the following:. Myproperty 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 propertyis a multifanz.ily 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-coinpliant plumbing fixtures shall be replaced with Nvater- 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-coinpliant 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 peijuiy that non-compliant plumbing fixtures will be replaced prior to date specified above with water-conseiving plumbing fixtures in accordance with Civil Code Sections 1101.1 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 followine Daae. I Owner or Owner Agent's Signature: Date:/ i / .2o IT Upon completing and signing this Certificate, please return it to the Building Division in order to final your buiidinj permit. SB407 2015. doc revised 01105117