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B-2017-0786CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0786 1067 NOVEMBER DR CUPERTINO, CA 95014-4129 (362 16 014) R E ROOFING AND CONSTRUCTION INC SAN JOSE, CA 95124 OWNER'S NAME: BLOOM LARRY F AND SUSAN L OWNER'S PHONE: 408-446-0705 License Class C-39 B Lic. #727599 Contractor R E ROOFING AND CONSTRUCTION INC Date 09/30/2018 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: L 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. 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 accr0e against said City in consequence of the granting of this permit. Additi6nally, a applicant understands an II comply with all non -point souFce regulati cJprthe ertino umcp I gode, Section 9.18. Signature--- ate 05/18/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: t. 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: t. 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 05/18/2017 DATE ISSUED: 05/18/2017 PHONE NO: (408) 626-9320 BUILDING PERMIT INFO: BLDG —ELECT —PLUMB MECH X RESIDENTIAL _ COMMERCIAL 3 DESCRIPTION: ROOF;TEAR-OFF; COMP SHINGLES - (27 SQ) Sq. Ft Floor Area: I Valuation: $13000.00 APN Number: Occupancy Type: 362 16 014 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: 05/18/2017 RF ROOFS: All roofs shall be spected prior to any roofing material being installed. If a roof is ilr'stalled without fir, taining an inspection, I agree to remove all new materials for ection„ / Signature of Applicant: Date: 05l18i2017 ALL ROOF COVERINGS TO 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 compliartmmith the _Cupertino Municipal Code, Chapter 9.12 and the Health & Safy "Code, Seed on �5505,25533, and 5534. Owner or authorized a�en � Date: 05/18/2017 ' f CONSTRUCTION LENDIIQG 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 DECL.A_RATION 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 • buildingO cupertino.org A` -'© C (p L -V PROJECT ADDRESS �� /� +,q /\A tJ(yI APN n ��w� J / ' / OWNER NAME �1 �U l ,j° PHONE (_ , + E-MAIL [ / STREET ADDRESS 4U., / _'n� ` CITY, STAT •ZIP �� �jVr FAX CONTACT NAME _J i Q my-� PHONE Z �V E-MAIL r� \ ` ,U �' G i r �o STREETADDRESS \ 1 �� /� CITY, STATE, ZIP *' I FAX p ,,{, _ �['L 1:1ORN'ER ElOWNER-BUILDER❑l./ORNTERA�GEENT C, CONTRACTOR 11CONTRACTORAGENT ❑`JARCHUECT 13 ENGINEER ❑ DEVELOPER TENANT CONTRACTOR NAME lI/� , i h ^LICENSE NUMBER '�] �I LICENSE TYPti — BUS. LIC. # I I COMPIL I E-MAIL In riJ G n M\.Ico, VF� IQi� STREET ADDRESS L C vvL 1 t CITY, STATE, ZIP � � / I l f PHONE q r � � ARCMTECT/ENGINEER NAME LICENSE NL14BER LJ -) BUS. LIC. # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD 0 Duplex ❑Multi -Family ROOF AREA: 71ALUATIONT:STRUCTURE: m-me7Clal�l EXISTING ROOF TYPE: ❑ BLIILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SFLAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE/REPLACEXYES IF NO, j PLYWOOD ❑ w, ❑ PLYWD ❑ OSB PITCH: ROOF 13 NO r LAYERS: I THICKNESS: 115/8" TYPE: 11CDX .12] CLASS: A PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT # DESCRIPTION OF WORK: A�� AID (nl, % `L t �( Tn p UIQ 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 • buildina(a-)-cupertino.ora PROJECT ADDRESS D 1 APN k OWNER NAME / J PHO. rl 7� E-MAIL STREET ADDRESS I I / }� / {YY ` CITY, STATE, ZIPt u V e , _ j I 0 i � I I �J, FAX / CONTRACTOR NAME % A LICENSE NUMBER/ Z (A LICENSE -P.E G BUS. LIC. #' COMPANY NAME/j�� tj -- { f f� � (J��� E-MAIL o a STREET ADDRESS O (� ] CITY, STATE, ZIPL� ('f PHONE 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 Fvork 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 fi-om 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: 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. 111 and and agree to comply with the re -roof policy stated above. I also understand that smoke detectors and car on monoxi del or required.ir6b iigstalled in accordance with Sections R314 and R315 of the 2016 California Residential Code. Signature of Applicant/Agent: / Date. ReroofPolicy_2019.doc revised 12115116 CUPERTINO ` PERMI7 COMPL PURPOSE SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - building(o)cupertino.org CANNOT BE FINALED UNTIL TRIS CERTIFICATE TEAS BEEN tTED, SIGNED. AND RETURNED T(O THE BUILDING DIVISION - rr _.... x: 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 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. 0 Address: I (: � I /�-Permit No. l✓ ��' .� Specify Number of Alarms: #Sti '©1 " ^ �rt p fYsrn raMrms:a :o fian.E ��-e�iw:etecto s: / have read and agree to comply with the terms and cgra-djtions of this statement Owner (or W)wner Agent') Name: ® —� eg irl lItS -:nature! ............... .. ......V...........................................................'Daft: .... Contractor N e: -' .S,.....! ure. ... ..� ...._�......_„-�.................... .... Lic.# .......�.................. Date:'....1........ 5A Smoke and COform.doc revised 0111012017 CUPERTINO Owner Name IA m WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 77-3228 • FAX (408) 777-3333 • buildinaCa cupertino.org �!A A1.1 ?) i n n M -. uo,...= Address ' - �I �� GNt,�A� NYl, Z 1 V� 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. 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 forin. ,eNO 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 fon-n. ,2 -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. — e2°Yos- Myreai-property-is-built and available-fvr-use-or-oecupaneyon or before -January l— 1-994.-- ---_--- --- _ _:_:.---- — 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 naultifanuly 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 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 NN�ater-conserving 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 following Daae. / s --N/% > i Agent's Signature: Upon completing and signing it to the Building Division in order to final your building permit. SB4072015.doc revised 01105117