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B-2017-0922CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0922 1043 PENNINGTON LN CUPERTINO, CA 95014-4929 (362 04 030) WESTSHORE ROOFING INC SAN JOSE, CA 95131 OWNER'S NAME: HUANG YING-KUEI ANN OWNER'S PHONE: 408-725-0581 LICENSED CONTRACTOR'S DECLARATION License Class Q -M Lic. #787221 Contractor WESTSHORE ROOFING INC Date 11/30/2018 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: 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. ` ' 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 pe Y e Cupertino Municipal Code, Section 9.18. Date 41-I&MOZIT&A I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: i. 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) z. 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. 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 ISSUED: 06/09/2017 PHONE NO: (408) 456-0200 BUILDING PERMIT INFO: X BLDG —ELECT —PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL DESCRIPTION: .00F; TEAR -OFF; INSTALL COMP SHINGLES - (26 SQ) Sq. Ft Floor Area: I Valuation: $13000.00 APN Number: Occupancy Type: 362 04 030 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: 06/09/2017 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. Signature ofApplican Date: 06-9=2017 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 compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Se 5505, 25533, and 25534. Owner or authorized age Date: 06-9-2017 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 Date 06-9-2017 Professional CUPERTINO REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777.3333 • build ingCo�cupertino.org B �2©c Z Z / n PROJECT ADDRESS to q fon APN 4 OWNER NAMEh r Vµ V KNE / ��+ ` E-MAIL I STREET ADDRESS / O L/t ` n tail N , a FAX CIT STATE, I C (/a CONTACT NAME -11;.e n w /' A Vv yG Pft E-MAIL s - ozss . STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNTER-BUILDER ❑ OWNERAGENT AONTTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONT TO N ME 'nP� I LICENSf, ER� LIC�N'Si C BUS :'J ✓P / COMP ,Y NAM V�tJl�i I v�e e, E-MAIL F / o s6Dz�3 ST�2Ef� A DASA ,/O ✓ L� N C (� 1, r T V lam pr • CIT ,STATE, Z3� ��' a v� J oJ-e c � PHONE (/�/ - O2 N1 7 v Vl/ ARCHITECT/ENGINEER NAME LICENSE NUMBER COMPANY NAME E-MAIL BUS. LIC. 4 FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi -Family STRUCTURE: [❑ Commercial ROOF AREA: VALUATION: 15/c)(00 EXISTING ROOF TYPE: ❑ BUILT-UP ROOF AASPH.ALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE/REPLACE I;I=S ❑ NO IF NO, PLYWOOD �i' ❑ __ r LAi'ERS: THICKNESS: 0 5/8" PLYWD ❑ OSB T} PE: ❑ CDX PITCH: G _12 ROOF CLASS: A PROPOSED ROOF TYPE: 13BUILT-UP ROOF SPFLALT SHINGLES 1:1WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER I ICC -ES RFPORT r DESCRIPTION OF WORK: RPwt�� C0V"A d ✓i fir~ li New Com (d� c I a ss A 6tzf .1 /,3, O( -x) �1 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 provide I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws rel ting to b mg constru n. I author representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Ag7: te: r 9� SUPPLE NT 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. oFcE"UsE oNLr PLAN CHECK TITE' ROUTING SLIP ❑ OVER -THE COUNTER ❑; EXPRESS:,- -, ❑ STANDARD ❑ BUILDING PLAN REVIEW ❑. , PiANNINGLnNREN"TEt�� , ❑ FIRE DEPT ❑ OTHER: ReroofApp_2011.d0c revised 03/16/11 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(a)cugertino.orq PROJECT ADDRESS l a„/ i 5 (j� n i �a APN # OWNER NAME t& it PHONE - `C?I E-MAIL STREET ADDRESS f v toK3 cti�f,� CITY TGGATE, ZIP /�I g01 ( �l FAX CONT CT N E�� n -C�66�4 LICEI BAR LICENSE TYPE -rl` BUS. LIC. # COMPANY`AAf NAME j"K`. eIv��- Ir.�LS karma E aa�f ' W FAX Va [ S'6 d Z� STREET ADDRESS Or . C TY, STATE ZIP v 3 PHONE �d �0 'L -15 h-07-00 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. To schedule inspections call (408) 777-3228 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 out to the job site 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 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/" 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. 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 de e required to be installed in accordance with Sections R314 and R315 of the 2016 California Residential Co of Date: ReroofPolicy_2014.doc revised 06/01/7 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 • buiidinq(a)cupertino.oro PURPOar, 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, xceeds$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 dti ' ing units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling touts, 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 8314 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 tiviring. 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: /0-4,3 Ler4A-e (, ?TV Permit No. 26L-) Specify Number of Alarms: # Smoke Alarms: # Carbon Monoxide Detectors: I have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: kueo %L(t,/7 Signature .............. .............`....................................................................Date: .:..!......... Contra or Name: Signature...................................................................... Lic.#........................................ Date:................... Smoke and CO form.doc revised 01/10/2017 CUPERTINO Owner Name y 7 WATER -CONSERVING PLUMBING FIXTURE_ S OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT % BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a.cupertino.oro C-7 k 14 e- , /�AfA.' f-1 L( i, a2 Perrr Address /0</-3 czl 91-0 7,5Z � P 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. A 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. JX 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. properly 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.. Please check ONE of the following: My property is a.single-family residential real properly. 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 iinprovements). ❑ My property is a multifamily residential realproperty. 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 properly. 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 properly, 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 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 page. _.7 I Owner or Owner Agent's Signature: /,(/.A_A_ d'i Date: A — c1'— )_3 e J I Upon completing and signing this Certificate, please return it to the B�ilding Division in order to final your building permit. SB4072015.doc revised 01/05/17