B-2017-0939C
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-0939
7515 FALLENLEAF LN CUPERTINO, CA 95014-5843 (359 28 034)
ABOVE ALL ROOFING
SOLUTIONS INC
CAMPBELL, CA 95008
OWNER'S NAME: RANGANATHAN NATARAJ AND NATARAJ JAYASHREE
DATE ISSUED: 06/13/2017
OWNER'S PHONE: 408-255-2944
PHONE NO: (408) 292-4188
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class C-39 Lic. #794435
Contractor ABOVE ALL ROOFING SOLUTIONS INC Date 04/30/2019
X BLDG —ELECT —PLUMB
MECH X RESIDENTIAL COMMERCIAL
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.
JOB DESCRIPTION:
RE-ROOF;TEAR-OFF; INSTALL OSB; COMP SHINGLE - (33 SQ)
I hereby affirm under penalty of perjury one of the following two declarations:
1. 1 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
Jperformance 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
Sq. Ft Floor Area:
Valuation: $15000.00
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
APN Number:
Occupancy Type:
and state laws relating to building construction, and hereby authorize
359 28 034
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 a ainst Iia "'es, judgments, costs, and expenses which
PERMIT EXPIRES IF WORK IS NOT STARTED
nsequence of the granting of this permit.
may accrue ag ' st d Ci iri�sands
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally, t e applic t u der and will comply with all non -point
source regul tions per a peno Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signature V Date 06-13-2017
Issued by: Kim Dunbar
OWNER -BUILDER DECLARATION
Date: 06/13/2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
RF ROOFS:
All roofs shall be inspected prior to mgmaterial being installed. If a roof is
1. I, as owner of the property, or my employees with wages as their sole
installed without first obta' 9" i pectio I agree to remove all new materials for
'on.
compensation, will do the work, and the structure is not intended or offered for
spec
sale (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed
Signature of Applicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 06-13-2017
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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.
HAZARDOUS MATERIALS DISCLOSURE
z. 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. 1 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 Bgement District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the CChapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
d 25534.
the Health & Safety Cod(!EH
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agent:
APPLICANT CERTIFICATION
Date: 06-13-2011
I certify that I have read this application and state that the above information is
CONSTRUCTION LENDING AGENCY
correct. I agree to comply with all city and county ordinances and state laws
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 06-13-2017
professional
CUPERTINO
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildingou ertino.or
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CITY. STATE, ZIP
PHONE
USE OF ,�_;r<FD or Duplex ❑ Multi -Family
STRUCTURE: ❑ Commercial
ROOF /AREA:
( 2
VALU'A ION:
EXISTMG ROOF TYPE: ❑ BL11LT-UP ROOF ❑ ASPHALT SHINGLESWOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE iPEPLACE YES I
❑ NO 1f LAYERS: _7
PLI �4 OOD �%" ❑
THICKNESS: ❑ 51s _
PLYWD OSB
TYPE: ❑ CDX
PITCH:
ROOF
CLASS:
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PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ASPFLALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER � ICC -ES REPORT
DESCRIPTION OFA\CORK:
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By my signature below, I certify to each of the fo g: 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 rS coi e I have read the Description of ��'ork and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building onstru ti I authorize representatives of Cupertino to enter the above
,, -i entifie property for inspection purposes.
Signature of Applicant'Agent: _ Date:
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.
OFFICE
USE ONLY
PLATT CHECK TYPE
ROUTING SLIP
❑ OVER-THE-COUNTER
❑ EXPRESS
❑ STANDARD
❑ BUILDINGPLANREVIEYY "
❑ 'PLANNING.PLAN REVTEWW
❑ FIRE DEPT;
❑ OTHER:
ReroofApp_2011.doc revised 03/16/11
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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()cupertino.ong
PROJECT ADDRESS " Z >'J1 '' (' V
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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 eachoft o wing is true: I am the property owner or authorized agent to act on the
property owner's behalf. I understan and agr comply with the re -roof policy stated above. I also understand that
smoke detectors and carbon monox' e detect r ar required to be installed in accordance with Sections R314 and R315 of
the 2016 California Residential Co e. �l f
Signature of ADT)hcant/Aeent: --' Date:
ReroofPolicy_2014.doe revised 06/01/7
OWktfR-CEitfiii ICATE OF COMPLIANCE 1 TICUI Ilr
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
CUPI15RT1140 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(@cupertino.org
PERMIT CANNOT BE FINALED UNTIL THIS CERTIFICATE HAS BEEN
COMPLETED, SIGNED AND RETURNED TO THE BUILDING DIVISION_ ;
PURPOSE
This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC Section R314, 2013 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 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)
X
X
On every level of a dwelling unit including basements
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: Intdwelling 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: far I.6' k,-i_d_L_E+V1_EAF / CW,:�P�TAIVO `?a0mj- Permit No. V lJ
Specify Number of Alarms: # Smoke Alarms: = # Carbon Monoxide Detectors: I '
t have read and aaree to comnty with the terms and conditions of this statement
Owner (or Owner Agent's) Name:
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Signature...................................................................`...........................................Date: �' /
.................................................................................................................................
Contracto a e:
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Signature ............ Lic.# .......7r.....
fid.04r[AIIA-
Smoke and CO fonn.doc revised 09127116
A
WATER -CONSERVING PLUMBING FIXTURES
-'OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408).777-3228 • FAX (408)'777-3333 • buiidincCa�cuoertino.org
Owner Name IVA` I_I—VZA-cl -
Perry
el lot_+_0 39
Address
1. Is your real property a registered historical site? g
❑ 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 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 plumber's certification has been provided to the Building Division:
Skip the rest of the form and sign bottom of form. _
VNo 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:
Z 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.
V Yes My real property is built and available for usesor 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..
5. Please check ONE of the following:
C 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 plumbingfixtures 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 -conserving plumbing fixtures.
On or before January 1,, 2019, alfnon-compliatiglumbing 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 tion -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 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.
La'L
Owner or Owner Agent's Signature: I A Date: 0-7/JR/ 17" 1
UDon connDletine and signinLy this Certificate_ nlease
it to the Building T)iviginn in order to final vrnir huildina nermit
SB4072015.doc revised 08/26/15