B-2017-0944CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0944
7716 SQUIREHILL CT CUPERTINO, CA 95014-5017 (362 23 032) CUPERTINO ROOFING
INC
SAN JOSE, CA 95129
OWNER'S NAME: SHEENY PATRICK E AND PAUAHI M TRUSTEE I I DATE ISSUED: 06/14/2017 1
OWNER'S PHONE: 408-691-8199
License Class C32 Lic. #565437
Contractor CUPERTINO ROOFING INC Date 03/31/2018
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 reb_ulgioks per the Cupertino Municipal Code, Section 9.18.
PHONE NO: (408) 973-9427
BUILDING PERMIT INFO:
X BLDG —ELECT —PLUMB
_ MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
RE -ROOF; TEAR -OFF; INSTALL OSB; COMP SHINGLES (22 SQ)
Sq. Ft Floor Area: I Valuation: $20000.00
APN Number: Occupancy Type:
362 23 032
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Kim Dunbar
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
t. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for
compensation, will do the work, and the structure is not intended or offered for inspection.
sale (Scc.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:
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
Signature of Applicant:
Date: 06-14-2017
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 C e Sections 25505, 25533, and 25534.
Owner or authorized agent:
Date: 06-14-2017
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
Professional
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buildingC@cupertino.org
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PROJECT ADDRESS ( 1 I t �^ �— APN # 2 („
OWNER NAME _L i C' j� ` PHOS$ r ` I E-MAIL
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CONTACT NAME ( PHOi E-MAIL
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STREET ADDRES f/ n CITY, STATE, ZIPY
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COMPANY NAME E-MAIL FAX
STREET .ADDRESS CITY, STATE, ZIP PHONE
USE OF SFD Or Duplex [I Multi -Family ROOF AREA VALUATION: r'
STRUCTURE: ElCommercial C/ G C't_1
EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHARES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE PLACE YES IF NO, r PLYWOOD %" El OSB ` PITCH:
/REROOF
❑ NO I r LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX :12 CLASS: A
PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT n
DESCRIPTION OF WORK:�'
P4� a� �-•�'i S' Ins
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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 info ve provided is correct. 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 tp bu ing constniqqn. I authorize representatives of Cupertino to enter the aOve-identified property for inspection purposes.
Signature of Applicant/Agent: 1 Date:
SUPPLEM AL INFORMATION REQUIRED OFFICE tlsE oALY..
_ If building is associated with a Home Owner's Association, provide letter 'PLANCHECK TYPE RouTh.c sim
of approval from HOA. ❑ (3\'ER-THE-COUNTER ❑ BUILDING PLAN REVIEW
_ Provide Planning approval to verify if there any restrictions. ❑' . EXPRESS ❑ . PLA.ING�PLAN REVIEW,'-
Provide
EY IEW ;-
Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT
Provide signed copy of Cupertino's Tear -Off Policy. ❑ 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 • buildino(a cupertino.org
PROJECT ADDRESS I
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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.
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 this inspection.
Unless new plywood roof sheathing is proposed throughout, all the nails/fasteners shall be either
completely knocked -dove 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 th ollowing is true: I am the property owner or authorized agent to act on the
property owner's behalf I understand and aE-s
comply with the re -roof policy stated above. I also understand that
smoke detectors and carbon monoxide detece r quired to be installed in accordance with Sections R314 and R315 of
the 2016 California Residential Code. r _[ Jr I -
Signature of Applicant/Agent: Date: h
ReroofPolicy_2014.doc revised 12115116
SMOKE / CARBON MONOXIDE ALARMS . `'F
r_cil OWNER CERTIFICATE OF COMPLIANCE . 'r t1
40.44.4., COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333•building aacupertino.orq
PERIIVIIT CANNOT BE"FINALED UNTIL.THIS CERTIFICA:TE_TIAS 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 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 Alaints 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 X X
bedroom(s)-(Smoke alarms shall not be located within 3 feet of bathroom door)
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 907.2.114 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 ,t ,bz I,>
Address I ,))4 z,, m 4 1 s z ` t Permit No. 1 )7-0 Zi f
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Specify Number of Alarms #Smoke Alarms ( 5 ( #Carbon Monoxide Detectors (
/have read and agree to comply with the terms and conditions of this statement
Owner(or Owner Agent's)Name:
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ontractor Name:
v 4.416'tipIc '4r' ' Signature .. Lic.# 6. ... . Date:P. ®�C7"---
Smoke and COform.doc revised 01/10/2017