B-2017-1018CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-1018
20061 SUISUN DR CUPERTINO, CA 950144426 (369 28 004)
CAL/WEST ROOFING
& WATERPROOFING,
INC
SAN JOSE, CA 95148
OWNER'S NAME: AFLATOONI KOOROSH AND EBTEDAEI MEHRNAZ
DATE ISSUED: 06/27/2017
OWNER'S PHONE: 408-368-8440
License Class C-32 Lie. #915333
Contractor CALMEST ROOFING & WATERPROOFING. INC Date 05/31/2018
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:
r. 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.
z. •/.l 1�have and will maintain Worker's Compensation Insurance, as provided for by
i ection 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
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.
Signature Date 06/27/2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
r. 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:
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.
z. 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 06/27/2017
PHONE NO: (408) 531-1961
BUILDING PERMIT INFO:
BLDG —ELECT —PLUMB
MECH X RESIDENTIAL _ COMMERCIAL
DESCRIPTION:
.00F; TEAR -OFF; COMP SHINGLES- (20 SQ)
Sq. Ft Floor Area: I Valuation: $11500.00
APN Number: Occupancy Type:
369 28 004
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: JASMINE ARCHBOLD
Date: 06/27/2017
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 ofApplicanr4_ �
Date: 06/27/2017
ALL ROOF COVERINGS TO BE CLASS "A" OR
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.
1
Owner or authorized agent
Date: 06/27/2017
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 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(alcupertino.org
PROJECT ADDRESS
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OWNER NAME
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PHONE(l (�
E-MAIL
STREET ADDRESS
CITY, STATE, ZIP
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CONTRA,C7QR NAME
LICENSE IJUMBIR
LICENSE TYPE
BUS. LIC. #
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CITY, STATE, ZIP
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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.
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 1/" 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 detectors are required to be installed in accordance with Sections R314 and R315 of
the 2016 California Residential Code.
Signature of
Date: 6w-
ReroofPolicy_2014.doc revised 06/01/7
CUPERTINO
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(a-)cupertino.or_q
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OWNER NAMEPHONE C,.�I I(�]� E-MAIL
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STREET ADDRESS CITY, STATE, ZI FAX
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CONTACT NAME PHONE E-MAIL
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STREET ADDRESS CITY, STATE, ZIP FAX
❑ ONNER ❑ OWNER-BUII.DER ❑ OVINTERAGENT C01?RACTOR ❑ CONTRACTORAGEN'T ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CTOR N LIC T E NUMB LICENSE TYPE BUS. LIC. P, O
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ARCHITECVENGINEER NAME
LICENSE NUMBER
BUS. LIC. R
COMPANY NAME
E-MAIL
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STREET ADDRESS
CIT , STATE, ZIP
P ONE
USE OF ❑ SFD or Duplex
❑ Multi -Family
ROOF AREA:
VALUATION:'
STRUCTURE: ❑ Commercial
`
EXISTING ROOF TYPE: ❑ BLIILT-UP ROOF
ASPHALT SHINGLES
❑ WOOD SH.AKFS
❑ WOOD SHINGLES
❑ OTHER (SPECIFY)
REMOVE /REPLACE KYES
IF NO,
PLYWOOD
❑ w, AdvW7
PLYVJD OSB
PITCH:
ROOF
❑ NO
# LAYERS:
THICKNESS:
❑ 5/8"
TYPE: ❑ CDX
457 :12
CLASS: A
PROPOSED ROOF TYPE: ❑ BUILT-UP ROOFASPILAI-T
SHINGLES
❑ WOOD SHAKES
❑ WOOD SHINGLES
❑ OTHER
ICC -ES REPORT #
DESCRIPTION OF W
'1__11 M1_.
ReroofApp_2011.doc revised 03116111
CUPERTINO
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms
for compliance with 2016 CRC Section R314,2016 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 and CSC 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: 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: Z�6/ �S cy� ,�� _ Permit No. ?-;, �_o L �L. l 5 C 8
Specify 1�Tumber of Alarms: # Smoke Alarms: # Carbon Monoxide Detectors: 1 1 1
I have read and agree to comply with the terms ad conditions of this statement
Irl
00pnTr or Owner A ent' 9 N e:
G(� OL.,fl
Signature ............ ......................................................................................... Date ?i`/
............................
Contractor Name:
q
Signatur ................ ............... ( .................. Lic.# dC 1................... Datep�`
Smoke and CO fonn.doc revised 12/15/16
CUPERTIN
Owner N
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 • buildina(acupertino.oro
�d6r®�Gs� A" Permit No.
Address Z,tG!
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.
2''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.
❑ 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.
.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.
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..
PlVse 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 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, all non-compliant plumbing fixtures shall be replaced with water -
conserving plumbing fixtures throughout the building (regardless of whetherproperty 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 iinproverrrents).
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 pluin ' g fixtures in accordance with Civil Code Sections 1101.1
through 1101.8, the current California Plumbing Code and California Teen Building Standards Code, and manufacturer's
installation requirements, and that the water -conserving plum ing rxtru s comply with the requirements as indicated in the
table on the following Daae. I I _
I Owner or Owner Agent's Signature: C ) Date: 4 /9�- H / I /_ I
Upon completing and signing this Certificate, please return it to�he Building Division in order to final your buil ing pe it.
SB407 2015.doe revised 01105/17