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B-2017-1107CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1107 10137 N PORTAL AVE CUPERTINO, CA 95014-2322 (316 21 042) JIREH INC LOS GATOS, CA 95031 OWNER'S NAME: CHANG JOHN N AND HELENA K TRUSTEE DATE ISSUED: 07/11/2017 OWNER'S PHONE: 408-253-7651 PHONE NO: (408) 298-9399 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class Ste$ Lic. #$00707 Contractor JIREH INC Date 10/31/2017 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 SHINGLES (32 SQ) I hereby affirm under penalty of perjury one of the following two 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 PC- permit is issued. Sq. Ft Floor Area: Valuation: $14200.00 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 31621 042 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 07-11-2017 Issued by: Kim Dunbar OWNER -BUILDER DECLARATION Date: 07/11/2017 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 1. 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 (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: 07-11-2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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. HAZARDOUS MATERIALS DISCLOSURE 2. 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. I 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 Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Section 5505, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date: 07-11-2017 1 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. Signature Date 07-11-2017 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 • buildingCo)cupertino.org I:I PROJECT ADDRESS APN # 2 / / _ O OWNERNAME PH 2 II E-MAIL STREET ADD CIT ST ZIP / FAX /�� CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT V ONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NILMBER LIC SE BUS. LIC. # D COMPANY NAMEE- AIL F 9 v J1616 L-05 z /!� a C2 2L793 STREET D 3 CITY, STA ,ZIP r �/ PHO �_ �] J /C ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS. LIC. # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OFSFD or Duplex ElMulti-Family ROOF AREA: VALUATION STRUCTURE: Commercial EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES u WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE/REPLACE EKES IF NO, 1 PLYWOOD ❑ vi: ❑ PLYWD eros. PITCH: 12 ROOF 1 APROPOSED ❑ NO # LAYERS: THICKNESS: El5/8" TYPE ❑ CDX CLASS: �(ASPHALT SHINGLES 11WOOD SHAKES ElWOOD SHINGLES ElOTHER ROOF TYPE: ❑ BUILT-UP ROOF u ICC -ES REPORT # DESCRIPTION OF WORK: O� 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 provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildirAg entatives of Cupertino to enter the above-identifi d pro rty for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMEN AL INORMATION REQUIRED OFFICE USE ONLY PLAN CHECK TIDE ROUTING SLIP _ If building is associated with a Home Owner's Association, provide letter of approval from HOA. ❑ OVER -THF -COUNTER ❑ BUILDING PLAN REVIEW Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT Provide signed copy of Cupertino's Tear -Off Policy. ❑ OTHER: ReroofApp_2011.doc revised 03/16/11 �yt.rass 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 crMcupertino.ora PROJECT ADDRESS � APN # OWNER NAME 0 I h PHW a� 3 E-MAIL STREET ADDREn 0 � � � A)- CTTY, ATE, IP (.4 95V FAX 1 CONTRACTOR NAMEr-_ I LICENSE1�� S�E-MAIL 7 LICENSE E BUS. LICA CO NAME / 1 s o o Ir�C o� n FAX U8�193�1 SS CITY TATE, J PHONE I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re -roof project shall comply with all applicable provisions of the 2013 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 7:30-3:30pm (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 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 knoc e�lc =down or removedpnor t�.iis 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 '/4" 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 e installed in accordance with Sections R3.14 and R315 of the 2013 California Residential C,o Signature of Applicant/Agent: / / Date: 714V �7 ReroofPolicy 2014.doc revised 01/15/14 • 10, 2--c� -�/ SMOKE / CARBON MONOXIDE ALARMS jA OWNER CERTIFICATE OF COMPLIANCE �ycr9rCOMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION � CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinq(acupertino.orq Permit No3I7/I© Address /61.3 J #of Alarms 'Smoke: Carbon Monoxide: • 'Z.-- PERMIT Z.-PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN'STGNED AND.RETURNED TO TH►+;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 interioraccess for inspections are required. • GENERAL INFORMATION Existing single-family and multifamily dwellings shallbe 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 X X bedroom(s)• On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not requiredin dwellings which do not contain fuel-burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smok 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 thereis 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 have been tested and are operational,as of the date signed below. ' !have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: Signature • Date: • C• /on_tractoor�Naame• Q q CdSCi7' Signature Lica....F1 c!Q` Date: Smoke and CO fonn.doc revised 03/18/14