B-2017-1108CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1108
10201 STONYDALE DR CUPERTINO, CA 95014-1029 (326 37 019) JIREH INC
LOS GATOS, CA 95031
OWNER'S NAME: WILSON JOSEPH G III AND KATHLEEN A TRUSTEE
OWNER'S PHONE: 408-739-7792
LICENSED CONTRACTOR'S DECLARATION
License Class C-18 Lic. #800707
Contractor JIREH INC Date 10/31/2017
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.
2. I have and will maintain Worker's Compensation Insurance, as provided for by
oc 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 per the Cupertino Municipal Code, Section 9.18.
Signature _!/(/L Date 07-11-2017
DATE ISSUED: 07/11/2017
PHONE NO: (408) 298-9399
BUILDING PERMIT INFO:
X BLDG —ELECT —PLUMB
_ MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
RE -ROOF; TEAR -OFF; INSTALL OSB; COMP SHINGLES (48 SQ)
Sq. Ft Floor Area: I Valuation: $17239.00
APN Number: Occupancy Type:
32637 019
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: 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
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 (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed Signature of Appl
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:
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.
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.
�@ iWil
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, Sectio s 25505, 25533, a 25534.
Owner or authorized agent:
Date: 07-11-2017
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
CUPERTINO
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building cDcupertino.org / }}
1 t n
PROJECT ADDRESS
/
APN # 32-&-3 7 ^ O /
LC
OWNERNAME -��
PHONE - 7-n E-MAIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
CONTACT NAME
PHONE
E-MAIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME .r.
LICENSE NILM13JER
LIC NSE T
BUS. LIC. #
COMPANY NAME
E- AIL
F
STREET D S
A�i
CITY, STA , ZIP
j J
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC. #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF SFD or Duplex ❑ Multi -Family
ROOF A
5
VALUATION:
/�
STRUCTURE: ❑ mmercial
EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE/REPLACE YES
I;FNO,
PLYWOOD ❑ '/,'
PLY\ SB
PITCH:
12
ROOF
A
❑ NO
# LAYERS:
THICKNESS: ❑ 5
TYPE: ❑ CDX
CLASS
WOOD SNGLES ElOTHER
PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ElHI
ICC -ES REPORT #
DESCRIPTION OF WORK:
p S,d tei
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 bui di strucoh. I authorize repr entatives of Cupertino to enter the above-idenof d property for inspection purposes.
Signature of Appl icant/Agent: Date:
SUPPLEMEN AL IN ORMATION REQUIRED
OFFICE USE ONLY
If building is associated with a Home Owner's Association, provide letter
PLAN CHECK TYPE
ROUTING SLIP
_
of approval from HOA.
❑ OVER-THE-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_201 1. doc 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
l (408) 777-3228 • FAX (408) 777-3333 • building aecupertino.org
PROJECT ADDRESS &2
APN #
OWNER NAME^�
\
PHONE r
j ��ML
STREET ADDRESS
CITY, STATE, ZIP
FAX
CONTRACTOR NAME i I
LIC EN 0 OBER ,
l
LICSE TYPE
BUS. LIC,
CO NAME - 1 I
E-MAIL
FAX
STRE _ _ DESS
CITY TATE,
PHONE
I UNDERSTAND AND AGREE TO THE FOLLOWING:
The re -roof project shall comply with all applicable provisions of the 2013.California Codes.
2. An inspection request can be scheduled un 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
-_ & bf the ins ectiori onl- after that -hase of the work is com leted:-- The buildi-n ins ector will be
Y p Y P P g P
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 -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 I/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 detector are required to be installed in accordance with Sections R314 and R315 of
the 2013 California Residential Code/ // 1// / %
of
Date:
RerooJPolicy_2014.doc revised 01/15/14
•
1 'I
\A../ SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
strsr COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•building cupertino.orq
(3)
/
Permit No. 6-,
Address /0 7_,40/ 5/0)1/ti cfC1.1e Q) #of Alarms Smoke: Carbon Monoxide: '
PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE
HAS BEEN SIGNED AND RETURNED TO TH H: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
$1000.90,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 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. and shall be approved by the Office of the State Fire Marshal.
Power Supply:In dwelling;units with no commercial power supply,alarm(s)maybe 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 wifl 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:
ISO/1 Signature 1. - Date:G?. T p. /
Contractor Name: /
•
Signature Lic.# Date:
•
1 S3noke and CO fonn.doc revised 03/18/14
\ t / WATER-CONSERVING PLUMBING FIXTURES
VOWNER CERTIFICATE OF COMPLIANCE
AIsi,,94, COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
UPERT[MQ 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
C (408)777-3228•FAX(408)777-3333•buildinq(c�cupertino.orq t/
Owner Name J6e (J)115a 11 Permit No. 2-uL i �1�(�'�b
Address l b10! ai-rwe oi,G(L Di
, ,PERl1IIT CANNOT BE�FINALED,,'AND COMPLETED.�UNTILTHIS CERTIFI,,,CATER; rE,
,�a aRAS BEENiSIGNEDPAND REaTURNED,TOWFFiE4B •DI IG`5DIYISIONb k ,,IE
t. 'W7-;:":7,,,,:i7-s r. t 4 + 1:;. a
12, -� t,,<'u :-, t ± f !:_ fi., . w J t A... i :Ii.„µ t-s "`uy_ ,,
Please refer to the attached California Civil Code Sections 1101.1-1101.8 which are part of this Certification form. '
1. Is your real property a registered historical site?
E l Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form.
Owner' Signature: /� f1 T_`7 .._ Date: V2V0 7 '
No Go to Question
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.
Sign below and skip the rest of the form.
Owner' Signature: ers9i Date: .5124/7
"k,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. Sign below and skip the restiof the form.
Owner' Signature: 4 ."7,-.4117--- Date: ' /25Jf'7
No Go to Question 4. /
4. Is your real property built and avai able 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. Sign below and skip the rest of the form.
• Owner' Signature: Date:
. 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. Refer to the attached.
AMy 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 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.
SB4072014.doc revised 03/18/14
1 I
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
UWe,the owner(s)of this property,certify under penalty of perjury that non-compliant plumbing fixtures have been replaced
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 o iply w:th the req ell ents as indicated in the table below.
Owner's (or Owner Agent's) Signature: G � _ Date: 2/1261/ 7
Upon completing and signing this Certificate,please return it to the Building Division in order to final your;permit.
Non-Compliant Water-Conserving Plumbing Fixture.
Plumbing Fixture/ (Fixture Complying with Current Code Applicable to New Construction) .
• Maximum Water Usage/Flow Rate'
Fixture Type 2013 CPC Ch.4 2013 CPC Ch. 4 ; ;2013 CPC Ch.4
Water Usage 2013 CALGreen Div.4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3
/Flow Rate
Single-Family Multi-Family ;: Commercial
Residential Residential ,
Water Closets Exceed 1.6 Single flush toilets: 1.28 gallons/flushj,
(Toilets) • Gallons/flush Dual flush toilets: 1.28 gallons/flush effective.flush volume(the composite,
average flush volume of two reduced flushes andone full flush)
Urinals Exceed 1.0 0.5 gallons/flush,
Gallons/flush
Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of
_gallons per minute U.S. EPA WaterSen_se Specification_for Showerheads
(A hand-held shower is considered a showerhead.)
For multiple showerheads serving one shower, the combined flow rate of all
showerheads and/or other shower outlets controlled by a single valve shall not
exceed 2:0 gallons per minute @ 80 psi, or the shower shall be designed to
allow only one shower outlet to be in operation at a time.
Faucets— Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5'gallons per minute @ 60
Lavatory per minute minute @ 60 psi; minimum .Maximum 1.5 gallons psi .j
Faucets 0.8 gallons per minute @ per minute @ 60 psi;
20 psi minimum 0.8 gallons
per minute @ 20 psi
In common and public
use areas: 0.5 gallons
per minute @ 60 psi
1.8 gallons per minute
@60 psi
Faucets— Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60
Kitchen per minute 60 psi @ 60 psi psi
. Faucets May temporarily increase May temporarily
up to 2.2 gallons per increase up to 2.2 ,
minute @ 60 psi, and must gallons per minute @
default to maximum 60,psi, and must
1.8 gallons per minute @ default to maximum
60 psi 1.8 gallons per minute
Where faucets meeting @ 60 psi
• the above are unavailable, Where faucets meeting :•
aerators or other means the above are
may be used to achieve unavailable, aerators or •
reduction. other means may be
used to achieve
reduction.
1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown,it is not required to be upgraded. '
SB4072014.doc revised 03/18/14 i