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B-2017-1290CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1290 11115 LA PALOMA DR CUPERTINO, CA 95014-4772 (356 16 033) PRINCIPLE ROOFING INC CUPERTINO, CA 95014 OWNER'S NAME: ROGERS IAN AND HE LIRONG OWNER'S PHONE: 650-701-3898 LICENSED CONTRACTOR'S DECLARATION License Class C39 Lie. #956887 Contractor PRINCIPLE ROOFING INC Date 01/31/2019 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: m. 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. 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 regulations per the Cupertino Municipal Code, Section 9.18. Signat , n Date 08/07/2017 OWNER -BUILDER DECLARATION I hereby -affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. 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. 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 Date 08/07/2017 DATE ISSUED: 08/07/2017 PHONE NO: (408) 898-7298 PERMIT INFO: BLDG ELECT —PLUMB MECH X RESIDENTIAL COMMERCIAL DESCRIPTION: .00F; TEAR -OFF; INSTALL OSB; COMP SHINGLES - (24 SQ) Sq. Ft Floor Area: I Valuation: $15000.00 AFN Number: Occupancy Type: 356 16 033 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: 08/07/2017 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 of Applicant: Date: 08/07/2017 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,Sections 25505, 25533, and 25534. Owner or authorized ag66? Date: 08/07/2017 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 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 R CUOERTINO (408) 777-3228 - FAX (408) 777-3333!- buildingCoXwertino.org , 8 , PROJECT ADDRESS F2 OWNER NAME PLYWOOD 0-w- 11 PHONE E-MAIL 7 STREET ADDRESS CITY, STAT a#- V FAX CONTACT NAME FAX' P(4HON192?) E ??!2 Q E-MAIL STREET ADDRESS CITY, STATE, Zip PHONE DESCRIPTION OF W ORM STREET ADDRESS CITY STATE, Z.tP AkcHITECTIFNGINEER NAME FAX 1.0 OWNER 0 OWNER -BUILDER 0 OWNER AGENT VCOITRACTOR ❑ CONTRACTOR AGENT 13 ARC=,CT 11 ENGINEER IJ DEVELOPER. 11 TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE PLYWOOD 0-w- 11 PLYWID 'R'OSB PITCH: A 0! NO COMPANY NAME E-MAIL FAX' .CLASS: C& STREET ADDRESS CITY, STATE, Zip PHONE DESCRIPTION OF W ORM &gagJ azo AkcHITECTIFNGINEER NAME LICENSE NUMBER BUS, LIC. 0 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE LSE OF Z7D or Duplex [I Multi -Family ROOF AREA: VALUATION: sy Commercial t� I k, r Sus V'RVILPI GPLAN,ftvibV STRUCTURE: EXISTING ROOF TYPE:'; bBU`ILT-UPROOF DASPHALT SFUNOLES 1<'0ODSHAKES 0WOOD SHINGLES 11 OTHER (SPECIFY) REMOVE)REPLACE !R,'17E IF No. PLYWOOD 0-w- 11 PLYWID 'R'OSB PITCH: A 0! NO O'LAYFRS THICKNESS: 5/8', TYPE: 13 COX .CLASS: C& PROPOSED ROOF TYPE::. BUILT-UP ROOF- 0ASPHALT SHINGLES 11 WOOD SHAKES El WOOD SHINGLES ❑ OTHER ICC -ES REPORT 9 DESCRIPTION OF W ORM 13y my signature below; I ceftifv to each of the following: I am the property owner orauthorized agent to act on the property owner's behalf I have read this application and the information Lhave provided is correct. I have read the Description of Work and verify it is accurate- I agree tocornpiyvliihall applicable local ordinances and state la'wi slatingtobuilding const ct on I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applican"gent: I Date: SUPPLEMENTAL INFORMATION REQUIRED IT =, !p,ROUTSLI If building is associated with a Home Owner's Association, provide letter -OVERIT11, "OTJNTER%�'V�A k, r Sus V'RVILPI GPLAN,ftvibV of approval froni HOA. Provide Planning approval to verify if there any restrictions. Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cupertino's Tear -Ofl'Policy. Reroof4pp,201 I. doe revised 03116111 Zgy 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(d)-cupertino,org PROIECT'ADDRESS l / Z -n__ P AL6 D� - APN l� OWNER NAME PHONE /wL, CGTa) I-3�39a E-MAIL STREET ADDRESS IrliS 1,4.1PC-4- CITY, STATE, ZIP 947154 FAX CONTRACTOR NAME 12 a10j6:Wk__— LICENSE NUMBER LICENSE TYPE BUS. LIC, # CP.tiIPANY NAME _ F E-MAIL FAX STREET DDRESS ' �f 66' a 5 - ._ CITY, STATE, ZIP �nS� 61 tai PHONE ZP'% 8,.Pg 2,-4 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'cgri -be scheduled up to one business day before the re ` nested inspection date_ To schedule inspections call (408) 777-3228 from 7:30-3:30pm (Mon-Thurs) or ,7:30-2:36pm (Friday) to schedule inspection: For Tear -Off and Nailing Inspections, you must also call, ori the day of 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 (Kion-Thurs) and 7:30=10:30am and 12:30-2:30 (Friday). Final Inspections will be given:q 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 rolof '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 i of all new material down to the sheathing so a proper inspection can be performed. G. A Final Inspection; and, approval shall be obtained fi-om the building inspector when there -roofing is completed. To receive a final sign -off, the following items will be verified: a. Flat roofs shall have a minimum of 1/4" per foot ofslope�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 h1ear-off or plywood nailing inspection and the work isnot 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.lnsta(led in accordance witl i SectIons 8314 and R3'15°of the 2016 California Residential G ReroofPal cy J014,doc revised 0610117 �i . " SMOKE / CARBON MONOXIDE ALARMS • OWNER CERTIFICATE OF COMPLIANCE #.44COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPER T O 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333• buiIdinq(a�cupertino.orq PROMPT'CANNOT.::$E EINAI:ED UNTIL TR,is:CERTIFICATE;HAS�BEEl . COl1! LETED,SIGNED AND RETURNED To THEI3 ' TJ_I IMNG 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 R314,2016 CBC Sections 420 6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION i 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 SMOICE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of X X the 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 420.6 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 i' Address t (1 ( t (rpti .pA I,oMA qtr- Permit No. 9 2GI?— t 2-go Specify Number of Alarms: #Smoke Alarms. J 4 I #Carbon Monoxide Detectors. I z I I have read and agree to compl ith the terms and conditions of this statement Owner(or Owner Agent's)Name: 1 Signature .. Date: 02//,/I(1). Contractor Name: Signature Lic.# 49:6f. .- Date:O V9- Smoke and CO fonn.doc revised 12/15/16 WATER-CONSERVING PLUMBING FIXTURES ' OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION UP RTiN© 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 C (408)777-3228•'FAX(408)777-3333• buildinq(a�cupertino.orq Owner Name l;sr12 L i / Lit i+-JG Permit No. (3--2ot 1 2- 0 Address t l t t ! ( (' Ler-tik lit-. G -of civ t� 1.- Is your real property a registered historical site? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. L/To 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? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. 0 The licensed plumber's certification has been provided to the Building Division. { Skip the rest of the form and sign bottom of form. R No Go to Question 3. 3. Is water service permanently disconnected for your building? O Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. [+ `No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? O 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 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.. 5. Please check ONE of the following: 117/Myproperty 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). ' °. " 0 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). 0 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 1 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 peijury that non-compliant plumbing fixtures will be j 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 j installation requirements,and that the water-conserving plumbing fixtures comply with the requirements as indicated in the table on the following page. Owner or Owner Agent's Signature: Date: at/21/#- Upon - Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit. 5B4072015.doc revised 01/05/17