B-2017-1332CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-1332
10331 LOCKWOOD DR APT B CUPERTINO, CA 95014-2615 (342 30 033)110331
CUPERTINO ROOFING
LOCKWOOD DRAPT A CUPERTINO, CA 95014-2615 (342 30 033)
INC
SAN JOSE, CA 95129
OWNER'S NAME. LIN NICHOLAS AND MELISSA
DATE ISSUED: 08/11/2017
OWNER'S PHONE: 408-621-1359
PHONE NO: (408) 973-9427
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO -
License Class 1C39 Lic. #565437
Contractor CUPERTINO ROOFING INC Date 03/31/2018
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 - (40 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.
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
Sq. Ft Floor Area:
Valuation: $20000.00
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
APN Number'
Occupancy Type:
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize
342 30 033
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
soorce re tions per the Cupertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signatur).=^ _—Date 08/11/2017
Issued by Kim Dunbar
Date: 08/11/2017
OWNEk-BUILDERDECLARA,TION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
following two reasons:
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: 08/11/2017
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
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
permit is issued.
Health & Safety Code, Section 25532(a) should I store or handle hazardous
s. I certify that in the performance of the work for which this permit is issued, I
material. Additionally, should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the
air cont ►ansa ed by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance wi a Cupertino Municipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Co-clu, Sections 25505, 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: 08/11/2017-- C
I certify that I have read this application and state that the above information is
I hereby affirm th re is a construction lending agency for the performance
correct. I agree to comply with all city and county ordinances and state laws
of work!ich this permit is issued (Sec. 3097, Civ C.)
relating to building construction, and hereby authorize representatives of this city
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,
Lender's Address
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understands
ARCHITECT'S DECLARATION
and will comply with all non -point source regulations per the Cupertino Municipal
I understand my plans shall be used as public records.
Code, Section 9.18.
Licensed
Signature Date 08/11/2017
professional
REROOF TEAR -OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION
ALBERT SALVADOR, P.E,, C.B4O., BUILDING OFFICIAL
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10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
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(408) 777-3228 - FAX (408) 777-3333 - buiIdingQcupi§rtJno,,org
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I UNDERSTAND AND TEE TO THE FOLLOWINT G:
I The re -roof shall cornply with all applicable provisions of the 2016 California Codes.
-ied -D. to one business - clans.
An inspection request, can be set uled u . uested,,Jnspection,,d_�
Aabefbre,the.req
To schedule, inspections call (408) 777-3228 from 7:30-3:3 )0pril (Mots -Thurso or 7:30-2-30pm (Friday) to
schedule inspection. For Tear -Off and Nailing Irtspectioils. you -must also call on, the day of the
inspectiononly after that phase of the work is completed. The building inspector will be Out to the -
job siterithin one hour. The hours for this service are: 7:30-1,0*30amand 12:30-24:30 (Mon-Tbtrrs)
and 7:30-10,30ani And 120.0-2.:30 (Friday. FinalInspee-tions, will be given a two hour window.
3. :Lgair-00 lnspgdion,jLr .c � i�°epi. Any and all dry -rotted wood shall be replaced prior to this inspection,.
unlew -fiew pl'yWnod , roof sheathing ut;j' _ tb 1 , te ,
is proposed throb all 4a Is/fa s ners shall be either
couiplgt,ely,k,xi.ockdo n or removp- d prior to this -inspect! 'Oil,
4. If plywood is installed. a plywood l La_fling.,In sLiec I dow.19 required.
5. Roofing shall not be applied without first obtaiftingall,priceins" &fion and written approvals from the
buildin,g, inspector. Any,r6.ofing,.vhicb:isapplied witho tif first obtaining an approved inspection will
require the removal of all new material. down. to theshe athing.so a p I ropor inspection can be performed.
0. A Final. Iii-ssection oval shol L -be the�bultdi,,,. - tl when the re -roofing is
agd app r ag Inspec, 0
A, sgn-off, s:
can�plztod. To receive a fna, if ffie Utowing-item. gall be vertiecl
a. Flat roofs shall have a minimum of !/,"per foot ofalolvanddemollstr, te . there iSno po.A
ding
b. Listings from approved. testing agencies for all pre -manufactured products used shall be
available on-site to rev,iew at the time of the inspection.
c. Proper spark arrestor installation. vents painted, g-Litter/downspouts installed, debris removed.
7. INOTE If you call fbr 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 aid Wore another ins p-ectiongan be
�Lchedifled.
lowing is true: I to act oil the
By my signing below, I certify each of the fbi gm the property owner or authorized ac,
property owner's bebalf. I I B d agree to comply with the .17eroof policy stated above. I also understand that
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red 0 �jqst4 0 qps.113 all
smae detectors and 6 req ti scare se Jk;l
fit -_nio=ddedeted m4te _�d 'T, 1,4 of
the 2016 Catif6rt`tia kesidential Colo'
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Reroq1Po1ic.v_.20J4,dac rei4sced 064)11`7
\\ `` SMOKE / CARBON MONOXIDE ALARMS , A A L
OWNER CERTIFICATE OF COMPLIANCE 7
c., COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPERTINO NO 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333• buildinq(a cupertino.orq
PERMIT CANNOT.BF FINALED UNTIL THIS CERTIFICATE.HAS BEEN
COMPLETED,$IGNED,,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 R314,2016 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 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 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
Address �- Permit No. 6- 1 T/33:2--
Specify Number of Alarms: #Smoke Alainus: IMO #Carbon Monoxide Detectors. 2 I
I have read and agree to comply with the terms and conditions of this statement
Owner(or Owner Agent's)Name:
6G - ii; s Signature Date: d/ i/
Contractor Name:
Signature Lic.# Date:
Smoke and CO form.doc revised 12/15/16