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B-2017-1390CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1390 22403 RIVERSIDE DR CUPERTINO, CA 95014-3960 (356 03 036) VISIONS ROOF DESIGNS SANTA CLARA, CA 95051 OWNER'S NAME: KAKAR DEEPAK AND NIENON LEENA OWNER'S PHONE: 408-892-9990 LICENSED .NSED CON A TOR' DECLARATION License Class C-39 Lic. #815133 Contractor VISIONS ROOF DESIGNS Date 03/31/2019 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: 1. I have and will maintain a certificate of consent to self -insure for Worker's mpensation, as provided for by Section 3700 of the Labor Code, for the rformance 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 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 inconsequence 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. Date 8/18/2017 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 DATE ISSUED: 08/18/2017 PHONE NO: (408) 247-5054 BUILDING PERAUT INFO: X BLDG —ELECT -PLUMB _ MECH X RESIDENTIAL _ COMAIERCIAL JOB DESCRIPTION: REROOF; TEAR -OFF; INSTALL OSB; COMP SHINGLES (24 SQ) Sq. Ft Floor Area: I Valuation: $16778.00 "N Number: Occupancy Type: 356 03 036 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. by: Abby Avende 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 spection. e of Applicant. Date: 8/18/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF 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 sucfi 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 .consthuction, and hereby authorize representatives of this city to enter upon the 1 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 8/18/2017 nAII HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 695 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, 25 ,and 25534. ne orauthorized age Date: 8/18/2017 CONSTRUCTION ING GE C 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 `,l r© .1ml (408) 777-3228 • building@cupertino.or ; PEMIT #B - LOP- �'t CUPERTINO REV # DEF # F-1 NTRw (YIN11TRTT(-TTC)N n AT-)T)T-rT(-)N n AT.TFRATTom n T T n MF.P I KRE-ROOF I—I SWIMMING POOL/SPA PROJECT ADDRESS 9 t �'N # O AME PHONE E -MALL r 1 STREET ADDRES , STATE, ZIP F Y1 ONTRACTOR NAME ❑ OWNER -BUILDER CO ANY NAMELICENSE f c NUMBER LICENSE TYPE G�VI` 6_�Mon J (_3S1— STIR l/BBU�S. E-MAILt LIC P ham�PHOI'�10R-71_R- z rens 3 ❑ ARCHITECT ❑ OWNER ❑ NERAGENT ❑ CONTRACTOR AGENT ENGINEER ❑ DEVELOPER ❑ TENANT CONTACT NAME E-MAIL STREET ADDRESS CITY, STATE, ZIP PHONE 1 DECRIPTON ` j 1'� ouc ex- f ✓i // S a 1 cnma63 NGLE-FAMILY/DUPLEX ❑ MULTI -FAMILY ❑ INDUSTRIAL ❑ COMMERCIAL USE TYPE OCC SQ.FT. VALUATION ($) EXISTING USE EXISTING IF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES ll TOTAL NET SF I I REMODEL REMODEL KITCHEN REMODELOTHR GARAGE �tTTACHED BATHROOM SF SF SF SF ❑ DETACHED EMSING ❑ YES FIRE SPRINKLERS ❑ NO EICHLER ❑ YES ❑ NO SECOND STORY ADDITION ❑ YES ®'NO DWELLING SECOND DWELLING []YES ❑ ATTACHED ❑ DETACHED OTHER UNITS q UNIT ADDITON: []NO S F I POOLS ❑ FIBERGLASS ❑ VINYL -LINED ❑ GUNITE ❑ PREFABRICATED POOL - SF SPA - SF SPA ATTACHED ❑ YES N NO TOTAL - SF REC VED BY:, TOTAL VALUATION: Commercial or Multi -Family Buildings with Public Swimming Pools requires Department of Environmental Henth ayprovnl RE -ROOF EXISTING ROOF TYPE:' ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES 2owOOD SHAKES ❑ WOOD SHINGL S ❑ TILE OTHER (SPECIFY) REMOVE /REPLACE ❑ NO',IF NO PLYWOOD 03/81, PLLY�Y/�WOOD TYPE: PITCH: ROOF CLAS S 18 OF LAYERS THICKNESS E]5/8" OTHER ITQOSB ❑ CDX OTHER_ PROPOSED ROOF -TYPE: ❑BUILT=UP ROOF SPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER *Provide a signed copy of the Cupertino's Tear -Off Policy SF 40%, #of SQUARES _&L_ 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 building construction. I authorize representatives of Cupertino to enter the above -identified, property for ins ection purpos cknowledge and authorize all information contained on this application form to be made available for public rec /'7 Signature of Applicant/Agent; Date: SUPPLEMENTAL INFORMATION REQUIRED *New SFD/Second Dwelling Units/Multifamily Dwellings: A Demolition permit is required prior to issuance of a building permit for all new construction. *Commercial Buildings: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. *Copy of Planning, Approval Letter or Meeting with Planning prior to submittal of Building Permit application. *HOA -Provide a letter of approval from the Home Owner's Association Bldg,4pp_2017.doe revised 08101117 COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 0300 TORRE AVENUE ENU-E - CUPERTINO, CA 95,014-3265. (408) 777-3228 - FAX (408) 777-3333 - bullding�b_cuperting.org PRojK,r ADDRESS _2290_3. �% MNER NAMEP a�rt r K i -R92- &kbMAIL z6a S'1"'T!,ETADDR�ZE �S wvc_ CITY, STATE. ZIP FAX WNITRACTORNW,fr BUS. LIC. 0 C().'X1 1P4N'V1 KANiE - E NIML FAX ' W- 7 Y7 - C"Ir'ns if ya SI h S T ITA az I l Z2-32(0 I UNDERSTAND AND AGREE TO TKE FOLLOWING: Le'llie re -roof project shall comply with all applicable provisions of the 2016 California Codes. 2.,/-A.n inspection request can be scheduled uR to one-businessz day before .the..recouested,insnection.elate. 10 schedule inspections call 'J'. 3`0'hi (N!6nJhurs) or 7,3 0-2 -3 Opm (Fr , i day) to X08) 717-3228 fiom 7:316- schedide, inspection, For Tear-Offand Nailino,,.Inspect.i.ons,,yo4-mtist -aFs—ocAll.1, or-MFe-Ta-y of thF— inspectibn. 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: 7:304.0-:30am. and 1,2:30-3:30 (Alon-Thurs), and 7:304.0:30ani and 1.2:30-2:30 (Friday). Final InsTe—etions will'be givZffTT5Mvo hour_�win o7v. 3. Tear -Off Inspeetion is required. Any and all dry -rotted wood shall be replacedprior to this inspection. Unless new plyw6od roof sheathing is proposed throughout, all the nails/fasteners shall be either completely 4-0ocked-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 xvritten approvals frons the building inspector. Any roofing which, is appPied without first obtaining an. -approved inspection will. require the removal of all new material down to the sheathin.g.so a proper inspection can be performed. 6. A Final fns ection-and -approval shall be obtainedftufti.the:-buildinginspector t when the re -roofing is . completed,. To receive a final- sign off, jl�e f ollowing t, br6s will :b6verified: a. Flat roofs shall have a minimum of 1/4" per foot of slope and demonstrate there- is no ponding. :b'. , Listings from approved testing agencies for all pfe-manufactured.prodticts used. shall be available on-site to review at the time of the ins,p&ction. ,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 charge4 a re -inspection -fee. The re -inspection fee shall be gaid, before another inspection can be scheduled. By my signing below I certify each of the following is true: - I ani the property owner or authorized agent to act on the property' bwker's behalf. I understand and agree to comply with the re -roof policy stated above. I also understand that S111oke ddietors!And' carbon.monoxide detector >,a . re required to be installed iti accordance with Sections R) 14 and R3'1 5 of the 2016 California Residentiale. - ionattire- bfknr)Kcint/A Dat ........... ........ Rcroq1Pa1ic,v.._20,74.doc revised 06/01," SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333• buildinq(cr7cupertino.orq ;PERMIT CANNOT;BE EIIVALEB UNTIL THIS CERTIFICATE HAS BEEN cO1 LETE3),$IGNEB,AND RETURNED TO THE VILD TG 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 �7,L Permit No.101��, Address 2s 4/03 Kr /1 �'� 7 f 3 3 J � �� r Specify Number of Alarms: #Smoke Alarms. I I #Carbon Monoxide Detectors J I I have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: p • A7 PCIA4e N Signature l12g):1 C tractor N '° Signatur . . Lic.# . ? Date:W7 Smoke and CO fonn.doc revised 12/15/16