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B-2017-1283CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1283 22296 S DE ANZA CIR CUPERTINO, CA 95014-3953 (356 02 016) R E ROOFING AND CONSTRUCTION INC SAN JOSE, CA 95124 OWNER'S NAME: CHEN FUCHUNG CLIFF AND MEICHING CYNTHIA TRU DATE ISSUED: 08/03/2017 OWNER'S PHONE: 408-313-1822 PHONE NO: (408) 626-9320 License Class C -M Lic. #727599 Contractor R EROOFING AND CONSTRUCTION INC Date 09/30/2018 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: 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 wliich'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. 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 understandsland will comply with all non -point source regulations per the Cupertino MUg4ipa-GQde, Section 9.18. I hereby affirm that, I am exempt from the Contractor's License Law for one of the following two reasons: J 1. , I, as dwner 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 liroperty, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). j I,hereby affirm; under penalty of perjury, one of the following three, declarations: 11. I have and willmaintain 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 Co . ensation.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 foitl with 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 08/03/2017 BUILDING PERMIT INFO: X BLDG —ELECT _ PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: RE -ROOF; TEAR -OFF; INSTALL CDX; COMP SHINGLES (40 SQ) Sq. Ft Floor Area: I Valuation: $25000.00 APN Number: Occupancy Type: 356 02 016 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. by: Kim Dunbar 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 inspection. Signature,ofAppl Date: 08/03/2017 ALL ROOF COVERINGS TO BE CLASS "A" 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 comp Ince wit he Cupertino Municipal Code, Chapter 9.12 and the Heal &Safety de, Sections 25505 25533�and J25534. Owner or authorsed agent: J Date: 08/03/2017 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 REROOF PERMIT APPLICATION 112 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 •FAX (408) 777-3333 * buildinra@cupertino.om PROJECT ADDRESS N /y �' t f/�N tZ r l� �f LICENSENUMBF, r 1 CI J 1 OWNER -NAME I - (AEN PHONE 40U _� 1� 1 C/2 o E-MAIL`l @ 01 -in LIZ STREET ADDRESS�f 2 L r r� ` IL . , / <b�" CITY, STATE, Zl1P /'u ,gyp X11 �` If STREETADDRESS i FAX ' CONTACT NAME ( I�` CITY, STATE, ZIP PHONE�� ; ly E-MAIL -. STREETADDRESS I " �0 , �,I,l ' C CITY, STATE, ZIP �V FFX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT XCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME �� l� �f LICENSENUMBF, r 1 CI J 1 LICE P COMPANY NAME r/ ,/ E-MAIL fAX STREETADDRESS i -1)19 lj` �l� I CITY, STATE, ZIP PHONE,_ J ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC. k COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF�SFD ' Duplex ❑ Multi -Family STRUCTURE; ❑ Co..CiClal , ROOF AREA: 40 U U VALUATIO 4/ 660 EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES AWOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER' (SPECIFY) REMOVE/REPLACE ;t§ -'ES IFNO. I PLYWOOD ❑ �_ PLY -WD ❑ OSB PTTCH: ROOF ❑ No 1 0LAYER& ` THICKNESS ❑ 5/8" TYPE: . jgCDX 12 .LASS -A 'PROPOSED ROOF TYPE: 11BUILT-UPROOF HALT SHINGLES 11WOOD SHAKES E].WOOD SHINGLES 11OTHER ICC -ES REPORT 0 I DESCRIPTION OF WORK: 1 By my signature below, tcertifv of the following: I am the property owner or authorized agent react on the property owner's behalf. I fiave read this application and the info on ! hBchave p vided is correct. I have read the Description of Work and verify it is accur te. I agree to comply with all applicable local ordinances and state la s relating to build Is ucdo hanresents z v s of Cupertino. to enter the ab R-ide rtifted property for inspection purposes.. Signature of Appiican ent: �,. Date: SUPPLEMENTAL INFORMATION REQUIRED I If building is associated with a Home Owner's Association, provide letter of approval from HOA. Provide Planning approval to verify if there any restrictions. Provide copy of Manufacturer's Installation Specifications. Provide signed copy of.Cupertino's'i'ear-Off Policy. n � OFCICl:tJSCiDNC>Ya .r, 1 1 y F6 '7a `V.; K 4i 4 PLA,`v'GHEGKTI"P>v, .,a E't,,, ROUTrhGSLH' `, ICI �ovEx TuisCouxrEa : I ' � © acFlta�rNG rir AN ItEy�Etiv' b ^ �� CI.PRF�S '' t PLa1�NtNOPLANREV(F\� r t©"CT.�u"�TDA12b tr`� � � FtREi)P.FT � d t Y ReroofApp_2011.doc revised 03/1611 t ►1'eo"-s 2O COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPE`NO 10300 TORRE AVENUE . CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 ° buildinq(cDcuoertino.org PROJECT .ADDRESS � � /f�t .4P't OWNER NAME("i�r ' PHO!vF�f�(�_"f(`J ���%�) E-MAIL STREET ADDRESS /} n �y C ` j\ _ n CITY, S�1�oil �SV 4:::1�� FAX CONTRACTOR NAhi?" 14v 1 ( , LICENSE NUVBER J 72_1 ` 9 LICENSE TYPt CRUS. LIC, tt CORtP.ANY NAME T( (� `� l v ,n E-MAIL CC,, o � �J C�QL cvffl FAX STREET ADDRESS I � /J �� fit �rt .�� t1 / CITY, STATE, 1 J ^(�j ([ PHONE I UNDERSTAND AND AGREE TO THE FOLLOWING: I. The re -roof project shall comply with all applicable provisions of the 2016 California Codes. 2. An inspection request can be scheduled up to one business day before the requested inspection date. To schedule inspections', 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 out to the job site 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 bailing 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 ail new -material down to the sheathing so a proper inspection can be perfor>ned. 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 certif}, each of the following is true: l am the property owner or authorized agent to act on the property owner's behalf. I un stand and agree to comply with the re -roof policy stated above. I also understand that smoke detectors and Garb K onoxi detectors are re be Inst i ccordance with Sections R314 and' R315 of the 2016 California Resi ential Code. Si:;nature of Applicant/AQe t Date: - -- 2014. doe revised 116,017 6 li SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE , x{ COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333• buildinci o(�cupertino.orq PERMIT CWIQ,T IW:F AEI)UNTjLT W, CERT. CATE,HAS BEEN: COMPLETE,SIGNED AND RUR 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 s __;LTi �i each sleeping ro'orn n- _ >_ = - •-- - — - -- 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 'i; and California Residential Codes. The alarms specified below have been tested and are operational, as of the h l date signed below t_ Aw2A 111 Address. 22/122/1°-.00S� Cs Permit No. �'201 ZO Specify Number of Alarms: #Smoke Alarms:t l #C bon Monoxide Detec ors. 1-71 i j — /have read and agree to comply with the terms and conditions of this statement Ownerl(or Owner Agent's)Name: /� Signature.. .� tom' e", ' (( I Contractor Namme.: q/ i_ / Cl /101 .1,1 ".�.1d,1 146 Signt ture #. Lic.# I .VN. Date: li\(7 1 Smoke and CO form.doc revised 12/15/16 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 ; CUPERTINO 408)77 3228 AX(408)777-3333• buildino(a,cupertino.oro Owner Name ,LI �� Permit No. Address 2 22 4 - k � 1. - Is your real property a registered historical site? ❑ 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 2. 2. Doesyour real roe have a licensedplumber certifyingthat, due to the age or configuration of the roe or its property rh' g � property m' 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. Skip the rest of the form and sign bottom of form. 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. 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? ❑ 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. - Ycs — My real erty-is-buil-available-for use oroccupancy on orbeforelanuaiy`h;--994._ __-: —_-- z_ Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. 5. ease check ONE of the following: My 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 i property undergoes alterations or improvements). El 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). CI 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 Januar 1, 2019, all non-compliant plumbingfixtures shall be replaced with water- conserving 1 S' P p P 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 perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water-conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 11 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 comply with the requirements as indicated in the table on the following page. _ r Owner Or Owner Agent's Signature: / "„,i1 Y / � ! Date: ;1l 7 Upon completing and signing this Certificate,pled return it to the Building Division in order to final your building permit. SB407 2015.doc revised 01/05/17