B-2017-1480 CITY OF'CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1480
20916 DUNBAR DR CUPERTINO,CA 95014-1802(326 30 140) BRIDGEMAN/
MANCHA ROOFING
SARATOGA,CA 95070
OWNER'S NAME: CARDAMONE MARIE M TRUSTEE DATE ISSUED:09/05/2017
OWNER'S PHONE:408-996-3839 PHONE NO:(408)806-5030
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class CC=39 Lic.#863045 -
Contractor BRIDGEMAN/MANCHA ROOFING Date 08/31/2019 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 CDX;COMP SHINGLES-(31 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
.p'Compensation,as provided for by Section 3700 of the Labor Code,for the
i. performance of the work for which this permit is issued. -
\ m 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. Sq.Ft Floor Area: Valuation:$13575.00
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 APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 326.30 140
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
source reg lations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
t
Signa e
\. I-'t ' •` Date 09-5-2017 Issued by:Kim Dunbar
��' Date:09/05/2017
OWNER-B 111! P ECLARA
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS:
following`two reasons: : i All roofs shall be inspected prior to any roofmg material being installed.If a roof is
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,Busmess'8 Professions Code) IRIL
2. I;as owner of the propeity,am exclusively contracting with licensed Signature.of Applic ; ..,►"14i.
contractors to construct the project(Sec.7044,Business&Professions Code). Date:09-5-2017 0111
I hereby affirm under penalty jof perjury one of the following three declarations: ALL ROOF COVERINGS TO BE ASS"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
1 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
shall'not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534.
Labdr Code,I'must forthwith comply with such provisions or this permit shall
be deemed revoked ; Owner or authorized ag-,
Al'PLICANT CERTIFICATION Date:09-5-2017
1 CO_ S_Y_'U AVCY.------
ENDING AGENCY
I certify that I have read this application and state that the above information is s
correct.I agree to comply with!all city and county ordinances and state laws I hereby affirm that there is a con .ction lending agency for the performance
relating to building,construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.)
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, '
judgments!costs,and expenses which may accrue against said City in Lender's Address
consequence of the granting of this permit. Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION ,
Code,Section;9.18. I understand my plans shall be used as,public records.
. Licensed
Signature Date 09-5-2017 Professional
/
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
..
rk
_.& 10300 TORRE AVENUE • CUPERTINO,CA 95014-3255 r
y1.I9ss (408) 777-3228 • building@cupertino.org PEMIT#B-7 (q-- - 1( f O
CUPERTINO REV# DEF#
❑ NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T.I. ❑MEP ,RE-ROOF ['SWIMMING POOL/SPA
PROJECT ADDRESS `! qj / ^'fl ��` APN# 3 � r 3 ,`' , /40
OWNER NAME Q` , e l.(� � CJ k-/6A'PHO�1iC/ 6 3 s „^ E-MAIL
{' X11 ��C�,?QJC I�
LiSTREET ADDRJ~SScot.� to a p c)1 , CITY, STATE SCP ICENSENU _, � 0 1 LICENSE TYPE
31 CONTRACTOR NAME ❑OWNER-BUILDER COMPANY NAME `` /�
�-eCC .c. Ic' elan c o�d�� cr���
ISTREET ADDRESS (3C� �, CITY,STATE
FS 6 )(1_iQV `1[ld6 lW � 6-7D I .
E-MAIL PHONE BUS.LIC
L(0 Mob f S3
0 ARCHITECT ®OWNER 0 OWNER AGENT 0 CONTRACTOR AGENT❑ENGINEER❑DEVELOPER 0 TENANT
CONTACT NAME 'E-MAIL
tier;e CaOcuvtore
STREET ADDRESS CITY TATE,ZI PHONE
ORA(0 0; far al r� CQ , R S"01 f
DECRIPTON ^ I.
t
QC-N\o\C nk,ke c�pc C_ a ) in- A\ ,) COX P1 azod
ic,s4cJA iNei):) . 11_,-k-k-ex- ,/ ,I E\S4a— r591) li 0 I 13' ce't+0 fa a p_sar)
I c S \ 9O 1�� A; lrese d� s(o f‘ct,1 C D ANTOS'c-\a(\
SINGLE-FAMILY/DUPLEX ❑MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL I
EXISTING USE EXISTING SF NEW'FLOOR SF PORCH SF DECK SF DEMO SF .STORIES# TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION($)
REMODEL REMODEL KITCHEN REMODEL OTHR',� GARAGE ❑ATTACHED
BATHROOM SF SF SF SF ❑DETACHED
0
EFIRE SPRINKLERS❑NO NG YES EICHLER 0I ❑YEs NO SECOND STORY ADDITION• ONO ,
DWELLING SECOND DWELLING ❑YES 0 ATTACHED 0 DETACHED OTHER
UNITS I UNIT ADDITON: ❑NO S F
POOLS) ❑FIBERGLASS 0 VINYL-LINED ❑GUNITE 0 PREFABRICATED I
POOL-SF SPA-SF I SPA ATTACHED ❑YES IN NO I TOTAL-SF
RE I ���' OTAL VALUATION �
Commercial or Multi-Pamiht Buildings with Public Swimming Pools requires Department of Environmental Heath approval %� 1I 97( � \.l
RE-ROOF EXISTING ROOF'TYPE: 1❑BUILT-UP ROOF LIASPHAI'JT SHINGLES WOOD SHAKES❑WOOD SHINGLES❑TILE OTHER(SPECIFY) ✓
REMOVE/REPLACE®1:1 NO IIF NO 1 PLYWOOD �'h„ ❑3/8" PLYWOOD TYPE: PITCH:i 12 ROOF CLASS
YES #OF LAYERS THICKNESS II 5/8" OTHER III OSB a CDX OTHERA
PROPOSED ROOF TYPE:❑BUILT-UE ROOF ®ASPHALT SHINGLES ❑WOOD SHAKES OWOOD SHINGLES 0 OTHER "
, *Provide a signed copy of the'Cupertinb's Tear-Off Policy SF3ICC) #of SQUARES 3
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 inspection purposes. I acknowledge and.authorize all information contained on this application form
Ito be made available for public record. ..,1 9-4-r-)
Signature of Applicant/Agent: - Date:
SUPPLEMENTAL INFORMATION REQUIRe III li •
*New SFD/Second Dwelling Units/Multifamily Dwellings:A Demo ition 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 •
• Bld APP_2017.doc revised 08/01/17
g
J ,
I REROOF TEAR-OFF POLICY
..! . , . COMMUNITY DEVELOPMENT DEPARTMENT 6 BUILDING DIVISION
. ,
ALBERT SALVADOR, RE.,C.B.O.,BUILDING OFFICIAL
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO
(408) 777-3228•FAX(408)777-3333.buildingctinertino.org
PROJECT ADDRESS APN 4
: 'SAM° 11• 0 0 ..:, V-) a 3 2_ —30 / '110 _
' OWNERNAME ripHoeo lc,. E-MAILlAce .. 4,
-- --
, STREETADDRESS 1 FAX
aP' • 1 0 0 Ct- NO a . CITY, STAe,ZIP., . CAI. •5-61
' CON/RA(7FOR INAlctec4 2, LICF,N$I.' MBEtrc . LICCSE1 BUS.LIC.0
V 1 Ilti A' 4 s,
AL a. A LI ZCI u
comPtrov Ni','!,‘, 1% nE-MAIL FAX
-b i 1 C I k aild-..a. \LOD9,,(\t, •
. .
STREET ADDRES11 ' ' g
o a PHON, -
11111 ••Viller c *
4 .
1 UNDERSTAND AND AGREE 0 THE FOLLOWING:
1. 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:-3:30prii (Mon-thurs) or 7:30-2:30pm(Frida).) 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*tr. The hours for this service are: 7:30-10:30am and 12:30-3:30 (Mon-Thurs)
1,
' and 7:30-10:30am ad '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 plywoodiroof 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 inspeetion can be performed.
6. A Final Inspection and approval shall be obtained froth the building inspectOr when the re-roofing is
completed. To receive a final Sign-off,the following in will be verified:
a. Flat roofs shall have a minimum of'A"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 ani 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
smoker detectors and carbon monoxide detectors are required to be installed in-accordance with:Sections R314 and B.315 of '•
the 2016 California Residential Co .e
1 I
/
surname Of Applicant/Agent: „4.4gt,_ii),..),14_,.:. li_ . Dat(.. q
VII 1111
RerogYPo1iey_2014.doc revised 06/017
. .
. .
r a
SMOKE / CARBON MONOXIDE ALARMS �''
OWNER CERTIFICATE OF COMPLIANCE
ri
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPERTINO10300 TORRE AVENUE• CUPERTINO,CA,95014-3255
(408)777-3228•FAX(408)777-3333• buildinq(a�cuoertino.orq
PERMIT CASINOTBE. AT°ED.UNTIL TRIS::CERTIE. CAT'E HAS BEEN:
OMPLOtilD3 SIGNED.ANDRETURNED-TO THE:BI ILDINGDIVISION
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
51000 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 ((''� ��,�� Co-. q
Address. �.0 .`L c a t.su. •u"0 lo `S-O 1' i Permit No. 7`—!L4
80
tt
Specify Number of Alarms: #Smoke Alarms: _an #Carbon Monoxide Detectors. 1771
I have read and agree to comply witl�the terms and conditions of this statement
Owner(or Owner Agent's)Name:
Signature . .
.: Dater
Contrac r ame: (� �
�7 Signature r,1. ..'/ '''� Date:��
IP
Smoke and CO form.doc revised 12/15/16
II!
A L-- ` .=A au _'
SMOKE / CARBON MONOXIDE ALARMS t�
OWNER CERTIFICATE OF COMPLIANCE
44-z.44 COMMUNITY DEVELOPMENT DEPARTMENT.BUILDING DIVISION
CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA.95014-3255
(408)777-3228•FAX(408)777-3333• buildinc(o�cupertino orq
:�` �t � a'c- -gym a'' a�„. � '2�-: e�. �. Avi - ll ,� �. ..
f PERMIT CANNOT BE`F'INALED TIL TillS CERTIFICAT SI3AS BEEN F
SND T RNE O T M BUI D SIO
-K .,... matta '^ae...,.,:Wei '-'" �. - �`
.,. �.. '.. .. ...moi. 3,�-%ice..�'^ �� �`�
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 907.2.11.4 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 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. fg
Address: Z.0 .`(> D A, , --,, ,,,,-.4.Permit No. era)17-11180
Specify Number of Alarms: #Smoke AIarms:
�� #Carbon Monoxide Detectors: 17��
I have read and agree to comply witl�the terms and conditions of this statement
Owner(or Owner Agent's)Name:
' .7, .� 4'.W.'.l l.Yt Do,a(�
POL-ti �INCf'ct- o l Signature ater 't�t`�
Contrac r Name: e ( �l ^�
a �• 40,o * Signature r,/..% . . �.j..
"' .__ Lic.# Y23° f Dater !
II
Smoke and CO f07771. revised 12/15/16
i
I