B-2017-1466 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1466
10571 FELTON WAY CUPERTINO,CA 95014-4305(359 18 014) MANADA ROOFING
INC
HAYWARD,CA 94544
OWNER'S NAME: CHIEN JUNG-SHIN AND RU-SHIN DATE ISSUED:09/05/2017
OWNER'S PHONE:408-981-3705 PHONE NO:(510)780-9517
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class CC=39 Lic.#800771
Contractor MANADARMELLGILLQ Date 10/31/2017 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;METRO TILE(32 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
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off Section 3700 of the Labor Code,for the performance of the work for which this
r` permit is issued. Sq.Ft Floor Area: Valuation:$18900.00
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 359 18 014
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 regulati•- p,r the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
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Signature -5, 1. 4� Date 09-05-2017 Issued by:Kim Dunbar
Date:09/05/2017
OWNE -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the BE-ROOFS:
following two reasons: All roofs shall be inspected prior to any roofing 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,Business,&Professions Code)
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2. I,as owner of the property,am exclusively contracting with licensed Signature of Applic d
contractors to construct the project(Sec.7044,Business&Professions Code). Date:09-05-201
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 cif the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534.I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous
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, ' ons 2..05,25533,and 25534 r
Labor Code,I must forthwith comply with such provisions or this permit shall /
be deemed revoked.
Owner or authorized age;6 /
APPLICANT CERTIFICATION Date:09-05-2017 r
I certify that I have read this application and state that the above information is CON `''RUCTION LENDING AGENCY
correct.I agree to comply withiiall city,and county ordinances and state laws I hereby affirm that there is a construction 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 09-05-2017 Professional
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CONSTRUCTION PERMIT APPLICATION ,
COMMUNITY DEVELOPMENT DEPARTMENT•BIJILL)ING DIVISION
B .
, . 10300 TORRE AVENUE • CUPERTINO,.CA 95014-3255
PEN 0-Irr#}3- II / IV‘'
(408)777-3228 • building@cupertino.org
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CUpERTINO • ,
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, D NEW CONSTRUCTION 0 ADDITION D ALTERATION fl T.I. 1:1 MEP. M RE-ROOF. []SWIMMING POOL/SPA
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PROJECT ADDRESS AI' : ,
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10571 Felton Way Cupertino;CA 95014 I 3..59 ig - / V
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, ,E,0,A,,,E.- - PHONE E-MAIL 'E-MAIL '
. Au-Shin Cliien• . 1 4087981-3705
STREW., ,ADDRESS CITY,STATE.ZIP
10571 Felton Way ,Cupertino,CA 95614 • _
croos#AcroRNANIE 0 QWNER-KiiIDEF COMPANY NAME LICENSE NI.DIPER ' LICENSE TYPE
Ruben Perez , Manada.Roofing,Inc 800771 '•c['- 9
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STREET ADDRESS ' CITY,STATE,n,t, .,
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i' 1593 Industrial Plai4r W#5 Hayward,CA 045,44
I E=MM,1.„ I PHONE BUS.LIC r ,
rnattllia0Manadaroofing.cOm I 510-780-9517 . , ...248:26 . (5tt,3 (-0
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0,Aitchn'Ecr,0'ov*it,0 OWNEIIAGEN'T MCONTRACTOR AGENT 0 ENGINEER 0 DEVELOPER 0 , 'f TENANT - _ ' ,
CPNTAcT NAME. E-MAIL
Martha Silva , , rtiartha@manadaroofing.63M
s"rit_Evr,AptiREss, ' . ., • CITTY,sTATE,ZIP PHONE
1593 Industril.-Pkwy W#5 . HayWard;CA94544 . , 510-780-9517
rgaup"Icia ' .
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Remove maxi,tile,,install'new Metro Tile 32 Sq
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los;INc;!..E•lr:Amil.*Di.0..pc .:-Elyufxf-f.io46, 0 mous-raw. ip COMMERCIAL
EXISTING USE EXISTING SF NEW,FLOoR SE PORCH SF DECK SF DEMO SF STORIES II 'hirAl.Nursr USE TYPE OCC SQ.FT. ' VALUATIO14($) . t
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1..
REMODEL. ' REMODEL KITCHEN, REMODEL OTHR GARAGE El ATTACHED ' '
BATIIRCK)M sp ; ' SF SF SF 0 DETACHED
i . ... : . , ...
1 Extsirzy 0 N'E,..! EictiLER= 0 YES SECOND STORY ADDMON DYES , '
iwrisiwNxt.gFrs 0 NO ' 0 NO . ' . 0 NO
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DWELLING' SECOND 13,V.VELPNO 0Y
yES.bATTACHEDO.DETACHED OTHER . .
, ists.art.g UNIT ADDTION: 0,..0
0. S F
P0941 1:111,!TR1...*.13 VINYLLINED'0 Guian 0 PREFABRICATED
t , .',POOL-SF .. SPA.-SF '1 SPA XITACHED DYES 0 NO 1 TOTAL-SF .
iat(y1...4.6 ,1 .
CoLiaravreial or,Inulti-FONtillitiliiitliftli%it irk Pub-tic Swirmotint,Peat reillifres nawrinfenf of Fluvlronnirritai Heath approval RECEAY : lairerovoN
....°E,EXISTING ROOT TITli D BUILT-UP ROOF 0 ASPHALT SHINGLES El WOOD SHAKES D WOOD SHINGLES[IDLE OTHER(SPECIEY) /
-REMOVE/REPLACE El,NO I IF NO PLYWOOD 0 w' 1:3 318- PLYWOOD TYPE: ' , Priq1:; ROOPCIASS xrp As ft b0).;ATERS THICKNESS D Sir OTHER NO 00513 0 cox 9TiTR. ' • . _L6._:,lt A
PROPOSED
ROOF TiP,Ei:PEDILT-UP ROOF,0ASPHALT SHINOLES 0 WOOD SHAKES 0 WOOD SHINGLES Don .:rile
Provide P.si b11dirotiyi)f the cupertipO's Tear,Off Policy •
.5F !ttif sOUAttEs-32
By my signature
below I C&*MeachUthefAeiviiig: /am the property owner or authorized
- "agent to act:mi'lhaproper,ty owner's liehah I'"
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liMt,read this application and the information I have provided is correct. I have read the Description of Work and verify i,is accurate: I agree I.
to comply with all applicable local ordi- c,,S and state laws relating to building,t.•onstiuctiori. I authorize representatives at Cupertino to
enter the above-identified property for nsp.etion• urposes. I acknotvle:, apd authorize all infOrinatibri;corif ined n„this application.form
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to be made available for public record .4.? . ,/ 7
„I Sigmature cif ApPliciiM/Agenti. r.,',., 1.,', 1.:11. !*. Date: 5' ,?/ .,:i1I /7
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SOftiftiiEICite';L)NtORmAtiltik RE.LURED
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NewS#b/Second Dwelling Units/Multifamily Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction.,
e 4Geniiiiercial Buildings i Provide atompleted,HaiardoitS Materials Disclosure form if any Hazardous Materials are being used as part of this•proiect;'
*copy of Planning Approval Letter or Meeting with Planning prior to subiti hal oftuilding Permit application.
• 'lith-,Providii a letter Of approval from the Home Owner's Association I
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.13 klgApp 2 017:doe revised 0.81014 f •
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\\ //fREROOF TEAR-OFF POLICY
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COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
,!,,4ti,' ALBERT SALVADOR,P.E.,C.B.O.,BUILDING OFFICIAL
CU
PERTlN4> 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•buildinatalcuoertino.arq
PROJECT ADDRESS 10571 Felton Way I APNa.
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`OWNERNAME ( PHONE _ I EMAIL
Ru-Shin'Chien I 408-981-3705
STEEL'!ADDRESS CITY,STATE.ZIP FAX
, 10571 Felton Way Cupertino,CA 95014
'CONT'RACTOR'NAME LICENSE NUMBER LICENSETYPR 'BUS.ITC.I_
Ruben Perez 800771 C-39 24826
COMPANYM?AME'Manada Roofing,Inc. E-MAIL EAX
mar thagnianadaroofing.coni .
RrRIWT ADDRESS CITY,STATE,ZIP PHONE, a
.1593Industrial Pkwy W#5' - Hayward.CA,94544 510-780-9517.
i . I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. There roof proJect shall comply with all applicable;provisions of the 2016 California Codes.
2. An inspection.request can be scheduled un 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 30-2:30pni;(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 ithe
jobFsite within one hour: The hours for this service are:-'7;30-1030antand 12:30-3:30(Mon Thurs) ,
and 7:30-10:30am and 12:30-2:3.0 (Friday). Final.Inspections•will be given a two hour window. '
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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 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 obtainingan approved inspection will; '
require the removal of all new material down to the sheathing so a proper inspection can.be performed., ;
6. A Final Inspection and approval shall be obtained from the building inspector when there-roofing is
completed. To receive,a final-sign:off,the following'items will be verified:
a. Flatroofs shall have a minimum of IA"per foot,of slope and demonstrate there is no ponding.` i
b. Listiings,fi-om approved testing agencies for all tpre-manufactured,products used shall be ; ,
available on-site to review at the time of the itispection.
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 cotplete,you will be
'charged are-inspection fee. The re-inspection tee 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`agentlo act,,on,the ';`j
property owner's behalf, I understand and agree to comply with the re-roof policy stated above. l'also understand that. , E1.'!
: smoke detectors;and carbon mon. id. det-ctors are required be installed in accordance with Sections R3 and 8315 of i
the2016'California Residential i ,. / 7
Si nature of A licant/A'"e Dat' e l '';i
, it
Rerogf?olicy,20l4:ddoc;retvsed 06/01,/.71
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P... ... .�._. .._...�.... a'4. ......._. n.,M:.._.—_....��__..._._
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SMOKE / CARBON MONOXIDE ALARMSa
OWNER CERTIFICATE OF COMPLIANCE is -I' .1
4tx ry COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPERTINO 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333• buildingAcupertino.orq
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I t 'ERMIT CANNOT BEFINALED,UNTILSTHIS CERTIFICATE HASBEEN` x _ `
r .v ,wx ' ` e7`� ",a vs '� z -� r x x r �. Y
y. t �, ,..�3' 'S m at �s � �� `�e "� &`� '�.. i
, �u,,� g>'-CO.IVIPLEJ,1+.D SIGNED AIBD RETURNED�TO IIkiEBUILDINGDISION
:,.fir c 1, ras "� # .4 F r r 7 a.ca x' �k.E. q r&s. M, ,N h c,} �, F� 3
41 iSk- a�'S, x .�>.L...� � s 7 xY�":r^ �.tv yr� s �' t-� x.�(i....�«-5....�s -.'u3�a�.���. � r �s��'�3�f ^�z.s.� �iV
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 j X
the bedroom(s) , ,
On every level of a dwelling unit including basements X 2 • X /
Within each sleeping room X 6
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 inhe re noval of wall and-ceiling finishes or there is no access by means of attic,basement or crawl
spate.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. '
Address: 057 e\#t rLOacki 0_,upfl1 4 r' C 9S (d1 Permit No. - I 1%66
Specify Number of Alarms: #Smoke Alarms: #Carbon Monoxide Detectors: ��C.
• I have read and agree to comply with the terms and conditions of this statement
Owner'(or Owner Agent's)Name:
` 2 ��N` /
)1 Y1 G' � Signature.... - — v� Date:
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Contractor Nat?: Signature / Lic# Y Date:14 14 rliaO .
Smoke and CO fonn.doc revised 12/15/16
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