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B-2017-1509 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1509 23575 OAK VALLEY RD CUPERTINO,CA 95014-6553(342 57 040) COSMOS ROOFING INC MOUNTAIN VIEW,CA 94043 OWNER'S NAME: WATTERS DONALD R AND KAREN A TRUSTEE&ETA DATE ISSUED:09/08/2017 OWNER'S PHONE:650-210-8480 PHONE NO:(650)969-7663 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-39 Lic.#785441 Contractor COSMOS ROOFING INC Date 04/30/2019 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 WOOD SHAKES(44 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 d will maintain Worker's.Compensation Insurance,as provided for by ` �' Sectioarid 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$45415.00 ' ' '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 342 57 040 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]§aid.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 regulations per.the Cupertino MunicipalCode,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature ' ,'_ • Date 09-08-2017 Issued by:Kim Dunbar ! Date:09/08/2017 OWNI '-1UILDERDEC.•.•.• ON ' tk>s" i I 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 roofing material being installed.If a roof is L. 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) z. I;as owner of the prop• erty; am exclusively contracting with licensed Signature ofApplican• contractors to donstructthe project(Sec.7044,Business&Professions Code). Date:0•-08-20 '.— I hereby affirm under penalty'ofperjury.one of the following three declarations: ALL ROOF COVERINGS.TO BE CLASS"A"OR BETTER LI 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,manitain 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 permit is issued.. ,I, I maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the a. I certify thatm the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous 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 contaminants as defined by the Bay Area Air Quality Management District I • Workers Conipepsatton laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I beeome,sybject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534. Labor code;I`must forthwith comply with such provisions or this permit shall be deemed revoked.' �i ' ,> ,i Owner or authorized agent: ! ';APPI:ICANT CERTIFICATION Date:09-08-2017 I certify that I have read,this application and statethat the above information is C s.Jli '' _ O.. E WC. ;G_ C , correct:I agree to,c0mplyiw!thall 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 iabove'rrientioned 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'withi all.non point sourc`e'regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. , 1 I l - I understand my plans shall be used as public records. Signature Date 09-08-2017 Licensed Professional 1 CONSTRUCTION PERMIT APPLICATION \ 4 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 /4,,,Sj.,9s::\ (408)777-3228 • building@cupertino.org PEMIT'#B.2)/ - /5-0 9. CUPERTINO • ❑ NEW CONSTRUCTION`❑ADDITION'CI-ALTERATION'❑-T.I. EMEP 'ERE-ROOF QSWIMMING POOL/SPA PROJECT ADDRESS ,...a. oA_KJktII. 7-7 APN# ,3q2. -5 1 - '`/ ,b OWNER NAME Ai J tJA r-� S PHONE 6s .740 `q'q�o E-MAIL STREET ADDRESS '- CITY,STATE,ZIP �, ®� �—� 7 5Oa4 f �`7 G���t2—r i n)©oA 9 CONTRACTOR NAME 0 OWNER-BUILDER eOMPANY NAME LICENSE NUMBER LICENSE TYPE COSMOS ROOFING 785441 C39 STREET ADDRESS CITY,STATE, ZIP 1901 OLD MIDDLEFIELD WAY#4 MOUNTAIN VIEW, CA 94043 I E-MAIL PHONE BUS.LIC it . 650-969-7663 ❑`ARCHITECT 'DUWNER'DOWNERAGENT fiCICONTRACfORAGENT❑'ENGINEER'❑-DEVELOPER'0 TENANT CONTACT NAME E-MAIL JEFF RAINEY, jeffrey.rainey@att.net STREET ADDRESS CITY,STATE,ZIP PHONE 1069 EDGEMERE LANEE� ^� r HAYWARAD, CA 94545 510-785-6340 DECRIPTON �j F5 I PL,Jqt. .1 I-C 2c7,�c - /E/-g. 0 14 3ç* * IA) --1,r) ,J C t,J "TE/r- 141-: - A 4C CIA---C( Ait-. ,J 4p Sftc:—F-'i ,--J D 36 i ('r. & 5t cz"t — I,iSINGLE-FAMILY/DUPLEX0MULTI-FAMILY 0 INDUSTRIAL ❑COMMERCIAL EXISTING USE EXISTING SF NEWFLO•OR SF,' PORCH SF DECK SF DEMO SF STORIES# TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION($) REMODEL, . REMODEL KITCHEN. ...REMODEI OTHR.. ..GARAGE_. .D..ATT.A ED._ BATHROOM SF SF . ' , SF SF ElDETACHED .1 EXISING O O O EICHLER 1 0 NS SECOND STORY ADDITION OYES NO FIRE SPRINKLERS DWELLING SECOND DWELLING 0 YES 0 ATTACHED 0 DETACHED OTHER uim's# UNIT ADDITON: ❑NO S F POOLS' 0 FIBERGLASS 0 VINYL-LINED'❑GUNITE 0 PREFABRICATED POOL-SF SPA-SF SPA ATTACHED ❑YES 0 NO I TOTAL-SF RECE, t D TOTAL(� VALUATION: Commercial or Multi-Fana7y.'Burildings.with-Public Swimming Pools requires Department of Environmental Heath approval _ C,Li l S _,� • RE-ROOFI EXISTING ROOF TYPE: i❑BUILT-UP ROOF❑ASPHALT SHINGLES$WOOD SHAKES❑WOOD SHINGLES❑TILE OTHER(SPECIFY) 7 REMOVE/REPLACE❑NO IF NO.' PLYWOOD ❑'/" ❑3/8" PLYWOOD TYPE: PITCH: ROOF CLASS tit YES #OF LAYERS THICKNESS❑5/8"" OTHER 1=1OSB ❑CDX OTHER 7 '12 A PROPOSED ROOF TYPE:❑BUILT-UP ROOF, OASPHALT SHINGLES P5WOOD SHAKES OWOOD SHINGLES 0 OTHER *Provide a signed copy of the Cupe tirio's Tear-Off Policy SF'947-6 Sof SQUARES /y By my signature below I certifyito 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 Illocal ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-identified property'for inspection pur.oI acknowledge and authorize all information contained on this application form to be made available for publictecord. -' ! Signature of Applicant/Agent:i I . - _.......•••*-- _ Date: SUPPLEMENTAL INFO ON REQUIRED' *New SFD/Second Dwelling,Units/Multifamily I ellings: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 approvai:from the Home Owner's Association BldgApp_2017.doc revised 08/01/17 REROOF TEAR-OFF POLICY ' COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildingacupertino.orq /3 . - s PROJECT ADDRESS,2:27 7 5 a Arte_ t /A_(I T.P APN# Ili �.. 5 0 L/0 OWNER NAME �/ 4 �1 _ ) �r 1 I2 S PH J+IE 1,O E-MAIL STREETADDx SS /V I1 ( CITY, STATE,ZIP FAX ' �3 7 7 5 0141C Li ALL est 7-i Gc2P1�2�r.�lc) 1 GJi 7'f�f CONTRACTOR 5 CAMEO 5 ` LICENSE NUMBER �/7 C``�j LICENG�E BUS.LIC.# COMPANY NAME /i t `� _6 t'f� E-MAIL FAX ' STREET ADDRESS . r' vv` CI STATE,ZIP P O go l ot-7 rbpI6-rr6) �� 'MI- vIe-zJ I GA ?Ito q-3 ?6 4?-766'3 I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimum of one day before the requested inspection date. Please schedule inspections online or call(408)777-3228 between 7:30-3:30 (Mon-Fri). 3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof is torn off and all the nails/fastene'rs have been removed. Any and all dry-rotted wood shall be replaced prior to this inspection.. A;building inspector will be available within one hour. There.are special hours for this service: 7:30 — 10:30am and 1:00—3:30pm(Mon—Thurs); 7:30 — 10:30am and 1:00—2:30pin(Friday). ' 4. ' If plywood lis installed, a plywood nailing inspection is required. 5. In-Progress roof inspection is' required. Call for an in-progress roof inspection to verify building is weather tight;;after installation of approximately 25% of the roofing material. 6. New roof coverings shall not be applied without first obtaining all inspections 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 inspection can be performed. 7. ,j A.final inspection and approval shall be obtained from the building inspector when the re-roofing is complete. :To receive a final sign-off,the following items will be verified: Flatroofs shall have.a minimum of 1/4"per foot of slope and must 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. 'Properspark arrestor installation. 8. NOTE: 'If;you call for a tear-off or plywood nailing inspection and the work is not complete,you will .be'charged;'are-inspection fee of$126.00. The re-inspection fee shall be paid before another inspection'I'can be scheduled. L' By mysigning below; I certify'each of the following is true: I am the pro•e ..owner or authorized agent to act on;the'property'owner's behalf I understand . •• __ ; to co i • t e re-roof policy stated above. Signatu el of'Applican't/Agent: Date: ? I ReroofPolicy_2010.doc revised 05/17/10 - -- -�- � .,-_, VJUJOYJUIO Uusmus ROOF PAGE 01101 'tip SMOKE / CARBON MONOXIDE ALARMS t •'' : OWNER CERTIFICATE OF COMPLIANCE :.-.,: ,'4N COMMUNITY DEVELOPMENT DEPARTMENT•SUILDING DIVISION CUP R INO. 10300 TORRE AVENUE• CUPEPTINO, CA 95014-3255 (408)777-322 _ i!.'!p.'',k'Nl"PrIVIRSM in• i3'FAX(408)777 33x3•i5uildino� ' ld,� � I�.'°1"�PII I I p!I �6 noor,� � ',};I I JJ.y'Ii,lI p�I',li II �fl"'li, i•pr!' �ill ,iUIlli� il?�!Iim�i�;t�j1�r0` �l I�°� ,���,{��� 1�177.i �ii� I�n,14 Idle'Nrl tl 141 I! �,..!#0149,6r 71 I' l ,�,� ;�. .4 . .,1'.k,11.4 I;!I!51`I I� �.�yilSltit fli�� al'.i n!'PIPM' P���� .l' •�i litre •S?I i S°'L.I..I.,!'a �p�.p,.. n.. i 1� V•�I� P6HAN'� ! L, 7! ', , ' . i !fltli, ° �..t h Iii, �J 1 ''�f,�!.,rfk,i1„l�llll:, d I f R 2>I�S�]K ;�vl 42,1 ,,,!,1k;.-.. �' F, , � � a!;i.b.�17nri�,�u �� y�.; ]�'�°'il}� p6�Tys� :E "�,'�li� Q J {pp��li;' tivye r aG�i �lF,I�i'' I^��'� R- �j' +r.. I'.,�r �N;�I o;e `�GI lilll'�IIyPP S�i��� � ! 41 11 �" 'Q°S�I 11. ' 6lib :,: ld; q 1 zir ` �k �r,� / I! I,W :, 4Y!•'I �1N'irn Ib, IIP �?u .,,.. j l�}t}�p/'��+�9 n.uAPA�6n�ltil !�,1' i o e ! �.I4Y!'.U'W ` ,.� ^�j',, .1�61G�, a Pn it',PUR O ,, "C, ,.",,� .<e,'_ , '"", ,a1.a. ! . '�/.� : "1^ !,a^Rg!'•,xt� ;',.,L"1Ir. 7 �. ry I � ',i! .y114 i. M.J !7+�R1•np I i ll.19 k I lhNI1N °I Ill f�'I'I This affidavit y a self-certification „- �� forthe 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 for,inspections are required, where no interior access GENERAL INPORIVIATION Existing single-family and m'ralti-family dwellings shall eith Monoxide alarms. When,the valuation of addii'ons, altexations7 orre1rairs to Smoke Alarms and Carbon $1000.00, CRC Section R314 and CBC Sections 90i,2,11,5 and 420.6 require that Smoke Alarmsexisting tg units exceeds Monoxide Alarms be installed in the following locations: kc and/or Carbon AREA m Outside of each separate sleeping area in the immediate vicinity of SMOKE ALARM CO ALARM the bedroom s) On ever level of a dwellinc-unit indu.dinc,basements . Within eachh slleeping,room. . Carbon Monoxide alarms are not required in dwellings do not have an attached aara.Q qellix>.�s Which do not contain fuel-burning appliances and that 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 wifilt,no commercial power supply, In existing dwelling units,alarms are permitted to be solely batterypoperated where y br solely batter, not result in the removal of wan and ceilingS operated. finishes or there is no access by f attic, or ajte or do a space.Refer to CRC Section R314 and CSC Sections 907.2.11,4 and 420.6.2.y Meana of attic, basementiiqit crawl alarms which must be connected to the building wiring An electrical permit is required for As owner of the above-referenced property,I hereby certify that trio alarin(s)referenced above has/have been, installed in accordance with the manufacturer's instructions and in compliance with and California Residential Codes. The alarms specified below have been tested and are o the California Buildingbelowperatioital, as of thedate signed,below Address: 57 S� A O C: ,L--'-t__ 1 ��i � r-'1 Permit No. W,4- 1509 Specify Number of Alarms y rr Smoke Alarms: .0 Y Carbon Monoxide Detactors• I have read end a.ree to corn.] with the Owner(or Owner Agent's)Name, terms end condltiens of this statement k tN It�ft-11 5ignatUre. • ,. , C' / Contractor N _ �I n��amo; . ..,,. ,., •' Date COst % R' FI hl e1 Signature -IAN, 1,,,, .., C'��-/ Llc. j Dale: tO 1K• Gtr-I ,c) CU130211 ts0 Smoke and C.O form.dor revised 12415/16 '51AS L!C =it- 4033-40