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B-2017-1542 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1542 919 BLAZINGWOOD AVE CUPERTINO,CA 95014-4618(369 20 015) ROOF ROOFING INC SAN JOSE,CA 95118 • OWNER'S NAME: TANIGUCHI WARREN H TRUSTEE DATE ISSUED:09/12/2017 OWNER'S PHONE:408-446-2596 • PHONE NO:(408)265-9270 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class CC=39 Lic.#687568 Contractor ROOF ROOFING INC Date 07/31/2019 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: REROOF;TEAR-OFF;COMP SHINGLES(23 SQ) I hereby affirm under penalty of perjury one of the following two declarations: i. 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 erformance of the work for which this permit is issued. 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 whiih this permit is issued. Sq.Ft Floor Area: Valuation:$11450.00 APPLICANT CERTIFICATION 1 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 369 20 015 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 regulations per the Cupertino Munici I Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. ' Signatures Date 9/12/2017 Issued by:Abby Ayende Date:09/12/2017 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is • " a. ,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 inspectio . sale(Sec.7044,Business&Professions Code) 2. .I,as owner of the property,am exclusively contracting with licensedgnature of Applicant: 'contractors to construct the project(Sec.7044,Business&Professions Code). Date:9/12/2017 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 Worketl'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 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,Sections 25505,25533, 25534. Labor Code,l must forthwith comply with such provisions or this permit shall be deemed revoked. caner or authorized agent: `-'\k APPLICANT CERTIFICATION Date:9/12/2017 I certify that I have read this application and state that the above information is i_Ti. I >, L ►i I. A EN V correct.I agree to comply with all 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. Signature Date 9/12/2017 Licensed Si g Professional CONSTRUCTION PERMIT APPLICATION . \jek COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION rOy 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 ,1.19, Ion- 15q2_s (408) 777-3228 • building@cupertino.org PEMIT#B- CUPERTINO REV# DEF# ❑ NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T.I. ❑MEP lErdROOF ❑SWIMMING POOL/SPA PROJECT ADDRESS APN pFJ lr /�,^ �r qiq �,/147 ,APC u.� ®1�) J/./il OWNE NAME PHON E-MAIL W A R g .1) 774/41.-600C,1'�' t 4-fc3 gtict�L 6 01 c, T r s c u.it On t o�r r��zIz� STREET ADDRESS CITY, STAT ,ZIP CONTRACTOR NAME 0 OWNER-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE STREET DRESS Z CITY, �ZI; �� f Cf s5P2 De, � '2 g E-MAIL n PHONE BUS.LIC 0 M, l/r" g (zoop est& (I{Og) 2 CS'.— 7,2_7 � 0 ARCHITECT 0 OWNER ❑OWNER AGENT,CONTRACTOR AGENT 0 ENGINEER 0 DEVELOPER'❑TENANT CONTACT NAME E-MAIL l- srgg• 0 L a CA-c,Le (�D 041-K P � s ts�5,34s1"-:: ___ cow STREET ADDRESS /� CITY,STATE,ZIP PHONE 8'"4-77 [f44,55!�-F2 Vftr, g►kNIT (- 435 tt g/ VAP 2(.. .C•122-ZD DECRIPTON t2-‘2_iiktsJE. 3 LIAN CrfzSI Cc>tAkf STJT L-L. ,i,, © &AA)A vAd►21, 5 c(...ex.5' SINGLE-FAMILY/DUPLEX 0 MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL I EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES I TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION($) REMODEL REMODEL KITCHEN REMODELOTHR GARAGE 0 ATTACHED 'BATHROOM SF - SF SF SF 0 DETACHED ' EXISING ❑YES EICHLER ❑YES SECOND STORY ADDITION ❑YES FIRE SPRINKLERS 0 NO 0 NO ❑,NO DWELLING SECOND DWELLING DYES 0 ATTACHED DETACHED OTHER UNITS I UNIT ADDITON: ❑NO 5 F - POOLS' 0 FIBERGLASS 0 VINYL-LINED 0 GUNITE 0 PREFABRICATED POOL-SF SPA-SF I SPA ATTACHED❑YES ❑ NO I TOTAL-SF RECEIVED BY: i T,. L Vi..1-1 1j Comnierciu!or Multi-Family Buildings with Public Swimming Pools reatrires Denartnrent of Environmental Heatli approval C XpJ-lD �, !"tm' I6 U t RE ROOF EXISTING ROOF TYPE ❑BUILT-UP ROOF[XA.SPHALT SHINGLES❑WOOD SHAKES❑WOOD SHIN LES TILE OTHER(SPECIFY) REMOVE/REPLACE I]NO IF NO PLYWOOD El 1/2" ❑3/8" PLYWOOD TYPE: PITCH: ' ROOF CLASS S SOF LAYERS lGA��// THICKNESS❑5/8" OTHER El 05B E CDX OTHER '12 A LJ yb PROPOSED ROOF TYPE:❑BUILT-UP ROOF SPHALT SHINGLES 0 WOOD SHAKES❑WOOD SHINGLES ❑OTHER _ ' *Provide a signed copy of the Cupertino's Tear-Off Policy SF /of SQUARES By my signature below I certify to each of the following: tam 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 to be made available for public re �+ Signature of Applicant/Agent: Date: %—1 Z "1-7 - 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 BldgApp_2017.doc revised 08/01/17 ,. .. . • . . • . ' . Alinitli: REROOF TEAR-OFF POLICY * .;.•:,/,' COMMUNITY DEVELOPMENT DEPARTMENT. BUILDING DIVISION ALBERT SALVADOR, RE., C.B.O.,BUILDING OFFICIAL ' I ialititii::! 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 . CUPERTINO (408) 777-3228•FAX(408)777-3333.building(fAcuoortinty.orci • PROJECT A2yrzliEssLZ-. '' l . -. , CO kQI:-- API‘!4' , OWNER NAME ,..., ''' ..__ I KICIIS-, E-MAIL • ....-It..) K--i / 1.-i‘-“ -2.7(6 . 1-- .__ ___ STREET ADDRESS ,.--) ..., CITY, STATE.ZIP I FAX CONTRACTOR NAME • LICE:'SE"BEL / LIENSFf.TYPE p BUS.Lie,B L4-/Jt2, 000 c(2,.../ g - — , - . _ CON Tr NAME E-MAIL I FAX 1-- Po,ofzilue., STREET ADDRESS CITY,SZAt 1,ZIP s-,---8 iip . I_'qiONE. •5 1%...) .,.. . 5 , f• . i`te,W. -as. 74i. • , 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 inspectiondate. To schedule inspections call (408)-777-3228 from 7:304:30Pin(Mon-Thurs).or 7:30--2: 0pm(Frida)) to schedule inspection. For Tear-Oil and Nailing Inspections-,you must also call oü the du of the inspection only after that phase of the work is completed.:The building inspector.41 be out to the job site within one hour. The hours for this service are: 7:30,10;30am and 1.2t*-3:30:(Mon-Thurs)! ' and 7:30-1.0:30am 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-clown 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.priorinspection 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.sheathitg so a proper inspection can be performed. . , . . 6. A Final-Inspection.and shall be obtained.frotit-the:building inspector when the re-roofing is . ... ... . completed. To receiVe a final sign-off,the following iterns:Will be:verified:, 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 prp,rnanufactured products used shall be- available on-site to review at the time of the inspection. c. Proper spark. arrestor installation, vents painted, otter/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. • , ,;:, . .. „„ . ww signing below, I certify each of the following is true: I am the property owner or authorized agLat to act on the By , property owner's behalf. I understand and agree to comply with the re-roof policy stated above. 1 ats0 ittnderstand that, smoke detectors and carbon monoxide detectors are requi ed to be installed in accordance with Sectione:IZ.3 i 4.and,R315 of -the 2016 California Resident' ode. dp ,_. . 1 :., Signature of ApplicantlAgept: IF ...- Date: 6Z----zr. . , i • 1 1 ReroolPoicy.....2014.ddr revised 06101/7 • 1 . 1 , .