B-2017-1593 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1593
970 CANDLEWOOD DR CUPERTINO,CA 95014-4653(369 19 016) M&S ROOFING
SAN JOSE,CA 95123
OWNER'S NAME: VINJAMURY MATHUR AND CHERLA VANI DATE ISSUED:09/18/2017
OWNER'S PHONE:408-230-7128 'PHONE NO:(408)314-0870
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C-39 Lic.#801218
Contractor N1&S ROOFING Date 11/30/2017 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;COMP SHINGLES-(23 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 \ .
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pensatias provided for by Section 3700 of the Labor Code,for the
formance of the work for which this permit is issued.
ave and will maintain Worker's Compensation Insurance,as provided for by
ction 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$13000.00
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 369 19016
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 Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
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Signatur r I t Date 09-18-2017 Issued by:Kim Dunbar
Date:09/18/2017 .
OWNER-BUILDER DEC LA TION '
I hereby affirm that I ant 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
t. 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) i
2. I,as owner of the property,am exclusively contracting with licensed Signature of Applic:.." V -` ,
contractors to construct the project(Sec.7044,Business&Professions Code). Date:09-18-2017 ,
' 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 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. T have and will maintaimWorker'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,;Cliapter 9.12 and the
permit is issued.
3. 1 certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I storeor handle hazardous
material. Additionally,should I use equipment or devices
shall not employ any person in any manner so as to become subject to the whicli emit hazardous
air contaminants as defined by the Bay Area Air Quality!Maiiagement District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal:Code,iChapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,x25533,and 125534.
Labor Code,I must forthwith comply with such provisions or this permit shall !1
be deemed revoked. �.
Owner or authorized agent, f' y y'
2017 � I�18
09
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APPLICANT CERTIFICATION Date: I ;
N
I certify that I have read this application and state that the above information is CONSTRUCTION LEND' AGENCY I
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,Ci /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, '1';'
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.' ,
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Licensed '
Signature Date 09-18-2017 Professional ,,
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CONSTRUCTION PERMIT APPLICATION
COMMUNl'1`Y DEVELOPMENT DEPARTMENT • BUILDING DIVISION
v .
10300 TORRE AVENUE • CUPERTINO,CA 95014-3255
(408) 777-3228 • building@cupertino.org PEMIT#B-2-0 1 -I 5-1'3
CUPERTINO REV# DEF#
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❑ NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T.I. ❑MEP Z RE-ROOF ❑SWIMMING POOL/SPA
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PROJECT ADDRESS APN# / I� O
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OWNER NAME PHONE ®��� E-MAIL
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STREET ADDRESS , CITY,STATE,ZIP
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[CONTRACTOR NAME 0 OWNER-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE
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STREET ADDRESS CITY,STATE; ZIP
E-MAIL P ONE BUS.LIC#
D - I —ON.).ElARCHITECT 0 OWNER 0 OWNER AGENT [CONTRA OR AGENT ElENGINEER El DEVELOPER 0 TENANT
. CONTACT,NAME ` 'f r( E-MAIL
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STREET ADDRESS CITY,STATE,ZIP F • PHONE
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DECRIPTON I {,
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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# TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION($)
, 11, •
REMODEL ' REMODEL KITCHEN REMODEL OMR , GARAGE" ❑ATTACHED
BATHROOM SF SF SF SF 0 DETACHED '
EXISING 0 YES
FSPRINKLERS 0 NO EICHLER'..E'NOS SECOND STORY ADDITION ❑YES
IRE I' 0 NO 1
DWELLING SECOND DWEILINGI ❑YES 0 ATTACHED 0 DETACHED OTHER
UNITS# UNTT ADDITON:'I 1
❑NO SF
POOLS! ❑FIBERGLASS I❑VINYL-LINED ❑GUNITE ❑PREFABRICATED
POOL-'SF SPA-SF 1I i, I SPA ATTACHED 1:1 YES 0 NO I 'TOTAL-SF '
I f i RECD I TOTAL VALUATION:
Commercial or Multi-Familq Buildings'with Public Swimming Pools requires Department of Environmental Heath airorovat 4 .../(4.4 ( ,\ _ I) s _O 0^
I RE-ROOFI EXISTING ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES❑WOOD SHAKES❑WO SHINGLES❑TILE OTHER(SPECIFY)
REMOVE/REPLACE.0 NO .IF NO PLYWOOD ❑w' ❑3/8" PLYWOOD TYPE: PITCH;" .. .12 RO9 LASS
gl YES #OF LAYERS THICKNESS❑5/8" OTHER ❑OSE ❑CDX OTHER C`/��
PROPOSED ROOF TYPE:❑BUILT-UP ROOF VASPHALT SHINGLES 0 WOOD SHAKES❑WOOD SHINGLES 0 OTHER •
'Provide a signed copy of the:Clipertino's Tar-Off Policy SF 23 d"C #of SQUARES
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
to be made available for public record. t.
Signature of Applicant/Agent: �.,. Dater' e' ) .
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
I. BldgApp_2017.doc revised 08/01/17
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RE.ROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
. .
ALBERT SALVADOR, P.E., C.B.O., BUILDING:OFFICIAL
:A0viNg:•,'
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CU'PERtINO
(408)777-3228. FAX(408)777-3333.building@cuperlino.arct ii; 2,00-—
PROJECT ADDRESSI t.
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OWNER NAME I PHONE: , E-MAIL
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sTiuKET ADDRESS CITY, STATE,ZIP FAX
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CONTRACTOR NAME !, • { LICENSE NUMBER LICENSE TYPE BUS.LIC.P
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C.OMPANY NAME E-MAIL FAX
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r STREET ADDRESS es CITY,STATE,ZIP .
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I UNDERSTAND AND AGREE TO 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.tousinksislaA before._. LieL.,1:,,t g i.i e St e d inspection-date.
To schedule inspections call (408) 777-3228 from 7:304i30PM.(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 11;30L :30 (Mon-Thurs).
and 7:30-10:30am and 12:30-2:30 (Friday). Final Inspections will be given a to 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/fastener i shall be either
completely knocked-down or removed prior to this inspection.
4. If plywood is installed, a plywood Nailing Inspection is required,
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, 5. Roofing shall not be applied without first obtaining all.priorinspection and writtenliaPprovals from the
building inspector. Any roofing which is applied without first obtaining an approyed'inspection will
require the removal of all new material down to the sheathing-so a proper inspectiOn.can be performed.
6. A Final Insnectioni and approval shall be obtainedfront-thebuildina•inspector'when the re-roofing is
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completed. To receive a.final sign-off,the following sterns will be:verified:
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a. Flat roofs,shall have a minimum of 1/4"per foot of slope and demonstrat4 there is no ponding.
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b. Listings from approved testing agencies for all pre-manufactured products Used shall be
available on-site to review at the time of the inspettion.
c. Proper spark arrestor installation, vents painted, gutter/dowmpouts inStalled, debris removed,
7. NOTE: If you call for a tear-off or plywood nailing inspeCtion and the work iSnkjtl'eOmplete, you will be
charged a re-inspection.fee. The re-inspection fees Jailbe.paidbefore anothriipection can be
scheduled.
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By my signing below, I certify each of the following is true: I am•the property owner or authOrOd.agent to act on the ...
property owner's behalf. I understand and agree to comply with the re-roof policy stated abo0.111alsio understand that
, smoke detectors and carbon monoxide detectors are required to be-installed in accordance with SectiOns R314 and R315 of
.the 201.6 California Residential Code. , k I ill:
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Signature of Appl icanOk gent: AA 7_ _,.•c!__ ; ' e- Date! 0. '.'- i f ,_. ---) .
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ReRIiroopllev 2.014.tioc revised 06/01,"2'
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SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(@cupertino.org
PERMIT CANNOT BE FINALED UNTIL THIS CERTIFICATE .,HAS BEEN
COMPLETED, SIGNED. AND RETURNED TO 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, R315, 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
$1000 00, CRC Section R314, R315, and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or
Carbon Monoxide Alarms be installed in the following locations
AREA
SMOKE ALARM
CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s) - (Smoke alarms shall not be located within 3 feet of bathroom door)
X
X
On every level of a dwelling unit including basements and habitable attics
X
X
Within each sleeping room
X
Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that
do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with
CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal.
Power Supply In dwelling units with no commercial power supply, alarm(s) may be solely battery operated.
In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do
not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl
space. Refer to CRC Section R314 and CSC Sections 907.2.114 and 420.6.2. An electrical permit is required for
alarms which must be connected to the building wiring.
As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been
installed in accordance with the manufacturer's instructions and in compliance with the California Building
and California Residential Codes. The alarms specified below have been tested and are operational, as of the
date signed below
Address. 9-7,0 Permit No.
Specify Number of Alarms. # Smoke Alarms I 7 i 7 # Carbon Monoxide Detectors.
I have read and agree to comply with the terms and conditions of this statement
Owner (or Owner Agent's) Name:
Si nature . --..:. �. . �� .l.6.ZR$ale; .......
Contractor Name:
Si nature Lic.# Date:
Smoke and CO forni.doc revised 01/1012017