B-2017-1676 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1676
1108 S STELLING RD CUPERTINO,CA 95014-5021(362 26 011) SIGNATURE
BUILDERS INC
BELMONT,CA 94002
OWNER'S NAME: GORDON BOBBY LAND BARBARA L TRUSTEE DATE ISSUED:09/27/2017
OWNER'S PHONE:408-252-4513 PHONE NO:(650)598-5444
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class.C-39 Lic.#686668
Contractor SIGNATURE BUILDERS INC Date 04/30/2018 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(24.5 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.
' .7'V^ 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:$9800.00 ' '
' 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:
I; and state•laws relating to,building construction,and hereby authorize 362 26 011
representatives of this city to enter upon the above mentioned property for
inspection purposes., (We)agree to save indemnify and keep harmless the
i , City of Cupertino against,liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK ISNOT STARTED
may accrue the againstsaidCity in consequence of the granting of this permit, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
1 Additionally,the applicant understands'and will comply with all non-point
source regulationsper the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
u ature V4 Date 9/27/2017 Issued by:Abby Ayende
' Date:09/27/2017
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFSi
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.
i sale,,(Sec.7044,Business&Professions Code)
2. I,as owner of the property,am exclusively contracting with licensed I '"= e of Applicant: S
'contractors to construct the project(Sec.7044,Business&Professions Code). Date:9/27/2017 '
Iihereby affirm under penalty of perjury one of the following three declarations: ,,; ;;
i. 'I have and'will maintain a Certificate of Consent to self-insure for Worker's ALL ROOF COVERINGS TO BE CLASS A OR BETTER
3 • :Compensation,as provided for by Section 3700 of the Labor Code,for the
'! i :perfo mance of the work for which this permit is issued: HAZARDOUS MATERIALS DISCLOSURE
i i. 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
i 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
a. ; ,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
sliall 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 Qualit'IManagement District I
Workers 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.
'Labor Code,I must forthwith comply with such provisions or this permit shall a 1
be deemed revoked. , i a or authorized agent:Lv `S �' '
cl
.1 APPLICANT CERTIFICATION 1's ate:9/27/2017 ; I
I certify that I'have read this application and state that the above information is CONSTRUCTION LENDING AGENCY
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, ; I
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 9/27/2017 Professional
1 ,
1' ,,
\EN/ REROOF TEAR-OFF POLICY
t�Jf COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ST,,9s� ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228• FAX(408)777-3333•buildinq(a.cupertino.orq
PROJECT ADDRESS 11 s • 1 L \ L 14 D • APN# 3(01
OWNER NAME s A w I A VI 1(4)0 �t � PHONE Li D - ^ r'�1 450 E-MAIL
STREET ADDRESS 11 a g: SQ G` W P� t� . CITY, \A V1 1 e 1`9)1 0i ctsb)1 FAX
CONTRACTOR NAME C�L�(,(4� li�•��J1 LICENS1 NiU� Is�bQ LI( DJ9'$1E BUS.LIC.# L)D q D p
COMPANY NAMEp ` 11 tA, �+Ii 3®�`L0e, 2sfIoMSiq�+ esi iol P mcit �. X
STREET A DRESS�`ll(1n�V�r�1 t� J �1/ Crr �.J��✓��b V 1 "'� J I`��`�f� PH . q /
�oi�k ri
I UNDERSTAND AND AGREE TO THE FOLLOWING:'
1. The re-roof project shall comply with all applicable provisions of the 2013 California Codes,.
2. An inspection request can be scheduled up to one business day before the requested inspection date.
Please schedule inspections online or call (408) 777-3228 from 7:30-3:30pm (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
available'within one hour. The hours for this service are: 7:30-10:30am and 112:30`3:30 (Mon-Thurs)
and 7:30-10'30am arid 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-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 inspection can be performed.
6. A Final Inspection and approval shall be obtained from the building inspector when the re-roofing is
completed. To receive a final sign-off,the following items will be verified:
a. Flat roofs shall have a minimum of I/4"per foot of slope and demonstratethere is no ponding.
b. L'istings 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 isnot complete,you will be
charged a re-inspection fee. The re-inspection fee shall be paid before another;inspection can be
scheduled. f
By my signing,below,I certify each of the following is true: I am 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
smoke detectors;arid'carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2013 California Residential Code.
Signature of Applicant/Agent: Date / .6 /19-'7'
RerOff'dIicy,12014.ddc revised 01/15/14
l lid.
\40,„.„,,„ REROOF PERMIT APPLICATION
V
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
�5�.,9fs 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•buildinq aC,cupertino.orq
PROJECT ADDRESS 1\ DS
SD e i ' 1,-�I . n O APN k N.02 ice,0
1 1
OWNER NAMEV®n )^iv) Alepico1VOPHONE yIA.OsQ-] 3E-MAIL
STREET ADDRESS 1101 U • . I f'10.1.3,.E ,n /) o CITY,ttAE I �1 op, fis O)4 FAX
CONTACT NAME %ro �� (3,s,`) \ PHONE (O�n.6C1Y-5`',1q �'�n� d
V T! r 0� 1�1 1"J MO►t J.Cly
STREET ADDRESS ( ILI (NA
OU1 1`1I1�' VIV / A 4C. CIf�Y ST,_ATE, 01 1 140 FAX
FAX
❑OWNER 0 OWNER-BUILDER 0 OWNER AGENT XONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT ' 0 ENGINEER ,0 DEVELOPER 0 TENANT
CONTRACTOR NAME `) 0 fat, filRaot.....- LICENSE NUMBER a 69bV LICENS)Cuci, BUS LIC.S 10 p
COMPANY NAME S 6, Iii-1A at- BvlVDY ,�rE-MA,Ln f ` FAX
c oo i-tin no .c-
STREET ADD
CITY, c4,1 opq
ARCHITECT/ENGINEER NAME LICENSE.NUMBER BUS.LIC.S,
COMPANY NAME, , E-MAIL FAX
STREET ADDRESS ' i.! CITY,STATE,ZIP PHONE
' id
• USE OF ,SFD or Duplex 0 Multi-Family ROOF AREA: VALUATION:
`� CL
;Commercial Aliso s • `J7 • `y�� b D v
STRUCTURE: 0, �1
1 EXISTING ROOF TYPE'i 11 ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES/ 0 OTHER(SPECIFY)
IREMOVE/REPLACE 12 YES IF NO. PLYWOOD 0 N" 0 PLYWD 0 OSB PITCH: `I ' ROOF
' I I l7 NO ft LAYERS THICKNESS: 0 5/8" TYPE: 0 CDX 'I '12 CLASS: A
1 "1 ; ICC-ES REPORT#
' 'PROPOSED ROOF TYPE: 0 BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES 0 WOOD SHINGLES 0 OTHER
DESCRIPTIONORj I� 1/s.n� ,IQ �� f�,�(� ,� �-N� C��1 ' (,n , ' ng
ij I
• 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 build'.• construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
i;l /
, 'Signature of Appllcant/Agent: ® • Date: D '
,+ SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE'ONLY .i ,
If building Is associated with a Home Owner's Association,provide letter , f •PLAN CHECK TYPE ,ROUTING SLIP:
11
1 1 of approval 06in HOA. ❑- OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. ❑',`EXPRESS ❑ PLANNING PLAN REVIEW
;,
Provide copy of Manufacturer's Installation Specifications. ,0!STANDARD ❑ FIRE WEPT
Provide signed.copy of Cupertino's Tear-Off Policy. ❑ OTHER
,
ReroofApp 2011.doc revised 03/16/11
,.
1 le- EL E
SMOKE 0,-,ARB'ON MONOXIDE ALARMS
OWNER CERTIFICATE4tP COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMEN I • HUILOINCif, VISION
loap TORRE AVEPIVE •<,',UPCRTINCI, CA 9501-1-32C4.
CUPERTINO
140-81 7n-32128-FAX 4O777,33n•Inednewpe.con..orci
'
Perm ii,N1). E2oL7- R7
Address Q o I 1)10 t Al; Smoke: Carlirm\lonitxide:
PERMIT CA NNOTBE FINALED AND COMPLETED UNTIL THIS C:ERTLEICATE.
IMS BEEN SIGNED AND PITEURNRD TO THE BUILDING DIVISION
PURPOSE
This affidavit is.a self-certification for the installation fif all required Smola, and Carbon Monoxide Alarmt,11)1'
compliance with 2013 CRC Section R314:2013 CBC Sect iont;.i 42116 and.9117.2.11.2-where no ink:dor acces:s for
irispeoions aw.requintl.
GENERAL INFORMATION
Existing single-farn i ly and multi-family d lliiig hall be provided with Smoke Alarms and Carbon
Xfonoxide a larn-t, When the valuation of midi lions; alterations..or repairs to existing d4iiag units exceeds •
S10110.00. CRC Section R314 and CliC!•-iectiltis 907,2.11.5 and 420.6 require that Smoke A iiirOls a rid/or Carbon
Monoxide .6.ianTi 5 IN installed in the following locations_
,
AREA F.'6:1 OK V.ALARM r CO ALA WO
IOut:side Of each st,p4rat-i%•:k4,Ting afe,:i in the inurocii:g.o v idnity o the X X
adurcomii..41 •
1 Cta evt:ry ot a dwelling lafth illthiOing basements I X X
1_1Ni:thin each roetn _ _ _ X , _ .
Carbun Monoxide alarm are not legal i red in &evenings which do not contain fuel-burning ti5ipliances and that
do not have an attached garage. Ca r•bon monoxide alarins combinedi 1
w.t.1 rnukc adilfE114;shall cclenpb,. with
CLC tetioo 42116 and shall he approved by the Of tif the Stale Fire N.ra rshal.
Power Supply: In dwelling units with mi eartirm.qcial power snpply„alarrn(s) may be solely battery orated.
Ir existing dwelling unit larms are permitted to IL'e battery'operated where repairs or alleralions do
not reiailt in the removal of wall and ceiling finishes or there k no accet,s meallS-of attic,basement or crawl
space. Refer to CRC Section R.314 and CBC Smtions 907.2.11.1 and 420.6,2, An electrical permit k required for
alarms which must be connected to the building.wiring.
Af,owner of the a Nave-feferenced property. I hereby certify that the alarm(s) leferenced above ha ave been
installttd in accordance with the manufacturer's instructions and in compliano&with the California T3uilding
and'California Residential Codes. The alarms have been tested and are ofx/rational,as of the date signed
below.
•
Ve reed end inMe'10 er.0111).K7e lorrhr MCI coPdatos or iiu StiAftWit
VorIaresern
0.71-k:a,:cr Aeptc-es%
/3ib d
alt-,6,1r4 C,20/..qfP7
COMIC.I.Cr r1)(0,C,
SsCfnittiff: .. Dsie.
,)me ,VviNoi
. •