B-2017-1677 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1677
18821 BARNHART AVE CUPERTINO,CA 95014-3601(375 16 052) RA CONSTRUCTION
SAN JOSE,CA 95136
OWNER'S NAME: SOLCHENBERGER JAMES GERARD AND TRACY A DATE ISSUED:09/27/2017
OWNER'S PHONE:408-252-4781 PHONE NO:(408)559-1877
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: •
License Class C-39 Lic.#633438
Contractor R A CONSTRUCTION Date 12/31/2017 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:
REROOF;TEAR OFF;PARTIAL RE-ROOF;COMP SHINGLES-(16
I hereby affirm under penalty of perjury one of the following two declarations: SQ)
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.
000 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
ermit is issued.
Sq.Ft Floor Area: Valuation:$6500.00
_ 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 lawe relating,to building construction,and hereby authorize 375 16 052
representatives of this city to enter upon the above mentioned property for
inspection purposes.,(We)agree,to save indemnify and keep harmless the
City oflC'upertino 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
Additionall ,the applicant derstands and will comply with all non-point
source re.ulations 500 upertino;Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
ature ..,
i Date 9/27/2017 Issued by:Jasmine Archbold
Date:09/27/2017
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
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)
2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:9/27/2017
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. 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
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
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 25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall - -
be deemed revoked. . - ------_.�--
Owner or au .r•it e. agent:
APPLICANT CERTIFICATION Date:9/2., '.t.
I certify that I have read this application and state that the above information is CON- ` ION LENDING AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there s 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!bf 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 i9.18. I understand my plans shall be used as public records.
Licensed
Signature 1 _Date 9/27/2017 Professional
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
,,
. B .,,. ..&.
10300 TORRE AVENUE • CUPERTINO,CA 95014-3255
gS.:19,i..
bi' " (408) 777-3228 • building@cupertino.org PEMIT#B- 2.C7 Il"' - ((pi,
CUPERTINO REV# DEF#
❑ NEW CONSTRUCTION ['ADDITION ❑ALTERATION ElT.I. 1=I MEP ❑RE-ROOF 1=1 SWIMMING POOL/SPA
PROJECT ADDRESS 2- /�( ,' /�r A'/ E-MAIL/ N 31 — r `
J
OWNER NAME / ?f
PHONE :..7 E
STREET ADDRESS A n /,/ CITY,STATE,ZIP
oNTRACTOR NAME 0 OWNER-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE
I STREET ��� et(weitifit. � CITY,S TE, ZIP ��� 1
2 I
E-MAIL PHONEBUSS.LIC#
7a' , 6/zD Lin dtii
❑ARCHITECT 0 OWNER 0 OWNER AGENT ❑CONTRACTOR AGENT 0 ENGINEER 0 DEVELOPER 0 TENANT
CONTACT NAME E-MAIL
STREET ADDRESS CITY,STATE,ZIP PHONE
DECRIPTON i q O�1 / d/''Z7 l/�Y Y- -oc n ,h)c'"((
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74- Lt&: 14 0 01410 -56.4,,,,y4-2 Ar
VINGLE-FAMILY/DUPLEX ❑MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL
EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES# TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION($)
S!re Ingo 2 L-°0
REMODEL 1 REMODEL KITCHEN REMODEL OTHR GARAGE ❑ATTACHED
BATHROOM SF SF SF SF 0 DETACHED
EXLSING ❑YES EICHLER ❑YES SECOND STORY ADDITION ❑ ES
FIRE SPRINKLERS❑NO 0 NO 0
DWELLING SECOND DWELLING ❑yES 0 ATTACHED❑DETACHED OTHER '
UNITSI# UNIT ADDITON: 0 NO S F
POOLS' 0 FIBERGLASS ❑VINYL-LINED ❑GUNITE 0 PREFABRICATED
POOL-SF SPA-SF I SPA ATTACHED❑YES 0 NO TOTAL-SF _
DIVED BY: TOTl L VALUA ON:
Commircial at:Multi-Family Buildings with Public Swimming Pools requires Department of Environmental Heath approval Q J\/W�/V��V. /' /a�'ti
RE-RO OFI EXISTING ROOF TYPE: ❑BUILT-UP ROOF❑ASPHALT SHINGLES❑WOOD SHAKES❑WOOD SHINGLES❑TILE OTHER(SPECIFY) ((0O J (/
REMOVE/REPLACE Q NO IF NO PLYWOOI' ''I ❑3/8' 44PLYWOOD TYPE: xc/rPITCH: / ROOF CLASS
EYES I #OF LAYERS 1 THICKNES u 5/8" OTHER`� l ❑OSB ❑CDX OTHER '12 A
PROPOSED ROOF TYPE:DBUILT-UP ROOF` 6SPHALT SHINGLES 0 WOOD SHAKES❑WOOD SHINGLES 0 OTHER VVV
*Provide a signed copy of the Cupertino's Tear-Off Policy SF I of, #of s)QUARES /6 `fir
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 1. relating to building construction. I authorize representatives of Cupertino to
enter the above=identified property for inspection . I acknowledge and authorize all information contained on this application form
to be made available for public record. `�
Signature of Applicant/Agent: - :I Date: G
SUPPLEMENTAL INFORMATION REQUIRE,
*New SFD/Second Dwelling Units/Multifamily o wellings: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
I REROOF TEAR-OFF POLICY
v .
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
:!-:::• ,,,..; :
ALBERT SALVADOR, P.E.,C.B.O.,BUILDING-OFFICIAL
kielVt:'
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 • 3 --`2-011- I (P1
CUPERTINO
(408)777-3228•FAX(408)777-3333.building@cupertimorq
PROJECT ADDRESS i 0 ZI 11 LI, ' 4-(2-, APN;4 3'15- (0 o52
.OWNER NAME --.
,,,/ i f . (A, rt: • 1 PHONE IA' ' 04 ,4715(
1
STREET ADDRESS
..7
CON TRACTOR NAME A erso -r LICENSE NUMBER I LICENSE TYPE BUS.LIC.0 .
COMPANY NAME.41111111111011111111..- gem j A/0/ E-MAIL FAX
., .
, .
F
STREET ADDRESS ."X1 CITY, .
STATE,ZIP,9.....1/‘.7eg.,5, , PHONE
ge 57 anirLri ' (F/t- .•
' '` •
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 to one business daV.before the requested inspection date.
,
'Fo schedule inspections call (408) 777-3228 from 7:30i3:30PM(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 out to the
job site within,one hour., The hours for this service are: 7:30-10:30am and 12:30-3:30 (Mon-Thurs).
and 7:30-10:30am 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-dOwn or removed prior tothis inspettiont---
4. If plywood is installed, a plywood Nailing Inspection is required.
5. Roofing shall not be applied without first obtaining alhpriorinspe5tion and written approvals from the
building inspector. Any Lro.ofing which is applied without fir0-ob-tairdng 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 obtainedlfronithe:buildinz inspector when the re-roofing is
completed. To receive a final.Sign-Off,the folloWinglerris.Will be'verified:
a:, Flat roofs shall have a minimum of 1/4"per foot ofSlope and detnonstrate 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.
.
c. Proper spark arrestor installation, vents painted, gutter/downspouts installed, debris removed.
7. NOTE: If you call for a tear-off or plywood nailing inspeetion and the Work is not complete, you will.be
charged a re-inspection fee. The re-inspection fee shalt 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 agent to act on the •
property owner's behalf. I understand and agree to corn ly with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide detector 3 "Kai ed to be installed in accordance with Sections R314 and R315 of
the 2016 California Residential Code.
Sjignattre dpApplicailt(Agept: Date- ,,<"0-F- .. : •
, .
---._
Pr. ReroglPolicy_2014.cloc revised 06/01,7
\tom,A1 SMOKE / CARBON MONOXIDE ALARMS I ,.
OWNER CERTIFICATE OF COMPLIANCE l O:5 (7 r—
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
GIUPERTtPiO
(408)777-3228•FAX(408)777-3333•buildinq a(,cupertino.orq
PERMIT CANNOT BE FINALED UNTIL THIS CERTIFICATE DAS BEEN
COMPLETED,SIGNED,AND RETURNED TO THE BUILDLNG DI SIGN
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 X X
bedroom(s)-(Smoke;,alarms shall not be located within 3 feet of bathroom door).
On every level of a dwelling unit including basements and habitable attics X X
Within each sleepingroom 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 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 accordartce 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: 0�;!� t �v� C1/4)10k.344'4+ CPI 9 O I Permit No.(7 'tit1-101
Specify Number of Alarms: #Smoke Alarms: I ,3 I • #Carbon Monoxide Detectors: I 3 I
I have read and agree to corn, with the ms an conditions of this statement
Owner(or Owner Agent's)Name:
J4wiiu Jo f c,,LeKL._r Signature ` Date: i0-3-1/
Contra We: //
ev/Vsi Signature � Lic.#. ••/•J•• Date: .l..6- /'7
Smoke and COfonn.doc revised 01/10/2017