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B-2017-1700 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1700 1075 NOVEMBER DR CUPERTINO,CA 95014-4129(362 16 016) EL CAMINO ROOF SYSTEMS CO INC SAN JOSE,CA 95112 OWNER'S NAME: DHIRAPONG SUPAT AND KAREN TRUSTEE DATE ISSUED: 10/02/2017 OWNER'S PHONE:408-564-5243 PHONE NO:(408)292-7644 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class CC=39 Lic.#987803 Contractor EL CAMINO ROOF SYSTEMS CO INC Date 09/30/2018 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: RE-ROOF;TEAR-OFF;INSTALL OSB;COMP SHINGLES-(23 SQ) I hereby affirm under penalty of perjury one of the following two declarations: t. 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. I have and will maintain Worker's Compensation Insurance,as provided for by • Section 3700 of the Labor Codc,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$14000.00 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 362 16 016 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. ''0� Date 10-2-2017 Issued by:Kim Dunbar Signatur`k� � Date: 10/02/2017 • OWNER-BUILDER DECLARATION 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 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: 10-2-2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER t. 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 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 C1_,e,Sections 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized age " APPLICANT CERTIFICATION Date:10-2-2017 I certify that I have read this application and state that the above information is CO II-RUCTION 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, 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. Licensed Signature Date 10-2-2017 Professional CONSTRUCTION PERMIT APPLICATION �%+� COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION [ 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 a-,,-1•1$,:t IYd 20 t T. - I OO s (408) 777-3228 • building@cupertino.org PEMIT#B- CUPERTINO REV# DEF# ❑ NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T.I. ❑MEp e.RE-ROOF ❑SWIMMING POOL/SPA PROJECT ADD ESS APN#3672. �. L f J((f /� /07Sgo ve ,ber p'`- OWNER NAME PHO E rziyE- AIL t Ay ea, e XiwD• toNj STREETrOV 7,�ADI 04/ CITY, STATE,ZIP ovc.n bar A/'- e`.c/ /1rt1+,® G•ol- • 1P/ El CONTRACTOR NAME 0 OWNER-BUILDERCOMPANYJVAI�E _live. go, LICENSE NUMBER LICENSE TYPE 0 41014-1, /44 Say s J 4- Sysvo.s ego . -e-- ,197 803 6.-31 ISTREET ADDRESS CITY,STATE, ZIP I E-MAIL PHONE BUS.LIC V. 1 , Gym/• a yob .7yz-7�Yy 0I. g69 0 ARCHITECT 0 OWNER ❑OWNER AGENT 'CONTRACTOR AGENT ENGINEER 0 DEVELOPER 0 TENANT • CONTACT NAMEE-MAIL �q �- � `I� 011,.9441."" 7 G%. 4r/ C019."kV' ems'.19,PVrY I• STREET ADDRESS . -7 ST' CITYSTATE,ZIP fery L "Mr-1 J PH 0 ?p—c'ZZ /4‘5 DECRIPTON ,r o �jCif.i, t,i�v4' so '�� ✓J 4 —0`1`x, Ai % t‘'-c. 0 s/.3 p/7 4,,,,,. € c ke.erl E - • ' :;'aSSINGLE-FAMILY/DUPLEX 0 MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL I EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES It TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION($) zaoo . REMODEL REMODEL KITCHEN REMODEL OTHR GARAGE 0 ATTACHED BATHROOM SF SF SF SF 0 DETACHED EXISING 0 YES EICHLER 0 YES SECOND STORY ADDITION ❑YES FIRE SPRINKLERS 0 NO 0 NO 0 NO DWELLING SECOND DWELLING 0 yEs 0 ATTACHED 0 DETACHED OTHER UNITS It UNIT ADDITON: 0 NO S F POOLSI 0 FIBERGLASS 0 VINYL-LINED 0 GUNITE 0 PREFABRICATED POOL-SF SPA-SF SPA ATTACHED ❑YES 0 NO TOTAL-SF RECE Y: O L Q=L��ON: Commercial or Multi-Family Buildings with Public Swimming Pools requires Department of Environmental Heath approval 11 i RE-ROOFI EXISTING ROOF TYPE: ❑BUILT-UP ROOF❑ASPHALT SHINGLES®.WOOD SHAKES❑WOOD SHINGLES❑TILE OTHER(SPECIFY) REMOVE/REPLACE D NO IF NO 9 I PLYWOOD „ ❑3/8" PLYWOOD TYPE: PITCH: ROOF CLASS ' t-i YES #OF LAYERS THICKNESS❑5/8" OTHER X OSB ❑CDX OTHER .,/ .12 A PROPOSED ROOF TYPE:❑BUILT-UP ROOF XSPHALT SHINGLES 0 WOOD SHAKES❑WOOD SHINGLES 0 OTHER *Provide a signed copy of the Cupertino s Tear-Off Policy SF S.2.070 #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 inspec' • purposes. I ackn.. •d e and authorize all information contained on this application form to be made available for public record. —- /0— s/7 Signature of Applicant/Agent: % Date: SUPPLEMENTAL INFORMATION RE? IRED *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 B1dgApp_2017.doc revised 08/01/17 ;'`: REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION !'yalgj, ; ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228 •FAX(408)777-3333 •buildinqacupertino.orq r7- O i1 - I --i-oD PROJECT ADDRESS /vJ. ow's., /__ p, , APN# 3 (e 1 f1 l( io . .c./10 PAi i elv6 F1-%T"a,g..6 v. 6v.— 't SZY3 .�. pk rY • / a' i�/I r €.0.4.1€.0.4.1 w i SN1l60. pr, %i41/� 44- 9 -Ar FAX �„O �" CO RACTOR NAME BUS.LIC.# W � ss/4"-j - �yLICE!TtP3 .., .1409Mal);NAMEArof.sysyfrio.f. �O G titn1"*A4P"Off,e;, Iy. Awi• FAX;toe vly-d IG � Vs,I`TADDRES�. sr. C .rY STA E LJb.TG Cmc yJ ` L__. PHO v��2p...76 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 day before the 'requested inspection date. ' ! To schedule'inspections call (408) 777-3228 from 7:30-3:30pm(Mon-Thurs) or 7:30-2:3Opm',(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: 7:30-10:3Oam and 12:30-3:30 (Mon-Thurs) and 7:30-10:3Oam and 12:30-2:30 (Friday). Final Inspections will be given a'two hour window.: , 1 . 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/fasten'ers shall b,e 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'fr'om 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 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. . 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 is hot complete,you will be charged a re-inspection fee. The re-inspection fee shall 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 comply with the re-roof policy stated above. I also understand that i. smoke detectors and carbon monoxide detectors are required to be installed in accordance with.Sections R314 and R315 of the 2016 California Residential Code. Signature of Applicant/Agent: ,��� _ s Date id,411050 /02- 7/y ReroofPolicy_2014.doc revised 06/01/7 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE x�p COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildinoacuoertino.orq PEIRIIIIT CANNOT BETriAxg,TyuNT.w THIS CERTIFICATEAAS BEEN: COMPLETED,SIGNED;AND,RETIClRNED TO THS BUILDING DIV SIO• Lh 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 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, alarms) 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 907.2.114 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 alarms)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 r _ r/ y Address 10 7 o v E M � � (/v ff e.T( 0 , Permit No.1 ` -�1 ii Specify Number of Alarms V #Smoke Alarms. J 5- I #Carbon Monoxide Detectors I 6 I I have read and agree to comply with the terms and conditions of this statement Owner(or�Owner Agent's)Name: / . V P 7_ .0 �e ll po, Signature ... ..'.. .�` .. . ... ,�. _. Date: 1 /..4.P°//�/ Contractor Name: 5*-if Signatures Lic.# f ��� Date: /' u� -/ ` Smoke and COform.doc revised 01/10/2017