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B-2017-1721
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1721 19996 BEEKMAN PL CUPERTINO,CA 95014-2453(316 30 110) MEIER AND SONS ROOFING CONCORD,CA 94520 OWNER'S NAME: KHADYE DILIP RAND PRADHAN MADHAVI S TRUSTE DATE ISSUED: 10/05/2017 OWNER'S PHONE:408-966-3495 PHONE NO:(925)577-3527 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-39 Lic.#724093 Contractor MEIER AND SONS ROOFING Date 06/30/2018 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-(12 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 Compensation,as provided for by Section 3700 of the Labor Code,for the performance 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 Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$15000.00 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 316 30 110 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,Secti•• •48— 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 10-5-2017 Issued by:Kim Dunbar Date: 10/05/2017 S • CL5I'-B I_D_ I,, i hereby affirm,[ at 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 inspection. sale(Sec.7044,Business&Professions Code) ' 2.I I,as oper wner of the pram exclusively contracting with licensed Signature of Applicant: , contractors to construct the;project(Sec.7044,Business&Professions Code). Date: 10-5-2017 • I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER a.I .'p I have and'willnaintaina 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.j !.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 material. Additionally,should I use equipment or devices which emit hazardous shallinot employ any,persoh in any manner so as to become subject to the 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,and 25534. Labor,Code,.I rust forthwith comply with such provisions or this permit shall it I. be deemed revoked: Owner or authorized agen• g —' `APPLICANT CERTIFICATION Date:10-5-2017 I certifythat I have'read this application and state that the above information is _°=�^��- 1 t 'fz V correct'I agree:to comply with all city and county ordinances and state laws t hereby affirm that there is a constru:+ •• - •mg agency for the performance relating to buildiing,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'mentionedproperty 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,grantingiof this,permit. Additionally,the applicant.understands and will:com'ply 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 10-5-2017 Professional CONSTRUCTION PERMIT APPLICATION \/'"k/ COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION Srie 10300 TORRE AVENUE • CUPERTINO,CA 95014-3255 s (408)777-3228 • building@cupertino.org PEMIT#B-20 t - • .-4...1 CUPERTINO �,� El NEW CONSTRUCTION ❑ADDITION ❑ALTERATION 111 T.I. [1]MEP [ E-ROOF ❑SWIMMING POOL/SPA PROJECT ADDRESS i / a K 1vi A. ?(�r APN# - 3 C)r//0 OWNER NAME I 17 K --A D y E P�Oq X966 ,3 1-75 E-MAIL V I STREET ADDRESSCITY, STATE,ZIP / I Q g el(p 7jcEEciv PI ACE Gvj'E2 I F� I C S®/ CONTRACTOR NAME 0 OWNER-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYP 5� r►'1i: tOE I 1 iIZ 1146-1cRi- EN ,0 / -% O q3 ��(1. . STREET ADDRESS CITY,STATE,ZIP 2061 G lE,,) lzcp-aI; &r. Go,3 Lo2D c A 94520 E-MAIL PHONE 1 BUS.LIC# 92-5. 577.3 52-7 0 ARCHITECT 0 OWNER ❑OWNER AGENT gI CONTRACTOR AGENT❑ENGINEER 0 DEVELOPER 0 TENANT CONTACT NAME E-MAIL 2/1-103 EL(ESS _J STATE,ZIP PHONE EZ1F l - -A �,J E y e A-r7. 4 E 7 510RL---- D Ewi€"Fc Lid K ery0/(-fz1)t e A ,4545 6 9S/o . c/27-42-60 DECRE?I'ONI 2-/r PEN`7t n- f t-r►r 'r - 1 (A---r '-Ni ? c-, �(tr r-- Imo,5-w( 1 fe,A-y✓1 cc h-r r4)3 e-0 5 y 7c-M e J&g_ 0K.I 5-7(e3 i 0 i /7 tp P—C7":31 � I r l rCr( — TT AS- 6('1 coni F .. -c c��7 1 J( 9 6 /105 11 /JEW e-07,4 p 51,JSIL - 12 (1/57-t--, rto rr(• e..-( $ A _ - SINGLE-FAMILY/DUPLEX 0 MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SFI DEMO SF STORIES# TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION($) REMODEL REMODEL KITCHEN REMODEL OTHR GARAGE ❑ATTACHED BATHROOM SF SF SF SF 0 DETACHED ' EMSING 0 YES EICHLER ❑YES SECOND STORY ADDITION ❑YES • FIRE SPRINKLERS 0 NO 0 NO 0 NO DWELLING SECOND DWELLING 0 YES 0 ATTACHED 0 DETACHED OTHER UNITS# 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 RECEIVED BY: TOTAL VALUATION: Commercial or Multi-Family Buildings with Public Swimming Pools requires Department of Environmental Heath approval /5 ea,- RE-ROOFI EXISTING ROOF TYPE: BUILT-UP ROOF7ASPHALT SHINGLES❑WOOD SHAKES El WOOD SHINGLES❑TILE OTHER(SPECIFY) REMOVE/REPLACE❑NOI IF NO PLYWOOD ❑ " ❑3/8" �I * PLYWOOD TYPE: PITCH: 4er ROOF CLASS tJJ'YES #OF LAYERS C''''C THICKNESS❑5/8" OTHER /i'0 NO CDX OTHER :12 A PROPOSED ROOF TYPE:'IBUILT-UP ROOF HALT SHINGLES 0 WOOD SHAKES❑WOOD SHINGLES 0 OTHER o ZS t *Provide a signed copy of the Cupertino's Tear-Off Policy SF 1? #of SQUARES 1 2- 1 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. ro 1 S r Signature of Applicant/Agent: Date: 1 I SUPPLEMENTAL INFO EQUIRED *New SFD/Second Dwelling Units/Multifamily Dwellings:A 'tion 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 \ REROOF TEAR-OFF POLICY ©' COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 404-c.19,, ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildingecupertino.orq PROJECT ADDRESS 9 9 / ovi_ 7( APN# 3 //), - 3 O — /1 OWNER NAME p t r-4 4 /L I C PHaraci n// 3 / 75 E-MAIL STREET ADDRESS I c �/ rfy Ti STATE,ZIP et/All-Iwo / G A 9 5€51 FAX CONTRACTOR NAME L %(� LICEN E NUMBER LICENSE BUS.LIC.# pi Pr rg. g 7-470TH,-13 COMPANYPIE CR-d` �n1 -crAIJ E-MAIL W2-5-- 4S 9 7/7 STREET 2-0 GD1 61 i�►T,'I�c t�K • cIT..STATE,�U 9( PHONE �-� _ �,� 2 G� 94SZo crzs- 577- 35.2-7 I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimum of one day before the requested inspection date. Please schedule inspections online or call(408)777-3228 between 7:30-3:30(Mon-Fri). `Ii 3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof'is torn off and all the nails/fasteners have been removed. Any and all dry-rotted wood shall';be replaced prior to this inspection. A building inspector will be available within one hour. There are special hours for this service: 7:30 — 10:30am and 1:00—3:30pni(Mon:- fhurs); 7:30 — 10:30am and 1:00—2:30pm(Friday) 4. If plywood is installed, a plywood nailing inspection is required. 5. In-Progress roof inspection is required. Call for an in-progress roof inspection to verify building is weather tight after installation of approximately 25% of the roofing material. 6. New roof coverings shall not be applied without first obtaining all inspections and written approvals from the building inspector. Any roofmg 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. 7. A fmal inspection and approval shall be obtained from the building inspector when.the re-roofing is complete. To receive a final sign-off,the following items will be verified: 1. a. Flat roofs shall have a minimum of 1/4"per foot of slope and must 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. 8. 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 of$126.00. The re-inspection fee shall be paid before'another inspection can be scheduled. By my signing below,I certify each of the followin' ' . e: I am the property owner orauthorized agent to act on the property owner's behalf. I u a - -'. a and ay -- to comply with the re-roof policy state'd above. I!I Signature of Applicant/I_e. : Date: f: f 571 2 ReroofPolicy 2010.doc revised 05/17/10 il� SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE FELE Yg COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildinq(�cupertino.orq PERMIT CANNOT BE MATED 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 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, alarm(s)may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated whererepairs 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 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 r Address: l' P Ci ( /F6 PgfriA, i'2- Permit No. 20I- ""0 72-1 Specify Number of Alarms #Smoke Alarms ' ! #Carbon Monoxide Detectors l have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: Signature .. .. . . . .. Date: f 6/111./. Contractor Name: ✓ Signature Lic.# Date: Smoke and COform.doc revised 01/10/2017