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B-2017-1800 CITY OF CUPERTINO BUILDING PERMIT • BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1800 985 S TANTAU AVE CUPERTINO,CA 95014-4601(375 38 055) COSMOS ROOFING INC ' MOUNTAIN VIEW,CA 94043 • OWNER'S NAME: MCATEE DALE E DATE ISSUED: 10/20/2017 OWNER'S PHONE:408-480-0886 PHONE NO:(650)969-7663 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C39 Lic.#785441 ' Contractor COSMOS ROOFING INC Date 04/30/2019 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 TAR&GRAVEL;INSTALL 4 PLY I hereby affirm under penalty of perjury one of the following two declarations: COO CAP 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 workfor 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:$16105.00 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 375 38 055 representatives of this city to enter upon the above mentioned property for 1 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 s.•d City in'consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally;the ar slicant. d'rstands and will comply with all non-point source regula•. . per the C. sertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. 'vim �- Signature ' Date 10-20-2017 Issued by:Kim Dunbar • Date: 10/20/2017 , - I D_RD .► • 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 f 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: 10-20-2017 . 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 ,.I ; performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE z. 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 Health&Safety Code,Section 25532(a)should I store or handle hazardous 3. I certify that in the performance of the work for which this permit is issued,I 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 A Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cup tino Mu 'eip':l Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the . the Health&Safety C.4; Se'tions 2550 -533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall frrg`ol 1 be deemed revoked. Owner or authorized agent: � ��� APPLICANT CERTIFICATION Date: 10-20-2017 —'' I certify that I have read this application and state that the above information is CONSTR!CTION 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(Sep 3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnifyand 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. Signature Date 10-20-2017 Licensed Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ..,„,„., 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 Ds .4. ' (408) 777-3228buildi�g»cupertinO.org PEMIT�B- )�� - / roo CUPERTINO • REV# DEFE ❑NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T.I. ❑MEP NRE-ROOF ❑SWIMMING POOL/SPA PROJECT Q o5 ...S, .1)3corp,w P 4E APNp' 45., s l ocs OWNERNAtv],li PI`ie Dei iv-et 1 1 �1_��.w 0sez� E-MAIL STREET ADDRESS 7Ki _lrvSGVhCITY, STATE,ZIP l CONTRACTOR NAME ❑OWNER-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE , C1Ot.?.Aa tte0Fi fJe) JJ � G 3° STREET ADDRESS CITY,STATE, ZIP � 4Q1 OLD ��� � 4 an�,c I ) k) Vr 1 (4 4043 1 E-MAIL PHONE BUS.LIC a cwmac.r®a •of ice irnt i Leonn (050) 40 33A-0 0 ARCHITECTiff OWNER.❑OWNER AGENT 0 CONTRACTOR AGENT ENGINEER 0 DEVELOPER 0 TENANT CONTACTNAMExx �p� �a r/� a--PS hh E-MAIL ' STREET ADDRESS CITY,Y,STATE,ZIP EHONE 50OO l'441 5 DECRIPTON . `rt,AR. o -54P- IQ G g,-PAI et SINGLE-FAMILY/DUPLEX 0 MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES I. TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION(5) I REMODEL REMODEL KITCHEN REMODELOTHR GARAGE 0 ATTACHED BATHROOM SF SF SF SF 0 DETACHED EXISING ❑YES EICHLER ❑YES SECOND STORY ADDITION ❑YES ' FIRE SPRINKLERS❑NO 0 NO 0 NO DWELLING SECOND DWELLING ❑YES 0 ATTACHED DETACHED OTHER • ' UNITS A UNIT ADDITON: ❑NO S F . POOLS ❑FIBERGLASS ❑VINYL-LINED 0 GUNITE 0 PREFABRICATED ,I POOL-SF SPA-SF ( SPA ATTACHED ❑YES 0 NO I TOTAL-SF ' RECEI0 TOTAL VALUATION: .I Commercial or Multi-Family Buildings with Public wimumfug Pools requires Deportment of Environmental Heath approval / �/, /)'YJ^'10 J�> RE-ROOF EXISTING ROOF TYPE: BUILT-UP ROOF❑ASPHALT SHINGLES WOOD SHAKES❑WOOD SHINGLES❑TILE OTHER(SPECIFY) } lJ ''I REMOVE/REPLACE D N IF NO PLYWOOD 01/2" ❑3/8" PLYWOOD TYPE: � /� PITCH: ROOF CLASS liffi YES IOFLAY,ERS THICKNESS❑S/8" OTHER 1=1 OSB ❑CDX OTHER . •12 A PROPOSED ROOF TYPE: BUILT-UP ROOF DASPHALT SHINGLES 0 WOOD SHAKES❑WOOD SHINGLES 0 OTHER ,i, ni *Provide a signed copy of the Ctipertino's Tear-Off Policy SF N' 'Aof 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 sta aws relating to building construction. I authorize representatives of Cupertino to enter the above-identified property for-inspe. '.. .0 q.. cknowledge and authorize all information contained on this application form to be made available for public record. ti7r. - Signature of Applicant/Agent: -s Date: 460174-01 IT•' - 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 BldgApp_2017.doc revised 08/01/17 . . . REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION r'...f ALBERT SALVADOR, P.E.,C.B.O.,BUILDING OFFICIAL I kfrAV,:t* . CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3265 (408) 777-3228•FAX(408)777-3333•building©cupertino;org t,-zo-L1--- 1'600 • PROJECT ADDRESS 0[48 b S . TIA.p...f-v--/k .1(4.. . APN OWNER NAME 0 i\c.......t.,-- \\Aa..plc. ..E., itz61: ..... 14%,0 octsg,0 E-MAIL s . 1 — -------- STREET ADDRESS CITY, STATE,ZIP I FAX CON TRACTOR NAME LICENSE NUMBERLICENSE TYBUS L C.4 S . An,MC6 12.000A6- "1-'f:12.5I 44-A .i •- - ok._ !.Cqs&A;(51)N ANT Eg L ' 1) A 44 1)DX ItT-t-D \AJN"4-411: Q'SYN;6..06CPer°°CiPga a CICI-Ce.@ 4 a AXa ,Q.CrIC\ , .STREET ADDRESS : 1 CITY,STATE,ZIP PHONE • : „ . MIL NTH Cq \,) ( \r\I 11A A I UNDERSTAND AND AGREE TO,THE FOLLOWING'. . 1. The re-roof project shall comply with all applicable provisions of the 2016 California Codes. 1, 2. An inspection request can be scheduled up to one husiness.day befdre the requestedinspeetion date. • 'Fo schedule inspections call (408) 777-3228 from 7:304:30Piri M66-thurs),Or 7:30-2:59Pm(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 comp:Wed. The building inspector,Will be out to the 1 job site within one hour. The hours for this service are: 7130-10:30amt,and- 12:30-3;30 (Mon-Thtirs), and 7:30-10:30ani and 11:30-2:30 (Friday). Final InspectiOns Will be given a twd hotT 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 install1ed, a plywood Nailing Inspection is required, . ,. ! . 5: Roofing shall riot be'applied without first obtaining altpriorinspection and written approvals from the building inspectot! .Any roofing which is applied without first obtaining an approved inspection will require the removal()f ait new material down to the sheathingso a proper inspection.can be performed. 6. A Final Inspection and approval shall be obtained from the building inspector When1the,re-roofing is completed. To',reeeiVe a final.sign-off,the following items At be verified:. a . . . . a. Flat roof shall have a minimum of'A"per foot of slope and demonstrate there i§no ponding. b. Listings from approved testing agencies for all premanufactured products.1Used 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-alt or plywood nailing inspection and the Work is not Comp etc, you will be , charged a re-inspection fee. The re-inspection fee shall benald before another!inspectiOn can be scheduled. . . By my signing below, I certify each of the folio ing is tru •,m the property owner or authorized;agn'p act on the - property owner's behalf,: I 6ii6rstand a•;ivi.. ,. coin•ly i i the re-roof policy stated above: 4 4solianiderstand that , --- . . . smoke.detectors and CarbOnl:_nionoxide 4,1i-ware relir q to be installed in accordance With ectilen PA).4 and R'.. 15 of the 2016 California'Resided 'al Code \WHIM ili . ,. - . - .. 10 ri XAD// $igliguro of,ApplicOVAgeri.: VLIP-AlIW' bati . L. LLL,.) ,- _...,.........1._ '• - Rer6OblicpI .i2014.doc!wised 06/01;7 ! . : ! .. . SMOKE / CARSON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE EFCOMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 /1^1M7 ti�r• (408)777-3228•FAX(408)777-3333•building a(�.cupertino.orq i, V�r t'+>- '�`5 ,% 'a*,, i4Orev W t P ��"" x � ,, PERIATi OANNOOXIFTNALEVINVEITHI ERTIFWATE AS B ;? pm% EDS SIGN ; ' az'w Y`,�.e..r...,,>e..Ae4.�..>..5,,. a:.:2_"4...n MnH",,:�w6> ,ra �a..,.M .�r..,>.,-...mT:..Y..re.T��.f��'��l';' 3;'.e.,.:m'K,4;4s„..zM,,',.RY' m».'.n: ..v ms e,Y.;wl:,. ,-saxm,%�".('�.': ..."»�,.rlc'Ss:-X'�:✓..' 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 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 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. _ /Cit(la Address: (1 5 S o'c'- ^• A'Q. Permit No. 17_ 1 V Specify Number of Alarms: #Smoke Alarms: 7 ! #Carbon Monoxide Detectors: I 0-- have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: cc C ATe e Signature......... 4A" Date: .� OCk 11 Contractor Name: Signature Lic.# Date: ' Smoke and CO form.doc revised 01/10/2017