B-2017-1940 •
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1940
1032 BUBB RD CUPERTINO,CA 95014-4939(362 04 019) VISIONS ROOF
DESIGNS
SANTA CLARA,CA
95051
OWNER'S NAME: SATTERLEE CANDACE K TRUSTEE I DATE ISSUED: 11/13/2017
OWNER'S PHONE:408-691-9253 PHONE NO:(408)247-5054
LICENSED CONTRACTORS DECLARATION BUILDING PERMIT INFO:
License Class C39 Lic.#615133
Contractor VISIONS ROOF DESIGNS Date 03/31/2019 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;COMP SHINGLE(22 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:$10124.00
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 04 019'
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 Cu,:-rti.o Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signatu _ Date 11-13-2017 Issued by:Kim Dunbar
/ , Date: 11/13/2017
OWNER-BUILDER DECLARATION
I hereby affirm that I am'exempt from'the Contractor's License Law for one of the RE-ROOFS:
following two,i easons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
a. 1,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 oroffered for inspection.
sale,(Sec.7044,Business&Professions Code)
2. 1,asowner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code).. Date: 11-13-2017
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
a. I have and will maintain,a Certificate of Consent to self-insure for Worker's •
-
Compensation,as providedfor 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. 1 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
shall not employ any'person hi 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.subjedt'to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505 255 3,and 25534.
Labor Code,I(mist forthwith comply with such provisions or this permit shall
be deemed revoked.',1 Owner or authorized agent. r
APPLICANT CERTIFICATION Date: 11-13-2017 ;r%'
I certify that I have read this application and state that the above information is CONSTRUCTION LEttil<IG 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'c''onstructiOri 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 andkeep harmless the City of Cupertino against liabilities,
judgments,costs,and expenses which may accrue against said City in Lender's Address
consequence of thegranting of;thisipermit. Additionally,the applicant understands
and will comply with,all non-Poiot 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 11-13-2017 Licensed
Professional
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT •• BUILDING DIVISION
v�� 10300 TORRE AVENUE • CUPERTINO,CA 95014-3255
,0„,-,.
GJ
/A+�1 — - - -/_'
(408)777-3228 • building@cupertino.org PEMIT#B- 1 iVa
CUPERTINO REV# DEF#
0 NEW CONSTRUCTION ❑ADDITION ❑ALTERATION 0 T.I. ❑MEP RE-ROOF ❑SWIMMING POOL/SPA
PROJECT ADDRESS Crxr
/032.2 �i,3t L' + d APN# /„2 -0(i
(i-OI `j
OWNER NAME (� �/ PHONE /i�,6�/ (�!)('rZ E-MAIL
STREET ADDRESS j�yl/✓Z`I l C6�1 STATE, L,[�1� 9y /'T
66_ C�/3 OWNER-BUILDER NAME Vi.) I y�'v(
0\1 V OT N C)" , nC ) CAVO 5'OS l ` S`tet LICENSE NUMBER LICENSE TYPE C-39
ITAD3711bn/4\v CI' ,STA 53� ,,,�6 ^/j 9,,,,..72s--/
I
E-MAIL / § * COM
PH BUS.
7l t��$3 BUS.LIC#'//f': 7/6`"7
U srans� h a (/
0 ARCHITECT 0 OWNER 0 OWNER AGENT 0 CONTRACTOR AGENT ENGINEER 0 DEVELOPER 0 TENANT
CONTACT NAME E-MAIL
STREET ADDRESS CITY,STATE,ZIP PHONE
DECRIPTONL rC_a Vr1— `i Ji(r5 W plp., 31-1l\('�(c (DO—) a pp Iy 1- IG I 1 vl ndV Iay meal--
)
,l
.0s-fa/(all recd - 1c5((Yns1 /()3412 1/ a /endue cz5ph /fc��
qO,shl/le,
SINGLE-FAMILY/DUPLEX 0 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($) I
REMODEL REMODEL KITCHEN REMODEL OTHR GARAGE 0 ATTACHED
BATHROOM SF SF SF SF 0 DETACHED
EXISING 0 YES EICHLER 0 YES SECOND STORY ADDITION 0 YES
FIRE SPRINKLERS 0 NO 0 NO 0 NO
DWELLING SECOND DWELLING ❑YES 0 ATTACHED 0 DETACHED OTHER
UNITS# UNIT ADDITON: 0 NO S F
POOLS' 0 FIBERGLASS O VINYL-LINED 0 GUNITE 0 PREFABRICATED
POOL-SF SPA-SF SPA ATTACHED OYES 0 NO TOTAL-SF
RECE /0TOTAL VALUJITI N:
Co i ercial or Multi-Famil 13u7din: with P blic S immin-P..ls r•'uires D•''rtm• t o En,.r.nmental H•,th,uo oval I it / 1"((
RE-ROOF'EXISTING ROOF TYPE: ElBUILT-UPROOF 4 ASPHALT SHINGLES D WOOD SHAKES❑WOOD SHINGLES❑TILE OTHER(SPECIFY) (J F
REMOVE/REPLACED NOIF NO PLYWOOD ❑1" ❑3/8" PLYWOOD TYPE: AVA- PITCH: ROOF CLASS
YES I 8 OF LAYERS THICKNESS❑5/8" OTHER /� ❑OSB 0 CDX" OTHER L�.12 A
PROPOSED ROOF TYPE:OBUILT-UP ROOF (ASPHALT SHINGLES 0 WOOD SHAKES OWOOD SHINGLES 0 OTHER
*Provide a signed copy of the Cupertino s Tear-Off Policy SF 2200 #of SQUARES r9-`
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• spection .0 ..f''s. I acknowledge and authorize all information contained on this application form
to be made available for public r .rd
Signature,of Applicant/Agent: _ /_/- Date: / ( , /J--/
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
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL -
CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 I L�7
(408)777-3228•FAX(408)777-3333•building aC�.cupertino.orq 20( f L'
PROJECT ADDRESS/032 032 h APN ft 3(n 77 -0
Le —101
OWNER NAME Can5 (�p cc PHONE �/�8 6Q j I &MAIL
STREET ADDRESS/03 �S d CITY, STATE,ZIPCu [( CA PM
FAX
CONTRACTOR NAME „ ( cznr\
o LICENSE NUMBER /5133 LICENSF YPE3 q BUS.LIC. O51/6
COMPANY NAME /151\ons vco-ra- ,30s. EMAIL\ i S jbf 5 yah"" corvi FAx
S 2
STREET ADDRES (f(27/, I ^b on/ CITY,STATE,ZIPciax4a Q`a/�; /'>/I� q � pawl/0s7/), j2c
/ 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 7:30-2:30pm(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 to this inspection.
4. If plywood is installed, a plywood Nailing Inspection is required.
5. Roofmg 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 fmal 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 not 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
smoke detectors andcarbon monoxide detecto .,. e required to be installed in accordance with Sections 8314 and R315 of
the 2016 California Resident'. _:I de.
Signature of Applicant/AgzDate: A/3— (�
ReroojPolicy_2014.doc revised 06/01/7
F
CUPS
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
1030.0 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408) 777-3333 • building Cc cuoertinaorr
,a:... ,.,nom...._.
i;
'L".:A..'�T.i\filr'�T=�Ti9;'LtiaF.T:��7:�Z�.'ra•'r.,x4mrr.s-�r+rrrix:,tz�r.+rsa,ra�r.a:�,..,,_.:���:;
PURPOSE _
This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2016 CRC Section 8314, 8315, 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 8314, 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
bedroom(s) — (Smoke alarms shall not be located within 3 feet of bathroom door)
X
X
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
riot 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
%nstalled 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
cute signed below 0
.Address: 'So,56 ,56 9-2) 0.4 Pat -7-1, G+, 'Z�/C f Permit N'o.
Specify Number of Alarms. # Smoke AJaLinis.j 41 # Carbon Monoxide Detectors =
l have read and agree to comply with the termq anrr of th;c ktatAmonr
Owner (or Ow`ner Agent's) Na i e:
A
�� IL
Si nature. Date:
4a"ctor Name: 012
y
>-v{ L'�- G •%'0
Signa
IN
/7
Smoke acrd COfonn.doc i-evised 0 1 /1 012 0 1 T