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B-2017-2070 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-2070 • 11157 PALOS VERDES DR CUPERTINO,CA 95014-4722(356 17 006) JIREH INC LOS GATOS,CA 95031 OWNER'S NAME: LUPIEN BROOKS H AND CELIA R TRUSTEE DATE ISSUED: 12/04/2017 OWNER'S PHONE:408-252-1824 PHONE NO:(408)298-9399 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-39 Lic.#800707 Contractor JIREH INC Date 10/31/2019 x BLDG ELECT —PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing —MECH X RESIDENTIAL_COMMERCIAL 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;INSTALL OSB;COMP SHINGLES(24 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 'as rformance of the work for which this permit is issued. 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:$11400.00 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 356 17 006 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. s ' S jnatur Date 12/4/2017 Issued by:Abby Ayende Date: 12/04/2017 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: - following two reasons: All roofs shall be inspected prior to any roofmg material being installed.If a roof is i. 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 gnature of Applicant:(L/ contractors to construct the project(Sec.7044,Business&Professions Code). Date:12/4/2017 I hereby affirm under penalty of perjuryene 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(akshould 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 35505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall l be deemed revoked. mer or authorized age t: APPLICANT CERTIFICATION Date:12/4/2017 I certify that I have read this application and state that the above information is. CONSTRUCTION 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 12/4/2017 Professional , R . &_7,014-._207 \,.,/ REROOF PERMIT APPLICATION ' V 9 COMMUNITY DEVELOPMENT DEPARTMENT•BOILDING DIVISION �yT,I9ss 10300 TORRE AVENUE••CUPERTINO, CA 95014;3255 (408)777-3228• FAX(408)777-3333•building(a,cupertino.orq CUPEFCTINO' - PROJECT ADDRE/ [ ! /-U o.7 Vade.v /v APN�.i 6-6 V /1-t L V7 OWNS 1 VDk•J L iebb y P �__0- 6 4iEMAIL STREET•+D: oh / / CI %1_STA,,ZIP //.5-0 FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,'STATE,ZIP FAX ❑OWNER 0 OWNER-BUILDER 0 OWNER AGENT ,CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER, 0 DEVELOPER 0 TENANT CONTRACTOR NAME LICENSE BER LIC NSE BUS.LIC.# cJ 1rEh , ��� ®`7 ' --` � <� l COMPANY AME 8A LOS Gds R, „-PI r, Ei2it.-IL fsc roo FqX( r gr-93-Y STREET AicyG / d /CjI CITY' CZUi/ 1G�e1 P 7E 9399✓ ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF V'SFD or Duplex ; 0 Multi-Family ROOF AREA: VALU TION: STRUCTURE: ❑ Commercial ' /1) litiO EXISTING ROOF TYPE: 0 BUILT-UP ROOF, 0 ASPHALT SHINGLES L7 WOOD SHAKES EKOOD SHINGLES ❑'OTHER(SPECIFY) REMOVE/REPLACE YES ' IF NO, q PLYWOOD 0 ''A” 0_ PLYWD IKOSB PITCH: ROOF glp ❑NO #LAYERS: i THICKNESS: 0 5/8" TYPE: 0 CDX ) :12 CLASS: PROPOSED ROOF TYPE: 0 BUILT-UP ROOF! ASPHALT SHINGLES 0 WOOD SHAKES U WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK: I.2Q: J / /w • /�L / _ �. 5 .. , f4A...),Le...4.- jAs.hie 'i2d,LA/ wJ, :,.._ !efts-igie Qwvpeiis e�oiei`` A G�h z oma- 1 Z bpikpost/Zak, 6 ' 1 /es.tail 1 1.444-4 4 d-41 i) . . ' 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 omply with all applicable local ordinances and state laws relating to bui di struc A. I authorize repr'sentatives of Cupertino to enter the above-iden'ied,roperty for inspection purposes. Signature of Applicant/Agent: 1 / _ Date: SUPPLEMEN AL N ORMATION REQUIRED �t f-ifftFCUENms ; inF l a▪3 '^AN^D.v-kx.. -$ ,,,, k Yi-- {RANN RELV p dei�x rx v RIf building is associated with a He Owners Association,provide letter ti` PLAN CECKTYPE . , e c4� r {re f 1 a&Yx AN $-aryigg of approval from HOA: £D▪OVER THECONTER ; �BUILDINGPLANREVIEW � 4 :?r4'.-, v Yw d I,k1t r1; WtvPI-41Provide Planning approval to verify if there any restrictions. <; ' f ,ar� ra. � ~ ' .� , 4, `, 4- r � EXPRESSk ., tx r® .PLANINGPLIEW^ie Alia 15p4 ' , `.4"r r4, A ,,Provide copy of Manufacturer's Installation Specifications. STARf 1 ® FLRDET , t 4 I ,il 7 3y ` +t *, ; yray `c�$ LT Provide signed copy of Cupertino's Tear-Off Policy. ' ` n i&, tit{ t® OHER. 4 1tiVr `ca1t * Vt, g ' " x " D. :t . ' il z k x 4 . £ a., 4'- ftil ,+4.wta,,iT; " ,,ai ,-z,yacdI tk7 -L. =.mr' Y v a, W, i, . ReroofApp_2011.doc revised 03/16/11 \ l REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION At.si.rass ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL • CUPitT1No 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333•buildinq(,cupertino.orq PROJECT ADDRESS,l -l//5 rf pabivijzda) APN .3d UJ 6 / D(d 6 OWNER NAMESto 7"' e PHONE E-MAIL oltd ST SS palm . CITY, TE, FAX 024/1.6 64 CONTRACTOR NAME' 'Ran 5E 69 7 LICENSE T?ciBUS.LIG1 34 CO NAME (� E-MAIL n FAX .Ila 'L s 0-4-40 s q o�`'l n •Al Lina @ 1 QS GJ a5 r' o-fir .cv�--. 4110&,..29Y--937 STRE aFSs -ashtli•�J CITY TATE,7SEf- l/ , PHONE , I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2013 California Codes. 2. An inspection request can be scheduled up to one business day before the requested,inspection date. Please schedule inspections online or call (408) 777-3228 from 7:30-3:30pm (Mon-Thur's);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;irispector will'be available within one hour. The hours for this service are: 7:30-10:30am and 12:30-3:30 (Mon- hurs) 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. Roofing 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 final;sign-off, the following items will be verified: a. Flat roofs shall have a minimum of'A"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. 1 c. Proper spark arrestorlinstallation, 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 prope'rty owner's behalf. I understand and agree to comply with the re-roof policy stated above. I also understand that smoke detectors and carbon monoxide detector are required to ,e installed in accordance with Sections R314 and R315 of the 2013 California Residential .i- Si natue of Applicant/Agent:: � Date: 7 Reroo7Policy2014.doc revised 01/15/14 yl - , SMOKE i CARBON MONOXIDE ALARMS O EER CERT(F[CATE OF COMPLkNCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CUPERTIN© 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 • buildina(a cuoertino.oro PURPOSE 0 This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with.2016 CRC Section R314, 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 and CBC Sections 907.2.113 and 420 6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA I I SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On every level of a dwelling unit including basements 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 dta%elling 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 8314 and CSC 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 A , n /1 Address - Permit No 2,0-76) Specify ?Number of Alarms: - Smoke Alarms. 1 �� "Carbon Monoxide Detectors. 1 have read and agree to comply with the terms and conditions of this starement Owner (or Owner Agent's) Name: Signature Date: Contractor Name:� 7►�. 7 Signature.. .. Lica Date:/' //o Smoke and CO fonmdoc revised 12115/16