B-2017-2047 •
CITY OF CUPERTINO BUILDING PERMIT
•
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-2047
10368 NORMANDY CT CUPERTINO,CA 95014-3109(369 29 027) R E ROOFING AND
CONSTRUCTION INC
SAN JOSE,CA 95124
OWNER'S NAME: TOMIMATSU TYAKIO AND LOUISE SACHI TRUSTEE DATE ISSUED: 11/30/2017
OWNER'S PHONE:408-555-8925 PHONE NO:(408)626-9320.
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C39 Lic.#727599
Contractor R E ROOFING AND CONSTRUCTION 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 CDX;COMP SHINGLES-(38 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.
,......74
z. 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;$28000.00
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 369 29 027
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 liabilitiesjudgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City inconsequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR "
Additionally,the applicant understands and will comply with all non-point
ource reg .tion '•- C .ertino 'ici.-1 Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signatur Date 11-30-2017 Issued.by:Kim Dunbar
Date: 11/30/2017
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 . .e in .-cted 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 installe without first ob'•ining an inspection,1 agree to remove all new materials for
i compensation,will do the work,and the structure is not intended or offered for ir_ tion.
sale(Sec.7044,'Business'&Professions Code) •' '
z. I,as ownerof the;property,am exclusively contracting with licensed Signature of7�ppli .• • � -�
contractors to cbhstruct.the project(Se .7044,Business&Professions Code). Date: 11-30-2017
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 •
performance of the workfor 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 Ghat 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 Compehsationllaws of California. If,after making this certificate of will maintain complianc• • i- upertino Municipal Code,Chapt• 9.12 and
exemption,lI become subject to the Worker's Compensation provisions of the the Health .- Safety Code,••est'`533,a cF25534.
• Labor Code,i must forthwith comply with such provisions or this permit shall 0 . ,
be deemed revoked. Owner or authorized agent: %A a w --
APPLICANT CERTIFICATION Date: 11-30-2017 %
I certify that I have read this,application and state that the above information is CO " ' . _ I '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 againat 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 11-30-2017 Professional
CONSTRUCTION PERMIT APPLICATION
V r' I - COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
.•. >;.'i 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 •
- ; 4 ,� I - 7-� `( [
(408) 777-3228 • buil dingccz�cupestino.org PEMIT B-
--
• CUPERTINO REVF DEFE
• ❑ NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T•1. ❑MEP RE-ROOF ❑SWIMMING POOL/SPA
PROJECT ADDRESS 1 11 3 V APN F
UNO ploy C.T.
OWNER NAME /u � / E-MAIL
G KA ` 5 !J " (JIryLiq ` r \ 5 4+om` rAc 1S o 0_, a,1106 e
STREET ADDRESSA. u t Y, STATE,ZIPIA4
J CONTRACTOR NAME ❑OWNER-BUILDER COMPAt NAME LICENSE NUMBER LICEN E TYPE
ISTREETAS,U RESS /�- ,I I�+J� I� n ' ' CITY,STATE, ZIPS / �c\2_4
I
E-MAIL ��{ Ovrn
CAA '( ,�� I.CC\1 V LPHONE 14-0(6-01-_6� o BUS.LIC g 2_01
t /
0 ARCHITECT 0 OWNER.❑jVNER AGENT 0 CONTRACTOR AGENT 0 ENGINEER❑DEVELOPER 0 TENANT
CONTACT NAME JJJfff E-MAIL
1\k
STREET ADDRESS CITY,STATE,ZIP �/y� ( PHONE
DECRIPTON _'A �(! p� � � � j�114
0 i
•
UU
. C 6( ( {17, '1Cf.)❑SINGLE-FAMILY/DUPLEX ❑MULTI-FAMILY ❑INDUSTRIAL ❑COMMERCIAL I
EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES F TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION(5)
REMODEL REMODEL KITCHEN REMODELOTHR GARAGE D ATTACHED
BATHROOM SF SF SF SF 0 DETACHED
EXISING DYES EICHLER 0 YES SECOND STORY ADDITION DYES
FIRE SPRINKLERS❑NO ❑ NO 0 NO
DWELLING SECOND DWELLING 0 YES 0 ATTACHED DETACHED OTHER
UNITS F UNIT ADDITON: 0 NO. S F
•
POOLS 0 FIBERGLASS ❑VINYL-LINED 0 GUNITE ❑PREFABRICATED
POOL-SF SPA-SF I, SPA ATTACHED❑YES ❑ NO I TOTAL-SF
y. .i.Kyip
,/ r A
Commercial or Multi-Family Haildiiirs with Public Smiouuinq Pools requires Devartment of Environmental Heath gramma! 0,--
•,,F EXISTING ROOF TYPE: fl BUILT-UP ROOF❑ASPHALT SHINGLES NOOD SHAKES E WOOD SHINGLES Q TILE OTHER(SPECIFY) •
REMOV' /REPLAC NO IF'NO • PLYWOOD i� ❑3/8" ' PLYWOOD TYPE: PITCH: i (( ROOF CLASS
O'ES °OF LAYERS ( THICKNESS Q 5/8" OTH El�x ❑OSB tACDX OTHER :12 A —
ROPOSEDROOF T ❑BLTILT-UP ROOF' ASPHALT SHINGLES ❑WOOD SHAKES DwOODSHINGLEES `❑OTHER ��
*Provide a signed copy of the Cupe ino's Tear-Off Policy SF €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 loca : ' : ces and state laws relating to building construction. I authorize reuresentives of Cupertino to
enter the above-identified;prop- ty for ins - 'on •ur.oses. I acklqwled7 and authorize all information contAined' n this application form
to be made available for public record. i :r�� (
�� r
Signature of Applicant/Agent: I Date: l
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.
"IOA-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
•' 1?!:Z ALBERT SALVADOR, P.E., C.B.O.,BUILDING OFFICIAL
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO
(408)777-3228•FAX(408)777-3333• buildincl cupertino.orq
IPROJECT ADDRESS \O 36,(K 0,6\L-osi b`I , APN#
OWNER NAME 4 " ! ` 1 PHONE rf,0�i 9.-t U 9,211 E-MAIL
STREET ADDRESS A(g,K �o', 1 eA CITY, STATE,ZIP I oicu7' /` FAX
CONTRACTOR NA Y g LICENSE Iii MBER 7-2V101 LII E� BUS.LIC.# %
COMPANY NAME � E-MAM �/CiI�D . (Ae„ C V FAX�/I�,��a--7(6/
STREET ADDRESS (p//] o n t �J l L c ,/ CrIY,STATE,ZIP /r �c-I/�r,� PHO V y 2
ly G v�/l 1, r,�(c 7�j Ll( ( (32-C 6�
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: 7:30-10:30am 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. 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 theremoval 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%"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 • •_ .Mowing is e: I am the property owner or authorized agent to act on the
property owner's be.. . d:-__.nd and age: t comply 'th he re-roof policy stated above. I also understand that
smoke detectors . . carbon ':noxi.- d-tector� k req. ire installed in accordance with SecrionE,a314 and R315 of
the 2016 Californi..Reside ti Cod= VSignature of Applican Agent: \ I Date: 17
ReroofPolicy 2014.doc revised 06/01/7
71-3
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE S Odi 19-
40-
4n COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333•buildinq(a�cupertino.orq
P.ER111): cA OTBE1INALED'TJ1 TILT IIS CERTIFICATE:HAS BEEN:
GOm:00 ED,SIGNED #ANI)RETT3RI\TE+D`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 alarmsshall 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 requited 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 belowl}
Address. 1 V 3� 1. 61(//10011N C1 ' Permit No. -20 l 1 _ L041
Specify Number of Alarms (k Smoke.Alanns #,Carbon-Monoxide Detectors 12 I
I have read and agree to comply with the terms and conditions of this statement
!Owner(or Owner Agent's)Name:
NNf wVl i
./� Y� 6gna2 —
Date . 57..0
.
Contractor Name: .2-.2-11' Date: \litC11
`�)\ Ituf Lic.#
Smoke and COforns.doc revised 01/10/2017