B-2017-2104 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-2104 ,
7928 MCCLELLAN RD CUPERTINO,CA 95014-4175(362 12 001)17918 CALIFORNIA
MCCLELLAN RD CUPERTINO,CA 95014(362 12 001) RAINGUARD •
INCORPORATED
SAN JOSE,CA 95112
OWNER'S NAME: MCCLELLAN ASSOCIATES LLC DATE ISSUED:12/08/2017
OWNER'S PHONE:408-257-7514 PHONE NO:(408)279-6116
. LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C-39 Lic.#943125
Contractor CALIFORNIA RAINGUARD INCORPORATED Date 02/2812018 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:
REROOF;TEAR OFF;TPO(135 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:$42900.00
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 12 001
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.
nature[ 7 Date 12/8/2017 Issued by:Abby Ayende
Date:_ 12/08/2017
OWNER-BUILDER DECLARATION
I:
•
I hereby affirm that Iam 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 Utile 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 spection.
sale(Sec.7044,Business&Professions Code) j/(1
of
z. I,as owner the property,am exclusively contracting with licensed _it,fibre of Applicant: kr_ /
contractors to construct the project(Sec.7044,Business&Professions Cod-uu Nate:12/8 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 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(a)should I store or handle hazardous
material. Additionally,should I use equipment or devices which emit hazardous
shall not employ any person 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 C'o'mpensation 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 e tions 25505,25533,and 25534.
Laboi Code;'I must forthwith comply with such provisions or this permit shall
be deemed revoked.
O er or authorized agent:/�'
'', APPLICANT CERTIFICATION e:9 2/8/2017
I certify that I have read this application and state that the above information is CONSTRU ION 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 411 non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION
Code,Section 9.1,8. ' . I understand my plans shall be used as public records.
I
Date 12/8/2017 Licensed
Signature
- - Professional
REROOF TEAR-OFF POLICY _
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
,!;,.w ALBERT SALVADOR, P.E., C.B.O.,BUILDING OFFICIAL
CUPERTINO
10300TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228• FAX(408)777-3333•buildino cuoertino.orq
PROJECT ADDRESS 7 i ( s - 111% rsA9t.Lv q� AI�
!LPN : / z _co`
OWNER NAME %tall...tall... 'T 4 ) Z,5-7 f,± E-MAIL
STREET ADDRESS t24. CITY, STATE,ZIP(uittskz2 FAX
CONTRACTOR A' LICENSERIlel LICEN TYr BUS.LIC.4
COMPANY NAME �j h E-MAIL FAX
(N4PSTOCA`1F()S•I-4A(vVtn,cel
STREET ADDRESS 5 3$ Tel �+�` CITY,STATE,ZIP C- ., t .sg./C�` Tri 1 7 PHONF6 ,7?-/1
6.4
J �+7r( W b 1. O
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. 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 I/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.
c.i 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 and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2016 California Residential Cod-
�1
Signature of Applicant/Agent: 'ti ` - Date:•
, /f
•
ReroofPolicy 2014.doc revised 06/01/7
CONSTRUCTION PERMIT APPLICATION
} • COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
l ,. 10300 TORRE AVENUE • CUPERTINO,0 U , CA 95014-3255 •
• , 04,: 2
f, ..., --te (408) 777-3228 • building@cupertino.org PEMIT;;B- a -- -
CUPERTINO REVS DEFF
❑ NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T.1. ❑MEP 21E-ROOF ❑SWIMMING POOL/SPA
PROJECT ADDRESS APN A
I1 t g. 15 r(?) M�-� �,L;A �t . aa- 11-0-Di
OWNER NAME IA + 4 a ,tt3. PcN4t z.5...7 _ - s,1 4 FEMAIL
STREET ADDRESS q 5.4 CITY, STATE,ZIL
7
'-Er CONTRACTOR NAME ❑OWNER-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE
ISTREET ADDRESS, J • �-C CI :4\ 4 / �` i S `
E-MAIL .5-'
�] PHONE STATE,(s BUS.LIC A
J'n W<di.1&r4-�mF.A e)ath�4�•CiSh► L• 2,/`� -61�1.�
0 ARCHITECT 0 OWNER.❑OWNER AGENT 0 CONTRACTOR AGENT 0 EN NEER❑DEVELOPER 0 TENANT '
CONTACT NAME J- --' E-MAIL
�'� —l-B 6-1E- ' IN Ire T9c4k 0, Nt�A 1 by 40 41?.. ',c�N�
STREET ADDRESS ^` Q`� ,, , CITY, Y1V.�PS J CA• 1 c I 11 Prq**2'4l°D
DECRIPTON J 1`' ` 1_I
ik'\oUt t)(\,5-C.tUG C,? 3 tkliZT S2--- b-4, _A k,$-51/4111--1.- 2-. co,y E 1 4 F 1 o
ctvs F'�SA p , U V Not-fid 1�7E-r2 (N rS-s1t'I-x- to 1l VW N‘\S !`'i'''a±
/
❑SINGLE-FAMILY/DUPLEX [}3MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL • I
EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES x TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION(5)
R.519 . 135 " 2-- l5-0
REMODEL REMODEL KITCHEN REMODEL OTHR GARAGE D ATTACHED
BATHROOM SF SF SF SF 0 DETACHED
EXISTNGN
ES EICHLER D IES U SECOND STORY ADDITION ,❑AYES
FIRE SPRINKLERS 1: NO O " NO
DWELLING_ I SECOND DWELLING D YES 0 ATTACHED!:DETACHED OTHER
UNITS#2_ UNIT ADDITON: ['ANO S F
POOLS 0 FIBERGLASS 0 VINYL-LINED 0 GUNITE 0 PREFABRICATED
POOL-SF SPA-SF ( SPA ATTACHED ❑YES 0 NO I TOTAL-SF
RE I BY: v' T -6,-. .TAL 7 LUTON:
Commercial or Multi-Family Buildings with Public Swimming Pools requires Department o(£»vironmeno:l Heath approval 7tf',-�'tC'7i" Gtl
RE-ROOF EXISTING ROOF TYPE: 2 BUILT-UP ROOF❑ASPHALT SHINGLES❑WOOD SHAKES❑WOOD SHINGLES❑ ILE OTHER(SPECIFY) -
REMOVE/REPLACED NO I IF NO PLYWOOD 211/2" ❑3/B" " PLYWOOD TYPE: PITCH: ROOF CLASS
a OF LAYERS THICKNESS E 5/B" OTHER El OSB [ 'CDX OTHER _4•12 A
PROPOSED ROOF TYPE:❑BUILT-UP ROOF DASPHALT SHINGLES 0 WOOD SHAKES Dq'OOD SHINGLES 0 OTHER 'T P 0 � ' t
• *Provide a signedjcopy of the Cupertino's Tear-Off Policy SF} 3t)JaomSQUARES b)�
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 ii tion p-rposes. I acknowledge and authorize all information c, ntained on this application form
to be made available for public record. (( ¢ f
Signature of Applicant/Agent: /7 I Date: 1 L t 7 -
SUPPLEMENTAL INFORMATION REdJIRED
*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