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B-2016-1322
CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO:B-2016-1322 10149 EMPIREAVE CUPERTINO,CA 95014-1204(326 24 036) (JIREH INC) LOS GATOS,CA 95031 OWNER'S NAME: LEE GEORGE AND BILLIE TRUSTEE DATE ISSUED:02/08/2016 OWNER'S PHONE:408-257-5492 PRONE NO:408-298-9399 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-39 Lic.#800707 Contractor(JIREH INC)Date 02/08/2016 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: (DUPLEX)TEAR OFF(E)WOOD SHAKE,INSTALL NEW CLASS A I hereby affirm under penalty of perjury one of the following two declarations: COMP ROOF SYSTEM(27 SQ,S) 1.1 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 �perfonnanee of the work for which this permit is issued, 2.f 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:$7919.00 AAPPLICANT CERTIFICATION certify that I have read this application and state that the above information is correct.I agree to comply with all city and county APN Number: Occupancy Type: ordinances and state laws relating to building construction,and hereby 326 24 036 authorize 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 PERMIT EXPIRES IF WORK IS NOT STARTED expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal 180 DAYS FROM LAST CALLED INSPECTION. Code,Section 9.18. f Issued by:MELISSA N Signature, Date 02/08/2016 Date:02/08/2016 OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of the All roofs shall be inspected prior to any roofing material being installed.If a roof is following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1. I,as owner of the property,or my employees with wages as their sole inspection. compensation,will do the work,and the structure is not intended or offered j for sale(Sec.7044,Business,&Professions Code) Signature of Applicant: ej�� 2. I,as owner of the property,am exclusively contracting with licensed Date:02/08/2016 contractors to construct the project(Sec.7044,Business&Professions Code). 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 HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the 2. I have and will maintain Worker's Compensation Insurance,as provided for California Health&Safety Code,Sections 25505,25533,and 25534. 1 will by Section 3700 of the Labor Code,for the performance of the work for which maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the this permit is issued. 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 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 will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and Worker's Compensation laws of California. If,after making this certificate of the Health&Safety Code ections 25505,25533,and 25534. exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall Owner or authorized agent: be deemed revoked. Date:02/08/2016 APPLICANT CERTIFICATION CONSTRUCTION_IENDINAGE N Y I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance correct.1 agree to comply with all city and county ordinances and state laws of work's for which this permit is issued(Sec.3097,Civ C.) relating to building construction,and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments,costs,and expenses which may accrue against said City in ARCHITECT'S DECLARATION consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the I understandmy plans shall be used as public records. Cupertino Municipal Code,Section 9.18. Licensed Professional Signature Date 02/08/2016 6 REROOP PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 FX E!lPERTFNt7! (408)777-3228•FAX(408)777-3333 buildingQcupertino.org 2,0 1 ,6 PROJECT ADDRESS s APN n +r c) '� rE OVT'ERNAME PHON E-MAIL CJ STREET ADDRESS dy CITY, STATE,ZIP FAX CONTACT NAME aAe r 4 r 9 v P Oh m n� j E-MAI J j Pd G$ STREET ADDRESS CITY,STATE,ZIP , FAX ❑ OWNER ❑ OWNER-BUILDER ll 0\VNERAGENT ❑ CONTRACTORS u CONTRACTOR AGENT ❑ ARCHITECT ❑ENGE41MR ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE Nrao LIOE E F� BUS.LIC.N,� COMPANY NAME � E d r FAX STREET ADDRESS n ®4 CITY, / ARCHITECT/ENGINEERNAME LICENSENTUMBER BUS:LIC:# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE VALUATION: USE OF ❑ SFD or Duplex El Multi-Family I ROOF AREA: STRUCTURE: ❑ Commercial EXISTING ROOF TYPE: O BUILT-UP ROOF ❑ASPHALT SHINGLES WWOOD SHAKES E]WOOD�SHININGLES ❑OTHER(SPECIFY) REMOVE/REPLACE YES IF NO, PLYWOOD IJ%" ❑ PLYWD L7 OSB PITCH: ROOF NO »LAYERS: / THICKNESS ❑ 5/8" TYPE: ❑ CDX '12 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOFSPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES OTHER ICC-ES REPORT n DESCRIPTION OF WORK: 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 h ve 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 relatin b Idin:construction. I authorize representatives of Cupertino to enter the above G-identified property for inspection purposes. oe Signature of ApplicantlAgent Date:.� _ .- SUPPLEM TAL INFORMATION REQUIRED If building is associated with a Home Owner's Association,provide letter gLAI.c>�cTZTYPE t xouTuc sLlr of approval from HOA. i© DVET$E COUNTER BUILDIAGPLAN2E�IE4} Provide Planning approval to verify if there any restrictions. Ex�xEss t flPL9ItiI\II�GPLr1I�RET3ESY Provide copy of Manufacturer's Installation Specifications. _] STIVDAirD� � , ❑ gl�R�np 4 Provide signed copy of Cupertino's Tear-Off Policy. F r g �aRt 'f p ry .s•Y-4 ,sa,"•-' s x - -' f"'.''�'.i iw` ieu''�.� -e " x` a_. ReroofApp_2011.doc revised 03116/11 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR,P.E„C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CiJPERT[PEO (408)777-3228• FAX(408)777-3333-building(a)cupertino.org PROJECT ADDRESS J I APNig 3-6Z OWtiERNAME C� HOI E-MAIL _�7� � � STREET ADDRESS _ CITY,STATE,ZIP I FAX CONTRACTORNAME LICEN 4BE 0 LICENE B�I�IC.n a� COMPANY NAME�� •-' CJ's•' E-MA L� ' FAX 3 STREET ADDRESS ¢. F CS=1 ZIP PHo (/ r I UNDERSTAND AND AG E 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-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 available 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 1/4"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 an 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 2013 California Residentia zd . Signature of Applicant/Agent: Date: " ReroofPo1icy_2014.doc revised 01115114 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION - ADDRESS: 10149 EMPIRE AVE DATE: 02/08/2016 REVIEWED BY: ABBY APN: 326 24 036 BP#; 'EVALUATION: 1$7,919 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Du lex PENTAMATION USE: p PERMIT TYPE: 1 SFDWLROOF WORK I TEAR OFF_ E WOOD SHAKE INSTALL NEW CLASS A COMP ROOF SYSTEM 27 SQ,S) SCOPE FEE ID ROOF AREA (SX) 1REROOFFRES 2,700 r P,!aria.Plein(,'heek !r; b.dc}7 '#,X..`"e'° ta'ai3zf3r1>u r"",: 1 7 i '!,£,• NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These ees are based on the prelimina information available and are only an estimata Contact the De t or addn'l in o. FEE ITEMS (Fee Resolution 11-053 F,ff. 711/13) FEE QTY/FEE MISC ITEMS 3'up Jl C Pei: lazttfP71,r`. ,'a;t.;' £3C; Permit Feer $459.00 1nsp),"eek Ahywdni�!radve Pee: Work Without Permit? 0 Yes Q No $0.00 GT ( c;s'£;I 'C I2Islft x Ic'es"- Strong Motion Fee: IBSEISMICR $1,03 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 e SUBTOTALS $461.03 $0.00 ;` TOTAL FEE; $461.03 _ _ _ Revised: 01/01/2016 SMOKE 1 CAP,,BD �1 MONOXIDE L-ISM'- OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDINGIVISION UPERT'N 10300 TORRE AVENUE•CUPERTINO,CA 95014-32515 5 (408)777-3228• FAX(408)777-3333• buildingCZD,cupertino org � INW PFRMIT CANNOT AF,FINAXIM AND COMI'I,FTED UNTIL THIS CERTIFICA'T'E 0 Tir 1311, I):[ -0ecN PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314,2013 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 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) On ever level of a dwelling unit including basements 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, alarms)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 8314 and CBC Sections 907.2.11.4 and 420.6.2.An electrical permit is required for alarms which must be connected ter,the buildiung wiring. As owner of the above-referenced property,I hereby certify that the al=arm(s)referenced above has/have been: =stalled in accordance with the manufacturer's instructions and im compliance with the California Bu ldlmg and CalIiifonnia Residential Codes.The alarms have-been,testednd,are operational, as of the date sigpedd be-lliow.. f have read'and a ree to com;l th,_.f�%e ferms and!cond�trans of this.statement` Adl� 1arur ;: ' u. _ Ld .. .........D e, Go t�acfo"rlUame. �J ._ ?S:i.n.�tgre.,_ ....:.. ....:.... ......... ....... a Lich ✓ ....... ...... Shwkearrd`COfbusm:.dacr-evued,'03/MRg) WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT]DEPARTMENT►BUILDING DIViSiON CUP6tT1i�tCD "10300 TORRE AVENUE CUPERTINO,CA 95014-3255 (408) -3228-FAX�408)777-3333 m buildinqAtcuperfino.org Owner Nam Permit N o. '2 d `"3 Address - 1. Is your real property a registered historical site? ❑ Y s Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of fonn. Go to Question 2. 2. Does your real property have a licensed plumber certifying that,due to the age or configuration of the property or its plumbing,installation of water-conserving plumbing fixtures is not technically feasible? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. k ANo Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ No My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. ¢ Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101..8 apply. Check one of the three following statements and sign bottom of form.. 5. Please check ONE of the following: ❑ My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1,2014 building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures throughout the building.On or before January 1,2017,all non- compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). My property is,a-multifamilyresidential real property. See Civil Code Section 1101.5., On and after January 1,2014,specified building alterations or improvements shall require non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. On or before January 1,2019;all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements). - - ❑ My property is a commercial real property. See Civil Code Section 1101.5. ` On and after January 1,2014,specified building,alterations or improvements shall require non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. On or before. January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements), I,as the owner or owner's agent of this property,certify under penalty, of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water-conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 11,01.8.,,the current California Plumbing Code and California Green.Building Standards Code,and manufacturer's installation requirements,and that.the.water--conserving plumbing futures comply with the requirements as indicated in the table on the following page.. Owner or Owner Agent's Signature e: Dats :=x Upon completing and signing this Certificate,please return it to the Building Division in order to,final your building permit. SB9072015.doc revised 08126/15