B-2016-1607 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1607
1475 JAMESTOWN DR CUPERTINO,CA 95014-5354(366 10 088) LUNNEBORG
ROOFING INC
CAMPBELL,CA 95008
OWNER'S NAME: LIM MING SENG AND LU IIUAI CHING DATE ISSUED:03/22/2016
OWNER'S PHONE:408-876-0241 PHONE NO:(408)402-1465
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C-39 Lie.#679725
Contractor LUNNEBORG ROOFING INC Date 04/30/2018 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:
REPLACE(E)ROOF-TEAR OFF WOOD SHAKE,FILL DECK,
I hereby affirm under penalty of perjury one of the following two declarations: INSTALL CLASS AAND INSTALL STONE COATED METAL TILE
1. 1 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:$17000.00
APPLICANT 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 ordinances APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 36610088
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 Cupe no Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Sig ure Date 3/22/2016 Issued by:ABBYAYENDE
` Date:3/22/20164E�R-BUIILDER&L TION
rQr
I hereby affirm that I am a pt 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 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(Scc.7044,Business&Professions Code) –r?
z. I,as owner of the property,am exclusively contracting with licensed Signature ofAppl
contractors to construct the project(Sec.7044,Business&Professions Code). Date:3/22 2016
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERING BE ASS"A"OR BETTER
a. 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 ofthe work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE
2. 1 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(x)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 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,Section 05 33,a d 25534.
Labor Code,I must forthwith comply with such provisions or this permit shallbedeemedrevoked. Ownerorauthorized a t:
APPLICANT CERTIFICATION C-Date:3/22/2016
I certify that I have read this application and state that the above information is ION LENDIN AEN,
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that here s a construction lendin ency for the performance
relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sea 97, iv 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 MunicipalARCHITECT'S DECLARATION
Code,Section 9.18. 1 understand my plans shall be used as public records.
Signature Date 3/22/2016 Licensed
Si
9 Professional
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPEItTtNt) (408)777-3228• FAX(408)777-3333-buildingQ)cupertino.org
It tuilU"T
PROJECT ADDRESSIAPN#` - Jw�
OWNER NAME PHO1`t E-MAIL
STREET ADDRESS _ � � c CITY, ST 1� FAX
L� EV a y tJ
CONTACT NAME^„ � PHONE E-MAIL
STREET ADDRESS!•` CITY,STATE,ZIP i°�• FAX C•
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR El CONTRACTOR AGENT ❑ ARCHIT'ECT ENGINEER ❑ DEVEaaaLO�PEPR- 11 TENANT
CONTRACTOR NAME e �a _\ _.r+ �v LI,CE,NSE NUMBER/_ ��yLICENSY�E BUS.LIC.# •ry„ .
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE, IP 6A
I PHONE_�B�7&^q,?
ARCHITECT/ENGINEERNAME V PIG b6 LICENSE NUMBER ! BUS.LIC.# tY;
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF 'FD or Duplex [I Multi-Family ROOF AREA VALUATION:
STRUCTURE: E] �OICommercial2 1 !�](r�°`'�
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES (WOOD SHAKES ❑WOOD SHINGLES ❑-OTHER(SPECIFY)
REMOVE/REPLACE�Q4S IF NO, I PLYWOOD ❑ 'w, ❑ PLYWD ❑OSB PITCH: ROOF
❑NO #LAYERS: t THICKNESS: 115/8" .TYPE:. 11CDX. 1/2 CLASS: A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES.REPORT#
3 Oq
DESCRIPTION O WORK:
(c( 4a k— otr ave7r4
p
4-45S
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 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 buil ' g ons ton. authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature ofApplicant/Age Date: ®��l
0t�
SUPP ME TAL INFO A ON REQUIRED orFLC> r�sl vNry
If building is associated with a H.(,, t,
-er's Association,provide letter � �`� � a° TINcSr nP
0z 101", ;
of approval from HOA. ovEx�i�coTIIVT�Iiv�Drl� srRE vv ;
C e
a
Provide Planning approval to verify if there any restrictions. p DiANNuv �ANTy�w
Provide copy of Manufacturer's Installation Specifications. TA D"aRD �r 3IRI nn r
2-
C'25,11 yet
Provide signed copy of Cupertino's Tear-Of#'Policy. 9T�R
ReroofApp_2011.doc revised 03/16/11
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL
CIJp EtT[Nt? 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255
(408)777-3228• FAX(408)777-3333-building(a cupertino.org
PROJECT ADDRESS APN#
OWNERNAMEiii.. t PHONE E-MAIL
9 L\W
STREET ADDRESSc 4f']_,�� CITY, STATE,ZIP FAX
CONTRACTOR NAME ` LICENSE NUMB LICENSE TYPE BUS.LIC.#
�.c.S1�?Zt 74— 'S .
COMPANY NAMEs/_ E-MAIL FAX
STREET ADDRESS ��. P Cl*� /y g CITY,STA ZIP 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-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. Ifplywood 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/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 and carbon monoxide detec i e required to be i � cor ance with Sections R314 and R315 of
the 2013 California Residential e.
Signature of Applicant/Ag Date:
ReroofPo1icy_2014.doc revised 01/15/14
SMOKE I CARBON MONOXIDEALARMS �\
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIV`iSION
10300 TORRE AMENUE OUPER11 O,CA 95014-3255
CUPERTINO
(408)777-3228 s FAX(408) 77-3333 g buildina(ftu aertino.org
v Vy�M Perm NgB �a
Address �5� kof Alarms-Smoke: Carbon Momxide
P +r � E13IahE ERTICA.
S. E = Nil*i44 C i'061
PURPOSE
Tfus affidavit is a self-certification for the installation of all reqLdred Smoke and Carbon Monoxide Alarms for
compliance-w ith 2013 CRC Section 8314,2013 CBC sections 420.6 and 907 2-11.2 where no int ?or access for
inspections are required.
GENERAL INFORMATION
Existing single-family and multi-fanuly dwellings shall be provided with Smoke Alarms and Carbon
Mq oxnde al s. Whent v£z f adiAtions, exceeds
$1000.00,CRC Se R-314 and CBC Sections :I.1.5 and 42D.6 reefuire 41-tat smoke Alarms andl r Carbon
Monoxide be mstalled in the following locations:
AREA STMOKE ALAI��f CO ALARM
Outside of each separate sleeping area in the immediate-vidnity of the X �
bedroo �l.
On every ievei of a dMTHIpg urat ireluding base
ilVithin ead�siee in rim X
Carbon Monoxide alarm arenot required art.d rellings which dortot contain f€mel burniYg appliances and that
do not have an attached.garage. Carbon monoxide alarms combined with smoke alarms comply with
CBC Section 428.6 and sballbe approved by the Office of the State ire Marshal.
Bower 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 oval of wall and c�g Bnishes,-or ffiere o ams by means of.attic basement or crawl.
space.Refer to CRC Sermon R314 and CHC Sections 907.2.1 1A and 420.6.2.An electrical permit is refired for
alarms-winch must be co ed 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 themanufacturer's instructions and in compliance with the California Building
and Califonma Re�de al Codes The alarms have been tested and are operational,as of ff-k--date% - d.
below.
I have read and agree to comMy with We lenns ang' conditions of this statement
F(Al
er(or Omer Agents)Name:
n .. . . _ ----------------------
-on
__.. DI _
O fie:
vV — Ss Hato e....u;. I:,,.g. Tag..........Dads 3 b_
,Smoke and CO farm doc revised 03118114
WATER-CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE y
COMMUNITY DEVELOPMENT DEPARTMENT.BUILDING DIVISION
CUPERT]INO 10300 TORRE AVENUE•CUPEATINO,CA 95014-3255
{408)777-3228•FAX(408)777-3333 bullftg cuoertiraoorq
Owner Name ®' kki 11 Lo Permit No-& (007
Address i � �1 N1/�t�S O tO 9 A .
1. Is your real property a registered historical site?
Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
No 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?
0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
; L No Go'to Question 4.
L_.n
4. Is your real property built and available for use or occupancy on or before January 1, 1994?
11 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.
1 , 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:
1 1` X—^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 multifamily residential 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).
❑ Mypropertyis 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 pluinbing fixtures will be
replaced prior to date specified above with water-conserving plumbing fixtures in accordance with Civil Code Sections 1101.1
through 1101.8,the current California Plumbing Code and California Green Building Standards Code,and manufacturer's
installation requirements,and that the water-conserving_ plumbing fixtures comply with the requirements as indicated in the
table on the following page.
Owner or Owner Agent's Signature. Date.wt
Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit.
SB40 7 2015.doc revised 08126115