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B-2016-1636 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1636 8107 HYANNISPORT DR CUPERTINO,CA 95014-4063(356 11 014) COSMOS ROOFING INC MOUNTAIN VIEW,CA 94043 OWNER'S NAME: FRANCOEUR MICHAEL LAND IMBERT DELPHINE DATE ISSUED:03/25/2016 OWNER'S PHONE:408-568-8940 PHONE NO:(650)969-7663 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-39 Lic.#785441 X BLDG _ELECT _PLUMB Contractor COSMOS ROOFING INC Date 04/30/2017 — 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: TEARING OFF WOOD-SHAKE.RESHEETING WITH RADIANT I hereby affirm under penalty of perjury one of the following two declarations: BARRIER(OSB).INSTALL LIFETIME COMP.CLASS A 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:2200 Valuation:$11886.00 APPLICANT CERTIFICATION 1 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 11 014 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,Sect' -9'1 180 DAYS FROM LAST CALLED I SP TION. Signature Date 03/25/2016 Issued by:ALEX VALLELUNGA Date:03/25/2016 ; R-B TLDER D R T I hereby affirm that I am a rom 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 r. 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 Signature ofApplicatit contractors to construct the project(See.7044,Business&Professions Code). Date:03/25/2016 - I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVER O 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 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 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date:03/25/2016 I certify that I have read this application and state that the above information is CO UC TON LE GAG NCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a constructio ending a e for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issue 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. 1 understand my plans shall be used as public records. Signature Date 03/25/2016 Licensed Professional REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•build inpa.cupertino.org PROJECT ADDRESS Ig 10 7 4/,4/i ,4/i/,j) c„Z / D�TAPN# 3 11 0114 OWNERrae E�r�N W t=L `-`I 1 PHONE -�V q !7© E-MAIL S 16 r DRrjss- 4/j!"1 5 �� CI_CJ TCtiZ�(N® q�©I C ATE.ZIP FAX CONTACT NAME PHONE E-MAIL` Bobby Payne 650-969-76.63 C'6r7 STREET ADDRESS CITY,STATE.ZIP FAX 1901 Old Middlefield Rd Mountain V-ew, CA 94043 650-584-3078 ❑OwNER ❑ OWNER-BUILDER ❑ OWN'ERAGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCIIn'ECT ❑ ENGINEER ❑ DEVELOPER ❑ TL-N,_T CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC.# RICH COSMOS 785441 C39 COMPANY NAME COSMOS ROOFING E-MAIL FAX 650-485-2314 STREETADDRESS 1901 Old Middlefield Rd CITY.STATE.ZIP Mountain View, CA 94043 PHONE 650-969��9--777766`3` ARCHrrECTiENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY"NAME E-MAIL FAX I STREET ADDRESS CITY.STATE.ZIP PHONE USE OF SFD or Duplex ❑ Multi-Family ROOF AREA: VALUA ION: gSTRUCTURE: �onnnercial II] 1 EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE YES IFNO; PLYWOOD ❑ ;';' ❑ PLYWD' ZOSB PITCH: ROOF ❑ NO #LAYERS: THICKNESS: 5!S" TYPE: ❑ CDX '12 CLASS: `� PROPOSED ROOF TYPE: O BUILT-UP ROOF 7910PHALT.SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORE: 12Zf CR_ i 2 �� I 5 L L��� f L7 I tm � G 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. 1 have read the Description of Work and verify it is rate. I agree to comply with all applicable local ordinances and state-laws relating to building constriction: I authorize representatives of o-enter-theabove-identified.property for-inspection-purposes. Signature of Applicant/Agcnt: Date: _j SUPPL AL INFORMATIOD OP"FICE USE ONLY If building is associated with a Home 0, her' �sociation,provide letter PLAN CHECK TYPE ROUTING"SLIP of approval from HOA. ❑ OVEit4IIE-COUNTER .` ❑ BurLDING PIAN REVIEW Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN RLVIEW Provide copy of Manufacturer's Installation Specifications. p STANDARD ❑ FIRE DFP•r Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTiIFR: ReroofApp 2011.doc revised 0311 G/11 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333• buildino-Qcupertino.orp PROJECT ADDRESS (RI o"71 ,! 5 2Q.Z-( q -�- APN# r 1 f,1 4 O\VNER NAV1Ey n 1 r , '„ A/`)e-0 t: F, PHO© �4 ,`o E-MAIL srREETADDREss iF'©�r7 ,t'���15 7V �Z C1z'7r�� FAx CONTRACTOR Nr\VIE ,• v A h� r LICE SE NU\•IAER 7,q5 j I LICENSE TYPL�� AUS.LIC.N COMPANYNANIE (� _, I - r E-MAIL F,A?( _ 1 STREET ADDRESS �> /\/ CITY. TATE.ZIP, PHONE 'i C_JJ 766, 3 1 VA qq5 I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimum of one day before the requested inspection date. Please schedule inspections online or call (408)777-3228 between 7:30-3:30 (Mon-Fri). 3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof is torn off and all the nails/fasteners have been removed. Any and all dry-rotted wood shall be replaced prior to this inspection. A building inspector will be available within one hour. There are special hours for this service: 7:30 — 10:30am and 1:00-3:30pm (Mon-Thurs); 7:30 — 10:30am and 1:00 —2:30pm (Friday). 4. If plywood is installed, a plywood nailing inspection is required. 5. In-Progress roof inspection is required. Call for an in-progress roof inspection to verify building is weather tight after installation of approximately 25% of the roofing material. 6. New roof coverings shall not be applied without first obtaining all inspections 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. 7. A final inspection and approval shall be obtained from the building inspector when the re-roofing is complete. 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 must 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. 8. 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 of$126.00. 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. Signature of Applicant/Agent: _. .-�"JDate:- �) �5 1/6. �� ReroofPolicy 2010.dac revised 05/17/10 i SMOKE / CARBONMONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERT IN O 10300 TORRE AVENUE•CUPERTINO,GA 95014-3255 (408)777-.3228•FAX(408)777-3333•building Acupertino.org tt� pp (Permi`t No� - 6,1(, . dress &Z Al a,n 1.:5e d Pl' O l �21.�C� �of A a-firms Smo e 14 L� own Monoxide:) PERMIT CANNOT BE FINALED AND COMPLETED UNTII,�THISyCERTIFICATE HAS BEEN,SIGNN SIGNED AND R T TRNFD 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 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 every 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 CSC 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 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 have been tested and are operational, as of the date signed below. 1 have read and agree to comply with the.terins and conditions of this statement Owner(or Ow—n�gent s-Name: ` n } r Ace , � .....(oat? r �1�;��� (Si ea ure....... 90_racior Name: 17 ID iinau ?...... Ch �e.. .......... - ........!Eich#. ). :......:. Smoke and CO form.doc revised 03/18/14 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)'777-3228•FAX(408)777-3333•building atupertino.orq (Owner ame ✓R4 t C,/141 e F! tit ey 2 u_`­" (Permit N 2 ddressS) �jy t t4pl ij po r t � t Ls �' d�j Y U a A 5,0 (1� .Is your real property a registered historical site? El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. I No Go to Question 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. 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. No Go to Question 4. (� Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ No Myreal 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. 19 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.. Please check ONE of the following: 10 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 11.01.5. 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 110 1.1 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 A ent's Si nature: _ � ate: ? Upon completing and signing this Certificate,please return it to the Building Division in order to final your building`permit. SB4072015.doe revised 08/26115