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B-2016-2343 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2343 20990 VALLEY GREEN DR CUPERTINO,CA 95014-1829(326 09 053) NEMMER ROOFING FREMONT,CA 94538 OWNER'S NAME: KORET VC I LP DATE ISSUED:07/19/2016 OWNER'S PHONE:650-592-3960 PHONE NO:(650)888-2915 LICENSED CONTRACTQRIS DECLARATION BUILDING PERMIT INFO: License Class METAL PRODUCTS Lic.#749304 Contractor NEMMER ROOFING Date 05/31/2018 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; BUILDING 648-663-REROOF;TEAR OFF;INSTALL COMP I hereby affirm under penalty of perjury one of the following two declarations: SHINGLES(138 SQ) 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. 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:$57872.00 APPLICANT CERIMCATION 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 326 09 053 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 the granting this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and willl comply with.all ll non-point source regulations per the Cupertino Municipal Code,,Section 9.18, 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 7/19/2016 Issued b •Abby A ende, Date:07/19/2016 OWNER-BUILDER DECLARATION I hereby affirm that I am 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 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 of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:7/19/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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. 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 25534.1 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:7119/2016 I certify that I have read this application and state that the above information is CONSTRUCTION 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 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. Licensed Signature Date 7/19/2016 Professional REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333• building0cupertino org �J/11' 9 6 63 � �° PROJECT ADDRESS 0 ��` � APN# � Es p OWNER NAME (� l �V _ 6olY PHONE E-MAIL Sr=' STREET ADDRESS /' �'+ C P, ST TE,ZIP �C1 fi<j /Cia` FAX CONTACT NAME PHONE E-MAIL -7 STREET ADDRESS CITY,STATE,ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR -El C0I11TRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE NUMBER ` ^ y i -9� LICEI�S�E TYPE BUS.LIC # COMPANY NAME /{ �3 FAX l'r f�d�B�l9rJ''dlLTCITY, , STREET ADDRESS �� ATE ZI PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER - BUS.LIC.# ' COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD Or Duplex OMultl-Faintly ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial / 3900 EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES 9WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE BYES IF NO, PLYWOOD ❑ /" F1PLYWD ❑ OSB PITCH: ROOF ❑NO #LAYERS: THICKNESS: 115/S" TYPE: ❑ CDX I Z CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK: { f(g 7 mar Ut.Y-• �t 1�. rY.. 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 rovided 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 t 6 ilding construction} authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED t •- -' ,,..OFPTCE�iJSE ONLY s, e a;i If building is associated with aHome Owner's Association,provide letter � PLANCHDcxTYPE `' F Y ';5 RovTutic'sLIP of approval from HOA. S ©tOERTHE COUNTER © BUILDIIVGPLANREVIEW r —Provide Planning approval to verify if there any restrictions.. EXPRF,SS5 .� rI a u; } PLANI4II�GPLANREVIE}Y x —Provide copy of Manufacturer's Installation Specifications. � N4 STANDARDF� r� z RIRI;DEPT E �+q r � e _ Provide signed copy of Cupertino's Tear-Off Policy. Yt yl 1. ReroofApp_2011.doe revised 03/16/11 Yt A 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•buildina(IDcupertino.ong PROJECT ADDRESS 1f .�/ nq A APN# OwNERNAME d Qa�d Ocn' V PHONEC�I�G� � �fP E-MAIL STREET ADDRESS /�.�-�j/d3-•'i.- _ T f" 'E ZIP e / F ONTRAC OR AME LI�CyE NUMBER LICE TYPE BUS.LIC.# COMPANY NAME,f § E-MAIL FAX nJ STREET ADDRESS CIT57-3 gr 8, ILLY STATE ZIP . P � —X926 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. 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-roofmg 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 monoxideetectors are required to be installed in accordance with Sections R314 and R315 of the 2013 California Residential Co Signature of Applicant/Agent: Date: ReroofPolicy_2014.doe revised 01115114 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERW—No 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333• building(a)-cupertino.org .� Permit No. Address ko q 4) c�/ ��—h.9 i�- , l`tcA-f#of Alarms Smoke: `7/ Carbon Monoxide: PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE S ISE SIC; ['UNI I2FT 1RNF �" 15 4 y { �I'S�IS�ON J 1prk 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 ALARILI 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 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 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. l have read and agree to comply with the terms and conditions of this statement Owner or Owner Agent's)Name: ''AA 6f L or Name i Signature... ... ..: ...........Date: ..19. C ntractr ame: ✓��r Signature ......... .... ..:....: . ... .........Lic.#...... ...........................Date: e..u.._' Smoke and CO form.doc revised 03/18114 WATER-CONSERVING PLUMBING FIXTURES46 OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 6�0e" CIYPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 Of (408)777-3228•FAX(408)777-3333 buildina(alcuoertino.org Owner Name kc.lvF� Permit No o —Z-c>/6— L3 `J Address Z_4C>!i40 � �`l 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. ,j4-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? Q 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. E�(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. No 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. j&,Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1.101.1 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 resid6ntial real property. See Civil Code Section 1101.4. Ori 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). ❑ 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 peijury 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 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: Upon completing and signing this Certificate,please return it toAhe Building Division in order to final your building permit. SB407 2015.doc revised 08126115