B-2017-1346CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS: CONTRACTOR: PERMIT NO: B-2017-1346
7709 HUNTRIDGE LN CUPERTINO, CA 950144262 (359 06 020) R A CONSTRUCTION
SAN JOSE, CA 95136
OWNER'S NAME: RICHARDS DAVID AAND FLWKO T TRUSTEE
OWNER'S PHONE: 408-257-5956
LICENSED CONTRACTOR'S DECLARATION
License Class C-39 Lic. #633438.
Contractor R A CONSTRUCTION Date 12/31/2017
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.,
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
n n3_ Compensation, as provided for by Section 3700 of the Labor Code, for the
t-- oPetforinance of the work for which this permit is issued.
OTI 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.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
information is correct. Iagree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize
representatives of this city to enter upon the above mentioned property for
inspection purposes. 09) agree to save indemnify and keep harmless the
City of Cupertino against liabilities, judgments, costs, and expenses which
may accrue against said City in consequence of the granting of this permit.
Additionally, the applicant un erstands and will comply with all non -point
(source regulations p" . pertino Municipal Code, Section 9.18.
Date 8/14/2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
1. I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec.7044,,Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
2. I have and will maintain.a Certificate of Consent to self -insure for Worker's
Compensation, as providedfor by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
2. 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
permi£is issued.
3. I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as.to become subject to the
Worker's Compensation laws of California. If, after making this certificate of
exemption,, I become subject to the Worker's Compensation provisions of the
Labor Code, 111111: st forthwith comply with such provisions or this permit shall
be deemed revoked.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct, I agree to'complylwith all city and county ordinances and state laws
relating to building construction, and hereby 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 expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
Code, Section 9.18.
Signature Date 8/1412017
DATE ISSUED: 08/14/2017
PHONE NO: (408) 559-1877
BUILDING PERMIT INFO:
X BLDG —ELECT _ PLUMB
MECH X RESIDENTIAL.—COMMERCIAL
JOB DESCRIPTION:
RE -ROOF: TEAR OFF; INSTALL OSB; COMP SHINGLES- (25 SQ)
Sq. Ft Floor Area: I Valuation: $10950.00
APN Number: Occupancy Type:
35906 020
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
by: Jasmine Archbold
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
ins ectio
Si fApplicant:
1 0l
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALSDISCLOSURE
I have read the hazardous materials requirements under Chapter 6:95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
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
the Health & Safety Code, Sections , 25533, and25534.
O e • authorized agent:
CONSTRUC�/QN LENDING AGENCY
4/201 ,
hereby affirm that there is a construction lending agency for the performance
of work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
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 • buildincdcuDertino.oM
PROJECT ADDRESS 7709 Huntridge Lane, Cupertino, Ca. 95014
AFN# 359.06-020
OWNERNAME
David A and Fumiko T. Richards
PHONE
(408) 257-5958
EMAIL
darlchards55@msn.com
STREET ADDRESS
CITY, STATE, ZIP
FAX
7709 Huntridge Lane,
Cupterino, Ca. 95014
CONTACT NAME
David Richards
PHONE
(408) 257956
E -MAB•
darichards55Cmsn.com
STREETADDRESS
CITY, STATE, ZIP
FAX
7709 Huntridge Lane
Cupertino, Ca. 95014
❑ OWNER 10 OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTORNAME &,v i - LICENSE NUMBER
LICENSE TYPE
BUS. LIC. #
COMPANY NAME /J�A,y O
P.MAH,
FAX
STREET ADDRESSre 35.;f
CITY, STATE, ZB' 5/,J,�/ 220 9.c- �C
f��J
PHONE -q9 I
E
ARCHITECT/ENGINER NAME
LICENSENUMBER
BUS. LIC#
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF SFD or Duplex ❑ Multi -Family
ROOF AREA:
VALUATION:,
Commercial
,26^ 00 �^
r
� 7-1
STRUCTURE: ❑
_
WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES X,
REMOVE/REPLACE EYES
IF NO,
PLYWOOD El Xr ❑
PLYWD 7COSB1
PITCH:
ROOF
❑ NO
#LAYERS:
THICKNESS: ❑ 5/8'
TYPE: ElCDX
'12
CLASS: A
PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF 0 ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER
ICC -BS REPORT #
DESCRIPTION OF WORK:
Remove wood shake roof, about 1,000 sf of roof is not sheeted, will sheet that portion with before installing new asphalt
shingles. Will Include removal of all gutters and valley or side wall flashing. G 5.6ey` 6v
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 behalL 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 co ofI authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAL R60RMATION REQUIRED
o cs USE'oNiY
If building is associated with a Home Owners Association, provide letter
" -PLAN CHECK TYPE
t "",ROUTING ?,4q:
❑ ova=rrns couNTeR
`� BUILDING PLAN REVIEW
of approval from HOA.
Provide Planning approval to verify if there any restrictions.❑
ExrREss
PLnxrt>Nc PLAN ivlEw
Provide copy of Manufacturers Installation Specifications.
„,p sTAxnnRD
_❑ iME DEPT ,N x
Provide signed copy of Cupertino's Tear-OffPolicy.
y
❑ oT»&rs ,•
4
ReroofApp_2011.dac revised 03/16/11
REROOF TEAR -OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
II ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTIN0 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildingna.cuoertino.org
FRO.ECT ADDRESS 7709.,Huntridge Lane, Cupertino, Ca. 95014
APN# 359-06-020
OWNERNAME
RiONE.
EMAIL
David A and Fumiko T Richards
408-257-5956
darichards55 msn.com
STREET ADDRESS
CITY, STATE, ZIP
FAX
CONTRACTORNAME SelA LICENSENUMBER �/
LICENSETYFE
BUS LIC.#
COMPANY NAME
EMAIL
FAX
[;�TREETADDRESS , ,ten �: �
CITY,—I-ZIP��LTP, 2� „
HiONE
I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. There -roof project shall Comply with all,applicableprovisionsof the2013 California Codes:.
2. An inspection request can be scheduled up to onebusiness'day before the reguested inspection date.
Reese schedule i nspecti ons online or c al I ' (408) 777-3228 from 7:30-3:30pm (M on-Thurs) or 7:30-
2:30pm (Friday) to schedule inspection. For Tear -Off and Nailing Inspections, you must also call on the
day of theinspection only after'that,phaseof thework iscompleted. Thebuilding inspectorwill be
avellablewithin one hour. The foursfor this service are 7:30-10:30amand 12:30-3:30(Mon-Thurs)
and 7: 30-10: 30am and 12:30-2:30 (Friday). Final I nspecti ons wi I I be gi ven a two hour wi ndow.
3. Tear -Off I nspection 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/fastenersshall be either
completely knocked -down or removed prior to this inspection.
4. If plywood is installed, aplywood Nailing Inspection isreguired.
5. Roof ng she] I not be apps i ed wi thout fi rst obtai ni ng al I pri or i nspecti on and wri tten approval s from the
bui I di ng inspector. Any roofing which i s appl i ed without first obtaining an approved inspection will
require the removal of all new material down to the sheathi ng so a proper inspection can be performed.
6. A Final Inspection and approval shall beobtained from the building inspector when the re -roofing is
completed. To receiveafinal sign -off, thefollowing itemswill beverified:
a Flat roofs shall have a mini mum of ;-4" per foot of sl ope and demonstrate there i s no pondi ng.
b. Listingsfrom approved testing agencies for all pre -manufactured products used shall be
ava I abl a on-'si to to Trevi edv at theti me of the i nspecti on.
c. Proper'spark! arrestor i nstal I ati on, vents painted; gutter/downspouts i nstal I ed, debris removed.
7. NOTE: If you call for a tear -off or plywood nai I i ng inspection and the work is not oompl ete, you will be
charged are-inspectignfep The re -i ns
pecti on fee sh al I be paid before another inspection can be
scheduled.
By my signing below, I certify each of the'following istrue: 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 r ui red to be i nstal I ed in accordance wi th Sections R314 and R315 of
the 2013 Cal i forni a Resi denti I Code
SignatureofApplicant/Agent: ! Date:
Rerool`Policy_2014.doc revised 01/15/14
Fr3LFLH
-91038114.
SMOKE / CARBON MONOXIDE ALARMS 40
• OWNER CERTIFICATE OF COMPLIANCE
1'-risx COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
UPI RT t NO 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333• buildinq a(�cupertino.orq
PERMIT CANNOT FINALED UNTIL TATS CERTIFICATE.HAS BEEN
COMPLETED;LD,SIGNED AND2ETURNED-TO TILE'BUILDING G DIV_ISIO
PURPOSE
This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms
for compliance with 2016 CRC Section R314,2016 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 X X
the 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 specified below have been tested and are operational, as of the
date signed below
�� 13
Address: `�' ' 4. .� �� �y J � � �1-2 � Permit tlTo. ..,
Specify Number of Alarms.. #Smoke A laims. 3 I #Carbon Monoxide Detectors.
I have read and agree to ,mmplywith the term and c@nditons of this statement
Owner(or Owner Agent's))Name:Na� ' 05 �d
l,0 R`ch���12es Signatur S .,,.; . �� Date: '�/1
Contractor Name:
Signature Lic.# Date:
•
Smoke and CO fonn.doc revised 12/15/16