15070019CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1469 PRIMROSE WAY
CONTRACTOR: ATHK CONSTRUCTION
PERMIT NO: 15070019
OWNER'S NAME: CHAU JENNY TRUSTEE
18950 AFTON AVE
DATE ISSUED: 07/06/2015
OWNER'S PHONE: 4082781650
SARATOGA, CA 95070
PHONE NO: (408) 849-2251
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
TEAR OFF (E) WOOD SHAKE, INSTALL (N) OSB, 15 #
License Class Lic. #
FELT, (N) CLASS A 50 YR COMP (25 SQ'S)
�C-1
r I S�
Contractor 1 Date
I hereby affirm that I am licensed under the provisions o Cha ter 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:
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
Sq. Ft Floor Area:
N'al uation: S7000
erformance 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
APN Number: 36617002.00
OccupancN TN pe:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN 180 DAYS OLEEIRMIT ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
180 DA LED INSPECT O
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 c
s ate:
with all non -point source regulations per the Cupertino Municipal Code, Sec n
9.18.
�—
RE -ROOFS:
Signature) Date b
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
inspection.
LL
7
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
Signature of Applicant: Date: N
the following two reasons:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1, 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)
I, as owner of the property, am exclusively contracting with licensed contractors to
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 25532(a) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self -insure for Worker's
material. Additionally, should I use equipment or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sections 25505, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
Owner or authorized agent: Date:
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
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I must
I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked.
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
APPLICANT CERTIFICATION
Lender's Address
I 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 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,
ARCHITECT'S DECLARATION
costs, and expenses which may accrue against said City in consequence of the
I understand my plans shall be used as public records.
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
9.18.
Signature Date
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 •FAX (408) 777-3333 • building(d)cupertino.org
PROJECT ADDRESS
F1 9 �
APN #
Z
OWNER NAME^ '��
4.STREET
PHONE 4 Q y �� ` EUMAIL
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CITY, ATE, Z n /
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FAX
CONTACT NAME -
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PHONE
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E-MAIL
STREET ADDSS f
CITY„STATE, ZIP ,
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FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGnNTEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NA 4
LICENSE NUMBER
LICENSE TYPE
BUS. LIC #
COMPA NAMEE-MAIL
t -H fi0 rvS i R -V G Ti o
FAX
STRE T ADDRESS CITY, STATE, ZIP
PHONE
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC. #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or Duplex ❑ Multi -Family
STRUCTURE: ❑ Commercial
ROOFAREA: nn
C12 S _jV 'UC,
VALUATION:
M 1� `]
EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES WOOD SHAKES ❑ WOOD SHINLES ❑ OTHER (SPECIFY)
REMOVE /REPLACE _DYES
❑ NO
IF NO.
# LAYERS
PLYWOOD ❑ '/:" ❑
THICKNESS: El 5/9"
PLYWD )OSB
TYPE: 1:1CDX
PITCH:
:12TLASS:
OOF
`4PROPOSED
ROOF TYPE: ❑ BUILT-UPROOF ASPHALT SHINGLES ElWOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER
-ES REPORT #
DESCRIPTION OF WORK:
c _ S t_i -1 r__ c--
- c
By my signature below, I certify to each of the following: I am the property owner or authorized agent to a on the property owner' f. 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 agre mply with all applicable local
ordinances and state laws relating to building co str ction. I authorize representatives of Cupertino to enter the above-identifie pro erty for inspection purposes.
Signature of Applicant/Agent: Date: '] %
SUPPLEMENTAL INFORMATION UIRED
_ If building is associated with a Home Owner's Association, provide letter
Of approval from HOA.
Provide Planning approval to verify if there any restrictions.
Provide copy of Manufacturer's Installation Specifications.
Provide signed copy of Cupertino's Tear -Off Policy.
oFF>c USEoivLi'
PLAN CHECK TYPE
ROUT Inc SLIP
5ir J,VER-THE-COUNTER
❑ EXPRESS
❑ STANDARD
❑ BUILDING PLAN REVIEW
❑ PLANNING PLAN REVIEW
❑ FIRE DEPT
❑ OTHER:
ReroofApp_2011.doc revised 03/16/11
CITY OF CUPERTINO
99-00 FEE ESTIMATOR - BUILDING DIVISION
FEE ID ROOF AREA
s.f.
1REROOFFRES 2,500
_T
ADDRESS: 1469 PRIMROSE WAY
DATE: 07/06/2015
REVIEWED BY: MELISSA
Ffe(,,; alt Fee:
APN: 36617 002
BP#:TO z2� 7 -
V
'VALUATION: 1$7,000
xPERMIT TYPE: Minor Building Permit
'
PLAN CHECK TYPE: Re -roof
PRIMARY SFD or Duplex
USE:
I
PENTAMATION 1 SFDWLROOF
I PERMIT TYPE:
WORK
TEAR OFF E WOOD SHAKE INSTALL N OSB 15 # FELT N CLASS A 50 YR COMP 25 SQ'S
SCOPE
<<q)p1. Insp Fee
FEE ID ROOF AREA
s.f.
1REROOFFRES 2,500
_T
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District. eta). These fees are based on the Preliminary information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff.' 7/1%73)
:itech. Plan Chick
Pl unb. Plan Check
1 lec'. Plan CheO
Ffe(,,; alt Fee:
Plum,
Frlc. Prrr,
Otheir kch. Insp.
01her Plumb lrar,Li
(Mier 1-1-161c. Insp.
'cch. Insp. Fee:
Plumb. hasp. Fec
r->. Fee:
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District. eta). These fees are based on the Preliminary information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff.' 7/1%73)
FEE
QTY/FEE
MISC ITEMS
fan Check Pie:
„ippl..PC Fee
� 7CJ7111.Li1'TeC'h✓�aeC
Permit Fee:
$425.00
<<q)p1. Insp Fee
'rrrntt'�. ;lfeclt.;`llec
Plt�mh.i;11c�clt.i"1s'lec Permit I'ee:
"«nstruction Tax:
i�lrninistrative Fec:
Work Without Permit? O Yes (F) No
$0.00
Advanced Planning Fees:
l -� a�fn<'nlutirrn Fee= ,
Strong Motion Fee: IBSEISMICR
$0.91
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$426.91
$0.00 TOTAL FEE:
F $426.91
Revised: 07/01/2015
CUPERTINO
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
(408) 777-3228 • FAX (408) 777-3333 • building(c-�cupertino.orq
c
PROJECT ADDRESS'
C' p 1 r / ;,T-APN
#
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OWNER NAME G N N=1 �� fl U
J
PHONE 9 Z 7 v/` �-0
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E-MAIL
STREET ADDRESC- �1
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FAX
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CONTRACTOR NAME�I
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LICENSE NUMBER `,
LICENSE TYPE
BUS. LIC. #
COMPANY NAMfg _T "1
1
IC , ^ / E-MAIL
V
FAX
STREET ADDRESS
/ CITY, ST T , ZIP
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PHONE 2
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 Nailina 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 detectors are required to be installed in accordance with Sections R314 and R315 of
the 2013 California Residential Code. I , I _ I
of Applicant/Agent: 4/ " ) i Date:
ReroolPolicy_2014.doc revised 01/15/14
CVPERTINO
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(a)cupertino.org
Owner Name C- R -A t 1 ...i C l't /-j ✓ Pen -nit No. cl O -1 o O
Address 1�4 h j T (z- I A' ro S � Vl -A ,1)
Please refer to the attached California Civil Code Sections 1101.1-1101.8 which are part of this Certification form.
1. Is your real property a registered historical site?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form.
Owner' Signature: J �
PNo Go to Question 2.
Date: ( I � ( 1�-
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.
Sign below and skip the rest of the fonn.
Owner' Signature:
No Go to Question 3.�
Date: -7 I Gi l I �)
3. Is water service permanently disconnected for your building?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the fonn.
Owner' Signature:
No Go to Question 4.
Date: ( j�
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. Sign below and skip the rest of the form.
Owner' Signature: �r" '�/ Date:
Yes My real property is built and available for use or occupancy on or before January 1, 19 4.
Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached.
y property is a single family residential real property. See Civil Code Section 1101.4.
On d after January 1, 2014, building alterations or improvements shall require all non-compliant plumbing
f es o be replaced with water -conserving plumbing fixtures throughout the building. On or before January 1,
2, a on -compliant plumbing fixtures shall be replaced with water-conseiving plumbing fixtures (regardless
of wh`etl 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. Seh�N
SB4072015.doc revised 02/04/1`5
On or before January 1, 2019, all non-coinpliant plumbing fixtures shall. be replaced with water- conserving
plumbing fixtures throughout the building (regardless of whether property undergoes alterations or
improvements).
I/We, the owner(s) 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
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 below.
Owner Agent's) Signature:
Date:
Upon completing and signing this Certificate, please return it to the Building Division in order to final your permit.
Non C m® plan- M
Water -Conserving Plumbing Fixture
Plumbin Fixture
(Fixture Complying with Current Code Applicable to New Construction)
a
Maximum Water Usage/Flow Rate
Fixture Type
Water Usage
2013 CPC Ch. 4
2013 CPC Ch. 4
2013 CPC Ch. 4
/Flow Rate
2013 CALGreen Div. 4.3
2013 CALGreen Div. 4.3
2013 CALGreen Div. 5.3
Single -Family
Multi -Family
Commercial
?
Residential
Residential
Water Closet Exceed 1.63
Single flush toilets: 1.28 gallons/flush
(Toilets) Gallons/flush
Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite,
avers e flush volume of two reduced flushes and one full flush
Urinals Exceed 1.0
1?
0.5 gallons/flush
Gallons/flush
,
Showerhead Exceed 2.52.0
gallons per minute @ 80 psi. Also certified to the performance criteria of
gallons per minute
,
U.S. EPA WaterSense Specification for Showerheads
(A hand-held shower is considered a showerhead.)
}�
For multiple showerheads serving one shower, the combined flow rate of all
showerheads and/or other shower outlets controlled by a single valve shall not
exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to
allow only one shower outlet to be in operation at a time.
Faucets — Exceed 2.2 gallons
Maximum 1.5 gallons per
Within units:
0.5 gallons per minute @ 60
Lavatory. per minute
minute @ 60 psi; minimum
Maximum 1.5 gallons
psi
Faucets
0.8 gallons per minute @
per minute @ 60 psi;
20 psi
minimum 0.8 gallons
�(!
per minute @ 20 psi
h
In common and public
use areas: 0.5 gallons
9
per minute a@ 60 psi
1.8 gallons per minute
60 psi
Faucets —Exceed
2.2 gallons
Vi 1.8 gallons per minute @
1.8 gallons per minute
1.8 gallons per minute @ 60
Kitchen
per minute
r
i, 60 psi
@ 60 psi
psi
Faucets
May temporarily increase
May temporarily
up to 2.2 gallons per
increase up to 2.2
.''
i minute @ 60 psi, and must
gallons per minute @
-_ default to maximum
60 psi, and must
1.8 gallons per minute @
default to maximum
60 psi
1.8 gallons per minute
Where faucets meeting
@ 60 psi
-; the above are unavailable,
Where faucets meeting
aerators or other means
the above are
may be used to achieve
unavailable, aerators or
reduction.
other means may be
used to achieve
--------- �
'I
reduction.
1
0'
l ,'the>exis`ting plumbing fixture wa er usage/flow rate is equal to or lower than the figure shown,ieq pgraded.
_. .
SB4072015.doe revised 02/04/15
Address
ffl
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(o)cupertino.org
FILE
?Mo�i,5 Res.
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
bedroom(s)
X
X
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.
,i
I have read and agree to comply with the terms and conditions of this statement
Owner (or Owner Agent's) Name:
�
J
Sinature................LY'Aq ...44 .......................................................................... Date: ..........
Contractor Name:
V 1
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signature ........... ............. ...................................Lic.4.s.l......1..�<.�...... .....Date: �...pG..(...
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Smoke and CO forna.doc revised 03/18/14