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B-2016-1986
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1986 21203 OROGRANDE PL CUPERTINO,CA 95014-4151(362 17 018) R E ROOFING AND CONSTRUCTION INC SAN JOSE,CA 95124 OWNER'S NAME: CHANG HOWARD AND NAGANO YUKI DATE ISSUED:05/20/2016 OWNER'S PHONE:408-718-0376 PHONE NO:(408)626-9320 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-39,B Lic.#727599 Contractor R E ROOFING AND CONSTRUCTION INC Date 09/30/2016 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: TEAROFF;INSTALL COMP.SHINGLES(39 SQ'S)-CLASS A 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 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:3900 Valuation:$17000.00 APPLICANT CERTIFICATION 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 362 17 018 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 Additional) plicant understands and will comply with all non-point source egulations the C' C u eFflinWdrdpalt�qde,section s.18. 180 DAYS FROM LAST L D �SPECTION. Signat Date 5/20/2016 Issued by:Alex Vallelunea Date:05/20/2016 O R-B 1Tf DER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RF.-ROOFS: following two reasons: Al be inspected prior to any roofing material being installed.If a roof is i. I,as owner of the property,or my employees with wages as their sole stalled without st obtaining an inspection,I a ee to remove all new materials for compensation,will do the work,and the structure is not intended or offered for coon. sale(Sec.7044,Business&Professions Code) z. I,as owner of the property,am exclusively contracting with licensed Signatt re.ofAnp contractors to construct the project(Sec.7044,Business&Professions Code). Date:5/20/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER t. 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 a. 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. Addition should I use equipment or devices which emit hazardous air contarni s as deft d by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maint n compliance w he Cupe iu Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the he Health&Sal e,Sections 55 533,a 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner ora orized age APPLICANT CERTIFICATION Date: 0 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 5/20/2016 Professional m; REROOF PERMIT APPLICATION 'y COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•building cupertino.orQ PROJECT ADDRESS �2_ APN O\VNER NAME JAIW , .PHONE U _ v )� E-MAIL STREET ADDRESS 2 ZU 7 '1 /! CITY, STATE,ZIP �i I q' ` �� I I FAX CONTACT NAME �}I�V� ri PHOAtE C� /jV�t` ��L� /WJE-1`2AIL STREET ADDRESS CITY,STATE, ZIP ^ /r(J FF ❑ owNER ❑ OWNER-BUILDER w❑`0NTIERAGEN-r CONTRACTOR ❑CONTRACTORAGENTr ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER TENANT IN❑TENANT CONT•RACTORIdAM / U r R/ / LICENSENUMBER r /� LICENS TYPE BUS.LIC, COMPANY NAME 1-1-. )[U, EMAIL •1 �i r 0 G lIl to O FAx I U�` L{p !I YJ l STREET ADDRESS I r7�`` w, � CITY,STATE,ZIP PHONF9 Cw„ ut e2() ARCHITECT/ENGINEER NAI,4E LICESENUMBER BUS.tIC: COMPANY NAME [ I I E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF SFD r Duplex El Multi-Family ROOF AREA: ( VALUATION: K STRUCTURE: O11mercial EXISTING ROOF TYPE: ❑BUILT-UP ROOF ^SPHALT SHINGLES 11W.OODSHAKES ❑WOOD SHINGLES ❑OTTER(SPECIFY) REMOVE/REPLACE 1'ES IF NO, PLYWOOD ❑ /r ❑ PLYWD ❑ OSB PITCH: ROOF ❑NO R LAYERS: *X THICKNESS: ❑ 5/6" TYPE: ❑ CDX 12 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF �1 ASPHALT SHINGLES ❑VdOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT R DESCRIPTION OFIVORK �� .\TAI. (yn` r� Iv �Y`c.� Iv C.OtA P 1,1 ALL K-I& Oo By my signa ie below,I certi to each of,!ba owing: I am the property owner or authorized agent to act on the property m ner's al£ I have read this application nd the information ave tiyided is co ct. I e read t i escr'iption of Work and verify it is accurate, I agr to comply with all applicable local ordinances and state laws relating o constructio au ri ere sen tives of Cupertino to enter the above-.i 1 1 e property for inspection purposes. Signatureo plicant/Agent: Date: ---------- SUPPLEMENTAL INFORM=ION REQUIRED tj ti :�a z ' 1 - r_OFFICE TSE,OI�Ll' F If building is associated With a Home Owner's Association,provide letterPL�n ??�E. :. �Rouir csL� mt of approval from HOA. �'o�ERlzxaEcoirEx z• fl �rrbrncPLAICREcSy ` Provide Planning approval to verify if there any restrictions, r t V ❑ EXPRESS q £ y❑rPdi�II� PLAIT REViEi3 �k t ; Provide copy of Manufacturer's Installation Specifications. ❑ $� �; �;,�z L ❑ F7RFDEPTx/ �� - Provide signed copy of Cupertino's Tear-Off Policy. Reroofy4pp_2011.doc revised 03/16/II REROOF TEAR-OFF POLICY ' COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL GUPERT[NO 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 (408)777-3228 - FAX (408)777-3333•building aakuoertino.orq PROJECT ADDRESS l/J rl 0 I btr P�, I APN r 6 OWNERNAME 1 ( V L ( � PHONE 6- 7U WE-MP.IL 11 STREET ADDRESS2I CITY,STATE,ZIPiD n, �(@ I I FAX CONTRACTOR NAME I LIC_ SF NrLAdBER � LIC 'SE TYPE BUS.LIC.R COMPANY NAME eRU C E-MAIL map( C' FAx c�U 26��1 -�( �( STREET ADDRESS `�Zai N CITY,STAT£,ZIP i PHO y / Zo/ -v1� -D I UNDERSTAND AND AGREE TO THE FOLLOWING: Q � Ip 1 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 7:30-3:30pin (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-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 ID 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 behhl . un tared and agree to'comply with the re-roof policy stated above. I also understand that smoke detectors a d carbon monox e det c eq it to be stalled in accordance with Sectioils R3 4 and R315 of the 2013 Californ'a Residential Code - Signature of Applic , t/Agent: _ �- Date: �Q ReroojTolicy_201 4.doc revised 01115114 SMOKE / CARB6N iM ONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CIIFt t III+t 10300 TORRE AVENUE CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333 building(a)-cupertino.org Permit No. 2_0 b_ Address 1 #of Alarms Smoke., - -^Carbon Monoxide: 0 PERMIT CAN1�I©T SE FINALED Al'+iD C01PLETED UNTO,THIS CERTIFIGC TE Ae EN +D AND IZF UR�+D HE'DI�, G DI' SON � 0 � N 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 an&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 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 have read and agree to comply with the terms and conditions of this statement _Ow er_(or Owner Agent's)Name: 5l2 �i. _Date :..,..... Contractor Name: t Signa ijre Lic.#...... .........Date: Smoke and CO form.doc revised 03118114 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION . CVPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 {408)777-322 •FAX{408)777-3333-building(a)cupertino.org Owner Name. Permit No. Address. ) - 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. VNo 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? El 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. Ei"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. 1Z 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. oe Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of.the form and sign bottom of form. _yea_,_, My•eal property is=built anel-availa'be-for-use or-occupancy on-or-before January-1,-i994:- -- i---w---•-._._. Civil Code Sections 1101.1 through L101.8 apply. Check one of the three following statements and sign bottom of form.. 5. Please check ONE of the following: 2T'*'Mypropertyis 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). ❑ 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 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. oe Owner or Owner Agent's.Signature: CDates 2!� Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit. SB4072015.doc revised 08126115