B-2016-2474 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2474
1982713EEKMAN PL CUPERTINO,CA 95014-2450(316 30 128) J E JOHNSON
ROOFING
SAN JOSE,CA 95127
OWNER'S NAMEKLUNG JOAN W TRUSTEE DATE ISSUED:08/09/2616
OWNER'S PHONE:415-810-6301 PHONE NO:(408)876-9630
LICENSED CONTRA TOR'S DECLARATION BUILDING PERMIT INFO:
License Class CC-39 Lic.#9.98269
Contractor J E JOHNSON ROOFING Date 10131/2016 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:
I hereby affirm under penalty of perjury one of the following two declarations: RE-ROOF;TEAR-OFF;INSTALL TPO MEMBRANE WHITE(20 SQ)
1. 1 have and will maintain a certificate of consent to self-insure for Worker's
— mpensation,as provided for by Section 3700 of the Labor Code,for the
ormance 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:$9000.00
APPLICANT CERTIFICATION
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 316 30 128
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 reg ul tions per the Cup. rti Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. .
Signature ate 08/09/2016
Issued bY'KIM DUNBAR
'Date:08/09/201.6
WNER-. DER DECL TION
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 spe tion.
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:08/09/2016
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
r. 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. 1 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 Q ality Management District I
Worker's Compensation laws of California. If,after,making this certificate of will maintain compliance with the Cupertino Muni "pal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions,of the the Health&Safety Code,Sections 2550 J25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall f
be deemed revoked. Owner or authorized agen
APPLICANT CERTIFICATION Date:08/09/2016
1 certify that I have read this application and state that the above information is CONS4TION L IN AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction ending 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. I understand my plans shall be used as public records.
Signature Date 08/09/2016 Licensed
Professional
t
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE,CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333 building(ftupertino.ora
UPERTINO
PROJECT ADDRESS �,g 2 APN# 1 0 12
Q
Waly
OWNER NAME PHONEE-MAILun 415'
-�c -��ol B_
STREET ADDRESS CITY,STATE,ZIP ,^ FAX
CONTACT NAME rS�-eay PHONE // f� E-MAIL
STREET ADDRESS CITY,STATE,ZIP moi( " �f FAX
❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ALJ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT El ENGINEER ❑ DEVELOPERS ❑TENANT
CONTRACTOR NAME LICENSENUMBER LICENSE TYPE BUS.LIC.# 3f ��
COMPANY NAME �� E-MAIL FAX (c�
..J l
STREET ADDRF ,, �` CITY,STATE,ZIP S> PHONE
SoilARCHITECT/ENGINEER NAME \ LICENSE NUMBER BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP
PHONE
USE OF SFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION:,
STRUCTURE: ❑ Commercial
EXISTING ROOF TYPE, � BUILT-UP ROOF ❑ASPHALT SHINGLES 1:1 WOOD SHAKES El WOOD SHINGLES El OTHER(SPECIFY)
REMOVE/REPLACE -AYES IF NO, PLYWOOD Elw, ElPLYWD 1:1 OSB PITCH: ROOF
El No r LAYERS: THICKNESS: 1:15/8" TYPE: 11CDX 12 CLASS: E,
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT R
DESCRIPTION OF WORK: Ik t �4 Rao
L IAV 9
By my signature below,I certify to-each of the foll ing: 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 provide is ect. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relaf g to building c ns ction. l authorize representatives of Cupertino to enter the above-id tiff property for inspection purposes.
Signature of Applicant/Age Date:
SUPPLE TAL INF ATION REQUIRED
.r," .. .>." a�.,. .�,...Oi SCE CISE;PNL . s r.,..
If building is associated with a Home Owner's Association,provide letter ?
NC k" F r _;:RovTiNc sLlr
of approval from HOA. I] ovER THE CouI� ER ❑ suzLDlz GrLOn IE�3 �
_'Provide Planning approval to verify if there any restrictions. Cl E�PxEgs L7 PLANNING'--Finn «w '
Provide copy of Manufacturer's Installation Specifications. I❑ sTANnARD1] .FIREDEPT �" �
, ;.
_Provide signed copy of Cupertino's Tear-Off Policy. ❑ oTxER
k
Z � �
ReroofApp_2011.doc revised 03116111
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR,P.E., C.B.O., BUILDING OFFICIAL
CUP1;RTtNC3 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255
(408)777-3228-FAX(408)777-3333•'building(a.cupertino.org
PROJECT ADDRESS, &2� APN#
OWNER NAME PHONE � EMAIL
STREET ADDRESS CITY,STATE,ZIP FAX
6 CONTRACTOR NAME + /+ LICENSE NUMBERny �� � LICENSE TYPE
COMPANY NAME � e E-MAIL t � 5 ((
81�nS�, opgmynSrrQ
STREET ADDRESS CITY,STATE,ZIP.
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 perforined.
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/"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 compAy with the re-roof policy stated above. I also understand that
smoke detectors and carbon neon xide detectors are qu d to be installed in accordance with Sections R314 and R315 of
the 2013 California Residential de. �j
Signature of Applicant/Agent: Date: i �✓
ReroofPo1icy_2014.doc Devised 01115114
WATER-CONSERVING PLUMBING FIXTURE
OWNER CERTIFICATE OF
COMPL[AN.CE .
COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION.
CU�E "�'1l'�'CQ
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 L'
� 1 G
Owner Name 7 322, (408 77-3333•building(�eupertino ora
Permit No.
Address �r ,
9
1: Is your real property a registered historical site?
11 Yes civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
No o to Question 2.
2. Does your mal property have a licensed plumber certifying that,due to the age or configuration of the property or its
plumbing, • stallation of water-conserving plumbing fixtures is not technically feasible?
El Yes Givil Code Sections 1101.1 through 1101.8 do not apply,
El The licensed plumber's certification has been provided to the Building Division,
Skip the rest of the form and sign bottom of form.
i'
t& No Go to Question 3.
3. Is water se ice permanently disconnected for your building?
XEl Yes:, Civil Code Sections 1101.1 through 1101,8 do not apply. Skip the rest of the form and sign bottom of form.
.No G o 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.
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 i
bottom of form..
5. Please check ONE of the following:
My Propcity is a single-family resid6ntial real property. See Civil-Code Section 1101.4.
Ori and af ter 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 uadergoes 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
j 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
improve m nts).11 s
My proper 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 f ixtures 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. ,the current California Plumbing Code a d C ifornia Green Building Standards Code, and manufacturer's
installation re uirements,and that t water-c
f onserving lu ing fixtures comply with the requirements as indicated in the
table on the fo lowing page.
Owner or Owne Agent's Signat
+ Date:
Upon completing and signing s ertificate,plevse r turn it to the Building Division in order to final your building permit.
SB407 2015.doc revised 08126/15
i
Burltl >< IG» �cod BEIlILED AN1)C� I'L
�C,�1��'ICF �A�B EJ � ETEll uNT)L TII�IS
,,u^f �. rmezr.zxim xn,
i Non-Compliant
i Water-Conserving Plumbing Fixture
I Plumbin Fixture (Fixture Complying with Current Code Applicable to New Construction)
i Fixture Typ Maximum Water Usa a/Flow Rate
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
Water Closet 3 Exceed 1.6 Residential Residential
(Toilets) Gallons/flush Single flush toilets 1.28 gallons/flush
Dual flush toilets: 1.28 gallons/flush effective flush volume(the composite,
-
average flush volume of two reduced flushes and one full flush
Urinals
Exceed 1.0
Gallons/flush 0.5 gallons/flush
Showerhead5 Exceed 2.5 2.0 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.)
I 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:
Lavatory per minute 0.5 gallons per minute @ f0
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
j per minute @ 20 psi
In common and public I
use areas: 0.5 gallons
per minute @ 60 psi .
1.8 gallons per minute
0 psi
Faucets_ Exceed 2.?_gallons 1.8 gallons per minute @ 1:86galions per minute 1.8 gallons per minute @ 60
Kitchen per minute 60 psi
Faucets @ 60 psi psi
May temporarily increase May temporarily
up to 2.2 gallons per increase up to 2.2 f
.minute @ 60 psi, and must gallons per minute @
default to maximum 60 psi, and must
1.8 gallons per minute @ default to maximum
I 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
reduction. {
1. If the existing p umbing fixture water usage/flow rate is equal to or lower than the figure shown,itis not required to be upgraded.
I
SB407 2015.doc revised 08126115
i
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SMOKE
SCE 1 CARBONVO OXIDE ALARMS .
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
� tTlI�C3 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333 building a-)-cupertino.org ,
�) Permit No.
Address � 6 T,9fi
-AEC2 #of Alarms Smoke: Carbon Monoxide:
I
PER1lIIT CANNOT BE PrINALED`AND COMPLETED UNTIL TiIS CERTIFICCATE
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.aw'.;. ..�.. .,. ven .-,w..w,.skrx-, ,m....:... u ur._.-per: .y«....�arw .awL'a�.`Yc��^.✓3u
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PURPOSE
This of f idais 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
I
inspections are required. �
I
GENERAL INFORMATION
Existing single-family and multi-family dwellings shall be provided with Smoke Alarms and Carbon
MQn.ox 0 de arms. When the valuation of additions, alterations,or repairs to existing dwelling units exceeds
Mon
000
b, 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: j
AREA ALARM CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the X X
bedroo (s)
I On everlevel of a dwellin unit includ hg basements X X
Within ach sleeping room _ X
Carbon Mo oxide'alarins 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 dwellingunits, 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/ ave
. been
installed,in e ccordance with the manufacturer's instructions and in compliance with the California Building j
and Cali for 'a Residential Codes.The alarms have been tested and are operational, as of the date signed
below.
4
I
l hapre read and agree to gomply with the t rm nd conditions of this statement
OwnPW
wner Agent's)Name:
Si nature
...... ........ .....:.....Dater ... .. ,.
Contractor i
r
Signature ....................
Lic# q.. . (......Date.9
t'(.
Smoke and CO forn¢.doc revised 03118114'
r