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B-2017-1055CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10350 MORETTI DR CUPERTINO, CA 95014-3639 (375 15 006) OWNER'S NAME: LUONG DOMINIC T OWNER'S PHONE: 408-257-7180 LICENSED CONTRACTOR'S DECLARATION License Class Q;'},Q Lic. #814909 Contractor DANEL ROOFING INC Date 08/31/2018 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 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 1 v 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. 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, 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 regul do er the Cu-6rtin//o''M/uni11cipal Code, Section 9.18. Signature �Date 6/30/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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) 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: 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. 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, I must 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 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, 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 6/30/2017 CONTRACTOR: I PERMIT NO: B-2017-1055 DANEL ROOFING INC SAN MARTIN, CA 95046 ISSUED: 06/30/2017 NO: (408) 695-0072 BUILDING PERMIT INFO: X BLDG —ELECT —PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: RE -ROOF; TEAR OFF TAR AND GRAVEL; INSTALL ASPHALT COMP SHINGLES (19 SQ) Sq. Ft Floor Area: I Valuation: $11960.00 "N Number: Occupancy Type: 375 15 006 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Jasmine Archbold Date: 06/30/2017 RF. -ROOFS: All roofs shall be inspected prior o any roofing material being installed. If a roof is installed without first ob ' ing i spection, I a ee to remove all new materials for inspection. q Signature of Applicant:, / v� Date: 6/30/2017 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I 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 A,.rea Air Qualianagement District I will maintain compliance with the pe ti Municip Code, Chapter 9.12 and the Health & Safety C de, ec 'on 25505, 2 3—ind 25534. ,{ Owner or authorized agent: -' Date: 6/30/2017 CONSTRUCTION LENDING AGENCY I 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 C1 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • building0cupertino.ora ` l rW5_ S— PROJECT ADDRESS 10 0ek)e1 777 J OWNER NAMEPHONE ZU 4 25-7 -)190 F -SUV L STREET ADDRESS M 14� ; �` CITY, L'S W 6 I ��-- Li FAX CONTACT NAME PHONE f[ -MAIL STREET ADDRESS CITY. STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME \ \ - ® I LICENSE QNU; �n O � O 1 "1 LICENSE TY BUS LIC'. aoet C COMPANY NAME(-Wit,,,, .�,��(� � E-AIL ��. FAX STREET ADDRESS 3 �, + CIT\. SKATE. ZIP lart��. Cear Cl SOH (o PHONE u C)$ 69 S ()C)-) 2 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS LIC4 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY. STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi -Family STRUCTURE: ❑ Commercial ROOF AR 0 VALUATION: COO Cl 60 EXISTING ROOF TYPE V BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE /REPLACE JO Y'ES ❑ NO IF NO, I # LAYERS. PLYWOOD ❑ b:" ❑ THICKNESS. ❑ 5/8" PLYWD ❑ OSB TYPE. ❑ CDX PITCH. _a_:12CLASS- ROOF A PROPOSED ROOF TYPE. ❑ BUILT-UP ROOF AI ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES OTHER 'rte n ICC -ES REPORT # DESCRIPTION OF WORK By my signature below, 1 certify rtidvachkthk following: am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information haWpvidis correc 1 haveread the Description ofWork and verify it is accurate. I agree to comply With all applicable local ordinances and state laws relati tonstructio I authorize representatives of Cupertino to enter the aboveAdentified Urty IT7ectlon purposes. Signature of Applicant/Agent Date' `('^ SUPPLEMENTAL INFORMATION REQUIRED _ 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. OFFICE USE ONLY PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ ExPREss ❑ STANDARD ❑ BUILDING PLAN REVIEW ❑ PLANNING PLAN REVIEW ❑ FIRE DEPT ❑ OTHER: ReroofApp_2011.doc revised 03;16'11 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@cupertino.org PROIF("r ADDRESS jQ 350 110­ce- AI'N a OWNS NAME c-� .�Ca(r i Y1 i L PHONE sa� A 0 S E-MAIL STREET ADDRESS CIT)".STATE. ZIP 9 S O 1 Li FAX (� e; C ci-fir^ O uOr CO.*TRAACTOR NAME �, LICENSE NI'MBER LICENSE rN"PE BL'S. LIC. COMPANY NAME pax�a-�^00 c� � hn "c- F-\IA11 1 (� \ O FAX STREET ADDRESS '% Geei r e C CITY, STATE, ZIP � 9 Sok ONE koLK S d 0'1 I UNDERSTAND AND AGREE TO THE FOLLOWING: I . The re -roof project shall comply with all applicable provisions of the 2016 California Codes. 2. An inspection request can be scheduled up to one business day before the requested inspection date. To schedule inspections 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 out to the job site 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 144" 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, l certify each of the following is true: I am the property owner or authorized agent to act on the property owner's behalf. 1 understand and agree to comply with the re -roof policy stated above. 1 also understand that smoke detectors and carbon monoxifN detectors are required to be installed in accordance with Sections R314 and R315 of the 2016 California Resident` 1 od Sienature of Amlicant/A>_ent: _ Date: RerooJPolicy_201 d.doc revised 06%017 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1055 10350 MORETTI DR CUPERTINO, CA 95014-3639 (375 15 006) DANEL ROOFING INC SAN MARTIN, CA 95046 OWNER'S NAME: LUONG DOMINIC T DATE ISSUED: 06/30/2017 OWNER'S PHONE: 408-257-7180 PHONE NO: (408) 695-0072 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class Q -M Lic. #814909 Contractor DANEL ROOFING INC Date 08/31/2018 X BLDG _ELECT _PLUMB — MECH X RESIDENTIAL COMMERCIAL 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. JOB DESCRIPTION: RE -ROOF; TEAR OFF TAR AND GRAVEL; INSTALL COMP I hereby affirm under penalty of perjury one of the following two declarations: SHINGLES (19 SQ) t. I have and will maintain a certificate of consent to self -insure for Worker's REV#1 - CHANGE ROOFING MATERIAL TO A TORCH -DOWN Compensation, as provided for by Section 3700 of the Labor Code, for the ISSUED 7/14/2017 performance 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 Sq. Ft Floor Area: Valuation: $11960.00 permit is issued. 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 375 15 006 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, a ap ant under nds and will comply with all non -point source regu a i ns a the Cup rtino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 07-14-2017 Issued by: Jasmine Archbold OWNER -BUILDER DECLARATION Date: 06/30/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the RF–ROOFS- following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is t. 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 (Scc.7044, Business & Professions Code). Date: 07-14-2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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. 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. 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 ea Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the pT o Municip ode, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Co s 25505, 2 533, 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: 07-14-2017 1 certify that I have read this application and state that the above information is CONSTRUCTION LENDINGAGENCY 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 07-14-2017 professional CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 r` ,� (408) 777-3228 • FAX (408) 777-3333 • building(okupertino.org REVISION # ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI N( REVISION / DEFERRED ORIGINAL PERMIT #Z � 0 1 '-f" -/ JJ PROJECT ADDRESS 1C.,e)go M� 0r I APN # 3-1^. (310/0 OWNER NAME T n I;*—b (P*bf) E-MAILl 11� a STREET ADDRESS CITY, STATE, ZIP( FAX V3 O�i IYV CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMES LICENSE NUMBER LICE TYP BUS. LIC # 4Q33 J COMPANY NAME l \ \VCV`•l\/\� E-MAIL � ` ' FAX ��Y �I 'i��` lNi 6n ` STREET ADDRESS 1��� I /\\� CITY, STATE, ZIP» PHONE (��Q�LQS I I �/ DU U U ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK {� a 1 10 h"/- �� , .� Lo ran -ell EXISTING USE PROPOSEDUSE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: UDETACH ❑ ATTACH I # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? []NO ADDITION? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES R D B TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO2±k 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 h ided - 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 int -la o bu' d' co tructio representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: —?— It/` SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW _ New SED or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure El STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_201 Ldoc revised 06/21/11