B-2017-1140CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1140
21622 COLUMBUS AVE CUPERTINO, CA 95014-4711 (356 18 051) T D ROOFING INC
SAN JOSE, CA 95111
OWNER'S NAME: REZAI-FAKHR M G ET AL I I DATE ISSUED: 07/17/2017 1
OWNER'S PHONE: 408-257-8684
License Class ROOFING Lic. #845591
Contractor T D 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
PHONE NO: (408) 892-8872
BUILDING PERMIT INFO:
BLDG —ELECT —PLUMB
MECH $ RESIDENTIAL _ COMMERCIAL
license is in full force and effect. JOB DESCRIPTION:
REROOF; TEAR OFF; INSTALL OSB; COMP SHINGLES (30 SQ)
I hereby affirm under penalty of perjury one of the following two declarations:
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.
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: $16000.00
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
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 applicayp urlde}stands and will comply with all non -point
source regulations per e,Qudertino Municipal Code, Section 9.18.
Signature K " - Date 7/1712017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
t. 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).
1 hereby affirm under penalty of perjury one of the following three declarations:
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.
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
permit is issued.
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 7/17/2017
APN Number: Occupancy Type:
356 18051
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Abby Avende
Date: 07/17/2017
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an ins ect' I agree to remove all new materials for
sp f n.
Signature of Applicant:
Date: 7/17/2017
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 Area Air Quality Management District I
will maintain compliance with the Cupertinou ic' al Code, Chapter 9.12 and
the Health & Safety Code, Section 5 5 5533, and 25534.
Owner or authorized agent:
Date: 7/17/2017
CONSTRUCTION
I hereby affirm that there is a construction lending agency for a performance
of work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCIIITECT'S DECLARATION
understand my plans shall be used as public records.
Licensed
Professional
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
L� 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildinga
CUPERT[NO cupertino.org
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USE OF $FID Or Duplex ❑ Multi -Family ROOF AREA:
STRUCTURE: ❑ Commercial
VALUATIO \':/
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EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES WOOD SHAKES
❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE/REPLAC YES IF NO,
13 NO n LAYERS:
PLYWOOD ❑ Y."
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TCKNESS: ❑ 5/B"
PLYWD OSB
TYPE: ❑ CDX
PITCH:(�
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ROOF
CLASS:
PROPOSED ROOF TYPE: ❑ BUiLT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES
❑ WOOD SHINGLES ❑ OTHER
]CC -ES REPORT'
DESCRIPTION OF WORK:
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By my signature below, I certify to each of the fo win : I am the property owner or authorized anent to act on the property owner's behalf I have read this
application and the information I have provided � torr c I have read the Description of \Fork and verify it is accurate. I afire to comply W' all applicable local
ordinances and state laws relating to building c s n. I a e representatives of Cupertino to enter the above- iIti d pr eriy fo inspec ' n proposes.
Signature of Applicant/Agent: Date: ( / I !:��
SUPPLEMENTAL INFORI`4ATION REQti
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 0'\LY
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ROUTING SLIT
❑ O\ ER-THE-COLTT£R
EXPRESS
❑ STA\ -D PD
❑ BUILDING PLAN REVIE\\
❑ PLANNING PL.4 REVIEW
❑ £IRE DEPT
❑ OTHER:
ReroofApp_2011.doc revised 03'16/11
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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(a cupertino.org
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I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. 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
ate.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 %" 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 agr t c mply with the re -roof policy stated above. I also understand that
smoke detectors and carbon monoxide detect eq ' d to be installed in accordance with Sections R314 nd R315 of
the 2016 California Residential Code. y ''%
Signature of Applicant/Agent: Date: ('/ r /
RerooJPolicy_2014.doc remised 06/01/7
GUPERTINO
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(a)cupertino.org
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/crr..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'd'o
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 periifitis 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. f% 9Sb� 41
Address: 62.2 C e �o tis u e- F% Permit No. IV) -2-0(7440
Specify Number of Alarms: # Smoke Alarms: r� #Carbon Monoxide Detectors:
I have read and agree to comply with the terms and conditions of this statement
Owner (or Owner Agent's) Name:
`�Nloh�,;-.wie4d'G, Ries.
ignature...............................................................................................Date: V V 17
�................:........
Contractor Name: '
..
Signature.................................................................. Lic.# ......................................Date:
Smoke and CO form.doc revised 12/15/16
CUPERTINO
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(cDcupertino.org
OwnerName T AleA,*,"meaJ/ 4, l7¢ -- -" --- v Permit No. 13=L� (7—`�
Address k 2162-L L rel -9 SC 1 L{
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.
IN No 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?
❑ Yes Civil Code Sections 110 1. 1 through 1101.8 do not apply.
JD"n 't ❑ The licensed plumber's certification has been provided to the Building Division.
/C •� s� Skip the rest of the form and sign bottom of form.
❑ 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.
No Go to Question 4.
4. Is your real property built and available for use or occupancy on or before January 1, 1994?
l] 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.
A Yes My reatproperty 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
bottom offorin.'. .l `I* 4 13arf% J aw,el Ze—/5pc
199 1
5. Please check ONE of the: following:
Myproperty.is a'sing'le: fmnily residential real property. See Civil Code Section 1101.4.
On and after January; l,'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 (regardles's of whether
'property undergoes alterations ,or.improvements).
❑ My pri dity,is aniultifamily 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.bef&0anuary'!1, 2019, all non-compliant plumbing fixtures shall be replaced with water -
conserving plumbing fixturesthroughout the building (regardless of whether property undergoes alterations or
improvements):'
❑ My property is a;,com'inercial real property. See Civil Code Section 1101.5.
On and aft er,Jarivaryll, 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).
as the owner or owrieri s agent;of- this property, certify under penalty of perjury that non-compliant plumbing fixtures will be
replaced prior to datelspecified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1
through 1101;. 8, the,'currentlCalifornia 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 p4ge.
Owner or Owner Agent's (Signature: Date: 16.1
Upon completing and ;signing this Certificate, please return it to the Building Division in order to final your building permit.
SB407 2015. doe revised 01/05/17
If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded.
n SB407 2015. doc revised 08/26/15
Non -Compliant
Water -Conserving Plumbing Fixture
Plumbing Fixture!
(Fixture Complying with Current Code Applicable to New Construction)
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 Closets
Exceed 1.6
Single flush toilets: 1.28 gallons/flush
(Toilets)
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
0.5 gallons/flush
Gallons/flush
Showerheads
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.)
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 g60 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
In common and public
use areas: 0.5 gallons
per minute @ 60 psi
1.8 gallons per minute
60 psi
Faucets —
Exceed 2.2 gallons
1.8 gallons per minute @
1.8 gallons per minute
1.8 gallons per minute @ 60
Kitchen
per minute
60 psi
@ 60 psi
psi
Faucets
May temporarily increase
May temporarily
up to 2.2 gallons per
increase up to 2.2
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
reduction.
If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded.
n SB407 2015. doc revised 08/26/15