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B-2017-1612 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1612 21603 LA PLAYA CT CUPERTINO,CA 95014-4802(356 23 008) DADDARIO ROOFING CO INC CAPITOLA,CA 95010 OWNER'S NAME: CHEN PATRICK H DATE ISSUED:09/20/2017 OWNER'S PHONE:408-838-4645 'PHONE NO:(831)476-9109 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-39 Lic.#430739 Contractor DADDARIO ROOFING CO INC Date 10/31/2019 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;COMP SHINGLES-(30 SQ) 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. 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:,$16870.00 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 356 23 008 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 regulations per}the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. or Signature 1"�°�l./Ak Dat V20/�1 Issued by:Phuong Devries Date:09/20/2017 OWNER-BUILDER DECLARATION 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 roofmg 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 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(Sec.7044,Business&Professions Code). Date: 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 willmaintain 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 Workers 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 Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shalV) 19.11.)be deemed revoked. . { Owner or authorized agent. "'�,�,APPLICANT CERTIFICATION Dater/wl`� I certify that I have read this application and state that the above information is t( \ 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:prdperty 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. Licensed Signature Date Professional CONSTRUCTION PERMIT APPLICATION ,:,. B , 1cp._.:/.: COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO,CA 95014-3255 51.195 (408)777-3228 • building@cupertino.org PEMIT#B- 0 I9- - - b12 CUPERTINO REV# DEF# ❑ NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T.I. ❑MEP !; E-ROOF p SWIMMING POOL/SPA PROJECT ADDRESS APN# 2\Cryo La PI&tip Ci- Cnve q' off - 2 -- 00E-5 OWNER NAME PHONE E-MAIL Pic;C,"+ Caen 1408--83g-46 4 B el cLB©.400 0.C 1 STREET ADDRESS - CITY, STATE,ZIP (2-iGo Ga. ?lU i C*. G���I�lr ` ��af?I hl CONTRACTOR NAME ❑OI R-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE 'Eve. ai o t o ci �1 ®72 C STREET ADDRESS C STATE, I LCo Cll. o-ii* Ale. �'f H Cc i Ick Gfl R lD E-MAIL ►IiUC o tJ`VV •l Li PHONE —`� f I® 1 BU�S. I 0 5 CI�I�i�d� � �� � ❑ARCHITECT ❑OWNER ❑OWNER AGENCONTRACTOR AGENT El ENGINEER❑DEVELOPER❑TENANT CONTACT N E- 1-� no P ,► c dhhdn c1c°�r : i Cam STREET ADDRESS CITY,STATE, PHONE. 7 VP C *• Ave. Si-e. H C'APAnka, CA ge010 P I-1-17t d11(, DECRIPTON e ti X`t�ouP. 2�2c 1n `C n .ceirai � eix C-CJfY Jo I-kx Ill , ,SINGLE-FAMILY/DUPLEX ❑MULTI-FAMILY ❑INDUSTRIAL 0 COMMERCIAL I EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES# TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION($) 5e O i MOO i REMODEL . , REMODEL KITCHEN REMODEL OTHR GARAGE o ATTACHED BATHROOM SF SF SF SF ❑DETACHED FIRE EXISISPRINKLERS El NO YEs EICHLER�0,NO YEs SECOND STORY ADDITION•*,NG �NO DWELLINCI SECOND DWELLING ❑YES;0 ATTACHED El DETACHED OTHER UNITS# J11- UNIT ADDITON: 0 NO S F POOLS' ❑FIBERGLASS 0 VINYL-LINED ❑GUNITE ❑PREFABRICATED POOL-SF SPA-SF I SPA ATTACHED❑YES 0 NO I TOTAL-SF RECEIVED BY: TOTAL VALUATION: Cotnmercial or Multi-Family Buildings with Public Swimming Pools requires Department of Environmental Heath approval Y 11 "; i _o P i +� RE-ROOFI EXISTING ROOF TYPE: ❑BUILT-UP ROOF❑ASPHALT SHINGLE i/i WOOD SHAKES❑W•QD S i' LES El TILE OTHER(SPECIFY) 7� REMOVE/REPLACE❑NO IF NO PLYWOODI IA" ❑3/8" PLYWOOD TYPE: PITCH: ROOF CLASS ViYES #OF LAYERS THICKNESS.LI 5/8" OTHER 'li OSB ❑CDX OTHER AL:12 A PROPOSED ROOF TYPE:❑BUILT-UP ROOF' ASPHALT SHINGLES ❑WOOD SHAKES❑WOOD SHINGLES 0 OTHER _ �y y *Provide a signed copy of the Cupertino's Tear-Off Policy SF e�, .J X)#of SQUARES 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 have provided is 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 relating to building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposee owledge an.�,,,..ze all information contained on this application form to be inade,available for public record. �� 1 Signature of,Applicant/Agent: - Date: SUPPLEMENTAL INFORMATION REQUIRED *New SFD/Second Dwelling Units/Multifamily Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction. *Commercial Buildings: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. *Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. *HOA-Provide a letter of approval from the Home Owner's Association BldgApp_2017.doc revised 08/01/17 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 CUPERTINO (408)777-3228•FAX(408)777-3333•buildingecupertino.orq PROJECT ADDRESS 1. !W�/�(� :l...t �.� . r4-i 15Oi'1 APN#S6Lo O NAME �j PHONE/:1, HONE - E-M tires--B -/*GLIB ? © OC 'CCM STREET ADDRESS CITY, STATE,ZIP - FAX 21l'o073 Let Plaie : , .Coa V+1nor LA CONTRACTOR NAME LICENSE NUMBER LICENSETYPE COMP O NC) IJIJ'\11 ' l.l C1(01601411 9 COM A1-q vSTREET ADDRESS ' "1 Vo CLI nlo. 1� e. ?. 14 cCr,�TA ik rlTEi G~!1 gF-('�1Pa- I'UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2616 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 tothis inspection. Unless new plywood roof sheathing is proposed throughout, all the nails/fasteners shall be either 1, completely knocked-down or removed prior to this inspection. 4. If plywood is installed;aplywood 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 cari be performed. 6. A Final Inspection and approval shall be obtained from the building inspector when there-roofing is ;completed. To receive a final sign-off, the following items will be verified: a. Flat roofs shall have a minimum of 1/47'per foot of slope and demonstrate there is no ponding. b. Listings fromjapproved 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 tear-off or plywood,nailing inspection and the work isnot 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 c.,=-4ly with the . •olicy stated above. I also understand that smoke-detectors and carbon monox • - aII alle i accordance with Sections R314 and R315 of the 2016 California Residential .' I;1 Signature of Applicant/Agent: Date ' ' 1,) RerooJPolicy_2014.doc revised 06/01/7 F i SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE 0 11 k,,.19 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 77 (408)777-3228•FAX(408)777-3333•buildinat cupertino.orq PERMIT CANNOT:BE FINALED UNTIL THIS CERTIFICATE HAS BEEN COMPLETED SIGNED,AND RITURNED TO THE B 1 DING DIVISION • 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,R315,2016 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,R315, 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)-(Smoke alarms shall not be located within 3 feet of bathroom door) On every level of a dwelling unit including basements and habitable attics 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 existingdwelling 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 specified below have been tested and are operational, as of the date signed below. Address: '221/\12()? 0 ��'` CO` ICU Permit No.?"-2“1-- i 40 Specify Number of Alarms: #Smoke Alarms: I ' ( #Carbon Monoxide Detectors: I I have read and atree tocomply with the terms and conditions of this statement Owner(or Owner Agent's)Name: AC1 Si.nature „gm -. Date: Contractor Name: � orldcu/y 0 Signature Lic.# 41 Date:etfaitl— Smoke and CO form.doc revised 01/10/2017