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15030153 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10632 LA RODA DR CONTRACTOR:ALTAP ELECTRICAL PERMIT NO: 15030153 OWNER'S NAME: HAMMILL RICHARD S AND PAMELA G PO BOX 41009 DATE ISSUED:03/24/2015 OWNER'S PHONE: 4082572628 SAN JOSE,CA 95160 PHONE NO:(408)561-2806 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL 200 AMP PANEL UPGRADE License Class 0 Lic.# 6 9 2 -L,9 I Contractor Al,ZAf i-(eC`f r-C4['Date 32`P 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: 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. Sq.Ft Floor Area: Valuation:$2100 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 APN Number:36933016.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPM IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 18 A OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAY AST CALLED INSPVTI indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Issued by: Date. granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 918. RE-ROOFS: Signature 6--4, a ate Z Y �� All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: j6 Date: -?Z2- permit ? 2permit 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 CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 918. Signature Date GENERAL PERMIT APPLICATION MEP LM COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION �47 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 U' CUPERTINC3 (408)777-3228•FAX(408)777-3333•building (a�cuoertino.org 61� MISC ❑PLUMBING ❑MECHANICA tL� ELECTRICAL DMISCELLANEOUS PROJECT ADDRESS .3 L ,�q� rC � �a ,\ �, APN# J&f 33 OWNER NAME t Iv PHONE E-MAIL I Yo19- 2 57-ZGZq I L-,"w,w.rI1 11")'Ltt, STREET ADDRESS CITY,STATE,ZIP FAX i 0 6 3 Z 1,_0, o w r, Gu vo�e,r t CONTACT NAME 1 saw Y�p 5'I PHONE E-MAIL t� L4 019 $X90 CL (-t--re1cGf�' �?���� STREET ADDRESS CITY,STATE,ZIPFAX 731 �/e_aoo 9 5 i2 d . ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC Z LI-A E(ectr "e"t 692'Z 1 C- ( o COMPANY YNAMEA Lf A r �(e—C- r� Ca� E0- k e P IE C \ r i C,I D),- c?.ev STREET ADDRESS CITY STATE,ZIP PHONE E�7 3r E�w�a c� , ' S a a G4 ;9S1 3 8 Zs�c� ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES BUILDING: E]COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLERHOME? ❑ NO DESCRIPTION OF WORK 44 X TOTAL VALUATION: I 0 © G i _ e,,...., �: By my signature below,I certify to each of the following: I am the property owner or authorized agent to a 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 buildmi construction. I authorize represents Ives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: !� SUPPLEMENTAL INFORMATI UIRED ,,: 4z' z 0100 MEPMiscApp_201 1.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10632 la rods dr I DATE: 03/24/2015 REVIEWED BY: Mendez APN: I BP#: *VALUATION: 1$2,100 *PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration/Addition/Repair PRIMARY SFD or Duplex PENTAMATION 1 REAP2 USE: PERMIT TYPE: i WORK 200 amp panel upgrade SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Services 1 ERT<200 200 Amps $48 TOTALS: $48.001 t4id 4 y s r ,�. Mech. Plun(heck I'i....b Plata C1111ti Elec.Plan Check 0.0 hrs $0.00 ;l1,1 Permit Fee.- Plumb. Permit Fee: Elec.Permit Fee: 1EPERMIT Other-llcch. /-,- Other Plumb Insp. Other Elec.Insp. El hrs 1 $48.00 P2:�] dlerh. 1712 Fee: Phsn1b. bash. ree: Llec.Insp. Nee: NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These fees are based on the prelimina information available and are only an estimate Contact the De t or addn'l info. FEE ITEMS(Fee Resolution 11-053 Eff. 7/1/13) FEE QTY/FEE MISC ITEMS Plein Check Fee: Suppl. PC Fee PME Plan Check: $0.00 Permit Fee: SuppL Iusp Fee PME Unit Fee: $48.00 PME Permit Fee: $48.00 C'c�r2shucta"rrn .la:�: Administrative Fee: 1ADMIN $45.00 Work Without Permit? ®Yes (E) No $0.00 Advanced Plarming Fees: Travel Documentation Fee: ITRA VDOC $48.00 i Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item BIdg Stds Commission.Fee: IBCBSC $1.00 _ $190.501 0.00 ; TO L F.EE: ` $190.50 _MFRevised: 02/14/2015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21924 SAN FERNANDO AVE CONTRACTOR:A-1 ROOF PERMIT NO:15030149 MANAGEMENT AND OWNER'S NAME: CRIDDLE LAREN J AND MARIA V TRUST 14100 DOOLITTLE DR DATE ISSUED:03/24/2015 OWNER'S PHONE: 4085052717 SAN LEANDRO,CA 94577 PHONE NO:(510)347-5400 10 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL RE-ROOF 9 SQ;OVERLAY TYPE 30#FELT PAPER,CLASS License Classy) 3��C'33 Lic.# 3g W A Contractor R'1 fLoti' Date 3�g__ 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: 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. Sq.Ft Floor Area: Valuation:$4900 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 APN Number:35715051.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAY AST CALLED N TION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, rr�� costs,and expenses which may accrue against said City in consequence of the Issued by: — Date: Ory 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. RE-ROOFS: Signature " Date 3�'� I All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applican � _ Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: / �— Date 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 CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION Ti( 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 4�� (408)777-3228• FAX(408)777-3333•building(o1cupertino.org CUPERTINO 1 PROJECT ADDRESS \ �Q a APN 4 55-7 5-7 I,5( O)ATER NAME �A` ` �r^o^D\ n ' PHOI(0,4 �� �,, '� E-MAIL STREET ADDRESS sp n f��YV�1� CITY, ST"1�TE,ZIP �o FAX CONTACT NAME [e, ` PHONE 0-6 ,0-6 S-L"1 E-MAIL STREET ADDRESS CITY, ZIP l C�' Ot-S 1-7FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ><ONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAM, LICENSE NUMB LICENSE TYPE BUS,LIC.9 Gni - 3" c�33 COMPANY NAME E-MAIL FAY _ �� -7 S� V_10% -�- Ahf-V @ �wFmein� 5vV STREET ADDRESS CITY,STATE,ZIP PHONE -Dr Sat h 5-1— ' `14 7 ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF SFD or Duplex ❑ Multi-Family ROOF ARRlE�A: VALUATION: STRUCTURE: E3Commercial f�z _* Li I 171D EXISTING ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE El IF NO, PLYWOOD ❑ vp ❑ PLYWD ❑ OSB PITCH: ROOF NO #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX 'I Z CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SI-IINGLES ❑OTHER ICC-ES REPORT R DESCRIPTION OF WORK: 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. II authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: 3 I amu' SUPPLEMENTAL INFO TION REQUIRED �, ,, v.. oriicE; sEor�� u r,T _If building is associated with a Home Owner's Association,provide letter = Pte` OPE, 14 ROUTrl�c sLIP OM of approval from HOA. r 4, sx� PP © O` COLJR'TER 3 13=-DING RE�IEN r Provide Planning approval to verify if there any restrictions. E7CP � � Y} riANNli:GrLAI�z�«Ety _ e `i. Provide co of Manufacturer's Installation Specifications. MS � ,_. , PYfl ST .DAH, fl F7RFDEPT t Provide signed copy of Cupertino's Tear-Off Policy. ry o�xER r ReroofApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 21924 san fernando DATE: 03/24/20157] REVIEWED BY: Mendez APN: BP#: I *VALUATION: 1$4,900 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY PENTAMATION 1 SFDWLROOF USE: SFD or Duplex PERMIT TYPE: WORK re-roof 9 s SCOPE FEE ID ROOF AREA s.f. 1REROOFFRES 900 MR10i Avow r� 210 ^ }, Mech. Plan Check l'(urnb.flan Check 1,lee.Plan Check tech. l'erniit Free: I'hamh.Permit Ice: Flec. Permit Fee., Other Heck, Insp. Other Plumb Imp. Oilier Elea.Insp, Wech.Insp. /gee: Plumb. Insp. Fee: tslec-Insp. Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These fees are based on the prelimina information available and are only an estimate. Contact the Dept-for addn'l info. FEE ITEMS(Fee Resolution 11-053 E . 7f 1113) FEE QTY/FEE MISC ITEMS Man Check 1°'ee: Suppl, P('F,ee I'laamb.ialech.%�slcc Permit Fee: $153.00 Saappl, Insp 1-ee Plu tal�.!z lc>c°h./7`lec Permit 1�'ee: Construction Tax: Administrative Fee: Work Without Permit? ® Yes No $0.00 Advanced Planning Fees: TrOvel Documenlaiion Fees: 99 Strong Motion Fee: IBSEISMICR $0.64 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 P � ` $154.64 $0.00 - ^ $154.64 Revised: 02/14/2015 ti FA REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERT[NO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 `-s, y (408)777-3228• FAX(408)777-3333•buildingna,cupertino.org / PROJECT ADDRESS I n 2_4 e "Y\A p a AVe APN# OWNER NAME ; n I � J p �C/`J� PHONE E-MAIL STREETflf4 ADDRESS e- ,��.Za `�/'�`���/,.„ CITY,STATE,ZIP J CA ')VID/k FAX CONTRACTOR NAME (' LICENSE NUMBER 3 8 y LICENSE E3 3 BUS.LIC.# A^ 1"2 COMPANY NAME E-MAIL /ry !,�._ / yN11(� C,t, "S-711) AXS-7fl 3-1? SI-101 A— I Ma vl• STREET ADDRESS 1 u I W CITY,STATE,ZIP PHONE Dao I tI'-0 �,n C a..��v-v c-A 9 y S ? Sy° 347 5`t 0 v 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 un 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 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 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 comply with the re-roof policy stated above. I also understand that smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of the 2013 California Residential Code. Signature of Applicant/Agent: ^ Date: ReroofPolicy_2014.doc revised 01/15/14