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B-2016-2398 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2398 11259 PALOS VERDES CT CUPERTINO,CA 950144721(356 21 029) BILL HAMILTON ROOFING INC CAMPBELL,CA 95008 OWNER'S NAME: DAVIS JAMES O AND HELENE M TRUSTEE DATE ISSUED:07/28/2016 OWNER'S PHONE:408-483-1287 PHONE NO:(408)379-1303 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO. License Class ROOFING Lic.# 46 4400 Contractor BILL HAMILTON ROOFING INC Date 04/30/2018 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 fallowing two declarations: RE-ROOF;TEAR OFF;INSTALL OSB;COMP SHINGLE(36 SQ'S), 1. 1 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. �Zqvi)-i 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:$20000.00 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 356 21 029 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 A-1_ ED INSPECTION. Signature.; M >LLDate 07/28/2016 Issued by:MELISS If// Date:07/28/2016 WN R-B DER/DE LARATI N 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 insection. sale(Sec.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant; ✓y� contractors to construct the project(Sec.7044,Business&Professions Code). Date:07/28/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVE )STO 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 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 Co Sections 5505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. l` �� /� --• Owner or authorized agent:/,,` ,� . APPLICANT CERTIFICATION ¢�� Date:07/28/2016 I certify that I have read this application and state that the above information is CONSTRUCTION L )iVDINGAGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a constru io 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 07/28/2016 Professional a ERR F PERMIT APPLICATI€l COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (4081777-3228 FAX{408;777-3333 5uiidinalecupert no:or2 C � Ifl f3- 2-0(,6 - �3 PROJECTADDRESSo Ler ., _ r0V f AFN# � �4 — v / o Z-2 OWNER NAME • �F PHONE E-MAIL �" (JIMav� yos}�l3 IZI cr �vcrr. coag STREET ADDRESSn CITY, STATE,.ZIP . FAX . g`t /'"�_ CONTACT NAME l (ISI P O 4- E-MA I STREET ADDRESS CITY,STATE,ZIP FAX ' : ❑o-wrwR l].oW_NER-BUIIAER 11 OWNER AGENT ❑cOINmAc oR ©CoNTRACroRAGENT ❑ A&CF=cT 0 ENGINEER ❑ DEVE OPER ❑TENANT CONTRACTOR NAMEViLICENSE NUMBER LICENSE TYPE BUS.LIC.i' Co`��`f C39 #2- t.S-- COPPANYNAMEE-MAIL _. F.9X. ( � t 'UIDI 1YlG (�IU�I)J71'"/ (� STREET ADDRESS. CITY,STATE,ZIP bek CA 1504T PHONE #f09)371-1303 ARCHITECT/ENGFNEERNAME LINENUMBER BUS.LIC. COMPANY NAME E-MAIL _ FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD Or D pleX ❑ M.Iti-Family, ROOF AREA '777TION: 2.0,000- 00 h STRUCTURE: ❑ Commercial j � Y`+ $G.0,ood• 0 EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES V40THER.(SPECIFY) cem REhIO:B/REPLACE YES IF NO, PLYWOOD ❑ %:" ❑ PLYWD ❑OSB PITCH: ROOF ❑Np #LAYERS: THICKNESS: ❑ 5J8" TYPE: ❑CBX '12 CLASS: PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ®ASPF.r1LT SHINGLES ®WOOD SHAKES ©WOOD SHINGLES ❑OTHER FCC-ES REPORT# DESCRIPTION OF WORK: ° ° . , ,,,v-e exr -hf ceras uoocd roof a.4d inc'W l nerd L.andr► -l- Prem a*n Color Pto x Oef WeaAwrd Wood. 3( �c- �IDS� c z `` 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 - 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 relat` g' buildingTconstruction. I authorize representatives of Cupertino to enter the above-'dentified property for inspection purposes. Signature of Applicant(.4gent. Date; SUPPI, NTA:L ORMATION REQUIRED 4P�ac vs orll Y _If buildin.-is ass iated with a e Owner's Association,provide letter �TYPE—, R0,U Lip of approval from ISO QVI•;R T°rIE-cPUXT*I3 I BMI)IIvG PLAIT imvmw Provide Planning approval to verify if there an)'restrictions. RssEl.r?A* G,P�Atvw _Provide copy of Manufacturer's Installation Specifications. d 17LPT Provide signed copy of Cupertino's Tear-Off Policy. d Reroofflpp_2011.doc revised 03,116111 REROOF TEAR-OFF POLICY ,01 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 buiiding&cupertino.orq PROJECT ADDRESS//251 y), M erd,eS cf. �rT Y!<T3 7 a+{ APN If OWNER NAME + ,y`,f• y� PHONE pq `� r �Pctrzwd�w;s.!m �+hY t,J E_M-kII.�, corn STREET ADDRESS 11251 1L51 rto d eae n C4% CITY", STATE,ZTP � FAX nh �Y iq CONTRAC7TOR.NAME_ "" LICENSE NUMBER LICENSE TNTE c 5q BUS.LIC.# COMPANY NAME p 1j 8 f {N I�✓I d C E-MAIL FAX f!( f0 0 J[1-13o(o CITY,STATE, HONE oPSTREET ADDRESS A 133Z30 #&nsin Ave. 037f, 03 I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2010 California Codes. 2. An inspection request can be scheduled up to the day before the inspection date. Please call (408)777- 3 408)777- 3228 from 7:30 -3:30pm(Mon-Thurs) or 7`.30 - 2:30pm(Friday)to schedule the next day 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. Progress .and 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. Progress Inspection is required when approximately 50%of roof covering is installed. 7. 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 1/4"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. 8. 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 of$126.00. The re--inspection fee shall be paid before another inspection can be scheduled. By my signing below,I certify each of the following is tnie: 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 etectors are required to be installed in.accordance with Sections R314 and R315 of the 2010 California Residential Code. I Signature of Applicant/Agent: Date: —7 ''-[ RerooJPo1icy_20II.doc revised 02116111 less IV Eno i SMOKE CARBON MONOXIDE ALARMS 9 OWNER CERTIFICATE OF COMPLIANCE t COMMUNITY DEVELOPMENT DEEPARTMENT t3;t!lLD[NG DIVISION' 3PEti i t 10343 TORRE A1fENUF.r CUP :-TING. A 95(Mi"-325;5 (401777-3229,FAX(408)7773a33 Per-m L itNa. Address Cres- Tt"t #;�ftazSmoke. snQ "tCl CarbonIonoxide —� PERMIT CAN-NOT BE FINALED AND FINCOMPLETED MIL THIS CERTIFICATE HAS ,REEN;Sj i ,Al RMIMM TO BUILDING DIVISION PURPOSE i This affidavit is a self-certification for the installation of all reed.Smoke and Carbon Monoxide Alarms for compliance with 2413 CRC Section 8314 2013 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 re .ails to existing dwelling units exceeds. 1E144.41a,CIBC Section R3I4 and CBC Sections 987,2.11.5.and 420.6 re4uire that Smoke Alarmsand/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALAW f CO AL1,M14 Outside of each separate sleeping area in the immediate vicinity of the X � X bedroom(s) On every level sof a dwelling unit including basements a X Within each sleeping room Carbon?monoxide alarms are:not required in dwellings ch do not gont 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 Firs Marshal. Power Supply=In dwelling units with rio commercial power Supply,al {s)maybe solely battery operated. In existing dwelling units,alarms:are permitted to be solely battery operated where repairs or alterations do not result in the removal of gall and ceiling finishes or there 13 no a s by means of attic,basement or Crawl space.Refer to CRC Section 8334 and CBC Sections 907.2.13.4and ,�1 2.An electrical permit is required for alarms which must be connected to the building wiring. i 4s owner of the above-referenced property,l hereby certify that the al rrn(s)referenced above has)have beer. installed in accordance with the Manufacturer's instructions and in compliance with.the California Buildingo and.Callifornia Residential Codes.The alarms have been;tested and ar�operational,as of the date sued below. t have read and agree to com I K with the terms and opndt tis of this statame nt o r(or Owner Agent's) arne e i. signature........ ...... . ,. .......,i .... ,,.. y.. ❑ase Contractor Name: i x t s' nature.......... .... .......... ....Lcc#.: . i Smoke and Co_form.aoe re-v sed 031-1i 4 WATER—CONSERVINQ PLUMBING FIXTURES OWNER CERTIFICATIANCE G �?a f twt' UEtt p ?v�C7FpA ?tu1ES T•Bt31�t !NG 3,1VlSfON C 4 aR T1 t 3 FQ3{lt}TGRREAVENUE•GupER_71NO,CF;9501,4 5 SCS 77-3228-FAX(408)777-3333,bt+iidirr^rdlcuoertino.crc Owner pante Permit No. Address 1, Is your real property a registered historical site? I- Yes Civil Corte Sections 1101.I through I 101-8 do not apply. Skip the rest of the form and sign bottom of form. o 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 isnot technically feasible? 0 Yes Civil Code Sections I101,1 thrott r I 10 1,8 do not apply- 0 : ly.0 The licensed plumber's certification has been pro ided to the Buifidlng Division. Skip the rest of the form and sign bottoms of form. ' No Co to Question 3. 3. Is mmater service permanently disconnected for your building? q Ye Ci it Question io � � st of the form and sign bottom of form. �7 Yes Civil Corte Sections [10l.1 through 1101:8 do notapply- S ' the r�' 4. Is your real property built and available for use or occupancy onorbefore January i,1 ? E No My real property is built and available for use or occupancy after Jan kaazy 1 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest ofthe form and sign bottom of form. Yes My real property is built and available for use or occupancy on or before January 1,1994. ff �'` Civil Code Sections 1101.1 through l 101,8 apply. !Check one of the three following statements and sign bottom of form.- 5. Please check ONE of the following. My property is a single fiamily res demia real property. See.Civil Code Section 1101. , On and alter 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 1.201all non- compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). 0 My property is a multifamily residential real properly. See Civil Code Sectiqn 1101.5. On and alter January i,2014,specified building alterations or improvements'shall require lion-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures- On or before January 1,2019,all non-compliant plumbingfixtures sliall be replaced water - conserving plumbing fixtures throughoutthe builtling(regardless of'Whetherproperty undergoes alterations or improvements). 0 rosy property is a commercial real property. See Civil Code Section 1101.5. On and after January 1.2014,specified building alterations or improvementsi shall require non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures:, On or before January 1, 2419, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building(regardless of'whether property ur dergoes alterations or improvements).V t,as the owner or owner=s agent of this property,cert under penalty of Pei that non-compliant plumbing futures will be replaced,prior to date specified above with water-conseming p umbii ag fixtures in accordance v4th Civil Code Sections 131 through 1101.8,the current California Plumbing Code and California Green Bu�lding Standards Code_and manufacturer's installation requirements,and that the water-conserving plumbing res comply with the requirements as indicated in the Fable on the following page. Qwner or Owner Agent's Signature " Date; 7 296 Upon completing and signing Ois Ce 'frcate,please return itto the BuildingDivision in order to final your buildinWpehnit- 58407 2015 doc reviyed 06'5