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B-2017-0662CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0662 10541 FLORENCE DR CUPERTINO, CA 95014-1105 (326 35 035) BILL HAMILTON ROOFING INC CAMPBELL, CA 95008 OWNER'S NAME: SMITH ROGER LAND JANET W TRUSTEE OWNER'S PHONE: 408-732-7794 LICENSED CONTRACTOR'S DECLARATION License Class C-39 Lic. # 4S 4400 Contractor BILL HAMILTON ROOFING INC Date 04/30/2018 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 DATE ISSUED: 04/27/2017 NO: (408) 379-1303 BUILDING PERMIT INFO: BLDG —ELECT —PLUMB MECH X RESIDENTIAL _ COMMERCIAL DESCRIPTION: .00F; TEAR -OFF; INSTALL OSB; COMP SHINGLES - (39 SQ) Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. C , I have and will maintain Worker's Compensation Insurance, as provided for by j Section 3700 of the Labor Code, for the performance of the work for which this (� permit is issued. Sq. Ft Floor Area: Valuation: $24000.00 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 applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature ; Date 04-27-2017 �f OWNER-BUILDERD LARATION I hereby following "N Number: Occupancy Type: 326 35 035 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Kim Dunbar affirm thai"I am exempt from the Contractor's License Law for one of the RE -ROOFS: two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is 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 contractors to construct the project (Sec.7044, Business & Professions Code). hereby affirm under penalty of perjury one of the following three declarations: r. 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. 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 04-27-2017 Signature ofAppl Date: 04-27-2017 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 Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533 and 25534. Owner or authorized agent:- �r7? Date: 04-27-2017 STRUCTION LF04D G AGENCY I hereby affirm that there is a constructi n le o, ding agency for the performance of work's for which this permit is issued�(S c. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional x l REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 1 (408) 777-3228 • FAX (408) 777-3333 • buildingp_cupertino.org CUPERTIN0 0 PROJECT ADDRESSJ& G q vJ�� ` e� 1 Lt�� APN � _35- "� J — 03-S OWNER NAME PHO_ E-MAIL STREET ADDRyE$e� CITY, STATE, P FAX CONTACT NAME �rl PHONE *� R)363 E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ ORINER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CO LI $FLTTjvi��LIC�FNSE�TE `( BUS.L f COMPANY NAME E-NLAIL FAX STRE T ADDRESS �r CIT ,STATE, ZIPS PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC. n COMPANY NAME E-MAIL FAX STREET .ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi -Family STRUCTURE: ❑ Commercial ROOF AREA: 4 --<I VALUATION: c(��� t Ue✓ EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPIiALT SHINGLES WWOODSTLAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE IREPLACE ,LTJ YES El NO, IF NO, "LAYERS: PLYWOOD � w, ❑ THICKNESS: ❑ 518" PLYWD � OSB TYPE: ❑ CDX PITCH: Y—:12 ROOF CLASS: A PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ASPHALT SHINGLES ❑, WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT # DESCRIPTI F 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 relatingnu cons ction I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of ApplicantlAgent: —��t Date: SUPPLEMENTAL INFbA4ATION REQUIRED _ If building is associated with a Home Ovmer 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. , OFFICEUSE.ONLi .;` , Pi �NYcI�EcxTYPE - itotlTJncsLIP I] pVHR-THE COUNTER ❑XrizEss ❑ -STANDARD eI�;.FIREDEPT 1]r BUiLDINGPI AN RENEW '' 1. PLANTi �GPi AN`REViEW ' RerooftlpP_25'JJ.doe revised 03116111 M1 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 • build ing(a)cupertino.ora PROJECT ADDRESS APN n �2, 0 — -35--0 OWNER NAM /� H � � � EMAIL STREET ADDRESS � CITY, SC�ATE, �IPL � E FAX CONT�O�R��ME, i LIMMBER LI�CaENSE E BU L j COANY TAME ` � !� E-MAII.FAX ST1� } (� � 5 �� CI1�li9 EL�E%� t_. i•�� IiQ�✓ U� 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. Please schedule inspections online or call (408) 777-3228 from 7:30-3:30pin (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: 7:3040:30am. 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 14" 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 R3 IS of the 2016 California Residential Code. Signature of Applicant/Agent: Date: ReroofPo1icy_2014.doc revised 12115116 Carolyn Miller,CRS RE/MAX PHONE NO. : 408 257 3167 Apr. 27 2017 04:39PM P4 .F SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION C U P E RTI N O 10300 TORRE AVENUE - CUPERnNO, CA 9W14.3255 (408) 777-3228 - FAX (408) 777-3333 - buikfinQ&.jjj2ertino.aor , PermitNo. `rfp� Address PURPOSE This affidavit its a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314,2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION J Existing single family and multi -family dwellings shall be provided with Smoke Alarms and Carboi Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling unitsjexceeds slum.uu, %-mt- mcnon x.-514 and C5C Secdons 987.2.11.3 and 420.6 requim that Suiuke A]arum aad/6x Carlfuit Monoxide Alarms be installed in the following locations: AREA SMOKE AIARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On ev . -level of a dweUin unit indudin 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 comely with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power -Supply: In dwelling runts 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 do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basemettj or crawl space. Refer to CRC Section R314 and CBC Sections 907.2-11A and 420.6.2. An electrical permit is. req�iired for alarms which must be connected to the building wiring. 3; As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above hasAUve been installed in accordance with the manufacturer's instructions and in compliance with the California M: 2ildmg and California Residential Codes. The alarms have been tested and are operational, as of the date signed Q Smoke and COform.doc rvvise+d 03118114 nk', : Caro 1 yn Miller , CRS RE/MAX PHONE NO. : 408 257 3167 Apr. 27 2017 04:37PM P2 WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300.1QRRE AVF.NIIF • C11P-W1Qln- , PRA SW 4-3115 ' (1001 ;r 1 Qfi3'0 rJU(1�00} ?1'P-�.SS'S - tiullJhru,d�vuuG,dcw.wu Owner Names :�� . ��:� - ;?�,� ,.,-- - enn Address I,� L Q .mac: �L i2. _,i '� -477.,f o ,) � 1. Is your real property a registered historical site? ©. Yes Civil Code Sean= 1101,1 throigh 110 4 R do not FMWly Ski1t thr f P. ,t , rf t1ir frrm frnd ;ig,466 tam cd' f6nr,, r1Worr w ySMVV NV4. ,,. plumbing, installation of water- mnserving plumbing fixtures isnot technically feasible? ❑ Yes Civil Code Sections 101.1 through 1101.8 do not apply. ❑ The licensed pl ber's certification has been provided to. the Building Division. Skip the rest of the f TmLLand sign bottom of fonn. }� No Go to Qucstion 3. 3. Is water service permanently dis nnected 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 fdrm. RNo Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January I, 19947 ❑ No. My real property is built and available for use or occupancy after January 1, 1994. t_iAI Coil 1.114IIIIR t Im I lIIPAIttit I Itll II .I,.....t „A,A 1'. Pillai. IL!, .,.,t -I-!ll..hlt....... A ,15.. .,PJLIu.. 1�Q or h dy Tell prnlwrgi to hin It nn. corm. n . o or uoo or 000pponm,i oa as rafins JeKWt5t 1, IN 4. rri-il(;949�wum 1141,1 Slii'4uch 1191.9 OT?iy. Choirk inns orf tlirl. bine i'oibirriitV -iinrrimnini niiiinrr 11SittS111'1 of term, 5. Pl se check Q1 F of the following: My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or improvements shall require all non-compliant plumbing frkxtures 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-�oonserving plumbing fixtures (regardless of v,;i�lether property undergoes alterations gr impmvell ants). * My propoM is a fflulli wn ly Nvid- endal real property. Sea Civil : uua 0-=""V1r i :rvi..5. On and after January? 1, 3014, opooifiod building altomdonn or mprwemeaEs 3hzM mgture nza- re,n p14j.d ; plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before January 1, 2019, Alt wn compliant plumbing fixtures shall be -replaced t: ith- water conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). d My property is a commercial real property. See Civil Code Section 1101.5. On.and after January 1, 2014, specified building alterations or improvements shall require neon compliant plumbing futures to be replaced vkffi water -conserving plumbing fixtures. On' or before January 1, 2019, all Iron -compliant plumbing fixtures sball be replaced with waiter- conseTNing plumbing.fixtures throughout rhe building (regardless of whether property undergoes alterations or improvemvma ). T, R1 a}yiul 1_tf Qua JAUV try, Law tal'y' W. dW VVIMILy Uf 1WjUrY thM non 00n1p11=P1UflRb1n8 fiueures Will be. replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101.8, the current California 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 page. Owner or Owner Agent's Signature: G. --d � ,6�� _ _ Date-*/-,&, 1 > - Upon completing and signing this CertificalW please return it to the Building Division in order to final your building permit. ''' $84072015Abc revised 08126115