B-2017-1136CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1136
7549 PROSPECT RD CUPERTINO, CA 95014-5242 (366 24 032) BILL HAMILTON
ROOFING INC
CAMPBELL, CA 95008
I OWNER'S NAME: JASKOWER, MARY C 2004 FAM I I DATE ISSUED: 07/17/2017
OWNER'S PHONE: 408-2054686 1 1 PHONE NO: (408) 379-1303
License Class Q -3S Lic. # 46 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
BUILDING PERMIT INFO:
X BLDG —ELECT —PLUMB
_ MECH X RESIDENTIAL _ COMMERCIAL
DESCRIPTION:
DOF; TEAR OFF; INSTALL OSB; COMP SHINGLES (28 SQ)
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: $18000.00
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 J41 2 Date 7/17/2017
I hereby affirm th4t I am exempt from the Contractor's License Law for one of the
following two reasons:
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 construct the project (Sec.7044, Business & Professions Code).
I 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.
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 7/17/2017
APN Number: Occupancy Type:
366 24 032
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Abby Ayende
Date: 07/17/2017
RF ROOFS:
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.
Signature of Applicant: <![
Date: 7/1712417 //�__ i
ALL ROOF COVERHNG'S 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:/tt
Date: 7/17/2017
N TRUCTION NDINGAGENCY
I hereby affirm that there is a construction lending agency for the performance
of work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
0 0
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
I��f,•��t—ii��� I� 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buildinq(a.cupertino.orq
PROJECT ADDRESS 75W 9 ,-, / 1 N
(���",P1HONE
(I l "'i�
W\ - / ) �0Q1
L(f
OWNER NAMF /J
C -Y
\�
/V(}�� ✓ ill�)O �(rl-\!111
(j
STREET ADDRESS �n / Ov�
CITY, STATE,, ZIP
`
FAX .--
CONTACT NAME �Mf as CYNn, � '_ /
W' vt (�
PHONE
E-MAIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT [/CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME Q�' � n`
(,
LICENSE NUMBER, Iqq ,/-i(
`x (rJ
LICENSE TYPE C 3(
r
BUS. UC. # j 741
/ •J
COMPANY NAME J/
E-MAIL
FAX
STREET ADDRESS 2'l J / J
CITY, STATE, ZIP / ,// U�
, CA q5
PHONE „� v \jJ� �3�3
L1 J
ARCHITECT/ENGINEER NAME
LICENSE NUMBER!
BUS. LI(' #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF SFD or Duplex ❑ Multi -Family
STRUCTURE. ❑ Commercialv`�
ROOF AREAr
VALUATION �Q,J ,l
I l `"'� ' vo
EXISTING ROOF TYPE. ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE /REPLACE YES
❑ NO
IF NO,
1 # LAYERS
PLYWOOD Cl SS' ❑
I HICKNESS ❑ 5/8"
PLYW'D OSB
TYPE ❑ CUX
PrrCH-
__q_: 12
ROOF
CLASS A
PROPOSED ROOF TYPE ❑ BUILT-UP ROOF 81ASPHALTSH1NGLES ❑ WOOD^SHAKES ❑ WOOD SHI\GI ES ❑ OTHER
I(( -ES REPORT #
DESCRIPTION OF WORK nelnoVe e"Ii��Y 1 q (Sha
a k ICU U / , vl.[ l GCll --� ,
V`�-�
rvUf Color - jA�YNvJC Bler dl 2� &a, -- _
w 05B rMi eak Iwn _ fr-
If
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 1 have read this
application and the information 1 have provided is correct. I have read the Description of Work and verify it is accurate I agree to complywith all applicable local
ordinances and state laws relating to h 'ng construction.' author representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Date:_-___ 7Z7 __/
N REQUIRED
SUPPLEMENTAL INFOR2ner's
_ If breuilding is associated With a I-loAssociation, 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 I'SEONLY
PLAN CHECK TYPE
ROUTIVGSLIP
O OVER-THE-COUNTER
❑ EXPRESS
❑ STANDARD
❑ BUILDING PLAN REVIEti'
❑ PLANNING PLAN REVILW
❑ FIRE DEPT
D OTHER:
ReroofApp_2011.doc revised 034611
iZ
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 - building0-cupertino.org
PROJECT .ADDRESS 7,57y y Prod ' ��vlo
APN k'
lC ✓ L -
OWNER NAME
Co ¢Marc as�or�
PHONE
r`ya�) 2o5 Lim
E-MAFL
STREET ADDRESSa, ^a
G
CITY, STATE, ZIP
FAX
CONTRACTOR NAME
LICENSE NUMBER/' �' `� r(
I (�I
LICENSE TYPE n��
`
BUS. LIC. k 279/.5
COMPANY NAME i� j?UW/� /' „� f I i �,
E-A4AIL
FAX (qd ^)37? 136(
STREET ADDRSS
Au
CITY, STATE, /„j%/�o
PHONE
' `09) 2n-13
I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re -roof project shall comply with all applicable provisions of the 2016 California Codes.
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 to this inspection.
Unless new plywood roof sheathing is proposed throughout, all the nails/fasteners shall e 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 '144" 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 2016 California Residential Cvd�e.. 2 ^�
Cinnature of AnnlirantlAvent �1.. Date:^
ReroofPolicv_2014.doc revised 06101/7
0"W
iC A R f 3 0
OWNER CE-RIfFIC'
ATE OF CONIPI tANCE,
v 07-tvrEN
'Mj [,,E Nat'. -N4
7- t-Z--Rk-R-T7T� WUIMOUIS� 71151S-112-1
1
CVT'ZR-Q INQ
POST,
C-ERTM'C-A f"IF
HAS BEEN AND
--i-f-d-r-d-it is .7, s
C'Secfiort.33
Seclom 420-6 ana, -
L
amily dw,6171Zw- s1r;4R be providm-tvat in -j '�e.
3 -ol, Aianrpd ,('gi
Min V,
Cocm72,n4. va:Sci-90.1a-f:qwe
Nlncixide All
,I! a
Ali " A
0 -INt 5, n7c! in th Ci m -d ig,
Y41
Lfaml an�v ncjl xmecn r�l 1-416 do r -.0t
S- y'
upply�, I �d iv-t.Aling u its i '-h no aimme , ,tg�
:rCial, v r
b _Ppl, x dam - -a% b, ,;b- Ty
zl=--r-s are vf,-rn salL attely f
zn theetnoval oi wall =id ceilliling
roa CL, by I
Ste on R -31-a and -C-Z3(-'Secdon2, 907-2-11-4 and 47-Umz An a pe—:mllt i-
p4ace, !Rafe.- w CIRC ti
As cawner of tahul abov�-referenced p-opurty" 3, 1,-,E,v�bry cerb e -�-, -
b",NT7
C U sz E RT'l N 0
Ow"'ttr 2N, n,-tt
Ad,&,xos
RJUMUNG; f4m,"RATT?
OWNER CER TIFICATE'OF COMPLMCE -
WID 14,3Z�5
OYSTS, "10211 T 9K - 09NAMAmul
W�
Q�
_11093! , _71
Y—;-. CjvRC(,-d a Wouji; WAS AV Mai zify, Wt *AV* Cc (Jbl�fbim-tmd
15 lop GO No
1 Ow Irm 1W P.OPz:r:y uavc a 1.,cCn:R_-d p-4umlocc flig"; 4A'n 0 Lbe agg,-
gplumbi
I al-[ Through
d -C, 1
Sop cc no CAS:bz fbm ar-A Sin, lbotom ON -on)),
Ck� w
wmalu)C74�"M lk� 7Pt.nTWw,'n11Y �j �-,Omtc7wl fj.- yvur buildur,
Yen,SOCArsomiko"M, U.01"!
ULJ q_q 0?
4,1-
its f4yaw" jvrqltt°iy isimails -itd For ase', OectIp,..,%y �Cftehmvz
A, t-h:rOt,,jgb_
Ifts MyonT pryp" n Wtt and aiLa
arbt
iz- Ry us fit I" #le woof 11le- ibfw, tv,..�3
"Y
110 1 A Smakh 1 ORzpph y�- ry 1, �� 9W
I Auss dwxk WE of to ORWOO:
ZVI r` -
af•d : n g '2 11 C =- T i,<) a; r 1) pr wk, tww ti v, I I T-4 pa f t Lt' f t- m PHi a 71 7 % P- n
mrapplian: phjmibi. aq, 11.ktircss_ :hair be repIced vv:'111 uu%zAynqWwi
vater,,miucm7Ag pJam'Mog xwes
-1-,wrafifins Or i-;MP70VeMk;nj�;),
(at vmd suet humv 1 AS; Alktvrqll
p1maYrHu,g W4 syAnd what
?I Ady PKTOmY m Commerria! = I pmPCmy. SCC Cr, -I! Codc $wim 1301.5
'Orl I
it nw- c, z�ntlhj
Ou �':, befb7e Jxmti�. �, 2-019� ;41 PhU bg IXVMM� Ab011 tbr vmhted vath _--zn.a:;�
fixtlulv3 !hzOughcnic thebuiMi-q - u
g -31ms
s, Agent
c � pd, r".T " 0 d we sp mi jkk ,t �7 Ov e mv'. th ' va w t- m, . s, ervii, ri gr pl=biAg WD res A wmamn euiz h Ci v Ed.,
An ujv a 10 1 S, A: 0too it C, -t 1i fo mi 1 P t Im,�*b i 1 g C+,: e In d Colons Gwresm Bdildin S I :*a W ards -C. o dtt.. ati; fl,nm a. 2 `-ze-,`
i Wlns it mmj u.Ire i s -, a?: d Rm A c r,--- t c r -c -o ms en't n 7 P -7 UnN i�g 'rm aa r3mply, . with: Th 0 'reT. 3i v 11) C I'l 1,7 ;5! ,; b t
Up")II-cow-mp"",�zIg
Ow.1wo
Divisballa"-dwo fl:,;2i -jctuz
S
�Laa Av=.