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B-2017-1344CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1344 5825 BOLLINGER RD CUPERTINO, CA 95014-3536 (375 35 016) BILL HAMILTON ROOFING INC CAMPBELL, CA 95008 OWNER'S NAME: LUTHERAN CHURCH OF OUR SAVIOR CUPERTINO DATE ISSUED: 08/14/2017 OWNER'S PHONE: 408-252-0345 PHONE NO: (408) 379-1303 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO.: License Class CC=39 Lic. #6 400 Contractor BILL HAMILTON ROOFING INC Date 04/30/2018 X BLDG —ELECT —PLUMB MECH RESIDENTIAL X 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: LUTHERAN CHURCH OF OUR SAVIOR - REROOF; TEAR OFF; I hereby affirm under penalty of perjury one of the following two declarations: INSTALL (N) 50 MIL 1B PVC SINGLE PLY (97 SQ) t. Ie and will maintain a certificate of consent to self -insure for Worker's ompensation, as provided for by Section 3700 of the Labor Code, for the rformance 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 Sq. Ft Floor Area: Valuation: $86218.00 permit is issued. 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 jaws relating to building construction, and hereby authorize 375 35 016 A (Tenant Improvements) representatives of this city to enter upon the above mentioned property for inspectiori 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. d`ditiorially, the applicant understands and will comply with all non -point WITHIN 180 DAYS OF PERMIT ISSUANCE OR ource regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 8/14/2017 Issued by: Abby A, ede OWNER DECLARATION Date: 08/14/2017 -BUILDER I hereby affirm that'I am exempt from the Contractor's License Law for one of the following two reasons: 1 RE=ROOFS: 11 roofs shall be inspected prior to any roofing material being installed. If a roof is 2. I, as owner of the property, or my employees with wages as their sole installed without fust 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) 1 I, as owner of the property, am exclusively contracting with licensed Signature of Applic contractors to construct the project (Sec.7044, Business & Professions Code). Date: 8/14/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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. 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 s. 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 C , c ons 3, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. #4weer or authorize age" . APPLICANT CERTIFICATION Date: 8/14/2017 I certify that I have read this application and state that the above information is 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 property for inspection purposes. (Vile) 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 igranting 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 8/14/2017 Professional REROOF PERMIT APPLICATION, COMMUNITY DEVELOPMENT DEPARTMENT' BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408)777-3 226 + FAX (408) 777-3333 • buildinc!bgt tiertino;orq , — _^ 17 �i • PROJECT ADDRESS C`�tD�� O( J P PN # : %�� %S— 0 ` co _ f 6 �J OWNER NAME c PHONE E-MAIL STREET ADDRESS � � _bA k,� er U. CITY, STATE, ZIP ' ` �1 �, %� ('�' j � FAX CONTACT NAME � • 7PHONE o(..', Cj,A' Q0._ `q�� L E-MAIL STREET. ADDRESS � � CITY, STATE, ZIP � FAX OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR 0 CONTRACTOR -AGENT ❑ ARCHTFECT' ❑ ENGINEER ID' DEVELOPER O TENANT ; CONTRACTOR NAME LICENSE'NUMBER LA -10 D LICENSE TYPE G BUS. LIC. tE y COMPANY NAME l �6U ``nes ` U ..1^� IL . E-MAIL FAX STREET ADDRESS (r w CITY, STATE, ZIP �/IAfl� Inn 1I r 6yQj(�jJ�Q V/` Vv:.r PRONE Q �L (J ARCHITECT/ENGINEER NAME LICE NSE:NUMBER BUS. LIC. 9 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or Duplex ❑ Multi -Family STRUCTURE; COmmCP6ial ROOF AREA: VALUATION: _- `� � _ t2 1 EXISTING ROOF TYPEi ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINIGLES OTHER (SPECIFY), , REMOVE /REPLACE YES 0 NO IFNO, #LAYERS: PLYWOOD ❑''/a" I�' THICKNESS: ❑ 518" PLYWD O'OSB' TYPE 'Z❑ CDX PITCH: 2 ROOF -, CLASSY A _ PROPOSED ROOF TYPE; ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES 11,W606 .SHINGLES AI OTHER - ICG -ES REPORT ff DESCRIPTION OF WORK: c� o�1 VVI By my signature below, I certify to each of the followings I am, the property owner or authorized agent to act ori tfie property' owner's' behalf. I'have read this'' application and the information I have r 'dsQi i5ce I have read the Description of Work'and verify -t is accurate.• I agree to comply with all applicable local ordinances and state laws relatin uildi constr ctfon. I au representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent- Date: 1 SUPPLEMENTA FIONREQUIRED _ If building is associated with a Home Owner's Association, provide letter Of approval from HOA. _ Provide Planning approval to verify ifthere any restrictions. _ Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cup,ertino's-Tear-Off Policy. oFFicEUSEON4Ys PLANCHECK T1TE 'ROUTING SLIP Or ER f11E COUNTER ❑ ntrREas{ © STArinARD •' ' n ,; BUILOINg P Ah REVI$)V ©PLavNllticrLNREvtFry r i © k1I2F DEPT � OTHER � ' r Rero`ofApp 2011.doc revised 03/16/11' I I� CUPEtI3TINO COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TOR RE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - buiidinga-cupertino.org PROJECT ADDRESS `exU OWNER NAME PHONE . 0 ��30 E-MAILULWA\®Lwl;,0f-1 STREETADDRESS SCI er C�APN�.kA CITY, STATE, ZIP � FAXC CONTRACTOR NAME LICENSE NUMBER �F1 LICENSE TYPE( 13U5. LIC. k COMPANY NAME 7 `°1 /°' r.^ Cl E-MAIL FAX 4r6 STRF_ETADDRESSV�/ CITY.STATE.ZIPr`nrb [} -�s�(q PHONE•li�t)gyl�tTt2'�5 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. 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. 'fear -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. S. 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 '11" 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 Nvith 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 C . „ _ , _ Sil-nature of Applicant/Ap-ent - w.� .9 _ _ Date: ReroofPolicy 201;r.doc'revised 06,0117