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B-2017-1503CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10090 PASADENAAVE APT A3 CUPERTINO, CA 95014-5939 (357 17 085)110090 PASADENAAVE STEA2 CUPERTINO, CA 95014-5939 (357 17 084)110090 PASADENAAVE STEAL CUPERTINO, CA 95014-5939 (357 17 083)110090 PASADENA AVE APT B4 CUPERTINO, CA 95014-5939 (357 17 090) OWNER'S NAME: WU WEI AND SUN YI OWNER'S PHONE: 408-930-3016 LICENSED CONTRACTOR'S DECLARATION License Class C32 Lic. #644400 Contractor BILL HAMILTON ROOFING INC Date 04/30/2018 hereby affirm that I am licensed under the provisions of Chapter 9 (commencing ith Section 7000) of Division 3 of the Business & Professions Code and that my cense is in full force and effect. 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 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. 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 �w `w..� / /+�Date 09/07/2017 �— K : I0t _9__:_0 1. I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. 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) 2. 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: 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. 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. s. 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. Date 09/07/2017 CONTRACTOR: PERMIT NO: B-2017-1503 BILL HAMILTON ROOFING INC CAMPBELL, CA 95008 DATE ISSUED: 09/07/2017 PHONE NO: (408) 379-1303 BUILDING PERMIT INFO - X BLDG —ELECT —PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION RE -ROOF, TEAR -OFF, INSTALL COMP SHINGLES (44 SQ) Sq. Ft Floor Area: Valuation: $31000.00 APN Number- Occupancy Type: 357 17 083 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by Abby Ayende RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspeclion. Signature of Applicant: �.- Date: 09/07/2017 "All HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 2550, , 25533, and 25534. Owner or authorized agent: +.® _ Date: 09/07/2017 CONSTRUCTION LE ING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097 Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CONTRAGT'OIfNAME LI.=S8 NTUMW!R m 1 � -q( LICF.NSISTWE COI PANY NAM -MAIL FAX �/ � f�Y�:�P�d4//u✓G/ / �(�!t!` E LE' r✓� � STRE3.7ADIPR SS PRONE �9 7 . %.?w AFF+ HITECT/EI�GINEERNATuIT LiGENSENUWER Et11$, LIC. # COMPANY NA,NW -.FWAIL PAX STREET ADI3R1 SS CITY STATE, ZIP PAO%7ii USE W 0 SFD or Duplex Ll Multi -Family PPP ARBA: VALID TION, sTIz23CTUR� _ � Ctrr3�tnsroial . j�� _71.�� JV 000, DO EXISTING ROOT T'O'PE: U BLUT-UP 1 00F W ASPHALT SEUNNOLES ONVOOD SHAKESWjGOD StIiNC:LES ❑ OTHER(SPECIFY) REMOVE IREPLACE `IES IF NO, PLYwOOb Q fx d %'t.YWD `n QSB PITCbI RAF ® NO #I tYE3YS: _. THtC[TESS: ® 518's ITYPt, MCi}?C . .. 12 GLASSTW- PRC, POSED ROOF TYPE: li BUWT-UP ROOF ASPHALT SHINGLES `0 WOOD SH -,$- InV'©5323 Si3IlQGLES n OTHER IMES Rfii Dit I1$SCRIPTION pF WORK: a Ili my signah re bei? certify to c ch of the following: 1 am the pzopeil} awner pr uthori2-ed agent to act on the prt3perty owncr's bellaif T -have read Shin application and the information I Dave provid d is correct. I have read the Description'of Work and verify it is accurate. 1 agree to comply Nvith all applicable local ordinances and state laws relating to 13 Ad' S nstruction. I authorize representatives of Cupertino to enter the ob -id ntifre pro�y for inspection purposos. Signature of Applicant/Agent; mate: Y( J REROOF 'SEAR -OFF FOLIC COMMUNITY DEVELOPMENT DEPARTMENT I3UILOING DIVISION ALOERT SALVADOR, P..>=., C,B10" BUILDI.NG1041CJAL 6 �! �I 'I0300 TORkE AVENUE • .CVPERTINO, CA 05tit4�320�� a— 1 L (408) 777-3228 + FAX t40% 777-3333 + bul1 ft a�cu,�eriino =, . PRQ.ILQT ADMESS - IAve. l7 --fig f -7- 6�'5 Owl - OWNER NAME ONE E-MAIL/ STREET ADDRESS CITY, STATJ�4Zii' FAX cVNI-K 'UTUANAME � ZIEENSE; UMBER �L]QEM$PE�JUS.L[COy1/,Z71 /5 C U vtI R iY NAME. _ �MAIL �` � _ 379:--I � t� n _ CTTY, STATE ZIP n .: a e n ., s , . r� PI ONE aA — 1, 4. 5. ® iA,! + III The re -roof project shall corrlply with all applicable ptovi Yon f the -2016 California Codes. An inspection request can be schedtded i� tc�..+�n� hu�in��s �a� `�ii�ft� a the.rei�uos�e� ins tf�n d�tom To. schedule inspections o ll (408) 77 '� 21c�zra 7�3U 3J flptrt .!Ion=Thhrs) or �.� � �Opm Iv i ley) lei schedule inspection. For Tear" ff and flailing Inspections, you must -also c411:on e day of tlnd inspection calmly after that phase of the work is comp"Tb� building inspector will bo out to f job site within one hoar. the hours for this serviceare, 7:3,040, 34.aicn and 1 .30-3, 0 (Mon .Thu); r and 7s 040.30am 4d 12:30-2:30 { ridayj Final Ix s ect ohs mall given a testi hour window, Tear tiff Inspection is required y and all dry -rotted, wood shall lie replaced prior to this inspection. Inless neaocd rcacifheags proposed tht`otlghott alb the 1lsffasleners _shall beeit� completely lwockedWown, or aremcavecl prig to this ns- tioni If plywood is instilled, a plywood Nailin , Inspection is required: I .00fmg shall not be applied without" first obtaining all ;pnor inspection and written approvals from the building inspector, y roofing which is applied wiibout first obtaiding appproved inspection will require the removal of all new material down to the she l ipg so- a proper hispection can be perfO ... ed, AFinal Inspection.and-a rowal shall be obtained -from the building inspector when the re 7rooftng is: coni feted.. To receive .a mal sib ofd- the following items will be �verifted> a. plat roofs shad have a runisnurn of" per foot of slope grad demonstrate there is>no, ponding.... b.. Listings from approved testing agenciesfor all pre- anufactured products used. shall be available cin -site to review at the time of the inspection. c. Proper spam arrestor installation, vents painted, gutter/downspouts installed, debris removed. NOTE If you call for a. tear -off or plywood nailing inspection:and the work is not complete, .you °ll be, charged are -inspection fee. The re -inspection fee shall be ` aid before another inspeef an. cats %e scheduled. y signing below, I certify each of the I perowner's behalf I understand and *e,detec ors and' carbon inbnbxide Clete+ 201 Cal0ororaesiderltiai Cade. . iatute of ApplicantlAgen't -' ting is true: I the properly owner or authorized agent to act on'the to cclmply with the re=xocsf pl�iiey stated abo�te. 1 also �1ltderstand that r7red tai; lie installed in accordance with eeti6i*R314 and i 5 f .. �r�, Date.:, Reroa, (Poli )�(II .doc revised 0610117 Monta Vista Woods HOA 10090 Pasadena Avenue #13-1 Cupertino, CA 95014 September b, 2017 To whom it may concern at Bill Hamilton Roofing, Inc. 230 Harrison Avenue Campbell, CA 95008 The Monta Vista Woods Home Owners Association has approved CertainTeed Landmark Series shingle roof system in the Georgetown Gray color. John H. Brown President, Monta Vista Woods HOA