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09090048
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1032 TUSCANY PL CONTRACTOR:BILL HAMILTON ROOFING PERMIT NO:09090048 INC --VNER'S NAME: ROSSMAN WALTER A AND MARY J 740 CAMDEN AVE STE E DATE ISSUED:09/09/2009 %jWNER'S PHONE: 4082553218 CAMPBELL,CA 95008 PHONE NO:(408)687-2540 011 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG f— ELECT f— PLUMB r License Class C,3qLic.# w MECH RESIDENTIAL COMMERCIAL Contractor p(Il "/ n �Dat All 31) JOB DESCRIPTION:RE-ROOF REMOVE CAP ROOF AT GARAGE ARE 1 hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions INSTALLING Code and that my license is in full force and effect. IB ROOF SYSTEM AT GARAGE AREA ONLY,CLASS A 12 SQ I hereby affirm under penalty of perjury one of the following two declarations: 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 Sq.Ft Floor Area: Valuation:$5540 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:35929042.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAW FROM LAST VALLED INSPECTION. granting of this permit. Additionally,the applicant understands and will comply with all non-po' source regulations per the Cupertino Municipal Code,Section 9.18. Issued b/ Date: -ature Date q1110 I ❑ OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. 1,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, Signatur of pplicant: 1 Date: Business&Professions Code) 07 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. 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 Owner or authorized agent: become subject to the Worker's Compensation provisions of the Labor Code,1 must Date: forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter the above mentioned property for inspection purposes.(We)agree to save Lender's Address unify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35929042 . 00 DATE ISSUED. . . . . . . : 09/09/2009 RECEIPT #. . . . . . . . . BS000008630 REFERENCE ID # . . . 09090048 SITE ADDRESS 1032 TUSCANY PL SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER ROSSMAN WALTER A AND MARY J ADDRESS 1032 TUSCANY PL CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4352 RECEIVED FROM . . . . : BILL HAMILTON ROOFI CONTRACTOR . . . . . . . : BILL HAMILTON LIC # 27915 COMPANY BILL HAMILTON ROOFING INC ADDRESS 740 CAMDEN AVE STE E CITY/STATE/ZIP . . . : CAMPBELL, CA 95008 TELEPHONE (408) 687-2540 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 5, 540. 00 1 . 00 0. 00 1 . 00 0 . 00 1BSEISMICR VALUATION 5, 540 . 00 0 .60 0. 00 0 . 60 0 . 00 1REROOFRES SQ FEET 12 . 00 156 . 00 0 . 00 156 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 157 . 60 0. 00 157 . 60 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 157 .60 #12285 --------------- TOTAL RECEIPT 157 .60 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF at- CITY OF CUPERTINO ce-)q L3 1) 0 c)4 REROOF CUPEkTINO PERMIT APPLICATION APN #�5 I L+ a • Date: 1 Building Address: t� 32 Tuscan PI. Owner's Name: V)a)t•ier jZD&S Ma44_ Phone #: HOA: Yes ❑ No EZ If Yes, provide letter from HOA M - � 5- 3`�/ 9 Contractor: '2 14V:M j /)v j� �f q 17k,&. Phone #: Fax #: �' Cupertino Business License #: q/ — Contractor License #: 02 !6 S 00 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood ShinglesI� ❑ Wood Shingles e�Other(Specify) ©r-C, ti/Other(Specify) 10K &17�1C I /y Number of existing coverings I ❑ Provide I.C.C.E.S. Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: C 01- > I G r " su� A �-. a Residential ✓r Commercial Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: ❑ applicable, include in plan set & the sheet index. Valuation: $S_' s • vo I Have Read, nderstand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09 Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 Fax: (408)777-3333 Building Department Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must agree to comply with 2007 IBC Standards and manufacturers specifications on re-roofing.All roofs are Class "A"per Cupertino municipal code 16.04.080. 2. New roof coverings shall not be applied without first obtaining all inspection and written approval from the building inspector. A final inspection and approval shall be obtained from the building inspector when the re-roofing is completed. 3. All roofs shall be inspected prior to any roofing installation. 4. To receive a final sign off from the City,the following steps are required: 1) Pre-inspection and/or tear off approval. 2) In-progress inspection approval. 3) Final inspection approval. a) Spark arrester installation. 5. If plywood is installed,a plywood nail inspection is required. 6. Any roofing which is applied without first obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of$176.18. The re-inspection fee must be paid before another infection can be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of 1/4 "per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O.report is required to be on the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: MPLI& posm4a&� Job Site Address: l D 3 a 1 4 SC-a4lt Y �I r CLJ�, � Roofing Company Name: b rfJ gaw I -Tn C Applicant's � 's Si ature: Date:IL I� Greg Casteel Building Official Revised.07/30/08 M.Indoor Air Quality and Finishes 1.Use Low/No-VOC Paint 1 IAQJHealth pts y--yes D 2,Use Low VOC,Water-Based Wood Finishes 2 IAQIHealth pts y=yes 0 3.Use Low/I4o VOC Adhesives 3 IAD-/Health pts y=yes 0 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y--yes D 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 5IAQ/Health pts y=yes 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQJHealth pts y=yes D 7.Sad all pleb d or W)F _ 4 IAOJH eal Lh_pts= es ___ _ D B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9,Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes D 10.Install Whole House Vacuum System 31AQ/Health pts y=yes D t i � N.Flooring 1.Select FSC Certified Wood Flooring B Resource pts y=yes 0 Z.Use Rapidly Renew ble Flooring Materials 4 Resource pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes D 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y--yess0 � 1 i Total Points Available: 1 1401301 57 Total Points Project Received: _ 1 01 0 Q� qlqlo G:datalprogslgreenbuildingguidelines/remodslers/greenpointsflna1212D4proteeted.res Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 CITY OF -UPEkTINO Buildin De artment JOB ADDRESS: PERMIT #� Q� t�3a Tt4sca�n f 1- OWNER'S NAME: PHONE # 409- 37--9--1303 GENERAL CONTRACTOR: i % r i FAX# I am not using any subcontractors: Date Signature Please check applicable subcontractors and complete the follow in information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile �. Date Owner/Contractor Signature