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08010074
CITY OF CIIPERTINO �Iaa,,ggI�,(�z}�a.;,,;�.,,.,�. BUILDING DIVISION PERMIT 2 CO;,:1RLfl:"l.�R�j�QA1Y1t7:�A�� au1Lq�Np6Ago,;cPs0689 PARK CIRCLE WEST COSMOS ROOFING 08010074 OWNER'S NAME: PERMITESUEDATH BILL LIN 1901 OLD MIDDLEFIELD WAY 01/14/2008 ONE: cmo 77 SANITARY NO. CONTROLNO. (650) 969-7663 ARCHI7ECTIENGINEER: BUILDING PERMITINFO BLDG ELECT' PLUMB MECH 3 m o cto LICENSEDCONTRd under DECLARATION �ly i hereby amrtn that I em IIaaW trndcr proviaiaa of Chapter 9(ammendng � Job Description nz1 ' w10Sermon701](1)ofDivision 3ofbeBusiness and PxfessionsCode.andmylicenxu RMV OLD RF, INSTL 1PLY BASE, 2PLY FLT, 1PLY CLASS A to full force and effect = p"xcjl p � r CAPSHEET 3 ARCHRECTSDECLARATION I understand my,lans.holl be used as public mmol. k Lseaued Professional y OWNER-BUILDER from m Cc ConorION a$ 1 Wrthy.(firm that 1 1. ,Bumph from the Cssions ora License law for the I:p O which ng mason.(Seaton](D 1.5,Business and Professions Coon:Any city or county IRE! which mquima•Permit b oras ft aloe,improve,h Permit i ore a repair any structure ME hit'l icosnw,shot mM-Ito the dmisim Of far suchhpetae bfileasLaw(umment Wtheisccgwithsction7bepmvidomofomConuxlorenanxlaw(Chapm9 Sq.Ft. Floor Area $ Valuation $ that gwiltherefrom 00)and latestfon SoftheegedexeandProfessionsCade)of 4880 Sec io la 31.5 b therefrom and am bur for the CU the exemption.Any l Penalty of Section 7051.5 by any applicant for a Meront subjew the applkant a a civil pemlty o! not mart Nan In hundred dollars(5500). 3 2 6 3 2 011.48umber Occupancy Type ❑1,u owner of be property,a my employees with wga u their role compenaadon, will do the work,and the structure is ant intended or offered for sub(Sec.7044,Business and Professions Coder CommunitiesTCommunitiesLi rs aae law dam nal apply b an owner of Required Inspections praliixy who Wildsaimproratmeon,.nd who daesauchwatk himmelfor Waugh his awn employees,provided bis such improvements art not intended mutilated fa ale.If, humver,the building ar improvements sold widemoa Coat ofampledn".&a a., builder will low live burden of proHng that he did nor build or improve fm purpose of ab.A ❑L as awuer of the property am eadwiwly contracting with Hamed antrecmrs 10 contact the project(See.7044,Business and Pmfusslam Code:)The Contramor's Lb orae Law does not apply to an owner of property,who Wilds or improves Wrtun.and. who contracts for such,pmjeeb with acontratortsl licensed pursant to W Gnurrtue, License law. ❑Iumaemptuader See. ,B&PCferblamaon Owaa Dam WORKERS COMPENSATION DECLARATION 1 Mmby affirm under penally of perjury oro of be folbwing decluadaa: I lam and will maintain a Certficam of Cogent b self4muro forWorkers Campton an,ss provided fa by Saud"3M of the labor,Cade,for th i performance of W work for which this permit is issued. C]1 haw and will maintain Worker's ComPenauon Iiuurance,as required by Section 5700.1 the Labor Cade.far the Perfarmana of be work for which this permit is Issued My W'rTC m anauo Iwran artier and Policy number am: Carrier. policy No,: TIFl COMPENSATION ATION ON FRAM ORKERS' COMPENSATION INSURANCE or less)mils ropermit s section neet he completed If the pit is for are,hundred dollars(5100) 1 certify that in Use perfverms a of the work for which this Permit is homed.l shall Out amploy any Person In any Manor an as to became abject to the Workers'Compensation Laws of California,Data Applicant NOTICE TO APPL ICANI.If.After making this CediOCne of Esempima.you should become subject m the Workers Compensation previsions of the labor Code,you mat .JO forthwith Comply with inch provisions or this Peanit Nail W damCJ ranked. rCONSIAUCTION LENDING AGENCY Ikmbyatllrm F UW Wro is a Construction lendingagemty for Ise Performance of a> the work for which this permit is issued(Sue.3097,Civ.C.) 0. Q Lenders Name Z lander,Address U Q I Certify than I have read this application and sum t u the aWve irdomiatun is ly Cement-1 agree b comply with all city and county On insom and sine laws mlating to Q Wilding construction,and hereby AmWom mprtsesrlali a of this city to enter upon be D.1 shave-menuoned Properly for Inspection Purpose, �„i Ltr (WO)agree to ave,indemnify ad kap harmless the City of Cupertino aginst ,a y in cone L dgme theuls.flooding lo s andof this pa witch may in any Coy acerae agaiah said City U Z APPLsegueae of DERSTeTSA D WIL ..i SOURICA GULADO SAND WILL COMPLY WITH ALL NON-POINT Issued by: Date -l Re-roofs Silltaftfib ffA,IicaunMmr i Dim HAZARDOUS M AIS DISCLOSURE Type of Roof WIIIdcaPPlinntorfuwrt dingaCupantstom a rbandmhaardoamaserisl u&Rmd by Irk Cupertino Munl al Code.Gapbr 9.13,and W Health and Safety Cato. zss3z(.)] 0y. All roofs shall be inspected prior to any roofing material being installed. ❑Ya No If a roof is installed without first obtaining an inspection,I Will bis applicant or future building Occupant tax equipment a devices which g ( agree to remove� nit hazardous air conumma: dsfbM by do Bay Arta Air Quality Management all new materials for inspection. Ytr el] ❑Yca No 1 haw read the haanhua Merida requirements un1erChapmr6.95 of the Glifa- nlaHcalO&Ssfery Cote Semimu255O5,25533and25534.1underaundihmifbc Wilding does net CurreMy have a ur am,bis it is my responsibility to entry to aaupant of to raquireavorms which must be met prior in issuance of a Ccnik.tc office Signature of Applicant Dale I" /7 Owner amborued agent Oa"ie?T All roof coverings to be Class "B"or better CITY OF CUPERTINO REROOF CITY of �CUPERTINO PERMIT APPLICATION APN 43,Q � 2 � p �l I ' � C Date: / Building Address: -J a a - all bKq C;rrl-e 65 Owner's ' Phone #: Contractor: Phone #: Fax #: Cupertino Business License : Contractor License #: ( $ yQ Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O. Report# lk To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: ' ernove old ropy , i lAa11 1 ply 3wse , 2 p 1y Tell , 1 plb Cap3he9A _7.2 eleAf -.A Residential ( Commercial Fire Zone: Yes ❑ No Rr Confirmed with Planning Dept. if there are any restrictions: ❑ Val ation: igC I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: / � gnature CITY OF CUPERTINO p� REROOF CITY Of ®CUPERTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 1REROOFRES Re-roof Residential B 1SFDWLROOF �dr— j IBSEISMICRE Seismic Residential B IREROOFMRES Re-roofMulti-FamilyB 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B 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 1997 UBC Standards and manufacturers specifications on re-roofing. 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 inspection 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: Job Site Address: a06IK77 - -20 li1QA Roofing Company Name: CflSlhnc IQ) Applicant's Signature Date:7/7 UAZ — ® Greg Casteel Building Official Revised 11/2/04 CITY OF CUPERTINO • 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32632011 .8789 DATE ISSUED. . . . . . . : 01/14/2008 RECEIPT # . . . . . . . . . : BS000003677 REFERENCE ID # . . . : 08010074 SITE ADDRESS . . . . . : 20687, 20689 PARK CIRCLE WEST SUBDIVISION . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . : OWNER . . . . . . . . . . . . : BILL LIN ADDRESS . . . . . . . . . . : 20687 PARK CIR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : COSMOS ROOFING CONTRACTOR . . . . . . . : COSMOS, RICHARD LIC # 18844 COMPANY . . . . . . . . . . : COSMOS ROOFING ADDRESS . . . . . . . . . . : 1901 OLD MIDDLEFIELD WAY STE 2 CITY/STATE/ZIP . . . : MOUNTAIN VIEW, CA 94043 TELEPHONE . . . . . . . . : (650) 969-7663 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 4, 880. 00 0. 50 0. 00 0 .50 0. 00 1REROOFRES SQ FEET 18. 00 234 . 00 0. 00 234 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 234 . 50 0. 00 234 .50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- -------------- '-------------------- CASH 234 . 50 --------------- TOTAL RECEIPT 234 . 50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- -- ------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS 605 FINAL REROOF _ CommvmtyDevelopmm[ 10300 Torte AV=" Cupadw CA 95014 Talephom(40;�-322 ' CFax UPE�,INO Buildm* De artment JOB ADDRESS:'� 81 20 4 S rl=_R1a C s oo- -1 OWNER'S NAME: a I c-LL LL v PHONE# GENERALCONiRACTOR smOs/ Ax FAX# �S'b `/iG� I am not using any subcontractpfs/ ` ` 1 wD tures Date Please check applicable subcontractors complete the following information SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets fir Millwork Cmient Finishing Eleehkal Excavation Fencing Flowing;Capeft Linoleum/ Wood ©ass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wall per Paving Plastering Pluxti1xing . Roofing Septic Tank Sheet Metal Sheet Rock T tractor Si Date