08030104 CITY OF CUPERTINO
BUILDING DIVISION pERMIT C�1�fT"C-TORIINk'QRI�'IAT�QN
PERMI NU.
BUILDRfp I,q?MIVERCREST CT COSMOS, ROOFING 08030104
OW NERR SUN3AMEIt ... PERMIT ISSUE DATE.
KAWARA MASAYOSHI 1901 OLD MIDDLEFIELD WAY 03/19 2008
IrNE: cmo nn SANITARY NO. CONTROL NO.
(650) 969-7663
ARCHRECT/ENGINEER: BUILDING PERMITINFO
-BLDG ELECT PLUMB MECH
0 0 0 0
oij LICENSED CONTRACTOR'S DECLARATION Job Description
U 1 hereby affirm that 1 am llcerucd under provisimu of Chapter 9(mourercing
with Section]0f10)of Division 3 of the Business atd Prelmov Code.and my licensee RE—ROOF T/O EXSTNG WDSHAKE ILYR,CLS A, 33 1/2
in full forte and eft -f �/
,M_ License Cin,—,-a����`w� Le.N SQRSHT OSB, 30LB FLT, PRES SHK COMP SHNGL
o Oeste 't 44•— 4 OO T Ga01 v
p W —'ARCHITECrS DECLARATION .
understand my plans shall beused u public rceord,
yU
' Licensed Pmfcssional
'n
t OWNERnoemp)ERDECe coati ON
f 1 hereby.(Sim on 11. tempt from Nc ctmtumrs Onto:Any
Law co the
1 O O following..on.(Section]m L5,Business and Profauav dAny easy at county
$of which requires issuance.emso re cwstruct,altar,improve,demolish,carfile a Sir any stnnwe
-ient
y prior mits ensdprsumquimeNovisiocam for.Cranuetto's amnseLowtCesemx9 Ft.FloorArea Valuation
c the he is license]pursuanuo the of Division
3 Ne GOms Business;
Limnse law(CMpun9 SG. $13440
a $ (commencing wiNSecfrour nd of Dasisfr of the he MBudnaompton.Any
Dealt)or
• Na h V acme,theefrom and she buss for ubj alleged 1licauon.Any viPm&Y of
Section them by vecryapplicantfanpermitrvbjemNeepplicanlmarivllpraaRyof �ypr Number Occupancy Type
not more Nan five hundred dollen($500). 3 2 6 3 7 C]0 8`.YIV
❑I,u owner of uic propwry,or my employes with wages u Nevsule comPeuseum,
will Pcfe wom,conamswaum tutee,1 imman ,m fn hot a ply in N,B®ea Required Inspections
and property
wh oa Cade iThemproves
Commcmr,License law dna not apply lf an woo of Q p
pme am whobuilds i Improvch improve who daasuchanded omseRar through his
awn employees,provided that vemimprowmenu in ne Year dem an@m.(main a.
however.Ne building or den of m vin is sole within one Year of completion,th purpose
a
builder will love the burden of moving Nat he did ms Wild w improve for purprse of -
ule.).
❑1,as owner of the prepeny,am eacludwly cemuacung wish Hamed contrssms so .
consumer the pmjem(Sec.7814.Business am Penfcaslons Code:)The Comsamufa Li,
cave Law does not apply to an owner of property who builds or improv theme n.send,
who contra for such projects with a conu¢mr(s)licensed personal to the Convenors
Have law.
❑I am tempt under See .B A PC for this ae�
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm under pointy of perjury one of the following declarations
haw and will maintain•Certificate of Contains o self-insure for Worker,Compm
,ad..as provided for by Section 3700 of the Labor Code.for the Md...of the
work for which this Permit is issued.
haw:and will maintain Wwkeh Compensation Insurance.an required by Satire
] of Ne lobes Calc.far Nc per(ormanca of Ne wodsfw which Nu permit ufmr6
My Workers Co/�mrpren�,auonJJlmm�1ncrteAAanis and Poliey��num—ab.er��m/:']�
Cann"'44 - */�W Polity No.:�.t/r1�1/v
ERTIFIC�ATE OF EXEM MON PROM WWORKERS'
COMPENSATION INSURANCE
Ohv at.need ootbecwnpleted if the permit In future hundred dnRav($1010
or lea)
1 cenify Nos in the Performenm of the work for which this permit is issued,l tltall has
employ any Mouth in any manncrao as in become subject to the Workers'Compeovuoo
Laws of California.Dau
Applicant
NOTICE TO APPLICANT:If,altar making this Certificate of Eam prion.yes,smukl
bemire'mbjca in the Worker's Ci mpessi km provisions of Ne labor Code,year moa .
.J O fwNwith comply with such provisions or Ni,Inaritshall be deemed revoked.
Z� CONSTRUCTION LENDING AGENCY
(••' I hereby aRrm that Nem is a covuucdon lending agency for the perfwmaramaf
a the work for which this Permit is issued(Sec.309.1,Civ.C.)
W Q Lender's Name
DD lender's Address
J O I eenify Nat i haw mad this application and..in that the above information is -
lO H correct.l agree w comply with all city and county omi.arms and sum law,mladng to '
O V building construction,and hereby auNariw tepo,smatives of this city to enter upon the
>' W alwve meminned proTcrty fur inepmd.npurposes.
y (We)agree to save,indemnify and keep hamless the City of CuMnino against
N Iiabilides,judgmcma.costs and esperuce which may in any way see=again,said City
C_12 in eonyy��urn¢of the granting of this permit.
'--' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
S Lf",,krA46 N .,
kr ala 1��w 3- S"ORe-roofs
Signature of Applian onuacbr Date
HAZARDOUS MATEFU 1 LOSURE Type of Roof
Will the applicant tar future Wilding occupant store or handle harardous manurial
as&food by the Cupenino Municipal Code.Chapter 9.13,and the Health and Safety
Code.Section 25532(.)] All roofs shall be inspected prior to any roofing material being installed.
❑Ya Ao
Will the applican or(titan,building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
t heramnus air conuminams a defined by the Bay Area Air Quality Managcmcm all new materials for inspection.
irudcO
❑Yes
Ihaveread Nehva tausmamrialsrcquiretnentsunderChapmrG95ofNeGiilm-
nia HwIN A SafctyCode,Swi.25505.25533 and 25534.1 wrlersunl thaifde b.lding
docyd0l currently haw a vnanL out it is my rosponsihilitY m testify the aaupam of the
m�'f pnwidthmn�°cm01 rminaanaof.cwRcaleortxmparef. Signature of Applicant Date
--�� ' hhf" ?'f All roof coverings to be Class"B"or better
O,vmroramhamcd —V Oa¢
CITY OF CUPERTINO
2 ITEMS OF 2 . PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32637008 . 00
DATE ISSUED. . . . . . . : 03/19/2008
RECEIPT # . . . . . . . . . : BS000004200
REFERENCE ID # . . . : 08030104
SITE ADDRESS . . . . . : 10371. RIVERCREST CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : KAWARA MASAYOSHI
ADDRESS . . . . . . . . . . : 10371 RIVERCREST CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : EDWARD A GREGORY
CONTRACTOR . . . . . . . : COSMOS, RICHARD LIC # 18844
COMPANY . . . . . . . . . . : COSMOS ROOFING
ADDRESS . . . . . . . . . . : 1901. 0LD 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 13, 440. 00 1.40 0. 00 1 .40 0. 00
1REROOFRES SQ FEET 33 . 50 435.50 0. 00 435 .50 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 436 .90 0. 00 436 .90 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- -----.-------------
CREDIT CARD 436.90 MC '• '
---------------
TOTAL RECEIPT 436.90
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
605 FINAL REROOF
o coq
CITY OF CUPERTINO
0 REROOF
•CUPEII;TINO PERMIT APPLICATION
APN # 302 w 3 D p r v v Date:
Building Address:
to 37/ dQ-C✓es4
Owner's Name: Phone #:
/Ilq s a y 0 sk swlc %J d'— 732 _ o d (s
Contractor: Phone #:6�- pert— 7,66-3-
COS
663COS P.V 0
Fax #: 6so- X6,9-
Cupertino Business License #: ( Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ;.EC Asphalt Shingles
)G Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles '
❑ Other (Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report #
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: -��}f s wa s4a�e 14,yer �c s��a�C7sQ� 30/6
n�l-J 1 �/�esK/ra( cv.,r,
1.-lcrr H
Residential Commercial ET
Fire Zone: Yes No Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation:
13 yVo
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
CITY OF CUPERTINO
REROOF
•CUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description .Fee Permit Type
Squares Group
- 1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
3 j Z 1RER00FRES Re-roof Residential B 1SFDWLROOF
1 1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 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 com�ply with the above stated policy on re-roofing.
Homeowner's Name: j't'l
nq S q / o.54 i le'C k,)r7
Job Site Address: lo 3 7/ 7; vee resp 0-4
Roofing Company Name:
Applicant's Signature: Date: -S'-7 zvdJp
Greg Casteel
Building Official
Revised 11/2/04