02080007 CITY
BUILDING G DIIVIIISIONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
22636/22646 SILVER OAK WAY COSMOS ROOFING 02080007
OWNER'S NAME: APPLICATION SUBD TE
JEFF & ANN PAGE 1901 OLD MIDDLEFIELD WY 08/022002
PHONE: SANITARY NO. CONTROL NO.
(415) 493-6373
ARCHITECTIENGINEER: BUILDING PERMIT INFO
iOq C BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
z1 hcreb Rim mat 1 am reco=rd anecr ' Job Description
oz-,O Y o provisions of Chepta 9(romma<ing RER00 F
F tui-; with Senion71X10)of Division3gf me Business and Profession.Cale.andmylicense
xm� 15in full' de t. COMP. SHINGLES OSB Sc 30JL FELT; ELK-40 YR.
ac 6 cai License C�, Li, S tt
Dae Co vecm
u O G 1 ITECf'S DCCLrAg, ION
4 ply
S understand my plans shall be used as pub i records
w d o O Licensed Pmfesxional
OWNER-BUILDER DECLARATION
u�A 1 hereby affirm mat 1 am exempt from the Contractor's License Law far the
following reason.(Section 7031.5.Business and Professions Code:Any city or county
f xH o which requires a permit to construct,alcor,improve,demolish,w repair any structure
iwj3$_Prior In its issuance.alw req epp Pf2ntl 8 ova.o�on 'Fa.r _..._.__ -._. .
u'ucs the lirantfwsuch iso rkasi rcdsu¢mcm .......
that nmif,licen.rd puauan,an.the provisions of the Carriacou,License Law Chapin,9 -xs S FIOOrQrea; t L/l's Valuation
(cam encing wgM1,Sainkii 70P,Ot)of Division 3 of the B,usmess pod Pro(µ,' �1�•\ i11.-\1�. 9 1.'. i'ttt (J.$ �sl.:�Y l}IL:
or mai tie IS ezeahpo thercflom and the basis for the allegrd'ekempggh.Any 1
-of Section-703 L5 by any appliant for n permit wbjmu die applicv t m e civil Penelry-
tof am mare than five hundred dollar:(5500). APN Number i rf_R::D:v: Occupancy Type
01,as owner of the pmpcny,m my employees with wages u their sole compensation. 105 - FRAME
-
-wiltda'mework-and-thestrle nre,'nol'Imended'or sins,offeredLaw doe sma apply 7010- --- -'-' - -
(Boxinei�ehd'Profes,ions Calc:TM Contmnor's License Lew does nw apply m an 307 - INSULAT I 684uired Inspections vt^'•'a n:rr
owner of property Who builds or improves thereon,and who does such work himself 601 _ - ROOF TEAR OFF
or through his own employees.provided that such improvements arc nw intended w _ ____ -- ..--__
":oRe-ed'f- ele:'IL hinweveq the build ng p- ment i,Fsold wnhiri one year of "----- -- - - -- -. - -'- -
Yomplinon,theowner-Willer will Mame burden of proving that he did not Wild or 602 ROOF PLYWOOD NAIL<:'•a'o
improve for purpose ofsile). 603 - ROOF BATTENS :
:, > -'D1;=.gWner gi.thc Pmanr.am escwxmely eantmwmg wito ranxw canvarmrsro - - - --- — ---'--`-a------------....._.__'.
ct.
construct the Profen(See.
appl 7011.owner o and Professions Code:)Thr vesCounselor'eon, i R.P'. J.;i-' i•I Y\If• '•�li:n
r License law las not apply m an owner th Properly who kills or improves thereon,
-i '....and whgro License Law,-
1
sucn.Prvlects.with.a.camavemrts).licenud.pursuanl.la.me._..___...
Conwnob License ^
❑I pt d S- t r 'B&PCT thism �1NALE®- ,.il[lllClll
Owner` Data
J.. _ t is i.•
.z
, "`-' "'WORKER',COMPENSATION DECLARATION
Y.
P... r7 7
"a" 1 hereby olrrm order penalty of perlury'om of tM following declarations:--- AUC 1 3 :-002
0 1 1u'4'ond';;ih`W;dntain'aCenificaie'of Conant io self-insure for Worker's
Y, ' Compensation, u;provided (or-by-Scction-3700 of the Labor Code; for me g�JILDI1�ICa
= performance of the work for which this,permit is lolled%,I�.„
i.
01 have i nd'will'maints'm Woik.r•s Compcnviionllnsu'mn<e,urequired bj.Senion
9itLine IoW Code f r th pcRomu Yat 'ak for hich Ih's pemin is
issn<d iMY Wo ker<Cn npenati nl.ur dP-I y be are ` :,t ...........
Q'STRF�'fkA)DNfPbh 571 ,DO�ll2S r !1 vrr t,\ :;uaur:
sl Is CI ETIPICATION OF EXE N FRPFf WORKERS i ' %� s t a u � 1 " I t "� a I L) s'.
('Ihii'xctic, need rumbecomplciel if the permnls for one hundred dollars \tIP:L3dI rvP•'a�,i ✓,)CC iIptL'i::) r 7:
(SPIN)or les )„
,.......
Icenf lhtin theP rf tat nceof the Vsrork fo wnaM1 ml permt s d,l t , .{ IL. .
shall nM employ aY�Pecnn m anY mann r�w.aslmlbxome xublcn to the Wo&cri
Cpmpe. t is '.ofC It I D¢'.
Applicant ”' - . . _ ._._.._ _ ..__. .. . -. - .. .__.-_..
NOTICE 10 APPLICANT If B rpenw glh Certificate th L bar on.yoq'u should ••' 1' - d
0 O hecom subject o i Mirk Cisions auo pro.. of m labor Code you must
form on comply-with such p this- l h II - do edinvoked, -.- _ .____„ -
au�' WI1 r 'fix tVYCONSTRUCTION LENDING AGENCY- 11�.t I' P "I'°' -
"; Ifrin that themI. construction lend n agency f the"fr rm.'ree 'i'IN c'i q t t�; ` l.
r
h b ightat peau issued 3097 iv.C)
m wokf
� Q Lend Name I L -
V.Z Letaki Address - ., >.!'til i'❑
1 n"y Not 1 2iiohave red N.applicai req t te that th above'nfmmauon is
L7+:.Es cbtren:l agree iq Comply with all city and enupty,prdinances and state Iowa relating
=C) 1.Idin8con.awn.antl hereby authoiiie iePksautivcx ofthis,city mm
enter upon
.fJJ the k ci .N,P PcnY f inspectionpurposes.
..
kis 1 Wel gree to sae mdemn fy ami ke p h Ic s the C ty of Cl p Aino against
h
liabilities.judgme ax r L d penux h ch m y ny y az g;ns aid J�
V City nc seq cohh gg t ggof th Mo.
APPL7CA\TL\DER}"fp\D$ANDµ'LPLY WITH ALL Nby:'01. Issued by: Date
5(iU P. i 5 r,
g Nr rA pl cantico t ad .'" ore , I h,( Re-roofs
"r Will the applHe ZAor future R�Ubuilding oe1APmare w handl hmardob mamriil .Type.ofROOf_..... .. _. ------
Ilk ,
- ..�
C Code iSeubim12553 jrs no Muni iP lCod Ch111111, ptu9l adth H`Ith eM$afcry -a I' Iart„1•cyF;(?)'-}d�. 1' t J.
.i ._. .�`Vlt 1'IJ.1
❑re, �. ' �Ha �' 1,, - "ti(3' `*;";;�'t ` All roofs shall be insrp cted.prior.to,any roofing material being.installed.__-._,__
_.
'•� Will the applicant or future building goc P n use equipment or dickkies,which If a roof is iistalled'wI[bbu[first obtaining an i
spectionagieeao remove
ecard M b s it ciiiiiandiumis Behned by the Bay Aica Ail Quality Management
Disi i 4/ all new materials for,inspection._ Appbcant understands and Wlll comply with _
1 _ e
.,."• all❑Oil- oro[source re ula[IODS ' - �
r. ..1 P g �;ur
1 h ' d'th Safety
Cod s agaz 1 qu reme to undo Chapter a nord hat
CPlitomu WaldokS fety Cale Seniom 25505 355)3 and 25530 I M .and that
it the b:Id g does not ell oily have a tenant Ihm't my responsibility t wily the -
Occupancy.ups If the r quit mat which atop be me,,pn 'to iixmnc< 19 C uifidam of
C;kk ', - SI cure of Applicant _
Z. -_ a _ _ - -
c c All roof coverings to be Class B or 8e[ter '
mh tea reg y r rj i:', Date rP .
OFFICE -
-
_•,.�', P rd -,t'1' �_ ... x .. a, f. ...,. 1 . _-_ .i i. I I.,'I:I"V 1tµ:
Building Division,
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
= OCIO Fax: (408)777-3333
CUPEkTINO
Building Department
Subject: Reroofing policy for the City of Cupertino.
1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards
and manufactures specifications on reroofing.
2. New roof coverings shall not be applied without fust obtaining all inspection
and written approval from the building inspector.A final inspection and
approval shall be obtained from the building inspector when the reroofing 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) Preinspection and/or tear off approval.
2) In progress inspection approval-
3)
pproval3) Final inspection approval.
r 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 that the
proper City inspection can be performed.
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 of inspection.
We understand the above policy on reroofing and will comply with this policy.
Homeowners
Address�d 'e—' Zlo
Reroofing Company Names./�/2 S R D F I,UG
Applicants Signature: �_Daatte: g Dol
Joe Antonucci
(Chief Building Official)
6125/01