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08020099 (2) CITY OF CUPERTINO - BUILDINGbIVISION' PERMIT Cd;•gs>f, 'I`r'L�� r "". BUIL 1 G ESS: PERMIT NO. g�(f MEIGGS LN COSMOS ROOFING 08020099 NEWS NAME: FETIMTTISSUEDATE BETTU COAD 1901 OLD MIDDLEFIELD WAY STE 02/15/2008 PHONE: SANITARY NO. CONTROL NO, ARCHITECDENGINEER: BUILDING PERMIT INFO RERF 1 LYR TAR&GRVL, ESTG BLDG ELECT PLUMB MECH O O O O �o XO LICENSED CONTRACTOR'S DECLARATION Job escri tion rd F 1 Wintry affirm that 1 am licensed under provisions of Chapter 9(commencing () t1`uj with Section 70(1)of Division 3 of the Business and Prafmalons Code.."my license is in full force and cffCCL 7 S r j Wcenee tau Lk.g J( 7 s Dao: � _Contractor 1- ARCHr1ECi'S DECLAR T I Z 1 understood my plus shall be need as public near& d 5 ,fir Licensed Professional 3 OWNER-BUILDER m the Can ON cto I hereby alum that I am exempt From the Contractor's License Law for to O O whip re rcunn.(Sec on 7 encu Business and Preove.de ions Code:Any city or aunty $ which m9uiaes a permit to mnswc4 alcor,imprrva,dcmallsh,or repair any awnum ^Z� prior m in issuance,Slant requires the applicant(orsuch permit file a signed sum taenl pp < thatheislicensedpursuanttotheprovialansofMeconveemr,ueenseLaw(Chapter9 'Sq.Tt.Floor Area Valuation Y49 (commencing wife Section 7M)of Division 3 of the Business and Professions Coc)tar Q ,at he I,axampl therefrom and the bub for the alleged etamption.Any vlolatihn of Section 7031.5 by any applicant for a permit subjeces the applicant o a civil penalty of APN Number Occupancy e net mom than five hundred dalW](SSW). p y -T�+p 0 1.o owner of the property,or my employees with wages as their sob mmpenudon, will do the work and theshuctute is not intended or offered for sale(Sec.W44,Business Required Inspections and Pmfessi0ns ve Code:The Concmr's Licanm Law aloes MA m e nsat apply an owner of q p property who builds or im proves thereon,and who does such wok himeelf orthrough his awnemployrra,provided Ihauuct,improvements arc not intended aro@red foraalt.If. lummomr.the building or improvement is sold within one year of completion.the Owner. Wilder will haw the burden of proving dart IS,did not Wild or improve for purge¢of tale.). 0 1,as comer of rhe Property.am exclusively convening with licensed convacmrs m construct Me pmkct(Sec 1044.Business and Professions Code)The Convenor's Li- center law don not apply to an owner of property who builds or improves daemon,sod who convects for such projects with a commctor(s)licensed pursuant to Me Conimures Lkeue Lew. 0 lamuempturder See ,B&PCf.thiseUm 40 mer Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penally of perjury am of dae following declarations: 0 l haw and will maintain a Cenifsnte of Consent to relf-Insure for Worker's Compen. urian,as provided for by Section 3700 of the Inbar Code,for the Performance of Ne work for which this permit is issued. 0 1 haw and will maintain Worker's Compensation Insurance,as required by Section 3700.(Us Labor Coca.for Ne performance.(the work f.,mMh this peamil b intend. ' My Worker's Compensation Imsurnmen carrier and Policy number are: Cartier. Jct 11 ^! ll l Polity Na.:.� GERTI CATS OF EXEMPITON FROM WO 1. S' COMPENSATION INSURANCE (This sectio need not be completed if the permit is for one hundred dollars($Hill) or Inns) 1 certify that in the performance of the work for which this Permit is issmd,I Shall not - employanyNounin any amencrao as to become Subject m the Workers'CompensWon . Laws of CalifamiL Dam Applicant NOTICE TO APPLICANT:If,after making this Cenillcete of Exemption,you Should become subject in the Worker's Compensation provisions of the lata,Code,you muss 0 O forthwith comply with Such provisions or this permit shall Ix dmk deemed rewcd. ! z51 CONSTRUCTION LENDING AGENCY [-a Ihemhyeffort that Nam is a consuuctimn Inmangegenry,for the perform...( CG> dae work For which Oils Permit is issued(sec.3891.Cb.C.) Lan w�O ders Name , Z Lender's Address U Q 1 certify that 1 haw read Nis application and shote that the Show is rt mtatim b tI.H Comm I agree to comply with all city and county ordinances and state laws teledng to QU building construction,and hereby authoriu¢pre¢nutiws of this city m enter upon the W above-mentioned propany for inspection purymes LL (We)agree to taw,indemnify and kmp hawlnss fee City of Cupertino against rn liabilities,judgmemW coca andeapeons which may In any way a cerin against Said City U ,'Z in cmv egmnc.of the gram,of this permit. ,Iy APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date sou RE99LATIONS. 4AN Re-roofs Signature plicin✓Cunvecter ow V HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will Ne applicant or future building occuP.LS ore orhandle huudou material - defined by Ne Cupertino Mun'ip.1 Code,Chapter 9.13,and Elie Health.d Safety 1e, 0r'.zss32(a)? All roofs shall be inspected prior to any roofing material being installed. ❑tins CJ Nu Will the applicant or futum building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,,l agree to remove emit haardnu air coniaminanor defined by the Bay Area Air Quality Management all new materials for inspection. District? 0Yes Nu 1 have mad the hvvdmu mabriaBrequimmenuunder Chapxr6.95 of the Califor- niaHealth&Sately Codd.Senium 2550.5,25533 and 25534.1 undcaaund thatifthe building does nOL curamly hew a tenanh then it is my responsibility,m notify fee Occupant of the requirt n hm mmpoor toia.anceofaCemncausofOccupancy. Signature of Applicant Date Obrfr at audit m Dam All roof coverings to be Class"Bo Or better 0 0q CITY OF CUPERTINO REROOF �cuPEr�Two PERMIT APPLICATION APN # 3 -7 25 ` o Date: Building Address: J 19ogn M L Owner's Name: Phone #: �011� co Gel Contractof: Phone #: (,SG- 96 M 7v10 G Fax #: Cupertino Business Licen #: Contractor License #: 785491 Type of Roof Covering: Existing: Proposed: a-'] uilt-Up Roof Q—B61t-Up roof ❑ Asphalt Shingles LiAsphalt Shingles ❑ 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: 1 �e C06F ] lay Er Residential Commercial Fire Zone: Yes No a Confirmed with Planning Dept. if there are any restrictions: ❑ Valuation: 71 Del aI Chp I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Si ature CITY OF CUPERTINO REROOF OCUPEI,TINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1RER00FC0M Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 2S� 1REROOFRES Re-roof Residential B 1SFDWLROOF ( 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 comply with the above stated policy on re-roofing. Homeowner's Name: e � U r.Ba Job Site Address: q C)5 (metc q s Roofing Company Name: Applicant's Signature: Date: 2 Q� • 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 . . . . . . . . : 37535049 . 00 DATE ISSUED. . . . . . . : 02/15/2008 RECEIPT #. . . . . . . . . : BS000003955 REFERENCE ID # . . . : 08020099 SITE ADDRESS . . . . . : 1901 MEIGGS LN _ SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : BETTU COAD ADDRESS . . . . . . . . . . : 19090 MEIGGS LN 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 8, 249 . 00 0 .90 0. 00 0 .90 0. 00 1REROOFRES SQ FEET 25 . 00 325. 00 0. 00 325. 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 325 . 90 0. 00 325.90 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CASH 325 . 90 --------------- TOTAL RECEIPT 325 .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 Comm,UdW DBVdopmmc 10300 Tone Awom Cupneao CA 95014 Teiep =(408)777-3228 Fax(408)777.3333 CUPEkTIN0 Building Department C� (� JOB ADDRESS: PEST#�(�Da� l9 05p ME(G, GS �O OWNER'S NAME: STT AD IPHONE# GENERAL CONTRACTOR 05 / PzgUe FAX# I am not using any subcontra e Date Please check aPPItcable subcontractors andcompletL the foUowinl,inforauuion ba SUBCONTRACTORI BUSINESS NAME BUSINESS LICENSE # Cabinets&Millwork Cement Finishing Meetricai Excavation Fencing H U*oleWood �/ Heating Insulation Landscaping Lathing Ornamental Sheet Metal Painting/ Wall Per Pay ing Sheet Rock T a 41 aflo • Contractor Sign,9 Date