08100106 CITY OF CUPERTINO �!��.=,r�g�«,kro p l Thi* -,%"Al
BUILDING DIVISION PERMIT t•�3�?i TACTOR jNP01
Bu110517 PERMIT
RAMPART AVE COSMOS ROOFING
NET'S NAME: PERMIT ISSUE DATE
ORLOW TERRY G AND CLAIRE V 1901 OLD MIDDLEFIELD WAY STE 10/17/2008
PHONE: 7 7 SANITARY NO, CONTROL NO.
ARCHr1 IENGINEER: BUILDING PERMIT INFO
RE ROOF , T/0 EXISTING COMP, BLDG ELECT PLUMB MECH
goo N5q 3e !B FEbcf, 48
LICENSEDCONIRACNRTDECLARATION
U I Iemby affirm Nat 1 are li¢nsend under Provisions of Cluper 9(commencing ^^-•— ^- - ^^ - ^^ ^^ JobDescri Description
4 W wi Sccuon]IX )ofDivislon3of Nc Busnms Pmfcasimu Codc.endmyliccnmia
in full rmee and coystr
2 jq= License Class_ _ - Lle.a Yy�nn
qq Dam Contnemr
5 R W ARCHrfECI'S DECLARATION m<7< 1 undersunJ my Plain shall be Lind u public rxnrds
JyU
'0:'
t, Licensed P (cuionel
OWN ER-BUILDER DECLARATION
E 1 herebyaRnn Nat I am exempt from on,Conuumrs License law for the
p O following lesson.(Section 7031.5,Business and Professions Code:Any city or county
s which onto.a peornit to thermoset.alter.Improve.dcmalLN,or repair any mrumme
3iy prior to its issuance.also ox,simstM applicant forsuch Permit to rile a signed suemem
ss< Nat heisllccnscsupmaesnttoNepmvisionsoftheContractor'sLicenseLaw(chapter9 Sq.F[. Floor Area Valuation
e52 and hecncixemit dominant
andtf but,fr ofdmBed exemption.
Anyonscodc)Lir
^ Na he u exempt therefrom and the Ensu for the alleged eumpdon.Any violation of
Section 70316 by any applicant for a permit ubjew dm applicant in a civil penalty or APN Number Occupancy Type
not mom done A.hundred dollen(ML P Y YP
I,uowmroftN pmperry,IXmy emplrycu wlN mgu uNe'vsrle compensation,
MB dodeewok.anddie an Con YMes Users,
Law,
ones
rant
to BIILIKL
and Pr, M Wilds calm one vas do mr,Lkare law arm not apply lf an r ugh err Required Inspections
propertywho u. ro i impot sudemon,andwbo suressuchwmk Aimrelfm insal his
own employee,prodded that mem improvements art not ear of c manerW fm,Wn B,
however.me building or improvement loath within one year of completion.the =ad
builder MB Nva Je Wrdrn of pmNng that K did wt build IX impose for pugoa of
ukJ.
0 I.ter awner of Ne Property,am exclusively contracting with licensed antrums to
cmmroa the project(Sec.7614.Business;add Pmfeed.Code:)The Comracmrs U.
eeme Law dues not apply an u owner of property who builds ar improtss Neeeem.and
who contracts for such pojcm with a conuammis)Recorded pursuant to the Colossuses
Licence Law.
❑l am exempt under Sec .B&P C for this moon
neer Dam
WORKIRS COMPENSATION DECLARATION
I bereby on=under penity of perpt,,arc of Ne following declamations,
❑Immam nmsinuinace fimeof Comntmmlf.insumfm Wo SComps
salon,u provided for by Section 3700 of the Labor Code.for the Performance of the
work for which this permit is issued.
ave and will maintain Workces Compnmation Insurance.u required by Section
7101,f de Labor Code.for the performance of dee work for which this permit u issued. '
My Worker Compensation humane carrier and Policy number art:
Carrier._3- 45 Ft)AIA Policy No.:� 04>� yyz+W
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(Thr rection need ambecomplcted lathe Permit is We=humbeeleadurri(5100)
or less)
1 certify that in the performance of deo work for which this Permit is issued.I mesh not
employ any person in any masher an u an become subject to the Worker'Compmuadan
laws of California.Date
Applicant
NOTICE TO APPLICANT.If.after making this Cedilicae of Exemption.you should
become subje a to the Workers Canpchamon provisions of the labor Code you most
Oforthwith comply with such provisions or this permit shall he deemed mrukce.
Zy CONSrgwnON LENDING AGENCY
[-e I herebyalrom than there Its construction lending agency for the oxformance,of
a > 0e work for which this permit is issued(Set.3(197,Civ.C.)
Lenders Name
Z Under.Adden:l
V Q I certify that 1 have mad this application asW sue Net the show information is
fr. F correct.l agree in comply with all city and county oNlnuees and arae has selecting to
0building eonmmction.and hereby authorise lepsuenutiva of this city to enter upon Ne
W move-mentimled property for inspection purposes.
�' py (We)agree to save,indemnify and keep harmless the City of Cupertino against
h liabilities Judgments,costs and expenses which may in any way sterno against saidCity /
of the snunfing of
C.)z PcAPL� NUNERSfANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOU EGUTATIOy1NS.
.far p . ,(1� t1)-1'7_n;y1 Re-roofs
Segnmureof AppliwnmConowle, -'V --Date
HAZARDOUS MATERIALS D CLOSuall a Type of Roof
Will the applicant or future building occupleAm me m handle huudous mmeriar
dented by the Cuper inn Municipal Code,Chapter 9.13,and the Health and Safety
.Section 25532(a)? ' All roofs shall be inspected prior to any roofing material being installed.
Oyer Nu
Will on, pneant or future building ocevpant role eyaipment or&,I.which If a roof is installed without first obtaining an inspection,I agree to remove
emit hnardous air contaminants as definut by the Bay Arca Air Quality Management all new materials for inspection.
District?
Oyer �*0
1havemad NeIearafdl maeriatsogttimmenuundcrCNper6.95rfNeCaifor-
niaHuith&Safmy Cador Sccdmu U505,25533mW25534.1uMmund N.ifNe Wilding
docs w nose ham•enan4 than it u my responsibility m Mary do occupant of Nc b / �V ! /'^ i>
reqs n himmrmx�dpnormianmurr.cailraurro apamy. Signature of Applicant Date
'tE�re f m U- ���`w All roof coverings to be Class'1W"or better
Owner m ah"U" ager Dam
Community Development
sm
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
�UPE(�TINO Fax(408) 777-3333
Building De artment
JOB ADDRESS: PERMIT #
/0 -5-/7 �S na Or>L �� I06 /D 5/
OWNER'S NAME: //g rrl PHONE # Yo f -2s7_ do 7 o
GENERAL CONTRACTOR: H, > / << FAX # G S79 - 9 6,P- 9 .9 �—
I am not using any subcontractors: �°1(� ( l-cJl�•J
Signa- turP2�5 Date
Please check applicable subcontractors and complete the following ' ormation:
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 �'p o leo tti
Septic Tank
Sheet Metal
Sheet Rock
• Tile
Owner/Contractor Si afar Date
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36926043 . 00
DATE ISSUED. . . . . . . : 10/17/2008 -
RECEIPT # . . . . . . . . . : BS000006383
REFERENCE ID # . . . : 08100106
SITE ADDRESS . . . . . : 10517 RAMPART AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : ORLOW TERRY G AND CLAIRE V
ADDRESS . . . . . . . . . . : 10517 RAMPART DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4524
RECEIVED FROM . . . . : EDWARD GREGORY
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 10, 155 . 00 1 . 10 0 . 00 1 .10 0 . 00
1REROOFRES SQ FEET 27 . 00 351 . 00 0 . 00 351 . 00 0 . 00
---------- ----- -------- ----------
TOTAL PERMIT 352 . 10 0 . 00 352 . 10 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 352 . 10 visa
---------------
TOTAL RECEIPT 352 . 10
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
Community Development Department
Building Division
Cityofof 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 inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/ "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:
lob Site Address: k�, i/J oN ;l 0.
Roofing Company Name: 00S Nyys
• Applicant's Signature: Date: /O//-r7?
Greg Casteel
Building Official
Revised 07/30/08
CITY OF CUPERTINO
REROOF
OF
•CUPEIITINO PERMIT APPLICATION
O aC-P
APN # Date:
2(-,,p z 00
Building Address:
OS/
Owner's Name: Phone #:
e- L/X 0r /ow `lo
Contractor: . Phone #: 6 JZl— 96q- 7%,6 .3
COS •"'
Fax#: tSv- 96s" 9903—
Cupertino Business License #: /T yy Contractor License #:
7y s VY/
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
Asphalt Shingles ;�_- Asphalt Shingles YO y,
❑ 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: T/ 9 Crow � � /t/,,, 33d /6
L' /F ss 2 7 Sss
Residential 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:
•I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
CITY OF CUPERTINO
LEREROOF
CUPE(iTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FCOM Re-roof Commercial B 1COMMLROOF
IBSEISMICO Seismic Commercial B
1REROOFRES Re-roof Residential B 1SFDWLR00F
a �
( IBSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08