Loading...
09040032 CITY OF CUPERTINO BUILDING DIVISION PERMIT � TlE►` lCZ I� � * BUILDING ADDRESS: PERMIT NO. 18725 TILSON AVE COSMOS ROOFING 09040032 OWNER'S NAME: PERMIT ISSUE DATE 711r-PNE MAY 9 0 ')NE: 7 7 A CONTROL NO. c•m>r (6500,59-7663 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH = 0 0 u o p LICENSED CONTRACTOR'S DECLARATION m I hereby affirm that I am licensed under provisions of Chapter 9(commencing Job Description Z with Section 7000)of that 3 of the Business and Processions Code,and my license is =y in full force and effet. Lic x r RE-RF ItMV OLD RF& INSTL 4 PLY TAR&GRVL ROLL CLSA j j Z License Class 7W5 q DateContractor 21 SQ ARCHITECTS DECLARA ON 904U 1 understand my plans shall be used as public records r.A. 4 O WLicensed Professional n rn OWNER-BUILDER DECLARATION a 1 hereby alfiirm that 1 am exempt from the Contractor's License Law for the p o following reason.(Section 7031.5,Business and Professions Code:Any city or county R which requires a permit to concoct,alter,improve,demolish,or repair any structure Z prior to its issuance,also requires the applicant for such permit to file a signed statement < that he is licensed pursuant to the provisions of the Contractor's license Law(Chapter 9 Sq.Ft.Floor Area Valuation YFz (commencing with Section 7000)of Division 3 of the Business and Professions Code)or y that he is exempt therefrom and the basis for the alleged exemption.Any violation of $8290 Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of anC APN Number Occupancy not more than five hundred dollars(5500). P Y Type ❑I,as owner of the property,or my employees with wages as their sole compensation, 37518001 . 00 will do the work,and the structure is not intended or offered for sale(Sec.7044,Business and Professions Code:The Contractor's License Law does not apply to an owner of Required Inspections property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for We.If, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business and Professions Code:)The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. ❑I am exempt under Sec. B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's Compen- .adon,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑1 have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Workees Compensation Insurance carrier and Policy number arc: Cartier.— 4t:?'t Q �tr/I PolicyNo.:gl j� �i i�,S�b� CERTIFICATE OF EXEMP ION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less) I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,atter making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must .J O forthwith comply with such provisions or this permit shall be deemed revoked. Coe) CONSTRUCTION LENDING AGENCY E-c I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec.3097,Civ.C.) WG4 A Lender's Name L.endees Address V Q I certify that 1 have read this application and stare that the above information is LL r.r correct I agree to comply with all city and county ordinances and state laws relating to 0V building construction,and hereby authorizt representatives of this city to enter upon the a above-mentioned property for inspection purposes (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit �+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by Date L11, SOURCE RIULATL %�, a d, Re-roofs Signature of Applican ntractor Date – HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Code.Section 25532(a)? ❑Yes �No All roofs ;hall be inspected prior to any roofing material being installed. Will the applicant or future building occupant use equipment or devices which If a roof i;;installed without first obtaining an inspection,I agree to remove it hazardous air contamina7N. efrncd by the Bay Area Air Quality Management all new materials for inspection. auict? C]Yes 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code.Sections 25505,25533 and 25534.I understand that if the building does not currently have a tenant,that it is my responsibility to notify the occupant of the requi nts w'ch must be met prior to issuance of a Certificate of capancy. Signature AApplicant Date M�^ V_,212 I All roof coverings to be Class%`or better Owner or authorized agent Dale CITY OF C'UPERTINO M. Y REROOF CUPEk ANO PERMIT APPLICATION APN # U J Date: Building Address: Owner's Name: Phone #: Contractor: Phone #: Fax#: SSG- ci�� - Cupertino Business License #: Contractor License #: 25✓ 14,1 t Type of Rc)of Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles V' Other(Specify) 40,r t 8 ' a- Other(Specify) v Number of existing coverings ❑ Provide I.C.B.O. Repo # ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: Residential Commercial ❑ 02 C) 1 Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are any restrictions: ❑ Valuation: (�, 91C I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Community Development Department Building Division City of Cupertino 10300 Tone 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 appL ed without first obtaining all inspection and written approval from the building inspector. A final inspection and approval shall be obtained from the t uilding 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 apF roval. 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 nai: 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 g n be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of lig " 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: 4 Job Site Address: 1 C6 715 T i l_s -A ►i e - Roofing Company Name: C(451620(_ Applicant's Signature: Z", Date:-� J Greg Casteel Building Official Revised 07/30/08 CITY OF C:UPERTINO al".1 REROOF —IJPEt,T1NO FEE SC:EIEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1RER00FC0M Re-roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Slandards B ALL PERMIT TYPES Commission Fee 1BSEISMICO Seismic Commercial B 1REROOFRES Re-roof Re;>idential B 1SFDWLR00F % 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commissio a Fee ' 1BSEISMICRE Seismic Re,,,idential B 1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commissio:i Fee 1BSEISMICRE Seismic Residential B 1BUSLIC Business Lizense B co==ny D 10300 Tare Avmw Cupedw CA 95014 TeIephofle(408)777-3228 Fax(408)777-3333 CUPEkTINO Buildin De artment I11 B ADDRESS: PERMiT • `� PHONE� OWNERS NAME: FAX# 5-t. >6,9 A4 e I am not using any subcontrac Date �tur� Please check a livable subcontractors coin tete the followin information: SLTBCON'I'RACT01t BUSINESS NAME BUSINESS LICENSE # Cabinets&Millwork Cmnent Finishing Eleclrlcal Excavation Fendng Hooring.carpeting Unoleam/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry . Ornamental Sheet Metal Painting// Wallpaper Paving Pbstedng P=Nn Roofing Septic Tank Sheet Metal Sheet Rock Tile Date Contractor�Si ��