13010099 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 18844 HUNTER WAY CONTRACTOR:COSMOS ROOFING PERMIT NO:13010099
OWNER'S NAME: HA CHAI&YEO HEE L 999 COMMERCIAL ST STE 105 DATE ISSUED:01/17/2013
OWNER'S PHONE:. 4083912845 PALO ALTO,CA 94303 PHONE NO:(650)969-7663
lV
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL U COMMERCIAL;
License Class - G J Lic. **DETACHED GARAGE ONLY**TEAR OFF(E)T&G.
INSTALL(N)4-PLY CAPSHEET
Contractor S ?CeK-td Date 11`7 (13
I hereby affirm that I am licensed under4e provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect. .
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$2500 -
1 have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the labor Code,for the performance of the work for which this
APN Number:37535064.00 Occupancy Type:
permit is issued
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM ALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities;judgments,
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply Issued b
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
`` RE-ROOFS:
Signature - Date l .f r3 All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection. _
❑ N - UILDER�DECLARATION
Signature of Applicant: Date:
I hereby,6 that I am exempt from the Contractor's License Law for one of - -
the following two reasons: - ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
t,as owner of the property,or my employees with wages as thew sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) -
I,w owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
concoct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. I will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(x)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authorized agent: Dater/j7 3
permit is issued.
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 Worker's
Compensation laws of California. If,after making this certificate of exemption,I CONS 8 LENDING AGENCY
become subject to the Worker's Compensation provisions of the labor Code,I must I hereby affirm that ther onsuuction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
I certify that I have read this application and state that the above information is
correct.I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18. - -
Signature- Date - -
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION �Q
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 0 /
C (408)777-3228•FAX(408)777-3333•building Gncuoertino.orci 0\0
n r-TAC410�) 4A?-AC�C
PROJECT ADDRESS I V V 1 1 u I IMI II A-tf "N'
O G ' "'}}i
1
OWNER NAME CAA,12"' L- PH �/� /' E-MAIL "'---
EC AD ESS CITY,STATE,ZIP
F I0-4-T Z- tJA-ter G P7 L,J o FAX A 9 5
CONTACT NAME WANDA O COSMOS ROOFING PHONE 650-969-7663 E-MAIL
STREETADDRESS 999 COMMERCIAL STREET #105 CTIY,STATE,ZIP PALO ALTO, CA 94303 FAX 650-485-2314
❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT KI CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGWEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC.k
RICH COSMOS 1 785441 C39
COMPANY NAME COSMOS ROOFING &MAR. FAX 650-485-2314
STREETADDRESS 999 COMMERCIAL STREET #105 CITY,STATE,ZIP PALO ALTO, CA 94303 PHONE 650-969-7663
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.A
COMPANY NAME &MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF �;SFD or Duplex ❑ Multi-Family ROOF'AREA:� VALUATION:
srRucruRE: Commercial "fw sr Z SC c�
EXISTING ROOF TYPE: XBUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE WYES E'NO. PLYWOOD ❑ 'h" ❑ PLYWD ❑OSB PITCH: ` ROOF
13 NO N THI ❑s/R" TVP : ❑Cox '�Zl [12 CLASS. A
PROPOSED ROOF TYPE: 3qBUILT-UPROOF ❑ASPHALT SHINGLES ❑WOODSHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT
DESCRIPTION OF WORK: 7
r - I� D 'r��
12 �l'Jff- N 7 tl 7/
G
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf I have read this
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state Laws relating to building construction. I authorize representatives of Cupertino to enter the above-identifiedproperty for inspection purposes.
Signature of Applicant/Agent: Date: i 17 (/ 3
SUPPLENIE9TTAL INF90YAVC50N REQUIRED OFFICE USE ONLY
_If building is associatedme Owner's Association,provide letter PLAN CHECK TYPE ROUTING SLIP
of approval from HOA. OVER-TH&COUNTBR ❑ BUH.DING PLAN REVIEW
Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT
Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER:
ReroojApp_2011.dac revised 03116111
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 18844 HUNTER WAY DATE: 01/17/2013 REVIEWED BY: MELISSA
APN: 375 3.5'064 BP#: *VALUATION: $2,500
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition
PRIMARY PENTAMATION
USE: SFD Or Duplex PERMIT TYPE: 1SFDWLROOF
WORK **DETACHED GARAGE ONLY**TEAR OFF E T & G. INSTALL N 4-PLY CAPSHEET
SCOPE
�I # .
f I] I a1•i � M'd;°'`w� .�r '+
.IrnS?.;i 45a Y�l 'ri S + us51R .F i
btech. um
.Plan Check Plumb.Plan Check Elec.Plan Check
,bfech. Permil Fee: Plumb.Permit Fee: Elec. Permil Fee:
Other Uech. Insp. Olher Plumb Insp. OlberElec. Insp.
Uech.hasp.Fee: Plumb. Insp.Fee: Eke./nap.Fee.
NOTE:This estimate-does:not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School. .
District etc). These eei are based on the PrellWWna information available and are only an estimate. Contact the De t or adds't info. -
FEE ITEMS (Fee Resolution 11-053 Eff 7/1112) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 F 400 s.f. Re roof
Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 $60.00 IREROOFRES
PME Plan Check: $0.00
Permit Fee: $0.00 T 71
Suppl. Insp. Fee-.Q.Reg. 0 OT F0,01 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Construction Tar:
Administrative Fee: 0
Work Without Permit? O Yes G No $0.00 O
Advanced Planning Fee: $0.00 Select a Non-Residential 0
Travel Documentation Fees: Building or Structure 0
i
Strong Motion Fee: IBSEISUICR $0.50 Select an Administrative Item
Bldg Studs Commission Fee: IBCBSC $1.00
Vfn 3 hn 1' ''�V+kl�lnniF11 dF �, t'Ek .fN'.:y
$1.50 $60.00aoi,' ffOL� T i $61.50
Revised: 10/01/2012
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255
(408)777-3228- FAX(408)777-3333-building ftuoertino.om
PROJECT ADDRESS / O 14 N 1-7-7o?, APN N
OWNER NAME E IC-IC-AJPH NO -� E-MAIL
STJE AD RESS I CI i� C S7 T ZIP FAX
W 1e7r,J0 CA-, 95(!7
CONTRACTOR
NAME t LICENSE NUMBER
I � LICENET BUS.LIC.#A1 / *1
COMPANY NAE E-MAIL
FAX I (O ,,/A (. Z
STREET ADDRES e{ /r�_ _- U,utr' CITY,STATE.ZIP /9 �7O /`,t P ONv0 7Y J
I �WII UNDERSTAND AND AGREE TO THE FOLLOWING:
1.
1. The re-roof project shall comply with all applicable provisions of the 2010 California Codes.
2. An inspection request can be scheduled up to the day before the inspection date. Please call (408)777-
3228 from 7:30- 3:30pm(Mon-Thurs) or 7:30- 2:30pm(Friday)to schedule the next day inspection.
For Tear-Off and Nailing Inspections,you must also call on the day of the inspection only after that
phase of the work is completed. The building inspector will be available within one hour. Progress
and Final Inspections will be given a two hour window.
3. Tear-Off Inspection is required. Any and all dry-rotted wood shall be replaced prior to this inspection.
Unless new plywood roof sheathing is proposed throughout, all the nails/fasteners shall be either
completely knocked-down or removed prior to this inspection.
4. If plywood is installed, a plywood Nailing Inspection is required.
5. Roofing shall not be applied without first obtaining all prior inspection and written approvals from the
building inspector. Any roofing which is applied without first obtaining an approved inspection will
require the removal of all new material down to the sheathing so a proper inspection can be performed.
6. Progress Inspection is required when approximately 50%of roof covering is installed.
7. A Final Inspection and approval shall be obtained from the building inspector when the re-roofing is
completed. To receive a final sign-off,the following items will be verified:
a. Flat roofs shall have a minimum of I/<"per foot of slope and demonstrate there is no ponding.
b. Listings from approved testing agencies for all pre-manufactured products used shall be
available on-site to review at the time of the inspection.
c. Proper spark arrestor installation,vents painted, gutter/downspouts installed, debris removed.
8. NOTE: If you call for a tear-off or plywood nailing inspection and the work is not complete, you will be
charged a re-inspection fee of$126.00. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing below,I certify each of the following is true: I am the property owner or authorized agent to act on the
property owner's behalf. I understand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide detectors are required to be installed 1 rdance with Sections 8314 and R315 of
the 2010 California Residential Code.
Signature of Applicant/Agent: Date: 7
RerooJPolicy_2011.doc revised 02116/11
Jan 16 13 le: e'/p cosmos !Goofing (bi Ujubu-"Wo p. e
CommmmY Dwdopmeot
iO3 MmAvcmw
Cupafmo CA 93014
Tekphom(408)777-3228
pa(408)777-3333
CUPEILTWO
Buildin De a h—nent
JOB ADDR M PERMIT
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OWNER'S NAME O Lem I PHONE# 4sD 944- 7cP 43
GIIVERALC3DNIRACT0R S s - �8 5 X31
X I am not using any subwn(raelow. U J !la
Date
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Pleacheck a subaonlracEais and the information
SUBCONTRACTOR BUSINESS-NAME " ' BUSINESS LICENSE#
Cabinets&Millwork
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