10030098 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10511 BARNHART CT CONTRACTOR:COSMOS ROOFING PERMIT NO: 10030098
OWNER'S NAME: NEERAT PAKALA 1901 OLD MIDDLEFIELD WAY STE 22 DATE ISSUED:03/17/2010
NER'S PHONE: 4084208663 MOUNTAIN VIEW,CA 94043 PHONE NO:(650)969-7663
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT[_ PLUMB
License Class Lic.# 7 q L4
MECH RESIDENTIAL COMMERCIAL
Contractor to /'7 U
I hereby irm license r the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF INSTALLATION OF 30#FELT,LANDMARK TL
(comme c' with a 'on 70 of Division 3 of the Business&Professions COMP
Code and that m cense is in full force and effect. SHINGLES.20 1/2 SQUARES.1 LAYER TEAR-OFF/NO
RESHEET CLASS A
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.
I 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
permit is issued. Sq.Ft Floor Area: Valuation:$7870
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:37537024.00 Occupancy Type:
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
indemnify and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature Date Issued by: Date: Tl 7��
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Code) /
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date: 4
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three ALL ROOF CO RINGS TO BE CLASS"A"OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Safety Code,Section 25532(x)should I store or handle hazardous material.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in anyvmanner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I must
forthwith comply with such provisions or this permit shall be deemed revoked. 07/0
oauth nt: 2 / 7
Date• 7 Q
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
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 I hereby affirm that there is a construction lending agency for the performance of work's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
-unify and keep harmless the City of Cupertino against liabilities,judgments,
,and expenses which may accrue against said City in consequence of the Lender's Address
g,,,r.ring of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Signature Date r G
Licensed Professional
� �V
CITY OF CUPERTINO
3 ITEMS OF 10 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 37537024 . 00
DATE ISSUED. . . . . . . : 03/17/2010
RECEIPT #. . . . . . . . . : BS000009956
REFERENCE ID # . . . : 10030098
SITE ADDRESS . . . . . : 10511 BARNHART CT
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER NEERAT PAKALA
ADDRESS 10511 BARNHART CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM JEFF RAINEY
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
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 7, 870 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1BSEISMICR VALUATION 7, 870 . 00 0. 80 0 . 00 0 . 80 0 . 00
1REROOFRES SQ FEET 21 . 00 273 . 00 0 . 00 273 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 274 . 80 0 . 00 274 . 80 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 507.30 VISA
---------------
TOTAL RECEIPT 507 . 30
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
CITY Of
CITY OF CUPERTINO
REROOF
Cl�PERTINO PERMIT APPLICATION
APN# Date: I I
.--, .1 . .)l I U
Building Address: 10511 BARNHART COURT
Owner's Name:NEERAT PAKALA Phone#:
408-420-8663
HOA: Yes ❑ No 0 If yes, provide letter from HOA
Contractor: Phone#: 650-793-5012
COSMOS ROOFING
1901 OLD MIDDLEFIELD WY #22, MENLO PARK, CA 94043 Fax#: 650-969-9905
Cupertino Business License #: Contractor License #:
785441
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
Sl Other (Specify) COMP SHINGLES g` Other(Specify) COMPOSITION SHINGLES
Number of existing coverings ❑ Provide I.C.C.E.S. Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: INSTALLATION OF 30# FELT, LANDMARK TL COMP SHINGES. 20 1/2 SQUARES.
1 LAYER TEAR-OFF/NO RESHEET. CLASS A.
Residential 0 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:
$7870
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 02/05/09
INPUT Resources Energy 1AWHeafth
.Indoor Air Quality and Finishes
1.Use Low/No-VOC Paint 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0
3.Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 6IAQ/Health pts y=yes 0
0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes
7.Seal all Exposed Particleboard or MDF 4 IAQ/Health pts y=yes 0
8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes I 1 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0
2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
1 1 1
Total Points Available: 1401 130 57
Total Points Project Received: U�� 0 0 0
G:datalprogs/greenbuildingguidelines/re Iers/greenpointsfi 1204protected..Is
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 2007 CBC 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:
Pre-inspection and/or tear off approval.
a) AT TEAR OFF PULL OUT ALL ROOF FASTENERS.
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$126.00. 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: 4 E CC►2, -T r—A 1/3
Job Site Address: ) 0 :5 11 3/t /iiz7 C -r.
Roofing Company Name. �c� zJz' ► �/
Applicant's Signature: Date:
Albert Salvador
Building Official
Revised 3/09/10