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14020036 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6165 SHADYGROVE DR CONTRACTOR:COSMOS ROOFING PERMIT NO: 14020036 OWNER'S NAME: RAHUL PANDIT 999 COMMERCIAL ST STE 105 DATE ISSUED:02/05/2014 OWNER'S PHONE: 6504650700 PALO ALTO,CA 94303 PHONE NO:(650)969-7663 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIALE] License Class C 3 9 Li..it le? 5 L/ y ' RE-ROOF 29 SQ-TEAR OFF GRAVEL,NO RESHEET, � ;�� INSTALL 4 PLY CLASS A Contractor (//��—f7 twl RV �-r Date 2 / I hereby affirm that I am licensed and the 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 whichthis permit is issued. Sq.Ft Floor Area: Valuation:$15970 I have an ll ntain Worker's Compensation Insurance,as provided for by S,cti o t e Labor Code,for the performance of the work for which this APN Number:37540014 00 Occupancy Type: permit 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 DAYSAH PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter ------'LED nter , upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS F OM LAST CAL ED INSPEC ION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the d b granting of this permit. Additionally,the applicant understands and Issue w'l comply y: Date: with all non-point source regulations per the Cupertino Muni ' ode,Section 9 18, RE-ROOFS: Signature Date 2-15 1 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 13 N BU Oinspection. CSignature o f Appli Date: 2— I I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF C GS TO BE CLASS"A"OR BETTER I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct 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. 1 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(a)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 whichthis 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: Date: 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 CONSTR �NLENDINCG AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction 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 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildin-ga-cupertino.org PROJECT ADDRESSJ_ I` 150, � � e APN# OWNER NAME T4 Ru 1 PA D E40E -465 - E MAU_ r,EkTADDRESr U��1ZTI�,Ja �A q501 FAX CONTACT NAME WANDA @ COSMOS ROOFING PHONE 650-969-7663 E-MAIL STREET ADDRESS 999 COMMERCIAL STREET #105 CITY,STATE,ZIP PALO ALTO, CA 94303 FAX 650-485-2314 ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT KI CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE NUMBER 7LICENSE TYPE BUS.LIC.# RICH COSMOS 785441 C39 COMPANY NAME COSMOS ROOFING E-MAIL FAX 650-485-2314 STREET ADDRESS 999 COMMERCIAL STREET #105 CITY,STATE,ZIP PALO ALTO, CA 94303 PHONE 650-969-7663 ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAII, FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF X SFD or Duplex ❑ Multi-Family ROOF AREA: VAL71 :5, N: 9 a� STRUCTURE: Commercial 2`' C-0 / 7 D �— EXISTING ROOF TYPE: )<BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE )<YES IF NO, PLYWOOD Elw, ElPLYWD ❑OSB PITCH: Z ROOF ❑NO #LAYERS: THICKNESS: ❑ 5/8" TYPE: ❑ CDX -:12 CLASS: A PROPOSED ROOF TYPE: .BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK: t /fi.Z O /h2-d iZ/hJ F v1 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. resentatives of Cu r the above-identjfed p opq for inspection purposes. Signature of Applicant/Agent: Date: 2 S SUPPLEMENTAL INFO �ssociation, OFFICE USE ONLY —If building is associated with a H O ovide letter PLv6MCK TYPE ROUTING SLIP of approval from HOA. Q -THE-COUNTER ❑ RuH,nING PLAN REv Ew 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: ReroofApp_2011.doc revised 03/16/11 CITY OF CUPERTINO IjFEE ESTIMATOR-BUILDING DIVISION ADDRESS: 6165 shadygrove dr DATE: 02/05/2014 REVIEWED BY: Mendez APN: BP#: *VALUATION: 1$15,970 TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Duplex PENTAMATION USE: pPERMIT TYPE: 1 SFDWLROO WORK re-roof 29 sq-tear off gravel, no resheet install 4 ply class a SCOPE ww Fes- 3 f t°3 ,• \ 0@� Aleck. 1'?£bat checA. htrib. Nan("Iteck P/Mz Chec 1 9exkl",�rmif Fee: hab, ferni1ee c.tl other I f sty. Other Plumb Insp. �)r: r Elec.Insp.ETLi L1e(..h, Iiavpl l'e'e: I'lra nb,IrT..Fee: Efec. fi?,fp. Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These.fees are based on the prelimina information available and are only an estimate. Contact the Dept for addn I info, FEE ITEMS (Fee Resolution 11-053 E . 7�11113, FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 2,900 s.f. Re-roof Suppl. PC Fee: (j) Reg. 0 OTT 0.0 hr's $0.00 $464.00 IREROOFRES PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee:Q Reg. 0 OT 1 0.01 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential ?-Favel Documentation F'ees Building or Structure Strong Motion Fee: IBSEISMICR $1.60 Select an Administrative Item Bldjz Stds Commission Fee: 1BCBSC $1.00 11 $2.60 $464.00 ,RT�DL FEE` $466.60 Revised: 01/15/2014 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(Wcupertino.org PROJECT ADDRESS 4 f /�N APN# / � OWNERNAME 7- A I fi u I ,4 I / (Y l v s `O 7co E-MAIL SrL 631RE 'I V ICJ IKNC 1 C t✓(J 7C�Z 7(Ne) _f'A T FAX CONTRACTORNA ..A LICENS NUMBER �I LICENSE TYPE BUS.LIC.# COMPANY NAME /'�5,�/0'x3 g�I ) G E MAU, F�.3C • 9 S -'z3/-/ STREET ADDRESS(JCJN CITY,STATE,ZIP (,S c wi L,-Z_0 A-l 7_ /O .rLo �o <--,A q o v ,969- � 3 I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimum of one day before the requested inspection date. Please schedule inspections online or call(408)777-3228 between 7:30-3:30 (Mon-Fri). 3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof is torn off and all the nails/fasteners have been removed. Any and all dry-rotted wood shall be replaced prior to this inspection. A building inspector will be available within one hour. There are special hours for this service: 7:30 — 10:30am and 1:00—3:30pm (Mon—Thurs); 7:30 — 10:30am and 1:00—2:30pm(Friday). 4. If plywood is installed,a plywood nailing inspection is required. 5. In-Progress roof inspection is required. Call for an in-progress roof inspection to verify building is weather tight after installation of approximately 25%of the roofing material. 6. New roof coverings shall not be applied without first obtaining all inspections 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. 7. A final inspection and approval shall be obtained from the building inspector when the re-roofing is complete. To receive a final sign-off,the following items will be verified: a. Flat roofs shall have a minimum of 1/4"per foot of slope and must 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. 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 pro er owner or authorized agent to act on the property owner's behalf. I understand and agree to co i the re-roof policy stated above. Signature of Applicant/Agent: Date: ReroofPolicy_2010.doc revised 05/17/10 Feb 04 14 10: 20a Cosmos Roofing (650) 969-9905 p. 2 10300 TO MAVMW 4NP&tioo CA 45014 t Tolq*m(408)777--3216 Fu(406)777-3333 OF CUPEkTINO Buil din De artment jos JWDRES& PERMIT# OWWWS NAME: Pftv-,L P A3 t:ptr- GErMAL CONMCrOft- FAX# 4 I am not using any Date Please ch>xk the"Owiatiabornnt iot>r: SUBCONTRACTOR BUSINESS NAME BUSUMS LICENSE# Caber&Mi11W Ork C�nes><t Eiecbkd E=vadan Hooeng g LhWleGM/Woad Gloss/Glazing Heating Ir�sulati�n Landscapitc�g . Lang Orramut<td Sliest MeW Painft/`Wall Paving Pl Pl - - R STLk Tank Sheet Metal Shea Rock - Date 2014-02-04 10:17 650 969 9905 Page 212