14030071 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1449 PRIMROSE WAY CONTRACTOR:COSMOS ROOFING PERMIT NO: 14030071
OWNER'S NAME: MORRISON RICHARD L AND MARY J 999 COMMERCIAL ST STE 105 DATE ISSUED:03/11/2014
OWNER'S PHONE: 6508890504 PALO ALTO,CA 94303 PHONE NO:(650)969-7663
16— LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL
�
(27 SQ'S)TEAR OFF(E)SHINGLES,INSTALL OSB
License Class Cc/
3 ?Linc.4 79 5 Cfq / LIFETIME COMP
Contractorc-0 r7,MC`j `�""rt Date 3 1
I hereby affirm that I am licensed under a 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
Co p sation,as provided for by Section 3700 of the Labor Code,for the
f nce of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$13400
e d will maintain Worker's Compensation Insurance,as provided for by
do 3700 of the Labor Code,for the performance of the work for which this APN Number:36617052.00 Occupancy Type:
ermi 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 LAST LED 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 Dates l J� /
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal de Section
9 18.
E- S:
Signature Date 3 f 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.
❑ OW R-B ER DECLARATION ? f 1
Signature of Applicant: e:
I hereby affir t I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERIN O 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. 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(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 Distri
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chap. 2 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 a e : Date:3 t
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 CONST �LENDINGAGENCY
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 (�O
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 v
CUPERTINO (408)777-3228 FAX(408)777-3333•building acupertino.orn INN
PROJECT ADDRESS 49
r^120SE APN# /�/ I r 1 2—
k<t
—
kZtPHONE (' E-MAIL
STREET ADDRESS I�'+p `V CITY,C vSTATE, FAX
1 A D/
CONTACT NAME WANDA @ COSMOS ROOFING PHONE 650-969-7663 H E-MAIL
STREET ADDRESS 999 COMMERCIAL STREET #105 CITY,STATE,ZIP PALO ALTO, CA 94303 FAX 650-485-2314
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT EJ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME LICENSE NUMBER LICENSE 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/ENGINEER NAME LICENSE NUMBER BUS.LIC.#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP .{ PHONE
USE OF ❑ SFD or Duplex ❑ Multi-Family ROOF AREA: (� VALUATION:
STRUCTURE: ® Commercial _�_6 S O 's l 3 g 0 O
EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE ItYES IF NO, O�r PLYWOOD )L%" ❑ PLYWD OSB PITCH: 4 •12 ROOF A
NO #LAYERS: G THICKNESS: 115/8" TYPE: ❑CDX CLASS:
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF IXASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT#
DESCRIPTION OF WORK: I—� I I C -7 J t
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 an verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I a prese es of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: Date: If
SUPPLE INFORMATIO D OFFICE USE ONLY
If building is associated with a Home O er's As on,provide letter PLAN CHECK TYPE ROUTING SLIP
of approval from HOA. R-zIIE couNTER ❑ BUILDING PLAN REVIEW
Provide Planning approval t0 Veri ere any restrictions. LJ 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
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 1449 PRIMROSE WAY DATE: 03/11/2014 REVIEWED BY: MELISSA
APN: 366 17 052 BP#: "VALUATION: 1$13,400
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY SFD or Duplex PENTAMATION
USE: pPERMIT TYPE: 1SFDWLR00
WORK TEAR OFF E SHINGLES INSTALL OSB LIFETIME COMP
SCOPE
FEE ID ROOF AREA
s.f.
1REROOFFRES 2,650
i hY'9
iLleeh. Ph,,,n{.`heck phos('heck /'/c,.:. PiOn C`h�:cir
1711,:h. 1'et-rnit Fee: 7�1111:mb. fermi!Fee, fare �'et�77r7i t��'cr
ti,h�r �ftcc h.r Oti'rer I',ur�slr 7r sl>. E3 Olhr>t't r r. linl r. L1
Flex t t =i�.1""(; Plurnlr li?sp. Vete: 1,17C(,?rstr I <
NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,eta). Theseees are based on the prefinddna information available and are only an estimate. Contact the De t or addn'l info,
FEE ITEMS (Fee Resolution 11-053 Eff 7/1/13) FEE QTY/FEE MISC ITEMS
1'11ctra Check 1"ce>:
Y° ,,e
('t:
Permit Fee: $432.00
f'Cctr t}3.%; i<r'?t.il tc>r Permit tee:
("'ons0,71(:iion Kr:t:
lc:ltr irrjg e"r tr 'E Fey
Work Without Permit? ® Yes Q) No $0.00
Str.onz Motion Fee: IBSEISMICR $1.34 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
$434.34 $0.00 TOTAL FEE: $434.34
Revised: 01/15/2014
REROOf TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E.,C.B.O.,BUILDING OFFICIAL
CIJPERTINQ 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•building(a cuaertino.ora
PROJECT ADDRESS /J a75 i5_ APN# I /� C -
OWNERNAME J�1 11 �/ J)COPItNC o , '-Q Q E-MAIL
STREET ADDRESS I` t4lI I M"C CJS CITY, STATE,ZIP FAX
�� ZIP
CONTRACTOR NAME L t LICENSE NUMBER/J ,l' LICENSE TYPF f BUS.LIC.#
JA4
COMPANY NAME /^ v ( E-MAIL 37_ ` ,�'
L-10 C
STREET A<7 e-0olPO tzc27- ^ r'Dl CIT0 70 HONE 416,7-,740
I UNDERSTAND AND `AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable provisions of the 2013 California Codes.
2. An inspection request can be scheduled up to one business day before the requested inspection date.
Please schedule inspections online or call (408) 777-3228 from 7:30-3:30pm (Mon-Thurs) or 7:30-
2:30pm (Friday) to schedule 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. The hours for this service are: 7:30-10:30am and 12:30-3:30 (Mon-Thurs)
and 7:30-10:30am and 12:30-2:30 (Friday). 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. 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.
7. 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. 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 in accordance Sections R314 and R315 of
the 2013 California Residential Code.
Signature of Applicant/Agent: Date: 3 � )
ReroofPolicy_2014.doc revised 01/15/14