14070078 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10744 MORENGO DR CONTRACTOR:COSMOS ROOFING PERMIT NO:14070078
OWNER'S NAME: RAYMOND MAUSLING 999 COMMERCIAL ST STE 105 DATE ISSUED:07/17/2014
OWNER'S PHONE: 4089730206 PALO ALTO,CA 94303 PHONE NO:(650)969-7663
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL
TEAR OFF(E)COMP ON IST FLR SECTION ONLY,NO
License Class C Lic.# 91 5 RESHEET,INSTALL LIFETIME CLASS A ROOF SYSTEM
Contractor M ] t 11, Date 7 t OVER
I hereby affirm that I am licensed under a provisions of Chapter 9 (E)FELT.(16 SQS)
(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
pe rmance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$6980
ve and will maintain Worker's Compensation Insurance,as provided for by
tion 3700 of the Labor Code,for the performance of the work for which this APN Number:37535058.00 Occupancy Type:
pe it 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 IT 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 0 DAY LLED 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 s Y: Date:
with all non-point source regulations per the Cupertino M Code,Section
9 18.
RE-ROOFS:
Signature Date 7 l 7 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 I new materials for
inspection.
❑ OWN -B R DECLARATION r r
Signature of Applic Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF CO 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)
I,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 District I
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Cha r 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: ?/1 7fi
permit is issued.
ell-
I certify that in the performance of the work for wh h this permit is issued,I shall
not employ any person in any manner so as to becom subject to the Worker's
Compensation laws of California. If,after making this certificate of exemption,I CONS �NNLFNDING 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 O�
13 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION , t
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 ` ,
CU PR`i"I NO (408)777-3228•FAX(408)777-3333•build ingna cugertino.org
PROJECT ADDRESS /074t4, �� 0 r APN# 3 /j 5
OWNER NAME 't/ J L( PAI P40 3 -7 r0 ,0 E-MAIL)
STREET ADDRESS t 0'744 .A/1 O f2 �D � - CITY,STATE,ZIP FAX
Y R, c-L-7 r nl0 C O l q
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 SI 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 6 5 0-4 8 5-2 314
STREET ADDRESS CITY,STATE,ZIP PHONE 650-969-7663
999 COMMERCIAL STREET #105 PALO ALTO, CA 94303
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 xooF ARE VALUATION:
STRUCTURE: ® Commercial 160-0
EXISTING ROOF TYPE: ❑BUILT-UP ROOFSPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY)
REMOVE/REPLACE YES IF NO. "PLYWOOD ❑ S4" ❑ PLYWD 1:1OSB PITCH: ROOF
El NO #LAYERS: THICKNESS: El 5/8',
TYPE: ❑CDX :12 CLASS: A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF g ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES' ❑OTHER ICC-ES REPORT#
DESCRIPTION OF WORK: � '4, e � 6` 6-+-I Aj O 2t—
aJ r l c F l r 7--z-7iwl e— weiz DJO (Itoz �
i;�(r- Gftr5,5 14 X1 (2-57 S CfzY 5CZ'_7r0,^J oA)L- L/,
By my signature below,I certify to each of the following: I am the property owner or authorized a en on the property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Descriptio an verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I authorize repre Yes of C pertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: Date: / 1`7
SUP L INFORMA UIRED OFFICE USE ONLY
_ If building is associated with a Home Owner's Association,provide letter PLAN CHECK TYPE ROUTING SLIP
of approval from HOA. 130.VER41[E-COUNTER ❑ BUILDING PLAN REVIEW
_Provide Planning approval to verify if there any restrictions. p E� � ❑ PLANNING PLAN REVIEW
Provide copy of Manufacturer's Installation Specifications. � �$z H p ❑ kkE DEPT
Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER:
ReroofApp_2011.doc revised 03116111
CITY OF CUPERTINO
FEE ESTIMATOR— BUILDING DIVISION
ADDRESS: 10744 MORENGO DR DATE: 07/17/2014 REVIEWED BY:
APN: 375 35 058 BP#: *VALUATION: $6,980
xPERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY PENTAMATION
USE: SFD or Duplex PERMIT TYPE: 1SFDWLR00
WORK TEAR OFF E COMP ON 1ST FLR SECTION ONLY NO RESHEET INSTALL LIFETIME CLASS A
SCOPE ROOF SYSTEM OVER (E) FELT. (16 SQ'S)
FEE ID ROOF AREA
s.f.
1REROOFFRES 1,600
A,,e,c I'ion E hce 4, I'fr�rtrh. hart C`Frec&� f r>��. /11 1n Check
Other 1'IDhah Irtstp_ Li
L3tir�ff t°c.z'n;1.
H,( hyp, ; 1'ilmd) h;,v). fere:
NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 info,
jFEE ITEM1-S(Fee Resolution 11-053 Eff 7/1/13) FEE QTY/FEE MISC ITEMS
pr_.. 1
Permit Fee: $272.00
•�.�{€#,TY!{7 _:.t;)(l T.icc l�tiJ"1'fltt /'ee.
T-T
Work Without Permit? 0 Yes 0 No $0.00
101", !710 inrr bees:
I
Strong Motion Fee: 1BSEISMICR $0.91 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
z ap $273.91 $0.00 $273.91
S TOTAL FEE•
H �
Revised: 07/10/2014
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR,P.E.,C.B.O.,BUILDING OFFICIAL
CUPERT'tNO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)77!7-3333•buildino(a-cupertinomg
_7PROJECT ADDRESS 6?-1 C bre f 1 APN# 3-4-57-- 5< Dg
OWNER M A-05,L 1".) 6 - PT V9 I �T 3- 02-06
E-MAIL
STREET ADDRESS CITY,STATE,ZIP FAX
t co?14 -f t�v,2� ,J o 1�iL c� ,R-T r..1 o c 4 �5., L(
ce
CONTRACJSTMOR NIAME� f t LICSCE�L OBER LICENSfq E ,J TYPE BUS.LIC.# r /
3 of
COMPANY NAME E-MAIL E-MAIL F X O , L4 2 S• Z 3 I
STREET ADDRESS Cr
STATE,ZIP PHONE
`7 GovvlG�lhZG� /4vE z� /�_7 �/ - 65d 96 9, 7G6 3
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-dawn 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 with Sections R314 and R315 of
the 2013 California Residential Code.
Signature of Applicant/Agent: Date:
ReroofPolicy_2014.doc revised 01/15/14
Building Department
City Of Cupertino
10300 Torre Avenue
.Cupertino,CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
CONTRACTOR/SUBCONTRACTOR LIST
JOB ADDRESS: 00 664010C 1Z- PERMIT# -1 tld'8 T
OWNER'S NAME: M64 UMbV Q612, PHONE# L(�rjg. (oq 1 -&e b
GENERAL CONTRACTOR: C>S BUSINESS LICENSE# Zq
ADDRESS: (017 DuW WAut- ywq- CITY/ZIPCODE:
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
j/ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical ( S bLb��j''j1JL�Oprt� Z� 1
Excavation
Fencing
Flooring/Carpeting
Linoleum/Wood
Glass/Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting/Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
`?- ,7 T
Owner/Contractor Signature Date