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14080213
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18760 NEWSOM AVE CONTRACTOR:COSMOS ROOFING PERMIT NO: 14080213 OWNER'S NAME: ANNAPARAREDDI PRASAD BABU AND ANNAP 999 COMMERCIAL ST STE 105 DATE ISSUED:08/20/2014 OWNER'S PHONE: 4087774011 PALO ALTO,CA 94303 PHONE NO:(650)969-7663 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL E] RE-ROOF 21SQ-TEAR OFF GRAVE,REPLACE WITH 4 License Class Lic.Il 7 gs Cz PLY /� (1 �p c CLAS A Contractor / /�t r4 iA c Date I hereby affirm that I am licensed under 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 which this permit is issued. Sq.Ft Floor Area: Valuation:$11130 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 APN Number:37530011 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 D 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 DAYSF 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 the20� c granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9 18. R - OOFS: Signature Date 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. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: 2 I hereby affirm 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 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,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. �24 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 CONSTRUCTION LENDING 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 CITY OF CUPERTINO BUILDING PERMIT Bt ILDING ADDRESS: 18670 NEWSOM AVE CONTRACTOR:COSMOS ROOFING PERMIT NO: 14080213 OWNER'S NAME: WICHMANN MARIE L TRUSTEE 999 COMMERCIAL ST STE 105 DATE ISSUED:08/20/2014 OWNER'S PHONE: 4087774011 PALO ALTO,CA 94303 PHONE NO-(650)969-7663 ❑ LICENSED CONTRACTOR'S DECLARATION (LL I"- F BUILDING PERMIT INFO• BLDG ELECT ' PLUMB License Class Lic.# MECH F_ RESIDENTIAL F_ COMMERCIAL r Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION RE-ROOF 21 SQ-TEAR OFF GRAVE,REPLACE WITH 4 PLY (commencing with Section 7000)of Division 3 of the Business&Professions CLAS A 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 klo performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$11130 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:37530002.00 Occupancy Type: APPLICANT CERTIFICATION I certify that 1 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 ofthis city to enter PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. ganting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9 18 Issued by: Date: Signature Date ❑ OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. t,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, Signature of Applicant: Date: Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 1 have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. 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 Owner or authorized agent: become subject to the Worker's Compensation provisions of the Labor Code,I must Date: forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct. I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address 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 ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9 18 Licensed Professional Signature Date `w REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION .10300 TORRE AVENUE•CUPERTINO, CA 95014-3255V r/ CUlitRTtNO (408)777-3228•FAX(408)777-3333•buildingancupertino.org I PROJECT ADDRESS 6 (770 Rwl'om A I't I APN# OWNER NAME PONE �y E JMAII. Q• 1 !/ 11 CITY, ATE,ZIP FAX STREET ADDRESS J D �e \. 70 if It-W r CONTACT NAME L PHONE E-MAIL STREET ADD S, CITY,STATE,ZIP FAX 4 1 Co. s ❑ OWNER' ❑'OWNER-Bu DEP ❑.OWNERAGENT Q:o-yrxACTOR ❑CONTRACTOR AGENT ❑ ARCHrrECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CO CTO N LICENSENUMBER LICENSE TYPE BUS.LIC.# 4 y � COMPANY NAME E-MAIL FAX ST Eq,T ADD SS CITY A ,ZIP Lt-3PH SCJ 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: n" j� STRUCTURE: ❑ Commercial J 0 EXISTING ROOF TYPE:. �hUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE t &S IF NO, / PLYWOOD ❑ Fi" ❑ PLYWD E�OSB PTTCH: ROOF NO #LAYERS: ` TTHICKNESS: Ir 5/8 TYPE ❑CDX 12 CLASS: `� ICC-ES REPORT# PROPOSED ROOF TYPE: 11BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES 13 WOOD SHINGLES ❑OTHER DESCRIPTION OF WORK 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 rovided 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 t ' ing construction. I authorize representatives of Cupertino to enter the;bbboove-'dentified property for inspection purposes. Signature of Applicant/Agent: Date: 7/ 2�-1 SUPPLEMENTAL INFORMATION REQUIRED - If building is associated with a Home Owner's Association,provide letter of approval from HOA. Provide Planning approval to verify if there any restrictions. i Provide copy of Manufacturers Installation Specifications. _ _ Provide signed copy of Cupertino's Tear-Off Policy. ReroofApp_2011.doc revised 03116/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION WDDRESS: 18760 newsom ave DATE: 08/20/2014 REVIEWED BY: Mendez PN: BP#: EVALUATION: $11,130 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PENTAMATION 1 SFDWLROOF PRIMARY SFD or Duplex PERMIT TYPE: i USE: WORK re-roof 21 sq-tear off grave , replace with 4 p1V clas a SCOPE FEE ID ROOF AREA s.f. 1 REROOFFRES 2,100 do racer. �'zs'ntil Fee: I'lr,rr1,>. Pel C}tire�`I'iu�t?7 fns.= NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fare,Sanitary Sewer District,School District,etc). These fees are based on the preliminarv,information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/13) FEE QTY/FEE MISC ITEMS Permit Fee: $357.00 S'ttr)rrr, Work Without Permit? 0 Yes C) No $0.00 pct* tC ; = tcsr,"'Urig /'t,e ?.r"t l'+`'j i(i,'LiYi'}7!/IlfttYt Fees: � Strong Motion.Fee: IBSEISMICR $1.45 0.0 hrs Inspections Bldg Stds Commission Fee: IBCBSC $1.00 $0.00 Inspection,Hourly $359.45 $0.00 TOTAL FEE: $359.45 Revised: 07/10/2014 REROOF TEAR-OFF POLICY .f 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-buildin4(akupertino.ong PROJEC D S APN# OWNERNAME , PI�Q� ` E-MAIL STREET ADDRESS CITY, S TE,ZIP FAX Y CO 'TORNAME ) ENSE NUMBER LICENSE TYPE BUS.LIC.# I COMPANY NAC!©V E-MAL FAX STREET AD RESS V CITY a ZIP ^ O P� o C1 1 Gq noin al 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 with Sections R314 and R315 of the 2013 California Residential C Signature of Apphcant/Agent: Date: ReroofPo1icy_M4.doc remised 01115114