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14080278I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 20377 CLAY ST I CONTRACTOR: COSMOS ROOFING I PERMIT NO: 14080278 I OWNER'S NAME: KELLER MARTIN J AND DEBRA A ( 999 COMMERCIAL ST STE 105 I DATE ISSUED: 08/29/2014 I OWNER'S PHONE: 4082558496 I PALO ALTO, CA 94303 I PHONE NO: (650)969-7663 I ZI LICENSED CONTRACTOR'S DECgLARATION License Class 5� I �Liic.. # G 3 I Contractor IY`rt Date 29 I hereby affirm that I am licensed under a provisions of Chapter (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 pte ance of the work for which this permit is issued. f1 e 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 er it is issued. \ APPLICANT CERTIFICATION 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequenceif the granting of this permit. Additionally, the applicant understand will comply—as with all non -point source regulations per the Cupertino icipal Code, Section 9 18. Signature / / Date ?� t ❑ OWNER- O LfiER DECLARATION I hereby affirm that V.Kempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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. 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 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. APPLICANT CERTIFICATION 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 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9 18. Signature Date JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ TEAR OFF (E) WOOD SHAKE, INSTALL (N) OSB, INSTALL LIFETIME COMP, CLASS A (33 SQ'S) Sq. Ft Floor Area: I Valuation: $16835 APN Number: 36938022.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS F LLED INSPECTIION.­S17,511 �/ --- Date:- S z ! 1 7 RE -ROOFS: All roofs shall be inspected prior to any roofing material being ailed. If a roof is installed without first obtaining an inspection, I agree to re ve all new materials for inspection. Signature of Applicant: Date:�� ALL ROOF COVERINGS;CO BE CLASS "A" OR BETTER I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit h rdous air contaminants as defined by the Bay Area Air Quality Manage t District I will maintain compliance with the Cupertino Municipal Co hapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 2 4. Owner or authorized agent: Date:A/. 5) l / I hereby affirm that there is a co stending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional REROOF PERMIT APPLICATION 0 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buildina(a)cupertino.ora j PROJECT ADDRESS ( 7 �j 7 ��.� � ( �/t/r7u'� APN# 6� I1AR� � IITj C� PHONE�J A E-MAILo S�/A�A '7 S GL� 1 Tf- C CIW TO(.'iC2D % f �t% ii/'r7 ( �� l FAX CONTACT NAME WANDA Q 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 -BUB -DER ❑OWNER AGENT XI CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME RICH COSMOS LICENSE NUMBER 785441 LICENSE TYPE C39 BUS. LIC. # 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 IKSFD or Duplex ❑ Multi -Family ROOF AREA: VALUATION: 0-0] � �� 3 STRUCTURE: I Commercial 330-0 "^ EXISTING ROOF TYPE: ❑ BUILT -IJP ROOF ❑ ASPHALT SHINGLES )KWOOD SHAKES ❑ WOOD SHINGLES 11NGLES OTHER (SPECIFY) REMOVE /REPLACE LYES IF NO, PLYWOOD �'7" ❑ r� PLYWD OSB PITCH: j' 'I ROOF 13 NO # LAYERS: THICKNESS: 115/8" TYPE: ❑ CDX —+— ' 12 CLASS: A PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF IcISPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -ES REPORT # DE CRIPT'O' OFA)l I /i�� )4� By my signature below, I certify to each of the following: I am the property owner or authorized agent to a5.o ®-pra(sefty owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work a Itis accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I aui sentatives o ertino to enter the above -identified property for inspection poroses. Signature of Applicant/Agent: Date: �b Z SUPPLF4I INFORMATION YQtOeD OFFICE USE ONLY PLAN COCK TYPE ROUTING SLIP _ If building is associated with a Home Own ssociation, provide letter 6Y S T)19�GIjIiN1ER ❑ BUILDING PLAN REviEw of approval from HOA. Provide Planning approval to verify if there any restrictions.(]XpREss. ❑ PLANNING PLAN REVIEW _ Provide copy of Manufacturer's Installation Specifications.t 0 gTANDARD;° ❑ FIREDEPT Provide signed copy of Cupertino's Tear -Off Policy. ❑ OTHER: ReroofApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION I& ADDRESS: 20377 CLAY ST DATE: 08/29/2014 REVIEWED BY: MELISSA MISC ITEMS APN: 369 38 022 BP#: *VALUATION: 1$16,835 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY USE: SFD or Duplex PENTAMATION PERMIT TYPE: 1SFDWLR00 WORK TEAR OFF E WOOD SHAKE INSTALL N OSB INSTALL LIFETIME COMP CLASS A 33 SQ'S SCOPE $561.00 Ifec'h. Phlt ? C:'hcci, A,fe 1K 11hinA .111a r C.'ht'<:k Fhvrnb. Ower 11,,mib Imp, 1' a nb, hnf.?.1`ee; E.,` ...., .€1746: fi £, NOTE. This estimate does not include fees due to other Departments (ie. Planning, Public Works, Fire, Sanitaq Sewer District, School umstrmct, etc.. 1 nese ees are aasea on me reumana mn ormanon avauaame ana are onty an estimate. contact the ve t or aaan'[ into. FEEITEMS (Fee Resolution 11-053 E . 711113) FEE QTY/FEE MISC ITEMS Pl(,,,n Check F*ee: T_ :}S�idppl. PCFee g p ec Permit Fee: $561.00 Sup,,pl. 11lsp ee, flE;rnfit d'C.e I OlUt.rUclioll Tux: T7 A�'iminisu-aiive Fee: orkry/Without Permit? Work0 Yes No $0.00 / d`flve l)ocZlD7ae7%Pafion `Fees: Strong Motion Fee: 1BSEISMICR $2.19 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 S ` ' $564.19 $0.00 ,., TOTAL FEE: $564.19 Revised: 08/20/2014 Ct1PERTINQ REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - buildinoacupertino.ora PROJECT ADDRESS 'Z 03 7 7 Gr c- a -5 74-6- 7 APN Y - 3 � — /'�' f OWNER NAME �J/� fZ �7 i J �C I I t R. '�� I� I P1H� b,2 ' 2- �' 1S 9 b b,2.2- E-MAIL STREETs 1-9t t- i b3 ?' l C C�e/T� 'f % 1 n1 U ---A- �� SU' 1 L f FAX CONTRACTOR NAME LICENSE NUMBER/J/� �� . ! LICENSE TYPE,^ p BUS. LIC. # � 1 t COM2ANYNA1,4E � VA CT Zr \CX/ ? /V E MAII I F�}SD' 41 f O 7 STREET PSS TS <9,4 ��-r -� �©s CrrY, STATE, ZIP - � kf ?130 P� � . 9G � a766 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 -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 >ny 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 inonoxide detectors are required to be installed ' cordance with Sections R314 and 8315 of the 2013 California Residential Code. ` Signature of Applicant/Agent: Date: i1/Z%%/ ReroofPolicy_2014.doc revised 01/15/14