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B-2016-1780CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: "CONTRACTOR: PERMIT NO: B-2016-1780 10162 BEARDON DR CUPERTINO, CA 95014-1931 (326 32 021) COSMOS ROOFING MOUNTAIN VIEW, CA 94043 OWNER'S NAME: YANG JEFF N AND YIH-NAN TRUSTEE & ET AL I DATE ISSUED: 04/18/2016 OWNER'S PHONE: 408-867-0878 1 PHONE NO: (650) 969-7663 License Class C-39 Lic. #785441 Contractor COSMOS ROOFING INCDate 94/30/2017 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: 1. 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. APPLICANT CERTIFI ATION 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 -p -a t source regulations per the Cupertino Municipal Code, Secti p.9-1 Date 04/18/2016 I hereby affirm that I am exempt 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) z. 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. 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. z 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. 3. 1 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 thiscertificateof 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 revolted. BUILDING PERMIT INFO: X BLDG _ ELECT —PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: REMOVE (E) TAR AND GRAVEL; INSTALL 4 -PLY BUILT-UP ROOF (22 SQ'S) Sq. Ft Floor Area: 2200 l Valuation: $11615:00 APN Number: Occupancy Type: 32632 021 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAS�T CALLED SPECTION. ,✓ Issued by: Alex Vallelunea �-fj Date: 04/18/2016 (j RE -ROOFS: 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. Signature of Applicant: Date: 04/18/2016 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE 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 hazardous air contaminants as dermed by the. Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. , Owner or authorized agent: APPLICANT CERTIFICATION I Date: 04/18/2016 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 04/18/2016 hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Nam6 Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 - building(d,)cupertino.orq CUPERTINO �1 Lo - If PROmcTADDRESs 16 Z.E �� 7- APN # OWNER NAMI y� ._ aV/ ®� AND lIV - ( /� t YFT N r� PHONE a ! ° O� 79 EMAIL ...� s i ss �O.�z�rt_, CITY, STATE, ZIP a FAX CONTACT NAME Bobby Payne ❑ ASPHALT SHINGLES ❑ WOOD SHAKES PHONE b50-969-7663 $MATT, IF NO, STREET ADDRESS 1901 Old Middlefield Rd PLYWOOD , CITYSTATE, ZIP Mountain View, CA 94043 PAX 650-584-3078 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT K CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCIIITECT ❑ ENGINEER ❑ DEVELOPER 0 TENANT CONTRACTOR NAME RICH COSMOS #LAYERS: LICENSE NUMBER 785441 THICKNESS: LICENSE TYPE C39 BUS. LIC. # *j Y Ltq, Ij COMPANYNAME COSMOS ROOFING 12 E-MAII PROPOSED ROOF TYPE: BUILT-UP ROOF FAX 650-485-2314 STREETADDRESs 1901 Old Middlefield Rd 11WOOD SHINGLES 11OTHER CITY,sTATE,zIP Mountain View, CA 94043 PHONE 650-969-7663 ARCHITECTIENGINEER NAME T/rZ 1- 6 0 ?,-75H,-r LICENSE NUMBER Sv® I-7- C4 ZOE1. BUS. LIC. COMPANY NAME STREET ADDRESS E-MAIL CITY, STATE, ZIP FAX PHONE USE OF '$ SFDorDuplex El Multi -Family ROOFAREA: VALUATION: � -Commercial STRUCTURE. EXISTING ROOF TYPE: ,BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES EIWOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE/REPLACE YES IF NO, PLYWOOD 11 %- ElPLYWD ❑OSB PITCH: ROOF ❑ NO #LAYERS: THICKNESS: ❑ 5/S" TYPE: ❑ CDX 12 CLASS: A PROPOSED ROOF TYPE: BUILT-UP ROOF 11ASPHALT SHINGLES ElWOOD SHAKES 11WOOD SHINGLES 11OTHER ICC -ES REPORT # DESCRIPTION OF WORK:i K- L-3 -Tlt- .AZ— OT -f T/rZ 1- 6 0 ?,-75H,-r i A) 11 q- 'PI,/ Sv® I-7- C4 ZOE1. r a SCS 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 constru au nze representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: -bate: Lf 1 r�? I I f, SUPPLEMENTAL INFORMATION RE If building is associated with a Home Owne ssociafion, provide letter of approval from HOA. Provide Planning approval to verify if there any restrictions. Provide copy of Manufacturer's Installation Specifications. Provide signed copy of Cupertino's Tear -Off Policy. ReroofApp_201 Ldoe revised 03116111 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 • buildinaCa)cupertino.org �- vI COP F+ X f PROTECT ADDRESS ( f . APN # p A.WD yIY I/ PHONE 0p.,C E-MAILOWNERNAME STREETADDRESS I11"L _8CnDQJ CITY,STATE, ZIP � CA FAX CONTRACTORNAME RICH COSMOS LICENSE NUMBER 785441 LICENSE TYPE C39 BUS. LIC.# COMPANY NAME E-MAIL FAX COSMOS ROOFING 650-584-3078 STREET ADDRESS 1901 Old Middlefield Rd CITY, STATE, ZIP Mountain View, CA 94043 PHONE 650-969-7663 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-roofmg is complete. To receive a final sign -off, the following items will be verified: a. Fiat roofs shall have a minimum of V4 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 property owner or authorized agent to act on the property owner's behalf. I understand and a comply with the re -roof policy stated ]j above. Signature of Applicant/Agent: Date: ReroofPolicy_2010.doc revised 05117110