B-2017-0364CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-0364
1486 JAMESTOWN DR CUPERTINO, CA 95014-5353 (366 10 078)
COSMOS ROOFING
INC
MOUNTAIN VIEW, CA
94043
OWNER'S NAME: CBEN KEYU AND YIQIONG
DATE ISSUED: 03/06/2017
OWNER'S PHONE: 408-242-9942
PHONE NO: (650) 969-7663
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class = Lic. #785441
Contractor COSMOS ROOFING INC Date 04/30/2017
X BLDG _ELECT _PLUMB
MECH X RESIDENTIAL COMMERCIAL
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.
JOB DES RIPTION:
RE-ROO ; TEAR OFF (NO PLY); INSTALL LIGHT WEIGHT METAL
I hereby affirm under penalty of perjury one of the following two declarations:
ROOF (ESR -1483) SYSTEM (29 SQ'S)
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
rmance of the work for which this permit is issued.
e and will maintain Worker's Compensation Insurance, as provided for by
on 3700 of the Labor Code, for the performance of the work for which this
Sq. Ft Floor Area:
Valuation: $22000.00
it is issued.
Athat
APPLICANT CERTIFICATION
I cave read this application and state that the above
information is correct. I agree to comply with all city and county ordinances
APN Numbers
Occupancy Type:
and state laws relating to building construction, and hereby authorize
366 10 078
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
PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit.
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally, the applicant understands and will comply with all non -point
source regulations per the Cupertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CAL + ECTION.
Signature. ` ate 03 6/2017
Issued by: N
Date: 03/06/2017
R -B ER
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
following two reasons:
1. I, as owner of the property, or my employees with wages as their sole
installed without first obtaining an inspection, I agree to remove all new materials for
compensation, will do the work, and the structure is not intended or offered for
inspection.
sale (Sec.7044, Business & Professions Code)
2. 1, as owner of the property, am exclusively contracting with licensed
Signature ofApplicanti _
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 03/06/2017'
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVE S TO BE CLASS "A" OR BETTER
r. 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.
HAZARDOUS MATERIALS DISCLOSURE
2. I have and will maintain Worker's Compensation Insurance, as provided for by
I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code, for the performance of the work for which this
California Health & Safety Code,'Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
permit is issued.
s. I certify that in the performance of the work for which this permit is issued, I
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the.
the Health & Safety Code, Sections 25505, 25533, and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agent: �I -
APPLICANT CERTIFICATION
Date: 03/06/2017
I certify that I have read this application and state that the above information is
I hereby affirm that there is a construction lending agency for the performance
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
of work's for which this permit is issued (Sec. 3097, Civ C.)
to enter upon the above mentioned property for inspection purposes. (We) agree
Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City in
Lender's Address
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Code, Section 9.18.
Licensed
Signature Date 03/06/2017
professional
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building()cupertino.org /Y
PROJECT ADDRESS %� a{I C-5 ,c _ e Z
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OWNER NAME f f/ (` j"
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PHONE .2,4 ? ' �p� jC _
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E-MAIL
STREET ADD SS �
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FAX
CONTACT NAME
ALEJANDRO OCEGUERA
PHONE
650-969-7663
E-MAIL
STREET ADDRESS
1901 Old Middlefield Rd
CITY, STATE, ZIP
Mountain View, CA 94043
FAX
650-584-3078
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT El CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINP.ER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
ALEJANDRO OCEGUERA
LICENSE NUMBER
785441
LICENSE TYPE
C39
BUS. LIC. # p Q
[•V -J y
COMPANYNA M COSMOS ROOFING
E-MAIL
FAX 650-485-2314
STREETADDRESS 1901 Old Middlefield Rd
CITY,STATE,ZIP Mountain View, CA 94043
PHONE 650-969-7663
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC. #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF X"SFD Or Duplex ❑ Multi Family
STRUCTURE: EI Commercial
ROOFAREA:
'L--f9es
VALUATION: ��ry
2—'2d
EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES XWOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE/REPLACE AYES
❑ NO
IF NO,PLYWOOD
1 #LAYERS:
❑ ''/i' ❑
THICKNESS: ❑ 5/8"
PLYWD ❑ OSB
TYPE: ❑ CDX
PITCH:
'12
ROOF
CLASS: A
PROPOSED ROOF TYPE: 11BUILT-UPROOF ❑ ASPHALT SHINGLES ElWOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER
ICC -ES REPORT #
DESCRIPTION OF WORK:
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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 construction. I a tatives Of Cue enter the above -identified roperty for inspection purposes.
Signature of Applicant(Agent. Date:
DFz
SUPPL AL INFORMATION 2sociation,
_ If building is associated with a Home Owner's provide letter
of approval from HOA.
Provide Planning approval to verify if there any restrictions.j,;
— Provide copy of Manufacturer's Installation Specifications.
Provide signed copy of Cupertino's Tear-OffPolicy.
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ReroofApp MLdoc revised 03/16111
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 - building(Wcupertino.org%3 r Z® /5 / _ 3 f�
PROJECT ADDRESSj g 1 >rML_ _7(ne � �
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OWNER NAME $ j [ L J �J
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I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re -roof project shall comply with all applicable provisions of the 2016 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 (40 8) 777-3228 from 7:30-3:30pm (Mon-Thurs) or 7:30-
2:30prn (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 -tiff 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 perfonned.
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 ac with Sections R314 and R315 of
the 2016 California Residential Code. 3I (I
Sienature ofADDlicant/Anent: Date:
ReroofPolicy 2014.doc revised 12115116