06070177 CITY OF CUPERTINO
BWLDINC D'vVIStON PERMIT 4CONTR>0Rj FORMAT- 10 ,
',�"+,T;Le:: n. � s :� .,dr d•r.a.; fix..-, 4.
BUILDING ADDRESS: L COSMOS ROOFING 1 PERMITNOO 6070177
10610 WUNDERLICH DR
OWNER'S NAME: PERMIT ISSUE DATE
MANFUNG IP 1901 OLD MIDDLEF 0
NE:
SANITARY NO. CONTROL NO.
(650) 969-7663
ARCHITECT(ENGINEER: BUILDING PERMIT INFO
BLDGELECT PLUMB MECH
0 t 0 0
too LICENSED CONTRACTORS DECLARATION IOS Description
W 1 hereby affirm But 1 am um
licensed kr provisions of Chamm
pter 9(Coencing
�IIm with Section 700M of Divi'..3 of the Rus.am/ProfessioK Code.sa lmy license is
mmnfoaaMer REROOF WITH TAR AND .GRAVEL CLASS A
m vn z License class 3 Lie.p
Dam — Contaacmr
ARCHI ECT'SDECLARA RoN
t a< 1 understand my plana shall be used as public records ��
aU
a G Licensed Professional
OW NER-BUILDER DECLARATION
f 1 berehy alum that 1 am exempt from the ContranaYs License Law far the
:O D following mason.(Section 7101.5,Business and Rufessiom Cade:Any city or County .�
m which roquims a Permit m cowtracl aIle+.Improve.demolish,or midair any suumure r J G $5840
_z< prior to its issuance,also mqui=the applicant for such Permit a fle a signed statement
:�0 that he is licensed puraumuo the provisions of the Contractor's License Law(Chapter 9 S Ft.Floor Area Valuation
R (commencing with Section 7000)of Division 3 of Ne Business and Professions Cede)ur
Oat he is exempt thcmfmm and the basis for the alleged exmnpil Any violation of
Section 7031.5 by any applicant for a permit subjects the applkanue a Civil Penalty of 1Occupancy Type
trot more Bun five huMmd dollars($5001
0 1,is,owner of the property.or my employees with wages as thew sole compensation,
will do Oc work and the structure is Cot Inundad or aRemd roe sale(Sec.7014,Business
and Rofessiom Cada:The Conuazmr's Liave Law dors not apply to an owner of Required Inspections
property who builds or ire proves thefuan and who deee meb work himsel f as through his
Own cmplayou%provided that such improvements sae notintended oroRered fmsak.If.
however,Ne building or improvement is Cold within arse year of completion,the Owner.
builder will have the bureau of proving Nat M did Cot build a improve for purpose of
ale.).
0 1,u owner er the property am exclusively Contracting with licewed conuanors to
constmtt the project(Sec.7044.Busirmss W Professors Code:)The Convacmr's U.
cause law dose not apply to an owner of property who builds or improves themon,and
who contras for such projects with a contractor(s)licensed pursuant to the Convector's
License Law.
0 1 am exempt under Sec .B h P C for Ora fusion
Owner Dau
WORKERS COMPENSATION DECLARATION
1 hcmby affirm under pewlty of perjury mm of the following dalaauons:
I have and will maintain aCeri ficase of Consent n self-insum for Worker's Compen-
aatiun,as provided for by Section 3700 of me[Aber Code,for the peAonnmco or the
weak for which this permit is issued.
0 1 have and will maintain WorkeYs Compensation Insurance,as required by Section
3700 of the Labor Code,for the performmce or the work fon which this permit is issae.
My Worker's Campeau1dor huurencef,Carriie1r and Policy number H:
Cartier. 1 'a S(��kk{e}a.ALAPoIicy Ne.: —
'' C ENCA RKERS'
COMPENSATION INSURANCE
(This sealom need mat becomplcied if thc permit is foronc hundred dollar($100)
loss)
I certify that in the Performance of the work for which this permit is issued.I shall not
employ any person in any mmaterm as an become subject in the Workers'Compensation
Laws of Califomia.Date
Applicant
NOTICE TO APPLICANT:If,after making this Ccnifrcak of Exemption,you should
become subject in the Worker's Compensation provisions of the Labor Coes,you mum
.J O forthwiN comply with such provisions or this permit shall In,deemed revoked.
z h CONSTRUCTION LENDING AGENCY
[+ I hemby affirm that Vert is a Construction knding agency for the Performance of
C
the work for which this Permit is issued(Sec.3091,Civ,C.)
0 Lcndefs Name
z Lendees Address
(J Q 1 certify this I have mad this application and Aum that the above informNun is
(L torten.I agree to comply with all city and county ordinances and awe laws relating to
0U building construction,and hereby aethoriae mprcsematimS of WS City m enter upon the
above mentioned P.,,Iy for inspection rposes.
H Pu0. (We)Agra to ave,indemnify and kap harmless the City of Cupcnino agmed
liabilities.judgments,toss and expmw eswhich may in my way ocean against said City
UZ In Co.,..or the granting of this Permit.
APPLICANT UNDE STANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: DateC-
SOU REGUL
�1 (� Y�
7-26' 6 Re-roofs
5ilillem.ofAppric _tuar HAZARDOUSMATERIALSDISCLOSURE Date of Roof ��-
Will the applicant of future building occupantmore arhandlc havmduw material
U defined by the Cupertino Municipal Code.Chapter 9.12.and the Health and Safety
Code.Section 25532(a)+ All roofs shall be inspected prior to any roofing material being installed.
41 GYw Na
If a roof is installed without first obtaining P g an inspection,I agree to remove
Will Ne applicant or future building Occupant tax equipment or dcvims which
emit harardnus air contaminants as declined by the Bay Area Air Quality Management all new materials for inspection.
Dimict7
DYw �Nu
I have real the haarMwsmakrials requirements under Chap crd.95 of the Calilm,
nia Heal"SafetyCade,Sectiones 25505.25533 am125534.1 andesmM ti icifRc Wilding
caw Cot curtend,have a Con that it u my Omponsibility m notify the«cupant of the
myvir5 which muse party commi ora Certificate or Occupancy.
�aG-Db Signature of Applicant Date
Owma or mthcuiro Dam All roof coverings to be Class "B"or better
CITY OF CUPERTINO
�m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 37527019 . 00
DATE ISSUED. . . . . . . : 07/26/2006
RECEIPT # . . . . . . . . . : 35386
REFERENCE ID # . . . : 06070177
SITE ADDRESS . . . . . : 10610 WUNDERLICH DR
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : . CUPERTINO
IMPACT AREA . . . . . .
OWNER MANFUNG IP
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : COSMOS ROOFING
CONTRACTOR . . . . . . . : COSMOS, RICHARD LIC # 18844
COMPANY . . . . . . . . . . : COSMOS ROOFING
ADDRESS . . . . . . . . . . : 1901 OLD MIDDLEFIELD WY
CITY/STATE/ZIP . . . : MOUNTAIN VIEW, CA 94043
TELEPHONE . . . . . . . . : (650) 969-7663
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- -- -------- ---------- -- -------- - ---------
BPERMFEE VALUATION 6, 000 . 00 126 . 36 0 . 00 126 . 36 0 . 00
BSEISMICRE VALUATION 6 , 000 . 00 0 . 60 0 . 00 0 . 60 0 . 00
-- - ------- ---------- ---------- ----------
TOTAL PERMIT 126 . 96 0 . 00 126 . 96 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----- ----- - - ----- ----- -- ----- -- ----------------
CASH 126 . 96
TOTAL RECEIPT 126 . 96
•
CommumW beveloptoent
t0300 Tate Avmoe
Cupatmo CA 95034
Telephone(408)777-3228
CUPERTINO Fax(4ft)777.3733
� Buildin De artment
JOB ADD" PEit1►tTI
OWNER'S NAME R N F u" ZP PHONE N bsa aim -7Lk,3
GENERALQONTRACTOR. inOs Dry- FAX At Sn, RGI 94t�5
X I am not Lasing any subcontractors; VA Od
Sa Date
Please cluck applicable subcontractors and Com lete the followin information;
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE 0
Cabinets&Millwork
Cement Finishing
IIecttical
Excavation
Fencing
Flooring Carpet
Linoleum/ Wood
Glass/ Glazing
Heating
• Insulation
Landscaping
Lathin
Maso
OnMuntal Sheet Metal
1' / Wall per
Pa '
Plastering
Plumbing
Roofing
• Tank
Sleet Metal
Sheet Rock
Tile
x
Owner/Con
Date
•
OU010111
CITE' OF CUPERTINO
Sua REROOF
• OF
CUPERTINO PERMIT APPLICATION FORM
APN# ��21- 01(21Date:
7-
Building Address:
10610 WlInatc.-Vrk DA
Owner's Name: Phone#:
M 1 `IO$- q Q6-
Contractor: License#:
CC)S(Y)Q5 Z Ll
Contact: Cupertino Business License #:
LIT 6,29- 9
Type of Roo Covering:
Existing: Proposed:
Rr Built-Up Roof a Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description:
r r
AY �f Gff
Residential Commercial ❑
Fire.Zone: Yes ❑ No Confirmed with Planning Dt. if
there are any restrictions:
Cost of Project: Type of Construction: Occupancy group:
Qty, if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
/ BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
•
Community Development Department
Building Division
City of Cupertino'
10300 Torre Avenue
• Telephone: (408) 777-3228
Fax: (408) 777-3333
Building Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards
and manufacturers specifications on re-roofing.
2. New roof coverings shall not be applied without first obtaining all inspection
and written approval from the building inspector. A final inspection and
approval shall be obtained from the building inspector when the re-roofing
is completed.
3. All roofs shall be inspected prior to any roofing installation.
4. To receive a final sign off from the City, the following steps are
required:
1) Pre-inspection and/or tear off approval.
2) In-progress inspection approval.
3) Final inspection approval.
a) Spark arrester installation.
5. If plywood is installed,a plywood nail inspection is required.
• 6. Any roofing which is applied without first obtaining an inspection,
will require the removal of all new material down to the sheathing,
so a proper City inspection can be performed.
7. NOTE: If you call for a plywood nail inspection and the job is not ready,
you will be charged a re-inspection fee of$176.18. The re-inspection fee must
be paid before another inspection can be scheduled
IMPORTANT:
1. Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: man Ll n G ( P
Job Site Address: 1pC�l f17„�.�g�1 64 Qc �Uer�iitYi
Roofing Company Name: Ca j M o It L,
Applicant's Signature: Date:
• Greg Casteel
Building Official
Revised 11/2/04