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08110071CITY OF CUPERTINO BUILDING DIVISION PERMIT CaNTRACwTaRT�t'EURMATION� BUILDING ADDRESS: PERMIT NO. 10046 CRESCENT RD COSMOS ROOFING ' OWNER'S NAME: PERMT17 L6UE DATE /2888 SA4614t69 CONTROL NO. 77 ARCHTTECDENGINEER: BUILDING PERMIT INFO RE -ROOF OVER NEW 40 YR COMPO BLDG ELECT PLUMB - MECH O O O LICENSED CONTRACTORS DECLARATION OVER EXISTING COMP Job Di tion escrp 1 hereby of ireln dI eco licensed muter Provisions of Chapter 9 (commencing wins Section 7OW) fDiAwm 3ofd. Business aM Professions Code, and my licwcu ""'-'- th con Toru and eR T .Sy - OnmcuClass Da¢ J/-/ f/A' Con r- ARCHTfECT-SD ATION i uMerwtxl my plane still housed as public records Licensed Profemonal OWNER -BUILDER DECLARATION I hereby aRrm that I am exempt from the Conuactofs License Law for the following mann. (Section 70313, Business and Pmfcsdons Codc: Any city or country which requires a permit m construct. slur. improve. demolish. a repair any sducture prior to its issuance, also requires dee applicant for such Permit to file a signed statement Ft. Floor Area Valuation that he is licensed percent to the provisions; of du Comracwr'a LJaenY Law (Chapter 9 Sq. (commencing with Section 7000) a Division 3 of me Business and Professions Cade) or that he is eumpt therefrom and the basis for the alleged exemption. Any violation of APN Number Occupancy e p y •T7y p Section 7031.5 by atry applicant fora Permit subjects 0th applicant to • peril penalty or not more than five hundred dollars MOB, ❑ 1, ar owner of me property m my cmploycea with wages a dmirsole compemadon, Required Inspections wiRdomew&andmewuctumbnotimmndedoroffemdrursale(Sec.7044,Bulinus and Proreseloes Code: The Contractors License Law does not apply in an owner or - property who builds a improv Merton, and who dos each work himself or through his own employees. provided that web improvements are not intended "offered for Bale. B. however, Ne building or irnmavement is sold within mm year of.omple i., the owner. builder will hate the burden of proving that he did nm build or improve for purpose of sale.). Q 1. u owner of the property, am exclaswily... totaling with licensed mndamon m construct me project (Sec. 7044, Business am Pretensions Code:) The Cwdanne. Li- ccnu law does me apply to an.went of property who builds m improv Ihemw, and, who comma is for such projects with a coneacroo(s) licensed pursuant to me Conoacmr's License Law. ❑ Iamesemptunder See ,BAPCfmmhmnwn owner Dau WORKERS COMPENSATION DECLARATION 1 hereby aBirm under penalty of perjury core of the following declarations ham and will maintain a Certificate of Consent t. self-inwm for Wod¢fs Compere 'on. as psavidcd fa by Section 3700 of 0. Labor Code. for de perfamrw¢ of the work for which mu permit is issued. rI have and will maintain Workers Compensation importance. as required by Section 70Oof me I wor Codc, fame perfa mare a of the work roe wbich this Permit is issued. My Workers Compound. lnwrwa carrier end Poliry number are: N� i/ - -p carrier. r�U Policy No.: O CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (fhusectim reed net bcconpleted if do permit ufaonchaMmd doll ($100) or less) 1 certify Met in me Mr.. or the work for which this permit a issued. I wall na employ my person in say mwner so u at become subject m de Workcn'Cohlawastian - Laws of CAlromie. Data Appliaam NOTICE TO APPLICANT: IL after making this Ccniaou or Eumpdon, you should become subject b the Workers Compensation provisions of me tabs Code, you must forthwith comply with such pwvisiow or this permit shag be doomed rooked I CONSTRUCTION LENDING AGENCY I hemby affmn that More is a construction lending agency for the performwa of the work for which thin permit is issued (Sec. 3097, Civ. C.) Lenders Name Lenders Address' . i I certify that 1 haw read this application sed stain mat the above information u ' correct. l agree m comply with all city and county onlinanas and utak laws mining u building construction, and hereby authorise mpresentairm of this city in emr upon the 1 aWvc-mendoned property for Impectiml purposes. (We) agree to save. indemnify and keep hamtlev the City of Cupertino against i liabilities,judgments. cons and experucs which may In say way secruc against said City in conaequenee of me granting of this permit. 1 APPL NT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT 'Issued by: Date SO EGUTATI�pNs. Re -roofs �--s Type of Roof y.hp,2S22o n.efdo /i -/4-j' Signature orApplrcanVConuwmr Data HAZARDOUS MATERIA01,61SCLOSURE Will pre applicant or in= Wilding oempant some orhandlc hwallow material ss portend by de Cuper iw Municipal Code. Chapter 9.13, and du Health and Safely Cade, Section 25532(a)T-` f/ ❑ Yes 16. 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 lk Will the applicant or to= building occupant use equipment or devices; which 't hvanwas air conuminants as dcfruM by the Bay Arta Air Quality Management all new materials for inspection. ;uictT ❑Yat I haw read me loccdarfidsompinernemsmulercamber6.95o(theCalifa- matHealmB Sarney Codk, Scotism 25505.25533 and25534. I uedrssmW tlutirlhe building v� Man; out curenty pew a rerun. that it u my responsibility m wtify de occupies or the GL L rtgt tswhlehmuBhe pdarmis .e.r.cmdrR,eoroccupincy. Signature of ApplicantDate -�c-C9 P All ro coo gs to be Class '/W' or better Owner Dae a suthorired Kept is 2 ITEMS OF 2 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 32617039.00 DATE ISSUED.......: 11/19/2008 RECEIPT #.........: BS000006647 REFERENCE ID # ...: 08110071 SITE ADDRESS .....: 10046 CRESCENT RD SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OPERATOR: patg COPY # : 1 OWNER ............: ASHJAEE JALAL AND NASRIN ADDRESS ..........: 10046 CRESENT RD CITY/STATE/ZIP ...: CUPERTINO CA, 95014-1012 RECEIVED FROM ....: EDWARD GREGORY CONTRACTOR .......: COSMOS, RICHARD LIC # 18844 COMPANY ..........: COSMOS ROOFING ADDRESS 1901 OLD MIDDLEFIELD WAY STE 2 CITY/STATE/ZIP ...: MOUNTAIN VIEW, CA 94043 TELEPHONE ........: (650)969-7663 • FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ----------- ------------------- ----- ------- 1BSEISMICR VALUATION 7,705.00 0.80 0.00 0.80 0.00 1REROOFRES SQ FEET .23.00 299.00 0.00 299.00 0.00 TOTAL PERMIT : 299.80 0.00 299.80 0.00 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT ---------299.80 --------------- 299.80 VOICE ID DESCRIPTION -------- ----------- - 601 ROOF TEAR OFF 604 ROOF IN -PROGRESS REFERENCE NUMBER --------- VISA VOICE ID DESCRIPTION -- ---------------------------- 602 --- ----- ------ 602 ROOF PLYWOOD NAIL 605 FINAL REROOF Community Development Department Building Division City of Cupertino 10300 Torre Avenue OTelephone: (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 2007 IBC Standards and manufacturers specifications on re -roofing. All roofs are Class "A" per Cupertino municipal code 16.04.080. 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. 5. a) Spark arrester installation. 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 " 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: Jou 4 S 4 1�z e e Job Site Address: /i/i D yti/� C!-CS2,4'1 7�ol Roofing Company Name: Applicant's Signature: Y Date: &_/19-000 • Greg Casteel Building Official Revised 07/30/08 ,CQ�:. I OF SCUPEkTINO 4 CITY OF CUPERTINO REROOF . PERMIT APPLICATION 4 /?// 401/ APN #/7 051 Date: Building Address: /o /6 C'l?Es�� d Owner's Name: Phone #: Iloy_ Y,06' 23 6 9 Contractor: Phone #:bcyt) y 6 p_ 7Tc d 3 C0Sk"OS Fax#: 9 994) s' Cupertino Business License #: / 7 �. Contractor License #: Type of Roof Covering: Existing: Proposed:. ❑ Built -Up Roof Asphalt ❑ Built -Up roof Shingles Asphalt Shingles ❑ Wood Shakes t�f- ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.B.O. Report # ❑ To be RemovAedd ❑ Provide Mfgr. Installation Specs. Iva Job Description:c7✓ e , ove,i' �Bul' f/Oy� y 2Y,is'� �prvrlo ass �r Residential Commercial El Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: ❑ applicable, include in plan set & the sheet index. Valuation: 77,,S- I 7DS— I Have Read, Understand and Will Comply with Cupertino's Tear -Off Policy: Signature Revised 6/16/08 a lo CUPEkTINO CITY OF CUPERTINO REROOF FEE SCHEDULE 0 Number of Squares Fee ID Fee Description Fee Group Permit Type 1RER00FC0M Re -roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 2-5 1REROOFRES Re -roof Residential B 1SFDWLROOF 1BSEISMICRE Seismic Residential B 1RER00FMRES Re -roof Multi -Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B Revised 6/16/08