04100042 CITY OF CUPERTINOr a r- ,e•�+�,Y " •u' r'� ., a s
BUILDING DIVISION PERMIT SCONTRACtfo*INFORMATIO.N
.fig. ,tea'( u3.YBE'. 4w , f
BUILDING ADDRESS: KNIGHT ROOFING CO PERMIT ND04100042
11244
OWNER'S NA7LINN
PERMIT ISSUE DATE
MA42035 OS(MOT) RT) jNE: SANITARY NO. CONTROL NO.
5104389077
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
700 LICENSED CONTRACTOR'S DECLARATION
w I Mreby affirm Nal l am IianN u r pmvisions of Clea 9(commencing Job Description
i with Sc do 7007)of Division Sof NCB sea and Profcuinns Codc,and myliccnu is -
n<n inronln andefrecg 7f'T`75 5 REROOF W/DURA. LIGT.. TILE /2 SUN TUNNELS
j a Llan I C 3L 5 "Lie.ConluulIDIDnnaa
gqF� Date ARCHITECTS DECEaCRATIOf4
DW U "I maind my plisse Nall he used as public records
R!
;may Licensed Pm(cssinnal
j3 OWNER-BUILDER DECLARATION
<M 1 hereby affirm Nat I em exempt from the Contnaors License Law for the
K:00 following mason.(Section 7031.5.Business and Professions Code:Any city or county
$ which requites a par rit to conurdet,almr,improve,demolish,Or mpoir any structure
–ai prior to its issuance.also requires dm applicant for such Permit o Ric aligned statement
E£ < that he is licensed pursuant to the provisions of due ConlRQorfLicense awChapter 9 Sq. Ft.Floor Area Valuation
y�ca (commencing with Seen..]")of Division 3 of On Business ssi
and Profeon.Code)ur
i 5$ that he is exempt therefrom and the basis for dm a11cgW enamption.Any violation of
Section 7031.5 by any applinnt for a permit subjecu the applieant N a civil penally of �IIII1�ter0(] Occupancy'ryI
not more than five hundred dollars(5500). P Y • Pe
❑1,u owner of the properly,m my empleycu with wage u Nair sole compcnudon,
will do the work and the structure is not intended or offered forsale(Sec.7614.Business
and Profession Cade:The Conuanor's Licetese law does not apply in an owner of Required Inspections
manproperty who sprovirid that
wch Improvements
doenauinuend himselfor for ughWe his j
ownemployes,provided Natsuchimprovemmuarenet intended MPICtirad for We. i,
however.the building or improvement is sold within One year of completion,thepose of
builder will have the burden of proving that k did but build or improve for purpose of
con tr
Q I,as owner of be pmpeny,am exclusively combatting with licensed Contractors to
nvej
coct the project(Sac.7014.weer of and rty who
Cade:)The Bum ors Lid
Genu taw don not apply m an owner or proper(who sed p or Improves M the thereon,and
who con®cu for such projects with a conmmor(s)licensed punwm b the Conuaaoh
License law. —(v\
❑lam ucmpt under See. ,BkPC for this reason
weer Dare
WORKER'S COMPENSATION DECLARATION
I hereby Num under Neaby of perjury aro of be following dceluatiome
1 have and will maintain a Codfiam of Cogent m snit-iuum for WorkeesCompen-
ion,as provided for by Section 3700 of Ne Labor Code,for the performance of Ne
1M3700.1'
rk for which this permit is issued.
1 have and will maintain Wmktrs Comperuauo t I...as requited by Section
abthe Lor Code,fm Ne perfmntmaof the work forwhich Nis permit is issued.
y Worker's Compenation lnwamea d Policy number arertier. cy No,0L-116 "7LS6
CERTIFlCATE EE�,ENIPTION FROM WORKER$'
COMPENSATION INSURANCE I /( /.D� t
(nmis section need not W completed ifthe Permit Is formich ndr /doilans(5100)
or let.)
1 ccnify Nat in the perfumes.of Ne work for which this permit is issued,I Nall not
employ any person in any mannerm as m bccoum subject ri Workers'Co n,enuman
Lawsof California.Data
APPlicam
NOTICE TO APPLICANT:If,after making this Ccniftcam or Exemption,you should
become subject in the Worker's Compeuadon previsions of the labor Cock.you most
.J z forthwith comply with such provisions or this Permit shall M domed revoked.
zO CONSTRUCTION LENDING AGENCY
f–' I homey affirm that Nem seaco.om mndingagme,for the perAmmame of
the wmk for which this permit is issued(Sec.309'f,Civ.C.)
W Q Lenders Name
= ,z lender's Address
O Q 1 certify that I Mise read this application and state that the above information is
W F correct.I agree to comply with all city and county oNinmets and sum laws relating to
0 building conswction,and humbly aubmin repramnutivei Of Nis city to enter upon Utc
aW.-Ommiumcd progeny for inspeNmn Purposes.
H y Consequence
agree m save,indemnify and keep harmless the City of Cupertino against
( 1
U Z Liacalitiu.judgments.cents and expenses which may in any way section againt aid City
n LICAcncc of ft UNDERSTANDS
Nis Permit. Issued by: Date
" APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT
tlRCE RE ULATIONS.
7 Re-roofs
ignarure ofA c HOAZARDOUS MATERIALS DISCLOSURE Dam Type of Roof
Will the applicant or
future Wilding occupant atom or handle harandous material
az defined by the Cupertino Municipal Code.Chapter 9.11,and the Health and Safety
ode.Sc Non 25531(1)? All roofs shall be inspected nor to an roofing material beim
❑Ya [,No P P Y g g installed.
Will',
Nc applicant or furore building Occupant tau equipment or dcvica which If a roof is installed without first obtaining an inspection,I agree to remove
In Fault hmardmta air comaminanta az dcfned by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Yea fi(Nu
Ih&Seml NehvSNc6..arcs,25quiamcnuu.ImChapmothatifthe Califon-
iia NaiNiumnl yanalcction tat it my beepd15534.1 understand Nazifup building C/ J� fJ ' (�
docs not currently hero a mnanL that it u my rcspmnsibility m notify tau occupant or dm �
mquirtment hich muse he met prior to issuance ora Cadfmam ter r /Slgnature0 p (Cant Dale
l fd y
some Or:m orived agent Dam All roof coverings to be Class"B"or better
x, Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF
�UPERTINO
BuildingDe artment Fax(408)777-3333
JOB AD S: P IT #
(fzr-/`( L
OWNER'S N mow« PHO # S'ro y3 p--Bio-7-%
GENERAL CONTRACTOR: L r r2_oG FAX #
I am not using any subcontractors: r- 7
Signature Date
Please check applicable subcontractors and complete the followin information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum/ Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
,Roofing / w /e��fz„a (r 5--7gCj
Septic Tank
Sheet Metal
Sheet Rock
Tile
G� f o
r/ ntrac or Signature Date
Community Development Department
! ,N Building Division
City of Cupertino
~ 10300 Torre Avenue
4 CITY OF Telephone: (408)777-3228
U P E IST I N O 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.
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: ! '6 l-) e, (i i 0
Job Site Address: 1 I ? y`i ,,//�ou// ,✓''- cres-7L P/.
Roofing Company Name: l`H'9f1 l�o od 'v a Ly,
A phcanYs Signature: j� Date: %o -z/v
Greg teel
Building Official
Revised 1/30/03
Printed on Recycled Paper
CITY OF CUPERTINO u u
REROOF
eCUPEkTINO PERMIT APPLICATION FORM
APN# S-� Z6 p/2, Date: 9-24-04
Building Address:
11244 Mount Crest P1 Cupertino
Owner's Name: Marie Lin Phone#: 408 732 3856
Contractor: Phone#: License#:
Knight Roofing Co. 510 438 9077 755799
Contact: Greg. Knight Phone#: 510 552-1902 Cupertino Business License#:
21191
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
>C 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: Tear off shake . Install Duralite Lightweight Tile ER 2656
Install ( 2 ) Sun Tunnels ER 5185
Residential Commercial F1
Fire Zone: Yes Confirme g Dept. if
there e an restrictions. LJ
Cost of Pro' ct: ype of Construction: Occu rou :
$ 15 . 340 Re roof
Qty. if
A li e Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Ener BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
B LIC Business License BUILDING
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