08100054 CITY OF CUPERTINO .ap*¢ �M
BUILDINC�IVISION- PERMIT CONTRAC�`T®R INEURMATION =
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BUI N99 f42DRESS: PERMITNO.
BOLLINGER RD KNIGHT ROOFING SERVICES 08100054
OWNER'S NAME: PERMIT ISSUE DATE
JOHN CHANG 42035 OSGOOD RD 10/10/2008
NE: SANITARY NO. CONTROL NO.
(510) 438-9077
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
X00 LICENSED CONTRACTOR'S DECLARATION
tit I thereby"m Wt 1 me Iia:uW under provisions of Chapter 9(commencing Job Description
with Section 7")ol'Division 3 of the BusinessaM Professions Code.and my licenc is RE-RF T/0 SHK RF INSTL SHTHNG DURLITE LGHTWT TILE
limn roes WeRecs-�S Lk.g `( I`'$
Usama Gus L ER1647 CLS A 34SQ
=ro Dam im_r.,-+,s. Cemuwm
e ARCHITECTS DECLARATI i
I andernand my piesis Shall be used as public records
On 6
g C Ucensed Professional
OWNER-BUILDER DECLARATION
% I hereby affirm that I em exempt from the Contractors License Law for Ne
❑O following mason.(Section 710 1.5,Business and Profeuiom Codc:Any city or County
la ff which requires a Permit m construct,alter,impose,demolish,or repair any structure
Z'a prior no its issuance,also,requires tha applicantfar such permit to rile a signed statement
F o
lost heislicensed porsuammdo,provisionsofda,ContractariUcems,Law(chapter 9 Sq.Ft. Floor Area Valuation
. yF (commencing with Second]000)ofDivuian 3 of the Business and Prof ions Code)tor $19610
t 5$— Net he Is exemp Nemf ass and Ne hues fm on,alleged exemption.Any violation of
Section 7031.5 by arty applicant for.permit subjects Ne applicant to a civil Family ofNumber Occas ane e
hat memwnRKhundred dallacsIS > 35922068 , p Y�Yp
❑I,uowdes of the popemry.or mY wploycea with wagassNe4 tele compenatiov,
will do Newark and the em eture is;not intended mroffered for sale(Sec.704W.Busi^»..
and Professions Cock The coaaxmrs Liana taw does rot apply m an rowdes or Required Inspections
property who bui les c r ins praKa thereon.aM who does such work himself m though hu
awn employees,provided that such impmsemem,art nos intended orollem4 forasle If.
buishm Ne building orimprovementVhindwithinarcyearofcopmwef ,Ihaoww-
builder will haw the WSdert Of poling Nat he did rot build or impow lm PumPos of
tile.). -
❑1.as owns of des Property em exclusively conducting with IlcemW mntacmrs to
construct the project(Sec.7044.Business and Professions Cade:)The Contactors U-
ccna Law docs net apply m an owner of property who build,s or improves thereon.and.
who contracts for such pmjecta with a ednusemr(s)licensed pursuant m the CondeemeS
Litems'law.
❑I am exempl under 5 .B&P C for UU nom n
Owner Date
WORKERS COMPENSATIONDECI RATION .
I hereby affirm under perWty,of isclsry,arc of the following do daruimse
ISw and will maintain a Cera fiesm of Consent m aIf-ovum fm WmknY Camper
salon,a provided fm by Section 3700 of the labor Cade,for Ns'perfonmence of the
work for which this permit is issued.
❑I haw and will muimain Worker,Compemnlon Increta.as required by Section
37Wof one Lauer Cade.for one performance of Ne woh furwhich this permit is issued '
My Workers Com usufon-lnwrfs�tta artier sand Paliry number am:
Cartier. S fsMs�Jf Poliq No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Odsss'airoa deed ant he completed lfth permit is foronc huedmddollars(510)) -
or teas)
I certify that in the performance of the wade for which this Permit is issued.I Shall rot
employ airy person in any maaderm as m become subject to de Workma'Compmtsatico
Lows of California.Due
Applicant
NOTICE TO APPLICANT:If,after mrt)ng Nu Ccrifiate of Exemption,you should
become Subject he Iha Werku's Compefktion provisions of Ne labor Code,you muff
.J O forthwith comply with such provisions Of Nu permit shall M accrued mooted
y 51 CONSTRUCTION LENDING AGENCY
[r IturethY,Rum that there isoemmroc"ion kndingugency far Nc perfarmanceof
!Yi i the work for which Ni,permit is issued(Sec.3097,Co.C.)
Q Lender's Name
.ti. 2 lander,Address
U 0 1 certify Nat 1 haw mad Nis application and State Nu the above information is
TL F Comm I agree to comply with LI city and county Ordinances Sed mute laws relating to
0 building construction,and hereby adharies mprrauudvu of Nu city to emu upon use,
r W alaw-mentioned pmpny fee inspection purposes
F 6r (We)agree to ave.immunity tad lamp bere lw the City of CupcNno agaiot
H in
of treating ofpespswhtch manylo anY'auY acmeagainstaid Gry
(„)'� A APPLICANT
of the treating of thanD WILL
F-m APPLICANT U STANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCEREG
2S t/4-&'le Re-roofs
Signature of ApplicattlConatwelor Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will tM appliesm m future Wilding occupanuo some or handle harallou material Z.
as&II.S d by the Colman.Municipal Code.Chapter 9.11.and the Health and Safety
Cade,Schon 25532(,)?
C]Y. All roofs shall be inspected prior to any roofing material being installed.
$."" .
Will de applicant or future Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
.huaAnu air cwuminants u defined by Nc Buy Area Air Quality Management all newamats for inspection.
sex t"?❑Yes �aI haw mad Ne hasatdousmataiaH roquimnvms makrchaptM6.95 oftha Califor-
nuHralN&Safny,Code,SxuUns25505.25533 and25534.1 undnmvtd Natifthe Wilding �
da
tet corm w•umane Gus i"u my espansihiliy m rotifY Ne occupant of We (fes "U
require= nit m met priormissuana or•Certirmate ar Ocsvpeey. Signature of Applicant Date
(42Aw 1J-A--tis All roof coverings to be Class'�W'or better
Owners Sm mi.d.g,.1 Date'
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: pdtg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35922068. 00
DATE ISSUED. . . . . . . : 10/10/2008
RECEIPT # . . . . . . . . . : BS000006317
REFERENCE ID # . . . : 08100054
SITE ADDRESS . . . . . : 7568 BOLLINGER RD
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : JOHN CHANG
ADDRESS . . . . . . . . . . : 7568 BOLLINGER RD
CITY/STATE/ZIP . CUPERTINO CA, 95014-4335
RECEIVED FROM . . . . : KNIGHT ROOFING SVCS
CONTRACTOR . . . . . . . : DAVID RICE LIC # 27646
COMPANY . . . . . . . . . . : KNIGHT ROOFING SERVICES
ADDRESS . . . . . . . . . . : 42035 OSGOOD RD
CITY/STATE/ZIP . . . : FREMONT, CA 94539
TELEPHONE . . . . . . . . : (510) 438-9077
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- --- -- - - - ------- - - ------
1BSEISMICR VALUATION 19, 610 . 00 2 . 00 0 . 00 2 . 00 0 . 00
1REROOFRES SQ FEET 34 . 00 442 . 00 0 . 00 442 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 444 . 00 0 . 00 444 . 00 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------= --------------- --------------------
CHECK 444. 00 #10785
---------------
TOTAL RECEIPT 444. 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- -- ------ -------- ---------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
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.
H omeowner's Name: John Chang
Job Site Address: 7568 Bollinger Rd.
Roofing Company Name: Knight Roofing Services
Applicant's Signature: Date:
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
REROOF
• CUPEP NO PERMIT APPLICATION
APN# 2ly Date:
5 l A a
U to d" UO 9-5-08
Building Address:
7568 Bollinger Rd.
Owner's Name: Phone #:
John Chang 408 253-1984
Contractor: Phone #: 510 438 9077
Knight Roofing Services
Fax #: 510 438 0604 .
Cupertino Business License M 27646 Contractor License #:
844108
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
A, Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) 10 Other (Specify) Lightweight Tile
Number of existing coverings -W Provide I.C.B.O. Report# ER 1647
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
Tear off shake roofing .
lnstall sheathing .
Install Duralite Lightweight Tile ER1647 3cjC kdXX
Residential Commercial El
Fire Zone: Yes ❑ No Er Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation: $ 19 , 610
I Have Read derstand and Will Comply with Cupertino's Tear-Off Policy:
•
Signature