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06040110 (2) CITY OF"CUPERTINO ()RMATtt3N BUIUDING DIVISION PERMIT Cd1I R .CT''L1Yi.Tl�f ' BUILDING ADDRESS: KN ROOFING CO PERMIT No.06040110 19671 DRAKE DR OWNER'S NAME: PERMIT ISSUE DAIS GAJAPATHI DEVARAJAN 42035 OSGOOD RD 04/20/2006 ONE: SANITARY NO. CONTROL NO. 5104389077 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDGO ELECT O PLUMB WECH O O 30p LICENSED CONTRACTOR'S DECLARATION lb Description i 1 hereby affirm that 1 am olicensed under powal of Clupter 9(commencing wob Section 7000)afDMA..3 of the Business and Profenal..Code,and my license is td fun fbroe and effeel. TEAR OFF EXIS �ISTALL OSB SHEATHING ' _z Ucense + e b, Lu.« �'y�//o� I{ y Data 7n, INSTALL CLA ILE CLASS A ROOF ' / ARCHITECTS DECLARAnoN ���rrr l I underwnd my plans shall W used u public reenrd. � °o Licensed Profrssund OZ 1006 sy OWNER-BUILDERcumptDE DECLARATION 0 1 hereby moso .fEmn(Sec that 11. exempt from the Cmusctors :License Law for the 0 o following mama Permian EDLS,Business and are.demolish. e nu Cade:Any chy ac county $(< which I.isu a Permit re sures the alter,imfor such dpermit,lire a sig ed mwmm not,sift Pnormlu issuance.also requires the epplieantfar tach permilm fileaslgned+wrmem < that he;+licensed Panama m the provisions of du Connector'sLicense law lCh.pier9 Sq.FI.Floor Area Valu Er, 8 (commencing with Section TODD)of Division 3 of the Busbmtsand Professions,Code)or C that he is exempt thrmfmm and the basis For the alleged exemption.Any violation of Section 7031.5 by my applicant far a permit mbjecu circ applicant to a civil penalty of 5��}p��y}If��`}j]t{Ify�er Occupancy Type rot mart than live hundred dt llam Mail, 3 1 O.J G tJ.]1 . O O ❑1,as a..of tier property,er my employcu with rages u duh sets compensation, will do thewark and themuctum 1s,not Nuuded uroReced fanale(Sec.7044,Business - Required Inspections and Profesaiou Code:The Counselors Licmu Law does rot apply lo e ns an owner of q P napery,who bu ild+or im proves thrown.and wha does such wank himself or througd his own employees,provided Nu such improvements an,notinteMed cropland far sale If. however,the building"Improvement is sold within am:year ofesmpledon,the owner. builder will have the human of proving that he did rot build or Improve for purpose of esu.). ❑I,as ower of dee property am exclusively conuauing with licensed conuanan in consumer the project(Sec.7044.Business and production Cade:)The Cmnrseme,U- cuss law doer out apply to an owner of proia ny he Wilds or Improves the..,ad, who contracts for such projeeu with a conuumr(s)licensed personal to the Canmemfs Lmense law. ❑I an dump[under See ,B&P C far this reason Owner Dam WORKER'S COMPENSATION DECLARATION 41 1 Umby anion ander penalty of pmjmy,oro of the following declmmione ❑Them and will malnuinaCeNficamofConuntmulf-insumforWormesCompen- sation.u provided far by Section 3700 of the labor Code,for the performance of W wort for which this permit is Woo 0 1 ham and will mainuin Wor sm's CampcsaNan Insurance,as mhdam by Section 3700ofoe Labor Code,far the penfarmeuee of the work for which this permit is issued. ' My Woruef.Compensation Insurance carrier and Policy number art: Camersr4Y1g, Co—i" Policy No.:Oe/(7IY CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE v (nils section reed rot be completed if the permit is foraxe hundraddollars($100) or Ica.) I certify that in the performance of the work far which this permit is issued,I shall not employ any person in my career an an an became subject to the Workers Compensation Laws of Califomia.Dam Applicant' NOTICE TO APPLICANT:If,aper making,this Ceninom of Exemption,you should breams subica W the Workers Competition provi+iou of the labor Cade.you mum .J Q forthwith comply with such provisions Or this permit$hall W deemed mvakM. z^ CONSTRUCTION LENDING AGENCY [—� IWmby a(Rrm than dem I.a construction lending agency for the performance of (X the wank for which this permit is Wood(See.3097,Civ.C.) d Q Under's Name , = z LeMers Address U O 1 anify that I have mad this application and mu that the above mfomaden Is ITa cmrml.I agree m comply with all city and county ordinances and sum laws miming to O building musuuctian,and hembymumciso rcluummativesaf this city to crautmou the [tl above-mentioned pmpeny for impaction purposes 6. (We)agree to saw,indemnify and keep harmless de City of Cupertino 1Pmnm ,.y cA liabilities,judgments,coat ape eawsms which may he my way amu against said City U 7 in comseguenm of the granting of this Permit, r� r1• APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-P INT Issued by: Date SOURCE REypLATIONS. Re-roofs Signature III.ApfoguVCon r HAZARDOUS MATERIALS DISCLOSURE au Type of Roof Will the eppimant Or futum Wilding aaupantmme orhandle husreous material u de0ud by the Common on Municipal Cade.Chapter 9.13,and the Health and Safety ethic.Se ye,255324)? Ne ❑Ys+ All roofs shall be inspected prior to any roofing material being installed. 41 l� Will the applicant or fu1ture Wilding easeful uc equipment m devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hu aunt air conuminans as dcOrod by the Bay Amo Air Quality Management all new materials for inspection. District? ❑Yu 14 No I haw mad du humdsomateWls mqubemewowerCMpur&95 of the Califor- niaHealo&Safety Cod.Senlerm25503,25533am125534.1mdcmandtheifdu building done trot C.IIy hew.tenant Net h i.mY responsibility m wliCy sur mupmt of Ne mquirc wbichmuaWmeapdormWuanceofaCcrdncamafa Signature of Applicant Date N� b ownera.a ori, .gens , Dam. All roof coverings to be Class"B"or better Community Development 10300 Torre Avenue .'` rte' ' Cupertino CA 95014 14 Telephone(408)777-3228 aCI OF Fax(408)777-3333 SCUPEkTINO Building Department JOB ADDRESS: PERMIT # 106,71 Do 0 60 1-( ar ( o OWNER'S NAME: �,d-K -T-gN� PHONE # GENERAL CONTRACTOR: ivic7 rr /GoO,4-,NC FAX # I am not using any subcontractors: `r 2 D Si ture Date Please check applicable subcontractors and complete the following 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 Septic Tank Sheet Metal Sheet Rock Tile CuQer/ Signature i�Date 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: F/�JAP14r#-1 �Et/PfL e¢c1 A� Job Site Address: M&71 D/ MI(Ier Q� Roofing Company Name: �n/�!F`� lea f-SNF Se-!,4VIC1F�' Applicant's Signature: _ Date: Z� • Greg Casteel Building Official Revised 11/2/04 CITY OF CUPERTINO •em 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . . 31632031 . 00 DATE ISSUED. . . . . . . : 04/20/2006 RECEIPT # •.• • • • • . . . : 34062 REFERENCE ID # . . . : 06040110 SITE ADDRESS . . . . . : 19671 DRAKE DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : GAJAPATHI DEVARAJAN ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-2433 RECEIVED FROM . . . . : KNIGHT ROOFING CONTRACTOR . . . . . . . : KNIGHT, WILLIAM LIC # 21191 COMPANY . . . . . . . . . . : KNIGHT ROOFING CO ADDRESS . . . . . . . . . . : 42035 OSGOOD RD CITY/STATE/ZIP . . . : FREMONT, CA 94539 TELEPHONE . . . . . . . . : 5104389077 •FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 14 , 000 . 00 212 . 76 0 . 00 212 . 76 0 . 00 BSEISMICRE VALUATION 14, 000 . 00 1 .40 0 . 00 1 . 40 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 214 . 16 0 . 00 214 . 16 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ CHECK 214 . 16 10222 TOTAL RECEIPT 214 . 16 • CITY OF CUPERTINO 0(0040110 • JE REROOF CUPEkTINO PERMIT APPLICATION FORM APN# 9 I 4i I n -304-- nL-I Date: c/ Zo Z& Building Address: Owner's Name: Phone#: C719-1-447-1f-7 Dcllv2Az m 90 1-139--e?o-7-7 Contractor: License#: NI a yy/O Contact* Cupertino Isinels License #: CT CI Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ,Ak Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) 0 Other(Specify) CC/I-��"t'kx C.htFTC✓e(hrv>' Number of existing coverings / ❑ Provide I.C.B.O. Report# CL A`( T(L&� AI To be Removed ❑ Provide Mfgr.Installation Specs. • I Have Read,Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: Lim L C-(a,ry f- 0Pr- LrnrrTlNe, s / KJ NS7/1t-L OS Slug vvr i;vrCL 4-1, 'Trte Residential ® Commercial ❑ CVfsf A Ro p Fire Zone: Yes ❑ No © Confirmed with Planning DMt, if there are any restrictions: IJ Cost Project: Type of Construction: Occupancy rou Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg Pennit Fees BUILDING BENERGY Energy BUILDING BSEISNU Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING •