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09090188I CITY OF CUPERTINO BUILDING PERMIT I I BUILDING ADDRESS: 20171 SUISUN DR I S CONTRACTOR: TOR: KNIGHT ROOFING I PERMIT NO: 09090188 I -_"NER'S NAME: BO YE V rVNER'S PHONE: 4088386901 ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. # tq4/ /� Conductor l AFf I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION 1 certify that 1 have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep hannless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. °' --iture Date ,S ❑ OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, 1 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter he above mentioned property for inspection purposes. (We) agree to save mify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this pennit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 42035 OSGOOD RD FREMONT, CA 94539 DATE ISSUED: 09/25/2009 PHONE NO: (510)438-9077 BUILDING PERMIT INFO: BLDG F ELECT f— PLUMB f— MECH f— RESIDENTIAL f— COMMERCIAL f— JOB DESCRIPTION: RE -ROOF TEAR OFF SHAKEIWOOD ROOFING. INSTALL SHEATHING. INSTALL CLASS A COMPOSITION SHINGLE 32SQ Sq. Ft Floor Area: I Valuation: $10560 APN Number: 36928012.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Date: RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, 1 agree to remove all new materials for inspection. /�% Signat re of pplicant: / ( W,� 6 Date: or 41Z_5-A - ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Ownerr auth ize ent: U/ Date: ZSR CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional 3 ITEMS OF 6 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36928012.00 DATE ISSUED.......: 09/25/2009 RECEIPT #......... BS000008769 REFERENCE ID # ...: 09090188 SITE ADDRESS .....: 20171 SUISUN DR SUBDIVISION ...... CITY CUPERTINO IMPACT AREA ...... OWNER BO YE ADDRESS 20171 SUISUN DR CITY/STATE/ZIP ...: CUPERTINO CA, OPERATOR: patg COPY # : 1 95014-4427 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 ---------- ----------------------- 1BCBSC VALUATION ---------- 10,560.00 ---------- 1.00 ---------- 0.00 1.00 0.00 1BSEISMICR VALUATION 10,560.00 1.10 0.00 1.10 0.00 1REROOFRES SQ FEET 32.00 416.00 0.00 416.00 ---------- 0.00 ---------- TOTAL PERMIT ---------- 418.10 ---------- 0.00 418.10 0.00 VOICE ID DESCRIPTION -------- ---------------------------- 601 ROOF TEAR OFF VOICE ID DESCRIPTION -------- ---------------------------- 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF a � s CUPEkTIN* CITY OF CUPERTINO REROOF PERMIT APPLICATION APN# qA96 /, . v e-) Date: 9-23-09 Building Address: 20171 Suisun Or. Owner's Name: Phone #: Bo Ye 408 838 6901 Contractor: Knight Roofing Services Phone #: 510 438 9077 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 A Asphalt Shingles tg Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings 2 Q Provide I.C.B.O. Report # qk To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: Tear off shake/wood roofing. Install sheathing. Install Class A Composition Shingle. 32 Sq. Residential V1 Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are any restrictions: ❑ Valuation: $ 10,560 I Have Read, Signature nd and ill ly with Cupertino's Tear -Off Policy: CITY OF CUPERTINO REROOF CUPEI�TINO FEE SCHEDULE Number of Squares Fee ID Fee Description Fee Group Permit Type 1REROOFCOM Re -roof Commercial B 1COMMLROOF 1BSEISMIC0 Seismic Commercial B 32 1REROOFRES Re -roof Residential B 1SFDWLR00F 1BSEISMICRE Seismic Residential B 1REROOFMRES Re -roof Multi -Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1 BUSLIC Business License B 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: Job Site Address: Bo Ye 20171 Suisun Dr. Roofing Company Name: K n' g h t R o o f i n e r v i c e s Applicant's Signature: Date: Greg Casteel Building Official Revised 11/2/04 CITY OF �MkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: "201 ? I -5U; r^ m �c PERMIT # d FU M OWNER'S NAE: © � PHONE #.SSD =y3 e- c7O-7 7 GENERAL CONTRACTOR: FAX # I am not using any subcontractors: kgz�k�/ Sign a ate Please check a licable subcontractors and com Tete the following information: Owner/ Contractor Signature Date 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 Owner/ Contractor Signature Date