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08090136 CITY OF CUPERTINO BUILMNCDIV.),SION PERMIT CzONTRAG7OI2INkU BUILDING ADDRESS: PERMIT NO. 10280 S BLANEY AVE KNIGHT ROOFING SERVICES 08090136 OWNER'S NAME: PERMIT ISSUE DATE LAU DAVID W MING ET AL 42035 OSGOOD RD 09/22/2008 IF)NE: (510) 438-9077 SANITARY NO. CONTROL NO. ARCHITECT ENGINEER: BUILDING PERMITINFO BLDG ELECT PLUMB MECH I� foo 4 LICENSED CONIRACnOR'SDECLARATION lob Description ue C I rebr a?m Wl1 am ved pns lisunder ovisioof Chapter 9(commencing z1W nhh Sccuon]lM1U)ofDivision 3ofihe Businw tied Pmfetions Code,and mylicense is RE-RF T7 .0 SHK RF, INSTL SHETHNG& INSTL EAGLELIGHT full foarme and effec - Lleenw u: Z4 La..• LIGHTWT TL CLS A 29SQ =� Da¢ Contractor epp ARCHITECI'SDECLA TION 1 undcrsund my plansNall a used as Public Means, ?W U 6 L O r^ LWonsed Professional OWNER-BUILDER DECLARATION I hereby al Nn I am mmpt from the Convemrfs License Law for the coo (.[Irwin,mason.(Section 703 1.3.Business and Prnfeadov Code:Any city or county �.9 T which requires a permit m cmuvtct.filer.improve,demolish,or repair am summon Z< prior In its issuance.also mluioes the applicant f0f Sueh permit In file a signed statement gA that ebliccvcdpursvnitotheprovisiovoftheConvector'sLiccme❑w(Cluptor9 Sq.Ft. FloorArea Valuation Y $ (eommncing with Section 7000)o(Divbion 3 ofthe Business mal Profeaiov Code)or $13340 y that he is esmpt urefrom and the hub for the alleged matinee.Any violation of Section 7031.5 by am applicant for a Permit subjects the applicant to a civil penally of Number ort mom dam ft.a hundred dWlan(15M3 6 9 0 4 016 .,e Occupancy Type 0 1,as owrcr of nae property,or,my employees with wagon as their see compensation, will do the work,and cite structure bact Wounded or oRemd fns sale(Sec.7064,Busimss and Prof..to.Code:The Convener/s License law does out apply to an owmr of Requited Inspections progeny who builds or improves therm.,and who does sued work himslf or thmugh his ewa<mployec,Provided out such improvemrnu me not intended orof ercd for aWa B, however.Ne building or improvement is mid within arc yesr of completion.the owner- builder will have ere burden of proving that he did ml Wild or improve for purpose of sa.j. 1,u owner of the property.am uGvively convening with licensed convectors W mosencl the projen(Sec.7064.Business and Profudons Code:)The Contractor's Li- a.Law doe at apply W an owner of interparty we Wilds or improves Memo.,and who contracts for such projeeo wide a conamour(s)licensed punuant wthe eom etaes License Law. ❑Lem vmpt under See ,B&PCforthismmen Owner Data . WORKERS COMPENSATION DECLARATION I hereby alum under pcvity of perjury arc of ere follow.a,decimations: I haw and will mainoin.Cmtifcam of Consent W s1f-Insure for Wo,kcfm Cents.. Galion,u pmvided for by Section 3700 of dee labor Code.for dee performance of the wort for which this permit Is mmod. 1 ban and will maintain Worker's Competition Importance,as required by Session 3700 of the labor Code.for tie Performance of the wort Mr which[less permit as issued. . My worysYvs ccoompeouuw esrarece artier and Policy number Cartier.STA�5P Policy No.: 23F—(O CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (fhb scctlon reed not ecompleted ifte permit bforme huntrnd au0en($100) or less) I cuufy Not in dee performeam of tic work for which this Permit b bated.l"I not employ any person in any smarter an as W bmomemb*l W 0c Workert Competialon Laws of CaliromiL Dale Appel., NOTICE TO APPLICANT:If.after making this ormil W of Exemption,you ,WW become subject W tic Wohets Compensation provisions of Ne Labor Coda you must .J z foMWide comply with each provisions or this permit Kali N mounted revoked. z O CONSTRUCTION LENDING AGENCY I hereby aRrm dean there is a cmuuoedon lending agency for the parammace of ai the work fm which dais permit is named(Sm.3097,Civ.C.) 0.0 Lamor'.Name 7 z Lcndaes Address - f,J Q 1 mnify that I have read W.application and sale Nat tic man information is mmcl.I agree W comply with all city and county ordinance,aIle sou laws testing W .O building mnstrcuon,and hereby mthori ,topes carom of this city W enter upon the Ill shovetle jurnedpmpeur for amemlon which may t„�y I%)agree to save,indemnify and amp,harmlo w the City of Cupertino against fA incoreajuda of the mong of this Permit. may Warty waY acme agminstseid City V z in PLICA ace of the among of this permit. / `-' APPLICANT UNDERSTANDS AND WILL PLY WRHA NON-POINT Issued by: Date S. SOURCE REGUTATI stgnuma.rnppuaanUCern 7z 2, Re-roofs HAZARDOUS MATERIALS DISCLOSURE Unite Type of Roof - WIII lite applicant or future Wilding mcupmtatort orhandle haeardo a maWrial u defmad by Oto Cupertino Municipal Code.Chapter 9.11,and cite Nashua and Safety ewe,section M32(.)? ❑Yes p All roofs shall be inspected prior to any roofing material being installed. �No wet the. licant or r.Mrre building«m If a roof is installed without first obtaining an inspection,I agree to remove PP , pant ver equipment or devices which g p O�cr us air conominma u defired by the Bay Area Air Quality Mmagcmc.I all new materials for inspection. ❑Yat �Nu I haw Ica[tee haraNwa1mauriab mquimmums under Chapter 6.95 of the Califor. rets Health k Safety Code,SecGmu 25505,25533 and 25534.lmdeessnd that ifthc Wilding dors ret cum.u,ban a Mason.19,It' y mepoviCilily W notify to pini of dee mquimmeno w h mute aE pet iuvltce of a Caruftcn,of i y. .�//// G Zl✓ Signature ofA (cant Date owner armtt Dow All roof coverings to be Class'/?.,'or better CITY OF CUPERTINO • 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36904016 . 00 DATE ISSUED. . . . . . . : 09/22/2008 RECEIPT # . . . . . . . . . : BS000006144 REFERENCE ID # . . . : 08090136 SITE ADDRESS . . . . . : 10280 S BLANEY AVE SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : LAU DAVID W MING ET AL ADDRESS . . . . . . . . . . : 10280 S BLANEY AVE CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-3191 RECEIVED FROM . . . . : GREG KNIGHT CONTRACTOR . . . . . . . : DAVID RICE LIC # 27646 COMPANY . . . . . . . . . . : KNIGHT ROOFING SERVICES ADDRESS . . . . . . . . . . : 42035 OSGOOD RD CITY/STATE/ZIP . . . : FREMONT, CA 9.4539 TELEPHONE . . . . . . . . : (510) 438-9077 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 13 , 340. 00 1 . 40 0 . 00 1 .40 0 . 00 1REROOFRES SQ FEET 29 . 00 377 . 00 0 . 00 377 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 378 .40 0 . 00 378 . 40 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 378:40 AMEX TOTAL RECEIPT 378.40 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF • 0 C) CITY OF CUPERTINO a REROOF • il cUPEVINo PERMIT APPLICATION APN# C) O Date: Z . Building Address: (P 10280 South Blaney Ave . Owner's Name: Phone #: David Lau 408 996 0128 Contractor: Phone #: Knight Roofing Services 510 438 9077 Fax#: 510 438 0604 Cupertino Business License #: Contractor License #: 27646 844108 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) Other(Specify) Lightweight :Tile Number of existing coverings a Provide I.C.B.O. Report# ER 1647 ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: Tear off shake roofing. Install Sheathing. Install Eaglelight Lightweight Tile C Residential x Commercial Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are nny restrictions: ❑ Valuation: 13 , 340 I Have Read Understand and Will Comply with Cupertino's Tear-Off Policy: Signature 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 Raid 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. Homeowners Name: David Lau Job Site Address: 10280 South Blaney Ave Roofing Company Name: Applicant's Signature: Date: G Z L • Greg Casteel Building Official Revised 11/2/04 vbv CITY OF CUPERTINO REROOF O • CUPEkTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 2� 0 1RER00FRES Re-roof Residential B 1SFDWLR00F 1BSEISMICRE Seismic Residential B 1REROOFMRES Re-roof Multi-FamilyB 1 MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B • Community Development sa 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CVOF Fax(408)777-3333 _S�UPEQTINO Building De artment JOB ADDRESS: PERMIT # v S- "C- 40 cv OWNER'S NAME: &AA PHONE #&c J GENERAL CONTRACTOR: N,� Rooar v FAX# I am not using any subcontractors: 4 LL SignaKre ate 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 Owne ontractor Signature Date