06070155 CITY OF CUPERTINO
OUILDING01VISION PERNIIT CONTRACTQTtINFU�u4
Buam"c ADDRESS: KNIGHT
N ROOFING SERVICES PE"MITNO'06070155
10679 NATHANSON AV
OWNER'S NAME: PERMIT ISSUE DATE
FUNK DOROTHY 42035 OSGOOD RD. 07/24/2006
NE: SANITARY NO. CONTROL NO.
(510) 438-9077
ARCHrIECT(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0, LICENSED CONTRACTORS DECLARATION lob Description
10 I hereby affirm Wt I am Ikenad unJur provLdom of Dhapwf 9(commencing P
(N Section]qwI of Division 3 often Business and Pwfereioaa Code.aM my license Is
in fYllfnRe and IF TEAR OFF SHAKE ROOFING. INSTALL SHEATHING. INST
{�z License s Lie.a s•((OY
�— Dao:3�Contractor ac CLASS A COMPOSITION SHINGLE.
ARCHITECTS DECLA TION
I understand my plans Nail be wed as public recnrN
r
u. Liccnwd Professional
tO Oat lam exILDSRempt
DECLARATION
I hereby a1Brm That 11. . iron the Costas os d:A License taw for the
p o
which
maven.(Saito 7031.5.B.I.Bmftar. and Prow,de an Calc:Any city car County
1$fLi which mqudma a permit re conWaL alter.her froom,h mMil w repair any structure
•ZS^ prior"No itscensmm.alw requires llevisio aafthe Com tit w0leasLrcdslolrmCot
� Thu Ae is licensed punuemwlhc proviGou of the Convawfs License law(LTapun9 Sq.FL Floor Area Valuat 6525
leF (commencing with Section 7000)of Division 3 or to Business and Professions Coca)or
that he is eumpi therefrom and the bub for the alleged eaamption.Any violation of �T1,�
Section 7031.5 by Ary applicant tar a petit subjeeu the IPPlbant w a civil penalty of AP NuTT 0 0 y Pe
act tam than live hundred dollars($500). 3N4 6 4 30
'/ Occupancy V
O 1,As awns of the Property,or my employees with wage As Neth tale Compensation,
will da the work.and the strumem is not intended or offered her sale(Sm.70M,Business enRequired Inspections
And Prefesslau Cade:The ContacmM1 License law n doest apply w an owner of q P
pmpywho bullasm(mp roves thereon,and who damsuch work himselforthrough his
howOwn ever.the a,PmNdedthnawhimprowm wain ono year
ofdmoffemd fordue Own(. Agp fJ
however.the the
b r dnprowmant is said within ere yev Or
rove on.for the owner. (ffI`L;kMp+8 fj
builder veal Nw the burden of proWng that k did cot build m improve(w purpose of '1'pl��im—f�RT_�/6�/
0 I.a owner of the property,am reclusively convecting with Ecerued Conuecoon to s,
contrera the er.prejea(S 7014.Bwdnmad ProfessionsProfessionCods)ThFe Contra tae,U. u V q1
came Lew does not apply w an Owner of property who builds or Improves thercon,and v
who for ash Projeelo with aeanuecmrtsl licensed punuanlwthe Contractor, !f j
License Law.
01 I am tempt under Be, .B Al P C for this moon
Owner Due f+W/tJ/)/3[''Jfl('h�f```vVfflfy
WORKER'S COMPENSATION DECLARATION
I thereby Lilt under penury of perjury one of the following declarations
1 haw and will maintain a Certi0ate of Consent to self-insure for Worker's Compeer
anion.a provided for by Section 3700 of ter Labra Code,for the performance of t>b
work for which Nis permit is issued.
❑1 haw and will maintain Worker's Compensation Inawutm,as required by Seldom
3700 of the labor Code.for the performance Ortho work leamich this permit is 4wad
My Workee.Compensation b enexce carrier and Policy number tae:
Carrier: Steri/rI"�/ PolicyNa:o46 oa ys'OS
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(this accOm need est be Complehad if the Permit isforanc hundmddollan(5100)
Or loss)
1 entry Nat In the Pufotanec or the work for which this Permit is issued.I shall not
employ any person in any manner an As An become subject to the Worbror Compensation
Laws of California.Data
Applicant
NOTICE TO APPLICANT:IL after making this Ccrtilicaw of Exemption.you should
become subject m One Wohefs Compensation provbiow of the Tabor Code,you must
.JO forthwith comply with such pmvdsimu m this Permit shall be dawned revolted.
Z► CONSTRUCTION LENDING AGENCY
I hereby atilt that them is a Comuverinn lending agency for the performance of
ai.> the work for which this permit is issued(See.3097,Civ.C.) '
W�Q Lenders Name
z Lenders Address
V O 1 certify that 1 have mad this application and slow that the Mow bwrarmadun is
(y P COMM I agree w comply with all city and county oNinam'm and sow laws misting to
0 building construction,and hcreby.mit.ne representatives or this city to cnmr upon the
W xhave-mcntioncd property for inspccdon pugwxa
(We)agree to taw,indemnify and kap hatless the City of Cupertino against
w..,y liabittiesjudgmenu,costs and expenses which may In any way acrue against said City
�Z in Consequence arae panting of this permit. 7) (fl
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH A NON-POINT Issued by: Date
SOURCER ULATI0N5.
�� �� Re-roofs
Signal o AMC nvecwr ^� Dave
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building aaupanmtara"ItAndle huanlow mawnW
As de0 xed by the Cupertino Municipal Code.Chapter 9.13.and the Health and Safety
Coda,sermon 11532(U? All roofs shall be inspected prior to any roofing material being installed.
❑Yes Ne
Will the applicant or fu m budding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
moll huxdous air contaminants as deRrcd by the Bay Arca Air Quality Management all new materials for inspection.
District?
❑Yce QNO
I haw real the hasud`caw materials mqu.mAnnts under Chapter 6.95 of the Califm. / �y
nu Health&SaletyCode.Seciom25505,25533al25534.1 undersand dm if the building / f Zv
Joos nmt en ty haw a Conant,that it is my uiMlity w wwaify de aaupant f the [[[
mquimmen inchm�me Tar arceofaccrt0ataofOCC arcy. Signatu 'A p icant Date!
own<r car Lt d.gen, caw All roof coverings to be Class"B"or better
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CI F Fax(408)777-3333
SUPEkTINO
Building Department
JOB ADDRESS: PERMIT#
I o 67 cl lV /f Soil tQ.,r�_
OWNER'SNAIVIE: Dorothy Funk PHONE# 408 732-5354
GENERAL CONTRACTOR Knight Roofing Servic $AX# 501 438 0604
I am not using any subcontractors:
ignature 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
• Til /
er Contractor Signature 15ate
Community Development Department
Building Division
• City of Cupertino
10300 Torre Avenue
CITY OF Telephone: (408)777-3228
Fax: (408)777-3333
CUPEI�TINO
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: ❑nrnthv Funk
Job Site Address: 10679 Nathanson Ave .
Roofing Company Name: Kndght
/Roofing n Services
Applicant's Signature: Date: -7 2 G
•
Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
am 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . 1 : 32643072 . 00
DATE ISSUED. . . . . . . : 07/24/2006
RECEIPT # . . . . . . . . . : 35348
REFERENCE ID # • : 06070155
SITE ADDRESS . . . . . : 10679 NATHANSON AV
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : FUNK DOROTHY
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : KNIGHT ROOFING
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
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 9, 000 . 00 158 . 76 0 . 00 158 . 76 0 . 00
BSEISMICRE VALUATION 9, 000 . 00 0 . 90 0 . 00 0 . 90 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 159 . 66 0 . 00 159 . 66 0 . 00
METHOD OF PAYMENT AMOUNT . NUMBER
-- --------------- ------------ ------------------
CHECK 159 . 66 10267
TOTAL RECEIPT 159 . 66
i
o oOlo 155
CITY OF CUPERTINO
1W REROOF
�CUPER°riNO PERMIT APPLICATION FORM
APN# Date:
32(,7- 3-0�2- 7 zv�L
Building Address:
10679 Nathanson Ave .
Owner's Name: Phone#:
Dorothy Funk 408 732 5354
Contractor: -- -------.- Phone#: License#:
- _ - --.__.-...---.. .8.4.4.10.8..
Knight Roofing Services 501 438 9077
Contact: Phone#: Cupertino Business License#:
Greg Knight 510 438 9077
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles yQ Asphalt Shingles
Wood Shakes Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) Cl Other(Specify)
Number of existing coverings 1 ❑ Provide I.C.B.O.Report#
$4 To be Removed ❑ Provide Mfgr.Installation Specs.
ffResidential
erstand and Will Com 1 With Cu ertino's Tear Off Policy: ❑
Tear off shake roofing. Install sheathing . Install
Class A Composition Shingle.
Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning Det. if
there are any restrictions: lJ
Cost of Project: Type of Construction: , ) Occup cy fs
$8, 525 Re roof lL�
Qty, if Fee Grou
A licable Fee ID Fee Description
BPERMFEE Bldcy Permit Fees BUILDING
BENERGY EnerL7v BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
•