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08080106 CITY OI:'.CUPERTINO . BUILDING DIVISION PERMIT ^�"�TTW ¢' BUILDING 440 ESS: PERMIT NO. ] O�yfi P:CNEVILLE AVE KNIGHT ROOFING SERVICES 08080106 OWNER'S NAME: PERMIT ISUE DATA AMILi IT PHANSE 42035 OSGOOD RD 08/14/2008 NE (510) 438-9077 SANITARY NO. CONTROL NO. ARCHITECVP.NGINEER: - BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 3 0 p LICENSED CONTRACTOR'S DECLARATION Job Description 9Ii 1 beeby affirm,that 1 sen 14enra under provisions of Clupter 9(commencing nt1 MO Section7000)ofDivisimt3oftheBusinessandProfessiomCode,sulmylicenrcu RE-RF T/0 SHK RF& INSTL SHETHNG, INSTL CLS A CMP olj!Uuaucaji e — Lies SHNGL 29SQ . S DamA CARAT .ntrcur e C.MCTS DECLON < 1 undenund MY Plans shall he used as public mcn ds 5 (n Licensed Prof..most 5 � OWNER-BUILDER DECLARATION -. I I borthy olEm that I am exempt from the Contractor's License Law for the O o fallowing mason.(seed..703 1.5.Business and Pmfusiuus Code:Any city ar county 9 which mqui es a permit m consutcL alter,barroom,demolish,or mpair any s mclum �^ prior m its issue=.ales requires the applicant forsuch Permit on rile a signed statement < thatbolslicensedpursuanttolMprovisionsoftheContractor'Umusclaw(Chapter9 Sq.Ft. Floor Area Valuation gb, mmmningwith Sccdon7000)MDiv ion3ofdmBuslncesundPmfessiamOodc)ur $12040 �3.• that he is Commit,dominant and the basis fm the alleged eaemptian MY vluhadon of Section 70715 by any applicants fan a permit subjects the applicant to a civil Penalty ofNumber Occupancy m more man five hundred dollars($5011 36913023 n'pe 1,a hewer of and the smack an rota a inuesdod us wire wag for Nab sole 04al.Business utioss Nn Out nnffesdons cock:::The c mmewr;Li offered Out apps"ly an an Ow'M� Required Inspections properlywho buildsorlmproms demon,and Cabolaicachmors himself arduough his owuemploycros provided than such impmwanau ice net ino-aded.roEered for sale If, however.me building or improwmenc is said within arc year of ampledon,Na owsa• builder M0 now the burden of proving that M did set Mid or impo m for purpose of sale.). ❑1,a owner of the property,am eaelusively contracting with llama d mnucmn to common On pmkct(sec.7044.Business and Rnfesslons Cade:)The Coavacmr's U. cense Low does Cut apply m an owner of property who builds or impmm there...and, who coomaeu far such pmjeeu wire a comae cmo(s)licensed puruunt m me Conuctara . License law. ❑Ima.mmptundarsee ,B&PCfmmbmalon , 0. Date WORKER'S COMPENSATION DECLARATION I hereby unions under Penally of Injury one of me follmaing declamd.N: I hsm and will maintain a GUdBGIe of Coman,m aclf-Insall far W.rtera Compea- .tion,u poovided fm by Section 77M of the labor Code.far the pmfamanco Of the work for which this permit is issued. ❑I haw and will maintatn Workers Compemation lasuram,as,required by Section 3700 of the labra Code,for the performance of the work for which this permit is umad. My Worker'smmadon In..Cartier and Policy number ice: Carrier. G F�yl Polloy No.: 2-1fQQ1Qq?1n CERTIFICATE OF EXEMPTION FROM WORKERS COMPP.NSAMON INSURANCE filtis section need not M completed If the permit is fanane hundred dollar($101 o eu.) 1 coolly the,in to pufanlnancs of On wars for which this permit is issued.I dull not employ any person in any mummer an a an become subject m the Workers'Compensation laws of California,Dam Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption.you should become subject m the Worker's Compensation provisions of me labor Code,you muss O forthwith comply Mutt such Pmvuma or this permit Mall he deemed mated. z'"" CONSTRUCTION LENDING AGENCY F .4. 1 hemb alliin Nu Nem la a com uctinn Icndin r g agency for the lerfarmwxe of Uj> wort ter wale.Ebb H issued b Permit 3097,em.ca D, O Le lander{Name =z LenderaAddma U O 1 modify Nat 1 haw read this application send sum that the show information u w y canecL I.gra 0 comply with all city and comely Ordinances and suss hen misting m building Conslmction,and hereby auNadze mpuxnudm or this city lit enmrupnn Nc Loy ahwe-mentioned property fan impaction purposes y (We)agree on sant,indemnify+sad trap hn n a the City of Cupertino against t'A 0abllida.judgmenu,cNE may many way a a,a Slwaid City t,)z to canxquence of the APPLICANT UNDECOMPLY WITH ALL NON-POINT Issued by: Date SOURCEREGULATI vat Re-roofs Signature of Appllun omrcmr Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant ar future building accvpanl Roe chandle haxardon material as defiled by the Cupertino Municipal Code.Chapter 9.17,and me HCalth and Safely Code,sauna 115324)7 ❑ora All roofs shall be inspected prior to any roofing material being installed. `frf7fh Will the applicant or future building Occupant use equipment or devices which DWricIf a roof is installed without first obtaining an inspection,I agree to remove h haaNnua air con nnimmus u defined by the Bay AeatAir Quality Management all new materials for inspection. t7 &/'L�_ ❑rCa )[No 1 hew mad the hwArdmumamrialsmqulmmcnu under Chapw6.95 of Ne Caiifor. nu 1L1=1af ode.sa7imu75505.255JJ and 255M.IwWcrsund mm Ode building ones wt cunt. Y a am at,dict is u my rapomiMlitY m teor,me emoPans of de tcymmmcnu hick metpriormissuanceofACardream.roeapam. Signature of Applicant Date -nC of Owner w mcomae agent Dam All roof coverings to be Class'J¢"or better ' ' CITY OF CUPERTINO • 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36913023 . 00 DATE ISSUED. . . . . . . : 08/14/2008 RECEIPT #. . . . . . . . . : BS000005792 REFERENCE ID # . . . : 08080106 SITE ADDRESS . . . . . : 10491 PINEVILLE AVE SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ABHIJIT PHANSE ADDRESS . . . . . . . . ... : 10491 PINEVILLE AVE CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4522 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 • EEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL - --------- ------------- ----- -- ---------- --------- ----- ---------- 1BSEISMICR VALUATION 12 , 040 . 00 1.30 0 . 00 1 . 30 0 . 00 IREROOFRES SQ FEET 29 . 00 377 . 00 0 . 00 377 . 00 0 . 00 ---------- ---------- ---------- - --- TOTAL PERMIT 378 . 30 0 . 00 378 . 30 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CIIECK 378 . 30 410767 --------------- TOTAL RECEIPT 378.30 VOICE ID DESCRIPTION _ VOICE ID DESCRIPTION -------- --------------------------- ------ ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF r CITY OF CUPERTINO • 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36913023 . 00 DATE ISSUED. . . . . . . : 08/14/2008 RECEIPT #. . . . . . . . . : BS000005792 REFERENCE ID # . 08080106 SITE ADDRESS . . . . . : 10491 PINEVILLE AVE SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ABHIJIT PHANSE ADDRESS . . . . . . . . . . : 10491 PINEVILLE AVE CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4522 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 ------- ------------- ---------- ---------- ---------- ---------- ---------- 1.BSEISMICR VALUATION 12, 040 . 00 1 . 30 0 . 00 1 . 30 0 . 00 1REROOFRES SQ FEET 29 !00 377 . 00 0 . 00 377. 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 378 .30 0 . 00 378 . 30 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 378. 30 #10767 --------------- TOTAL RECEIPT 378. 30 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CUPERTINO REROOF • CUPERTINO PERMIT APPLICATION APN# o Date: Building Address: 10 Y9 k Vm ON 1 Q A-4 2,. Owner's Name: Phone #: Abh►�; t PhQnse Log) gs°I - �3qo Contractor: Phone#:(SID 4 'g 1'7 / 1 ni Yti Roam SeANt Q.SZS Fax#: cS t 3g '0Coo� Cupertino Business License #: Contractor License #: '34410K Type of Roof Covering: Existing: Proposed: u Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles pt( Asphalt Shingles 34 Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings I ❑ Provide I.C.B.O. Report# A To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: Te&,C p4 8)102 VCQ n.-:wst0.� sh o fth�n q , �ns1a.0 cius-sA .Co)r.gasl-tion Residential Commercial Lj Fire Zone: Yes Lj No Confirmed with Planning Dept. if there are any restrictions: ❑ Valuation: /oZ) Y'b40 �c� I HaveeaUnd�erstand 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 artment 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: Ajloll� Phan"-,2 Job Site Address: I ba-q l Pinp\ 1\e .dA& P Roofing Company Name: K n I Qhk Q Oo�An G �CSLS Applicant's Signature: Date:3 140? Greg Casteel Building Official Revised 11/2/04 CITY OF CUPERTINO REROOF •CUPER Ivo FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1RER00FCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B Z � 1REROOFRES Re-roof Residential B 1SFDWLR00F 1BSEISMICRE Seismic Residential B 1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC ' Business License B • Community Development 10300 Torre Avenue I,aw, Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 OCUPEkTINO Building Department JO! ADDRESS: e v` t� k PERMIT OWNER'SNAME: ARglTrr eFIANC67 PHONE # S0-q&,?jo77 GENERAL CONTRACTOR: ' Nt p 4-r cn/c, FAX # 57o- Y3tP--(Xo t{ I am not using any subcontractors: �� li7Y-aLf- Signature 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 Owner/Contractor Signature Date