06060200 CITY OF CUPERTINO
BUILDING DIVISION
PER CON=TRACTOR.,11�`iF0RMATIO,N ;
BUILDING ADDRESS: KNIGHT ROOFING, SERVICES PERMITNO-06060200
19915 PRICE AV
R'S NAME: PERMIT ISSUE DATE
KATHY LIMA 42035 OSGOOD RD. 06/23/2006
PHONE:
SANITARY NO, CONTROL NO.
(510) 438-9077
ARCHITECUENGINEER: BUILDING PERMIT INFO
BLDGELECT PLUMB MECH
0 I� 0 0
apo LICENSED CONTRACTOR'S DECLARATION Job Descrl tion
mC 1 berc ay affirm Nat 1 am licensed under provisions of Chapter 9(commencing P
�iW with Scenario]CDB)of Division 3 of the Busioen and Pocham ioe,Code,and my licenau
aid in full Tome and effect. q Vo TEAR OFF SHAKE WOOD .ROOFING. INSTALL SHEATHING.
y,i Liccno�1y �S Lie g taY ! fr
k- Daro comrrC RATIOK?mFwwo INSTALL CLASS A COMP SHS L ��_®
_/ _', ARCHITECTS DECLARATION q�''q� �"
Sa s 1 undersand my plata dull W nod u public msorJs
3yU
k G y Licensed Pml
fcuiona
3 OWNER-BUILDER m the Commencer
JUL IV 2006
E i I hereby o1Bem Nat 11. exempt from the fontroto of o:A n c taw for ted
E e
which
coving ressns. Pani,t 703 1.5,Business and Pmfcemols Calc:Any city or aunty
5= which its
a permit la ones the alar.Impow,demolish,ri repair any structure
AN 11 49�4
that hpoor U.licenleptoccou 1.ea.also the
lraniai ao far such CiontormitlUttleasiawchNm[nl92—K `,' ppp aaaggq
y < that he isdngwilp d; othepmviaiio ofof Buaaor's Lianalaw(Chapter9 Sq. Ft. Floor Area _ 95
fZ-� (commenring with 5ecum]000)of Divpion 3o(du Businessand Profession Cade)ur �.f
y
that he u exempt Bumine.and the bun far Ne alleged tie Tial Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant o a civil penally of y,�k RRN NNumber Occupancy Type
not mare Nafins
n hundred dollen(5500). 3 b 7 0 5 0 4 3 . 0 0
El I,u goner of ted pmpeny,or my employes with wages u,heti sole mmpcnudnn,
will do the work.and uncsmrnam is not intended or offered forok(Sec.roti.Butmea, Required IeCClOns
and Profession Codc:The Comanc ors Laceme law data at apply n e ns an owner of q P
property who Wildsarimpmvrs therms,and who does such workhimulfmilmagb his
awn employee,provided Nat such improwments arc not intended oroRered for sale.If.
however.the Wilding or improwmum 4 old within arc year of compkdon.Bre owner-
builder will haw the Wrden of roving that he did not Wild or improve ry
for puose of
are.I.
❑I.as comer of the property on exclusively contracting wida licensed cmdrorma an
construct ted project(Sec.7014,Buvincu and Profemmis Cali:)M Caolractets U.
cerate law don not apply in an owner of Pmpeny,who Wilda or improvca daemon.and.
who canonical for och projects with a contractor(s)Reamed purnman an Ne Conuacmh
License Law.
EDI am exempt under Sea B At P C for this reuan
I Dau
WORKER'S COMPENSATION DECLARATION
1 hereby afBmr under pcvlly of perjury ane of Bac following declaration:
❑Ihaw and willmilnuioaCerdfimurfCenentmself-inortforWorkersCompcn-
otim,ss provided far by Section 3700 of the labor Code,far the peAonnmce of the
work far which this permit is issucd.
❑I have and will maintain Workers Compenatien Insurance,u required by Section
37M.1 On Labor Coca.far Ne performance of the work for which Nu pennir ix bound. '
My Workers Cann matfion In..carrier and Policy number art: _
Cartier. $T FiLr (e�"I* Policy No.: ON6OS Y9
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Ibuucttnn mad na,lecompleuJ if the permit tr Corona hundred dollars(SIM)
ar lass.)
1 cenify that in the performance of the work for which dais permit is ivucd,I shall not
employ any person in any manmrea as to become object in the WorkcrY Compensation
Laws of Califomia.Dam
Applicana
NOTICE TO APPLICANT:If,afar making this Cenificau of Exemption.you should
become oh int to the Worker's ConaNniarion provisions of the Tatar Code,you mus
.J O forthwith comply with such provision or this permit Nall W dmnaed,eked.
z� CONSTRUC ION LENDING AGENCY
(•-' 1 hereby attain that Nert is a conounim lending agenry,for Ne Code .of
D:> the,work far which Bus permit b iumd(Sec.3097,Cih,C.)
Lendn's Name
d Q
Z:) z Lenders Add.
U Q 1 cartfCy that I haw rod Nis application and stats that the aWw inforea0oe Is
ly F^ correct.I agree in comply with all city and county ordinsntts and sou laws relating to
0 Wilding construction,and hereby authonne upmscntatiws of this city to tour upon rhe
Wahow-mentioned proplrc
property Tor Inseuan purposei.
CL (We)agree m one,indemnify and Meeh Wool.the City of Cupertino again,
,Hi V] habilidu,Irrigators.cos;and exponent which may in any way accrue armor said City /
of the granding of
U z APPL CANftUNDERSTANDS ANDWILLWILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULA IONS. // ^/
G1i 6�2s/h Re-roofs
Stgruwre of Appr on Du
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will du applicant ror mforum building acupant store or handle hmallondSafrmaterial
do Sed Section
the Cupenim Municipal Code.Chapter 9.13,and IW Health and Safety
.section zs532a>] All roofs shall be inspected nor to an roofing material beim Installed.
❑Yn p�INa P P � Y g 8
Will the applicant or future Wilding Occupant use equipment or Jcvi=which If a roof is installed without first obtaining an inspection,I agree to remove
emit hazardan air comennuanu u defined by the Bay Area Air Quality Management all new materials for inspection.
District] P
❑Yn asrNu
1 have mail the Winadmax maurials requimmcnts umlcr Chapur6.95 of Bu Califar
nix H"]Lh&Safcty Cade,S .25505,25533and25534.IunMuunddutifJc Wilding G 2 3
Jars nmnuw1 howaunanLda,i,umyrcpmibili,ywnodfyreaupntofNe
require
Signatureo QIIC Date O
Owner or_aoffiofib<d ash 'to. All roof coverings to be Class"B"or better
• CITY OF CUPERTINO
Item 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36905043 . 00
DATE ISSUED. . . . . . . : 06/23/2006
RECEIPT 4 . . . . . . . . . : 34993
REFERENCE ID # . . . : 06060200
SITE ADDRESS . . . . . : 19915 PRICE AV
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : KATHY LIMA
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 12, 000 . 00 191 . 16 0 . 00 191 . 16 0 . 00
BSEISMICRE VALUATION 12, 000 . 00 1 . 20 0 . 00 1 . 20 0 . 00
---------- ----- -- --- - -- - ------ ----------
TOTAL PERMIT 192 . 36 0 . 00 192 . 36 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
-- - ------ - - ------ ------------ ------------------
CHECK 192 . 36 10254
TOTAL RECEIPT 192 . 36
•
a
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF
gUPEkTIA to Fax(408)777-3333
fC ISI Building Department
JOB ADDRESS: PERMIT#
19915 Price Ave 66 0 66 t—D D
OWNERS NAME: Kathy Lima PHONE # 408 314 7169
GENERAL CONTRACTOR: Knight Roofing Se'rviiC FAX# 510 438 0604
I am not using any subcontractors: 6/Z 7— b
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
Owne6toh5actor Signature Date
.c Community Development Department
• Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEI�T1NO
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: Kathy Lima
Job Site Address: 19915 Price Ave .
Roofing Company Name: Knight Roofing Services
• Applicant's Signature: C Date: ty ZL/6
Greg Casteel
Building Official
Revised 11/2/04
W00040
CITY OF CUPERTINO
REROOF
CUPEkTINO PERMIT APPLICATION FORM
APN# 31.Y`I—Or ^0`i'5 Date: Z �
Building Address: �,J
19915 Price Ave
Owner's Name: Phone#:
Kathy Lima 408:314 7169
Contractor: License #:
Knight Roofing Services 844108
Contact: Greg Knight Cupertino Business License#:
27646
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Jg' Asphalt Shingles
R Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O.Report 1t
❑ To be Removed ❑ Provide Mfgr.Installation Specs.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description: Tear off shake/wood roofing . Install sheathing.
Install Class A Composition Shingle
Residential 0 Commercial ❑
Fire Zone: Yes ❑ No Q' Confirmed with Planning Dept. if
there are any restrictions: U
Cost of Project: Type of Construction: Occup cy up:
$ 11, 895 Re roof
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
•