08020052 CITY OF CUPERTINO
BUILDING DIVISION PERMIT QIN
�O � � 0
au`T`1o1A2W'kTHERLAND AVE KNIGHT ROOFING SERVICES PERMIT
08020052
NER'S NAME: PERMn ISSUE DATE
LIN GARY K AND SI—MEI 42035 OSGOOD RD 02/08/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHITECTIENGINEER: TEAR OFF SHAKE ROOFING, BLDG BUILDING PERMB*PIITMECH
INSTAII SHEATHING :P;4113 Z
0 0 0 0
3Ca LICENSED CONTRACTOR'S DECLARATION
Ihmebyamrmtion,Iunlicamedunder provisions ofChapter 9(amnmeencing -•_ _ .... _ ,.,..-_,.,. _ ___.._Job.Deseription
nZ1 with Section 70(k)ofDivision 3 afthe Busioeu mW Profession Cade,and my licenxu
pn in full(arca and cffel O P
�:s 3 License Cl —Lle.a II
Dam 3uC..'aactordW112
/ it
e ARCHITECTS DECLARATION
y I understand my plum shall be used an public recom"
g cad
Licensed Pmftesianal
5 OWNER-BUILDER DECLARATION
0 i I botchy.(Sero that 11. exempt m from the Cusions o License Law for the
C p O fallowing moon.permit
t 7!ommu t. Jun, and e.dear m Cade:Any city or county
3$ which mquim n permit m pti.et alma impress,de permit
t,or repair any at.wm
_Zan priormiuwwee,a,o mquimdivoisubuant fee such Comem('m ce aaUw(comment
o that to rReammpnect,mtoshcpmvwaearOmconummrYlatt. aw(C nus)9 Sq.Ft. Floor Area Valuation
3 (cat M Is ing exempt
with Sereion rom and don Imuiaf S sir al egad enc and Prorcon.Any"Code)W
Nat Ise u emmpt Ilmmfrom and Ue baro for Ne alleged exemption.Any violation of
Section 7051.5 by very applicant for a pemiuubjects dm applicant to a civil penalty of APN Number Occupancy e
not mom than OW). P Y ve headland dollars(SSTYP
❑1.u owtmr of U,pmperty.sir my wploym with wags u thou mle compemdon,
will do the woes.and Neswmum,not Intended maQeeed forsale(San.7044,Budm••
and Prafeailau Cade:That Cotsricmrs Litt.law dm We apply m an ower of Required Inspections
property who buildsorimprom themes,andwho doessuchwark himselrmdirough his
awn employm,provided Ural such improvements arc not intended oroRered for We.If.
however,Ne building or Improvement amid within arc Year of romp tdon.the owner.
Wilda will have th burden of proving that K did act Mid or improve for pumm,or
sale.).
❑1.as ower of the property,am exclusively contracting wish Rtt.d aammuss to
construct the prolan(Sec.7044,Beat..and Professions Cada:)Ilse Conuacmrs V-
cern Law dean not apply to an owe of property who builds or wproves Uumon,and
who contracts for such projects with a conuacter(s)Ilae.d pmawnt to the Contractor's
Lice.Law.
(]l am exempt under Sec ,B h P C for NisO
semen
e Dam
WORKER'S COMPENSATION DECLARATION
I hereby same,under penalty of perjury nee of the following declamations:
❑I have and will main,in a Certificate of Cont to sait-Wo m for Western Carmpen.
aaion.u provided far by Section 5700 of the labor Code.for the p dormwx of tie
wart for which this Pam,is Issued
❑1 have and will maintain Workers Compensation Insurance,as mquimd by Section
5700 of the Mbar Cotler,far Ne performantt of Ne work for which this permit is issued. '
My Worker.Comparisons Immme,carrier and Policy number art:
carrier. 1:f if131 G ITY InyS Policy No.:041C —/S SO 9
CERTI FTON FROM WORKERS'
COMPENSATION INSURANCE
(This semlm mood ant becompleted lithe remit is for one huntlrW dollars(SIW)
or tai)
1 certify that in the performance of the wart for which this perm,,issued,I Nall not
employ any person in my manorm u to became subject to the Workers Compensation
Laws of California Dam
Applicant .
NOTICE TO APPLICANT,If,after making this Ccnificate of Exemption.you should
become subjen m the Wor e s Conformation provisions of the talar Coda you mum
.JQ fmdiwith comply with such provision Or this permit shall W dttmW mnliad.
CONSTRUCTION LENDING AGENCY
[—�4 1 humor atfimm Nat Nem is a construction lending agency for the performance of
a the work far which N,peen,Is wand(Se.5097,Cm.C.)
0 Lenders Name -
Iendeh Address .
UO� I cart Nu I have read th,application and sum Nu the above unr eadm,
I7. Ecomet.I agree to county ordinances with all city and counordinances and mm lawn relating to
_O building construction,and hereby audience repmaenooivu of this city m now upon the
W shove-mentioned property for inspection purposes
G (We)agree to save,indemnify and keep humlm the City of Cupcnfno against
o-,t IA Ilabilitim judgmei.co,and"Percent which may In my way acme,against said City
U Z in consequence of the grmting of this immis. /
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 2 ^—
SOMC EGULAT}ONS,
on&'c /� X 09'0 S
Signatumcf App�ntrseW Dam Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building aeuPant sem as handle hamtlow material
defined by the Cupertino Municipal Cade.Chapter 9.12.and the Health and Safely
Section 25552(a)7
❑Y" ®Na All roofs shall be inspected prior to any roofing material being Installed.
Will the applicants or future building occupant use equipment or devise which If a roof is installed without first obtaining an inspection,I agree to remove
emit harudoes air contaminants as defied by the Bay Area Air Quality Management all new materials for inspection.
District?
0Yen ®Nu .
I have road Ne hanrdmst materials remommenu under Chapter 6.95 ofthe Califor.
nu Health&Safety Code,Satins 25505,25555 and 25534.1 undemmand that if the building
dm not currently love a mnanl thu it u my mspanthility m bodfy the ceupant of the
oxim enuwhlehm kmytPoor tosmnceofacm,BcateorO'c" . Signature of Applicant Date
7Z., ' "" f`°1 6 2�g�$ All roof coverings to be Class"B"or better
Owner or anthor,ed agent Dam g
CITY OF CUPERTINO
REROOF
�CUPER,TINO PERMIT APPLICATION
D Cts
APN# S� / QU Date. I _ LI -Q�
Building Address:
(Ave
Owner's Name: Phone #:
E qry bAl
Contractor: Phone#:
I 510) X1.38' go77
n1 16LI Sen/+Ces Fax #: S(o) 43ssoCCLI
Cupe. ino Business License #: 776 y6 Contractor License #: gcl y /Q8
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles p Asphalt Shingles
la Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report#
,a7 To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: ghea�� n
ieor OKc 5Aole. rooAnj ins� oI ( �r
1)14, 11doss A . bropostCion 5kxnyles.
Residential Commercial
Fire Zone: Yes H No Confirmed with Planning Dept. if
there are anv restrictions: ❑
Valuation: 91qG0
•1 Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Manu �%u
Signature
CITY OF CUPERTINO
'G o REROOF
WUPEfZTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
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 Department
• Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
CITY OF
C U rn E��'N O Fax: (408)777-3333
Building Department
Subject: Re-roofing policy for the City of Cupertino
- 1:- -- Prior 10 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: Gary Lin
Job Site Address: 11138 Sutherland Ave .
Roofing Company Name: Knight Roofing Services
• Applicant's Signature: - Date: Z
Greg Casteel
Building Official
Revised 11/2/04
• - CITY OF CUPERTINO
2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35617057 . 00
DATE ISSUED. . . . . . . : 02/08/2008
RECEIPT # . . . . . . . . . : BS000003896
REFERENCE ID # . . . : 08020052
SITE ADDRESS . . . . . : 11138 SUTHERLAND AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : LIN GARY K AND SI-MEI
ADDRESS . . . . . . . . . . : 11138 SUTHERLAND AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4731
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
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 9, 900. 00 1.00 0. 00 1 . 00 0. 00
1REROOFRES SQ FEET 30. 00 390.00 0. 00 390. 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 391. 00 0. 00 391 . 00 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 391 . 00 10633
---------------
TOTAL RECEIPT 391. 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
605 FINAL REROOF
•