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07010085 CITE'OF CUPERTINO •le,JILDING!DIVISION PER1yIIT r� �TI�N PERMIT NO. BUILDING ADDRESS: 6721 JOHN DR KNIGHT :Z PERMIT ISSUE DATE OWNER'S NAME: 42035 O 3GOOD RD. 01/16/2007 DICK DEGEUS SANITARY NO. CONTROL NO. ONE: (510) 433-9077 , BUILDING PERMIT INFO ARCHITEC IENGiNEER: BLDG ELECT PLUMB MECH O p LICENSED CONTRACTOR'S DECLARATION Job Description t= I hereby affirm that I am licensed under provisions of Chapter 9(commencing REROOF- TEAR OFF COMP SHINGLE. INSTALL CLASS A =Z with Section 7000)of Division 3 of the Business and Professions Code,and my license is y in full Corte andeft � u[ MP r 23 SQUARES 2 License Class Lic.y F a Date-1 Contramr ARCHITECTS DECLAR67-140-fN1191 I understand my plans shall be used as public records 4 G H Licensed Professional n n OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the LOO following reason.(Section 7031.5,Business and Professions Code:Any city or county Kwhich requires a permit to construct.alter,improve,demolish,or repair any structure a-} prior to its issuance,also requires the applicant for such permit to file a signed statement $ Ft.Floor Area Valuation E=G that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 q $4875 z F (commencing with Section 7000)of Division 3 of the Business and Professions Code)or y that he is exempt therefrom and the basis for the alleged exemption.Any violation of Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 36927057 . N Number not more than five hundred dollars($500). ❑1,as owner of the property,or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale(See.7044,Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon,and. who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's Law. ❑ plunder Sec. ,B P C this reason Owner Dale '3 C ENSATIO LARATIO I hereby affirm under of perjury one of the in Iarations: ❑I have and will maintain a Certificate of Consent to self-insure for Worker's Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑I have and will maintain Workers Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Work ea nes c and Policy number am: Ca * i�o[icy No.: 0'76 "M 1 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) 1 certify that in the performance of the work for which this permit is issued,1 shall not employ any person in any manner so as to become subject to the Workcrs'Compensation Laws of California.Date— Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must Z forthwith comply with such provisions or this permit shall be deemed revoked. z 2 CONSTRUCTION LENDING AGENCY (~.t m-. I hereby affirm that there is a construction lending agency for the performance of tai> the work for which this permit is issued(Sec.3097,Civ.C.) W A Lender's Name az Lender's Address U 0 1 certify that I have read this application and state that the above information is LL H correct.I agree to comply with all city and county ordinances and state laws relating to 0 U building construction,and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. W (We)agree to save,indemnify and keep harmless the City of Cupertino against HCpj liabilities,judgments,Coss and expenses which may in any way accrue against said City U z in consequence of the granting of this permit. Dat ►� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOUR EREGUL ONS Jr-01(D 7 Re-root's Signature ntract_v�7 O 1e T Ot Roof HAZARDOUS MATERIALS DISCLOSURE Type Will the applicant or future building occupant store or handle hazardous material as defined by Ute Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roo..-s shall be inspected prior to any roofing material being installed. [3 Yes ❑No If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes ❑No I have read the hazardous materials requirements under Chapter 6.95 of thc Califor- nia Health&Safety Code,Sections 25505.25533 and 25534.1 understand that if the building does not currently have a tenant,that it is my responsibility to notify the occupant of the requirements which mus&met prior ip Issuance of a Certificate of Occupancy. Signatl.re of Applicant Date 4z -/,6-0'7 All roof coverings to be Class"B"or better r or authorized agent Date Community Development 10300 Torre Avenue F Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 �UPEkTIN0 Buildjin De artment JOB ADDRESS: PERMIT# 6721 John Dr . OWNER'S NAME: Dick De eus PHONE#408 252 4309 GENERAL CONTRACTOR FAX# I am not using any subcontractors: Signa a Date Please check applicable subcontractors and complete the following information: 60 SUBCONTRACTOR BUSI*NESS 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 Community Development Department Building Division City of Cupertino 10300 Torre Avenue CITY F Telephone: (408)777-3228 C�� O 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 na:.l 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 pet formed. 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: Dick Degeus Job Site Address: 6721 John D.--- . Cupertino Roofing Company Name: Knight Roof.Lng Services Applicant's Signature: Date: '7-/&"6,7 Greg Casteel Building Official Revised 11/2/04 D.7..In.J-+..Onn..nln.J Onnn. prlDI �� CITY OF CUPERTINO I RE ROOF C R. UPE TING PERMIT APPLICATION FORM Date: APN# 3A- r - 051 11-21-06 Building Address: 6721 john Dr . Phone#: Owner's Name: Dick Degeus 408 252 4309 Contractor: Phone": 51License#: 844108 . . - .0 4 3 8 9 0 7 7 Knight Roofing Services Cupertino Business License#: Contact: Phone#:510 438 9077 Greg Knight 27646 Type of aloof Covering: Proposed: Existing: D Built-Up roof ❑ Built-Up Roof rX Asphalt Shingles Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) ❑ Provide I.C.B.O.Report# Number of existing coverings ❑ Provide Mfgr.Installation Specs. ❑ To be Removed I Have Read,Understand and Will Comply With ('u ertino's Tear Off Policy: Job Description: Tear off composition shingle . Install Class A Composition Shingle. 23 Sq. Residential Commercial ❑ Confirmed with Planning Dept. if rFire:Zo—ne: Yes ❑ No ❑ there are any restrictions: LJT e of Construction: Occupancy group: st of Project: n' $ 4 , 875 Qty. if Fee Description Fee Group A licable Fee IDBUILDING BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy Seismic Fee Res BUILDING BSEISMICRE BUILDING BSEISMICOM Seismic Commercial BUILDING LAN BPCHK Plan Check Fee BLAN Business License BUILDING