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08030022 CITY OF CLwERTINO " - BuILDtno DIVI51oN PERMIT C01�1�TR:�CTOR IAIP'ORMATION:, a,a.An,L• t sans.u�"u'E-'ch.oP"t1> �'�z' PERMR N0. ❑UILDL�VG.AD2T'ALVES DR LINDY ROOFING CO INC 08030022 nWNERL'SVNbAMLE; PERMIT ISSUE DAIS, ED URATA 5554 HARVARD DR 03/06/2008 NE: SANITARY NO. CONTROL NO. (408) 286-9990 ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH C 0 Op LICENSED CONTRACTOR'S DECLARATION Job Description v 1 hereby affirm that 1 am Ikcnsed under pmvWm of Chapter 9(commencing P 'T`orf with SansonluxrrtuDivuinlofabcBudnussandProfcesiansCade,artamyRkense,is RE-RF,RMV WOODSHK&INSTIL 1/2"OSB,CLS A, 64 d° in full forte 7 )fere ,y Licame Class Lk.g Conlracbr 7W ARCHr1ECTS DECLARATION _ wI understand my plans dull W uad as public records cU ,a. Licensed Pmfcssional OWNER-BUILDER DECLARATION i S I hereby alum Not I am exempt from the Contractors License Law(or tac p O following mason.(Section 7(n 1.5,Business and Pmfeasions Code:Any city or county j$tai which require a permit to emtstruct,that.improve,demolish,or repair any mos su , -iy prior to its issuance.also requires the applicant rot such Permit to Ita signed.mternmst �Q that he is licensed pursuant rat da Provisions arae Contractor's li ertx law(Chapter 9 Sq.Ft.Floor Area p Valuation (commencing with Section 7")of Division l of the Sualnw mu Proressions Cade)or y 19 0 0 0 s $ that he u exempt abcrefrom and du basis far the alleged exempdon.Any violation of Section 7031.7 by any applicant for a permit subjects the applicant to a civil Penalty of Number Occupancy Type not ream than five hundred dollars(3500), 3 2 6 3 4 0 6 9 A 0 1.as own.of die property,or my employe.with wages as dab sole co apewUm. will do the work and to sboares is not lnteMed car offesW for bit(Sm.T(3ad.Business Required Inspections and Profions essCadc wtrc The Cars Liave reto Iaa does t apply a,owner of q P Property who Wilds or imlvoacstWnoe,and wltodassahwork himselfarduaugh his own employees,provided abstracts Improvements am nolinanded oronered fortake If. however,the building or improvement is said within nm yam o(compmuon.the mmur- builder will have the burden of proving dist he did rot Wild or improve for Paribas,of sake.). 0 1,as owner a the property,.camhuively connecting with licensed conuacuss as construct the project.(Sec 7014.Business and Profasvov Code:)The Contractors LI- - cave Law does not apply an to owner of Property who Wilda ar improv demes.wait , wW conmuts homes projects wish a contrcmr(s)licensed puremat an the Contractors Lice me Law. 0 l am exempt under Sec ,B At P C for this ream Dau WORKERS COMPENSATION DECLARATION I Wreby aR.under perulty of perjury tow of the following worst a 1. ❑1 ham and will mwnuin aCenifaaa o(Gvenlmulf•ivum fa WarkersCompen- sation.an provided for by Section 3700 of the Labor Code.far the Performance of 1W work for which this permit is Israel. 0 1 have and will maintain Worker.Compensation I...as required by Section 3700 of Ne Latour Code.for the performance of the work for which the .it is I-- ' My Workers CCompevauan Insurance artier and Policy number �l� ... . . Conder )J )`r'rC' Ty , r'O Policy Na.:1mb CERTIFICATE OF EXEMP ION FROM WORKERS' COMPENSATION INSURANCE (Thb section need not W completed if the permit Is foram hundred dollars($100) or lest) 1 anify that in to perfarmmen of o e work for which this permit u issued,l"I not employ any person in any mama an as an become subject to the Workers'Compeasasly Laws of Cali(omka.Dora Applicant NOTICE TO APPLICANT:IL afar making this Cenificaa of Exemption.you should Weome subject to the Workers Campenution provisions of the labor Code,you must 0 Q forthwith comply with svh provisions or this permit all be damcd mmokcd. 'Z '--' CONSTRUCTION LENDING AGENCY [+� I hereby afran that them iso construction loading agency for the perfurns.of a me work ruse which this permit is issued(Sec.3097,Civ.CA ' WM Q Lamine's Name , ] z Landers Addmas C.)Q 1 canary out I have read Nis application and sea that thea Wve information is . LL F comm I+lira to comply wilt all city and county ordiruncesand sum laws relating to r)V building construction.and hemby amborim mpmsenutives ofthis city to enter urymt W move-mentioned propeftY for inapeninn put om.r F 4 (We)agrte to save,indemnify and keep harmless the City of Cupertino against cel liabiliti.,judgments.costs and.......hich may into,way acerve against a to City �)Z inemtusitsee.orthe granbngoflhis Permit. - / '-' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Dale �� b SOURCE uuno •l� �Q —� - 3-(oa8 Re-roofs Sign pplicmuCanuxwr Data �— HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will IW applicant or future building occupant mate or handle hvardous material as defined by the Cupertino Municipal Code.Chapter 9.13.and the Health and Safety mk,Section 35533(,)± All roofs shall be inspected prior to any roofing material being installed. ❑m pilo Will thea licantar future building oats am am If a roof is installed without first obtaining an inspection,I agree to remove PP g p equipment devices emir h.uNnus air conuminanu u defined by da Bay Ants Air Quality Management all new materials for inspection. District DYu Ihave&Salc lhebanNtinecZ ialste33and 5534.1rCluPad!due tithe Cabling / `�• nicer rrum urrentlyhave.Scctionshat iii my responsibility understand! occthe Wilding lou tot currently have a tenant dist it I my«sponsihiliry to mtifY abs oavpant of the mquimmenuwhichmustW eLpdormimsaameofaC rWaLe rOcapaney. gnatureof-Applicant Date C ) Q '_ - suthorized agent ma All roof coverings to be Class"B"or better ® CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32634069 . 00 DATE ISSUED. . . . . . . : 03/06/2008 RECEIPT # . . . . . . . . . : BS000004094 REFERENCE ID # . . . : 08030022 SITE ADDRESS . . . . . : 20625 ALVES DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ED URATA ADDRESS . . . . . . . . . . : 20625 ALVES DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : LINDY ROOFING COIN CONTRACTOR . . . . . . . : RUMFORD, LINDY LIC # 3921 COMPANY . . . . . . . . . . : LINDY ROOFING CO INC ADDRESS . . . . . . . . . . : 5554 HARVARD DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95118 TELEPHONE . . . . . . . . : (408) 286-9990 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ------ --- ---------- ---------- ---------- IBSEISMICO VALUATION 19, 000. 00 3 .99 0. 00 3 .99 0. 00 1REROOFCOM SQUARES 64 . 00 490. 00 0. 00 490 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 493 .99 0. 00 493 .99 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ---------------- --------------- ---- --------------- CHECK 493 . 99 #3460 --------------- TOTAL RECEIPT 493 . 99 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- --------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS 605 FINAL REROOF agD�ooa� CITY OF CUPERTINO REROOF ®CUPEkTINO PERMIT APPLICATION APN# �5Z (02 H C)�0 CC) Date30 BuildiAddress: no as Awes r. Owner's Name: Phone#: CA 4073 `74 Contractor: Phone #: 40% _age L,r\ca� R cxrrtnS C O . Fax #: Cupertino Business License #: Contractor License #: �ISgI Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles 'Asphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O. Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: reM0U*k wW Skc�t6�, (.r L4 0 -- 0 r---srA, Residential H Commercial In Fire Zone: Yes No © Confirmed with Planning Dept. if there are any restrictions: ❑ I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signatu CITY OF CUPERTINO REROOF •CUORTINO FEE SCHEDULE Number of Fee ID Fee Description Fee 'Permit Type Squares Group `"I 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 1RER00FRES Re-roof Residential B 1SFDWLR00F IBSEISMICRE Seismic Residential B 1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF IBSEISMICRE Seismic Residential B 1BUSLIC Business License B Community Development Department Building Division City of Cupertino • 10300 Torre Avenue Telephone: (408)777-3228 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 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: C_a �rr Job Site Address: , C1 (ola S Roofing Company Name: Lt�_ c�O4n4 Applicant's Signature: Date: 3—(0-0 cs ® Greg Casteel Building Official Revised 11/2/04 Community Development 10300 Torre Avenue ✓- Cupertino CA 95014 Telephone(408) 777-3228 4 OUPERTINO Fax(408)777-3333 Building Department JOB ADDRESS: PERMIT # - OWNER'S NAME: F PHONE # q U GENERAL CONTRACTOR: vo FAX # � � 7 I am not using any subcontractors: ��L 3�(n Signature Date Please check applicable subcontractors and complete the following information: 60 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