06080111 CITY OF CUPERTINO
"ILDINGD ,
IVISION PER CONTRt CrePORIL �URMA'IIIQN
BUILDING ADDRESS: a LINDY ROOFING CO INC FERMTIND'06080111
20947 FAIRWOODS CT
OWNER'S NAME: PERMITISUEDATH
DAVID KUNG 5554 HARVARD D
E: SANITARY NO. CONTROL NO.
(408) 286-9990
ARCHITECT/ENGINEER: BUILDING PERMITINFO
BLDG ELECT PLUMB MECH
0 C= l�
86 LICENSED CONTRACTOR'S DECLARATION helob Description
W i reby affirm Nal I sm licrenaed umler Pronsvidaa ChePmr 9(mmmmeing
iUF wide Suction 70M)mf Diviaon 3 of Ne Budneu and Pmfwmas Cade.aM my lkewcu '
e�> N(YIIfnReaMeifZ J
Contractor REMOVING THE EXISTING WOOD SHAKE ROOF AND
M. `i " °�' `ire'" INSTALLING 1/2" OSB 30# AND 33 SQUARES OF NEW
CL
q2 AacxrtEcrs DECLARATION L
ULIFETIME DIMENSIONAL COMP
�
WU I understand my plans Nall be used ss public records
)M
:8t; Licensed Professional
3OWNER-BUILDER DECLARATION
N @@ I hereby
norm that I am exempt itemsthe Contractor's License Law for the
Z C 6 following mason.(Sacdon 7031.5,Bus arras and Profenal..Cale:Any city or county
$ which requires a permit m.nom en,alar.improve,demolish.or repair any structure
•z�, prior on its issuance,also requires the applicant for Such permit to 0lc a signed sumenvat
That he u licensed pursuant m ate provisions of the Canuacmr's Lmorm Low(Chapmr9 Sq.Ft. Floor Area Valuation
i� (commencing with Section 7000)of Division 3 of Ne Buslncu and Professions Code)or $'20000
4�9 that he is exempt dmrcffem and the basis for the alleged exemption Any violation of
Session 7031.5 by any applicant for a permit objects the APPlkant to a civil penalty of APN Number Occupancy Type
.at mare this five hundred dalun(5300).
❑I,
as owner of tlmProperty,or my employ=wide.1.as man ask compensation, 3591-3112 . 90
will do the work and the swctme is out mtended or offered for am(Sm.7044.Buslam
and Professions code:The Comuwnofa LJtTaue Law d=ant apply in an owner of Required Inspections
property wine build unimprov=tlmseon,and whod=aueh work himselfm Nmugh his f� ��� rr��
owever,teWipmvlorI Nu richImP�dwuart of year
ofewonerW resaler, I� �
however,the Wilding or Improvement owmentumid Im did
year of mpolefor thrower- Illi— FF)1
builder will have W Wrdan of proving Nat he did tet Wild or Improve for Puepoa of
ask.).
❑1,u ower of the property,am"abusively contracting wit licensed conwctms to
comtmct Ne project(Sec.7WA Business and profesIons Code:)The Contra un's U.
came Law docs not apply in an owner of progeny who builds or iropmvm thereon,and
who contracts for such projects with a eanmesa4A licensed punwnt to the Conoagues
Lknse lw.
❑ImeptumhaSe .Bk PCfmmisreamn
Ower Dau B` 1
(%��
WORKER'S COMPENSATION DECLARATION
1 hereby ammo codec penalty of perjury ane of the following declarations:
1hsveandwillmalmada Cerdr.mof Consenttoulf-WanfarWorkcesCompcn-
adon,u provided for by Section 3700 of do labor Cade,for the performance of use
work for which this scarab is issued.
❑I have and will maintain Wormer Compensation Insurance,as required by Semon
37W of the labor Code,for Ne performance of the work for which Nis permit u issued. '
My Werkm`1,2 ensaIJ m ter and Polity nu ryC
Cartier. S`TaT� policy No.: 7� 2 �.e
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu section need sat W completed if ths permit Is Faroe hundred dn0an($100)
lass.)
1 certify tet in Ne performance of the work for which this Permit a Issued.l"I rmt
employ any Person In my manrcrm u m become Abject to the Workers'Claopenadan
Laws of Califomia.Data
Applicant
NOTICE TO APPLICANT:If,&Act making this Certificate of Esemption,you Mould
become subim to dee World&Compensation previsions of dee Labor Code.you mull
.J O foMwith comply wish such provisions or this Permit Mall W assumed revoked.
'ZCONSTRUCTION LENDING AGENCY
(~0
l hcrehyamrm that Nero is a conswedan lending agency for the performance of
lYi > the work for which this permit is issued(Sec.3097,Civ.C.)
W�E Lender's Name -
2 Lender's Address
V Q I certify that I have read this application and sum that the above ur..into u
l7.H coned I agree to comply with all city and county ordinances and sou laws relating to
p U building construction,and hereby authorim rcpn: nmvu iof this city to enter uivan the
rU abovomentioned property for impaction purposes.
I,, (We)agree to saw,indemnify ad keep hatedle s the City of Cupcnino against
„F"•e N imbilides,judgments.cuts and estimates which may In any way acerue against aid City
C)2 in consequence of Ne granting of this permit.
Date
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL tfON-P INT Issued by:
RE A714N49 VatRe-roofs
Signature of ApplicanUContractnr Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or fuuro Wilding occupanutoro or handle Wee dons material
as defined by the Cupertino Municipal Code,Chapmr 9.11,and the Health and Safety
Code,SeNon 35532(0)7 All roofs shall be inspected prior to any roofing material being installed.
40 ❑Yw �N
Will No mpli mt ar tare building occupant ase equipment w devi=which If a roof is installed without first obtaining an inspection,I agree to remove
molt hexudow air cmogrom u as d ire d by the Bay Arca All Quality Management all new materials for inspection.
Dlsbmt7
❑Yrs Nu
the=rev)NehasSwa=25M5,25quinmc5534.I Wcmmd 95afthe Glding
nu Hat cAentlyyham aSaniom 25505, My Nenanetal y undersand Nmifde Wilding
dao et currently hew•mnanL this it u my rcsponsiM1ility m notify amryant of Nc
qzzl`mcmlw be met prior to iauance of a Cmtrfcam ofJk rL0 Signur Applicant Date
owwrm.amarimaaagam' 7�1k'll((QDDa 10 All roof coverings to be Class"B"or better
CITY OF CUPERTINO
om 2 of 2 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35913112 . 00
DATE ISSUED. . . . . . . : 08/16/2006
RECEIPT # . . . . . . . . . : 35643
REFERENCE ID # . . . : 06080111
SITE ADDRESS . . . . . : 20947 FAIRWOODS CT
SUBDIVISION . . . . . . :
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . :
OWNER . . . . . . . . . . . . : DAVID KUNG
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : LINDY ROOFING
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
---------- ------------- ----- ----- ---------- -- -------- ---------- ----------
BPERMFEE VALUATION 20, 000 . 00 277 . 56 0 . 00 277 . 56 0 . 00
BSEISMICRE VALUATION 20, 000 . 00 2 . 00 0 . 00 2 . 00 0 . 00
------- --- ---------- ---------- ----------
TOTAL PERMIT 279 . 56 0 . 00 279 . 56 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- -------- ---- --------- ---------
CHECK 559 . 12 2166
TOTAL RECEIPT 559 . 12
•
Community Development Department
Building Division
j City of Cupertino
' 10300 Torre Avenue
CITY OF Telephone: (408) 777-3228
�
-� CU.PE(�TINO
Building Department Fax: (408) 777-3333
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 sheathung,
so a proper City inspection can be performed.
7. NOTE: If you call for a plywood nail inspection andthe 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: -Da U t`� V-LA�
p <
Job Site Address: a� 1 7 -�Cttrt� c u V CT
Roofing Company Name: —` cx�— ;r,c� CO
Applicant's Signature: n: Date:
• Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Pgper
CITY OF CUPERTINO (;��)
REROOF
�CUPERTINO PERMIT APPLICATION FORM
APN # �I'n Date: g_ I S Ifo
Building Address: LJ
a0'1't_- -P:Cttr"S cr_
Owner's Name: r_-X,tv,,Cj ((/0 6 7- 6Z
QL
Contractor: \n o8)
� �(o'ig40 icasl s8do
Contact: Ws�^ Phone : - ��� CupeEliao Business License #:
-q 0gl
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#
bC To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job escription:d"eMautAn � .S n� w StCe. r-oa ., rns 12 O t
Rkf- 3 4-A CO % me Lxmensiol;,Z_Q CO 'i,
Residential ICommercial ❑
Fire Zone: Yes ❑ Non Confirmed with Planning Dept. if
there are any restrictions: LJ
Cost of Project: Type of Construction: Occupancy group:
(R4p--- Sin
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