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06080110CITY OF CUPERTINO. ` �s1�,� y S�}�,]!�.�t�' x ^ �°'k `��,�(y`�t- Q1LUY>.AT BUILDING DIVISION PERNHT V14 , CQNTlt'A��"TO,IgtIIt �r _a BUILDING ADDRESS: LINDY ROOFING CO INC PERMITNo.06080110 20978 FA R OWNERS NAME: - PERMIT ISSUE DATE CHAN RODDY 5554 RVAR12 DR 08/16/2006 NE: SANITARY NO, CONTROL NO, (408)286-9990 ARCHITECUENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION lob Description 1 Manby afflrm Nat I am llecncd umkr provision of Chapser 9 (commencing with Section 701X1) of Division J of the Besinraamd Profcssiun Code.aM my license b inl`ullllfaC offs 3 X51 0 REMOVING THE EXISTING WOOD SHAKE ROOF AND and Lig Does contracuor INSTALLING 1/2" OSB 30# AND 33 SQUARES OF NEW ARCHTIECTS DECLARA ATION oN LIFETIME DIMENSIONAL COMP IuMersun my pluu shall he use0upublic Licensed Professional OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Cannactors License Law for the fallowing moan. (Section 703 1.5, Bananas and Profession Cade: Any city of county which mqulfes l permit in NnLluC4 alser, remove. demallfh, or repair my iWLum prior to its lasuence, also requires the applicant fafsoh Permit m Me a signed statement the Counselor's License law(Chapmr 9 Sq. FL Floor Area Valuation that he is peened parasol to On provision of (commencing with Section 7000) of Division 3 of tiro Business and Profusions Code) or $20000 that he is exempt therefrom and the bub for the alleged emmpdom Any violation of APN Number - Occupancy Type Section 7031.3 by any applicant for a permit subjects the applicant m arnil penalty of not mom than five hundred dollars (SSW). I, u owner of the pmpoy, m my wplayeca aim wage u desv wleompenadan, wiRdethe work and theawctumbotlaesMed oaRertdfds sale (Sa.]BH, Busireslo Inspections and Pmhsrian Cade: The Characters License Law dao of apply lo an man of and property who builds or improves Norma. and who dos such work himml(or through his own employou, provided that such improvements tie notinunde l or offered (vane. IL however, the building or Improvement is sold within an you of completion. The owser- wilder will have the burden of proving that M did of build or Improve for purpose of sale.). s with Domed ooseters - I. as twee of the Sm. 70 sena exclud,vely,and Professions Cade:) The Cohseters Li - control the project (sec. o an comer of and property who who c law don not apply to ts owner of pommy who Wilds of Improves Neuron. and who contracts for such projects with lonvutor(q licensed pursuant to the Ctuntrselors Xz� m L. 0 1 am uempt undo gee ,BBPCfor this won n / Owner Dau WORKER'S COMPENSATION DECLARATION I hereby a1RmI oder penally of perjury oro of the following dalerstions: G /I I have and will maintain a CeniButo of Consent m self-lnsam for Workers Compen- / solids, u provided far by Section 3700 of the Labor Code, for me performance of the < work for which this pmmit b issued. ❑ 1 haw: aM will maintain Workers Compenatlan Insurance, u required by Sectio O 6 3700 of me Labor Code, for me performance aides wart far which this Permit b iuued. - CCCJJJ My Warkera C gspammOm Intim n and Policy Wjcg,v - "2- Cartier.Policy No.: / 1D,i T CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This sectio need of bocomplemd Htie Permit is fortune hundred dollars (SIMI or mm) I certify that in the performance of On work for which this Permit is issued. 1 shall not employ any person in my mmmcrm as he became abject an theWorkers' Compensation Laws of Californic Dam Applicant NOTICE TO APPLICANT: If, after sulking this Cenificale of Exemption. you should become subject to the Workers Cmnpcosation provision of the Labor Cade you mus forthwith comply with such provisions m this posit shall m decnesd reveled. CONSTRUCTION LENDING AGENCY 1 hereby thi that mem le l c landing agency for de mcrfurmence of which d (Sec. 0 Oewad fur wMch this pemtitbissued (Sec. 3097, Civ. C.) 1 Lenders Name lenders Address • iI cannily that I have mad Out application and sum On de show, info ernalun is ' ' cones. I agree m comply with all city and county oNinance and sum laws misting to Wilding construction. and hereby aathorin representaives of this city l0 enter upon the above-mentioned property for inspection purposes. (We) agree to love, indemnify and kap harmless; the City of Cupertino against Iiabllmes,judgmenlx. coats and expenses which may in my Way accmc against said City In eanequene of the Standing of this permit. ' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POI Issued by: Date s REGULATIt ON � t� S' e -roofs Type of Roof _h _ior HAZA DOUS MATERIALS DISCLOSURE au Will the applicant orfuture Wilding occupantuom or handle Inza donsmaterin as defined by tie Cupertino Municipal Cade. Chapesr 9.13, and the Health and Safety Code, Sermon 23332(.)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yu If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or fumm building occupant use to ulpmenl or devices which dcnacd by the Bay Asea Air Quality Management DiuricO ..It hmaNno oI, co2macrials all new materials for inspection. El Yrs Ih&Safet me,reg3mrresmsu.IwWc Pur Q93ofine Glifor- under mayCd Cerstsr 6.95a d'i I nbHcalHunc de,Sa9oru233J7 amens the building O/— (0 docs not currently have a LLnanx that it b my responsibility in notify the occupant f the natiateemaq which MUS WMCI prior toWoman ofaCertificate of '' Si(Applicant Date 1 f¢ All roof coverings to be Class "B" or better Ownersaptarl&ixod agent I Dou CITY OF CUPERTINO em 1 of 2 PERMIT RECEIPT OPERATOR: amyw COPY # : 2 Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35913108.00 DATE ISSUED.......: 08/16/2006 RECEIPT 4.........: 35643 REFERENCE ID # ...: 06080110 SITE ADDRESS .....: 20978 FAIRWOODS CT SUBDIVISION ...... CITY .............: CUPERTINO IMPACT AREA ...... OWNER ............: CHAN RODDY 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 • i i CITY OF CUPEkTINO Community Development Department Building Division City of Cupertino 10300 Torre Avenue Building Department Subject: Re -roofing policy for the City of Cupertino Telephone: (408) 777-3228 Fax: (408) 777-3333 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 andthe job is not ready, you will be charged a re -inspection fee of $176.18. The re -inspection fee must be paid before another inspection can be scheduled. IMPORTANT: 1. Flat roofs must have a mininnum of 1/4 " per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O. report is required to be on the job site at the time on inspection. I understand and will comply with the above stated policy on re -roofing. Homeowner's Name: 20chan job Site Address: ��CiTg a`rS CC - Roofing Company Name: Applicant's Signature: Greg Casteel Building Official C_0, Revised 17/2/04 , Printed on Recycled Paper Date: aF CUPERTINO MV CITY OF CUPERTINO REROOF PERMIT APPLICATION FORM APN# 3 - �2�(b� Bldg Permit Fees Dat : _, Building Address: Energy Owner's Name: ��C owun BSEISMICRE P n�: % Contractor:hone #: C �. �s BSEISMICOM License #: a I s81 Contact: -Phone—4: BPLANCHK Cupertino Business License #: BUILDING BUSLIC Business License 'Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles V Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Number of existing coverings _ ❑ Other (Specify) Provide I.C.B.O. Report # To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: V2 'ems '� t �` � tC2. f�1 in In' �U t " 0S$ �-Lkl" 0-*. 33 ,S caves 6-C nus - 'L)i Ansa� CoM esidential Commercial ❑ Fire Zone: Yes ❑ Nom_ Confirmed with Planning Dt. if there are any restrictions: Cost of Project: Type of Construction: Occupancy group: act oob.cZ.) -re---rz:,F s, i -e- Qty. if Applicable Fee ID Fee Description LS Fee Group I 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