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03040037 [OWNECITY OF CUPERTINO BUILDING DIVISION PERMIT = CONTRACTORINFORMrATION•� R'S ILDING ADDRESS PERMIT NO. 10668770 HALE PL LINDY ROOFING CO INC 03040037 NAME: PERMIT ISSUE DATE BARABRA KOPELS 5554 HARVARD DR 04/07/2003 NE: (408) 269-2025 SANITARY NO. CONTROL NO. ARCHITECUENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH �Op LICENSED CONTRACTOR'S DECLARATION 1 ion 7 affirm incl 1 em licensed under and Prof ss ofClapacsCode. n(commencingsIs Job Description wt1 with Section 7IXIU)of Divl�9l3, usiupe and Prafcsslnns Code.and my license is Feu Ofulltotcea f I �j zpz Ueen,eeler. l.k( ..Z- /S-k�^�� REROOF ����® Dale Contractor a CHIT crsD6 APR 1 7 2003 1urukry dmy seal�ud iF ds 3 u Liccnud Pmfcssmnal 3 NE.ex. R DECLARATION 6UjLDIN S 1 meso.(Fero Net 11. exempt from the le nine Coi Lion y c taw for the F.22 following mason.Section 7 cont; Bminer, and w,dcouli Cade:Any city or mouq B whkh its isu a enroll re construct.fled Blur,Improv,n permit t or e a sig any structure, prim to itsissuance.0.aleu 11.the noviss.or for men permit l.Blcise Law rh¢mcm ss< that bcislI,widpurction7 h)of DivisionoftheBeat.the,Cmumcur's licenulaw(Clodc)or Sq. F[. Floor Area V I Ion ¢f (commencing with Section and of bass;for the theeged acaanOon.Mynna Codc)or $18 � that Section h mumps b Iherefmm and the.perm far Ibe allsubjects tic accordion.W Any it Nulty of �7 ta� not mo7031.5o .y my applicant.(a permit mbjects the applicant m a civil anally of 3 M UU 1 er 0 0 Occupancy Type not mom Nan raw hundred dollen(5500). G FJ ❑1,as nwncr of Ne pmpwy,m my employees with tinges u them mle comperadon, willdo the work and the structure k not intended or offered for We(See.7014,Businnas and Pmtcss(ons Cade:The Condamine,Lixve law dace rte,apply to an ownm of 305 — FRAME Required Inspections Property who builds.,Impmmi Nemon,amd whodoessuch work himulforateme,h his 307 - INSULATION ow...Pkiyces,pmvl@d Nu such improwmcnh art not intended oroffered forssle.IL however,the Wilding or improvement is sold within one year ofcompletion.the owner- 601 — ROOF TEAR OFF n�life,will haw the burden of proving that he did not baud or improve for purpose of 602 — ROOF PLYWOOD NAIL 1,as Dame,of the Property,am exclusively contracting with licensed contractors to 603 - ROOF BATTENS construct the project(Sec.7M,Business and Professions Cade:)no Conductor's Lb 604 — ROOF IN-PROGRESS ecru law docs not apply to an ownm of pmpeny who Wilds or indpmws themem.and who contracts fm such pmjecu with a eonaaetor(q licensed pursmnl m thea Co eactoes License law. ❑lamuemptunder See. ,BAPCfaradmomen Owner Data WORKERS COMPENSATION DECLARATION 1 hereby affirm matter Nearly of perjury ane of the following dalamions: I have and will maimed.a Cerditcau of Consent Io ulfgmurt fm WorkersCompOn- _•/ _ ion,pe provided for by Section 3700 of Ne laWf Code,for the performance of Ne work for which this permit Is Issued. ❑1 have and will maintain Worker's Comattudon Iran==.as required by Section 3700 of IN labor Code,for the performance of the work for which this Permit is issued. My W rkees C mpemadom Insurance ear(e,aM Policy n her art: ee: Policy IF�PTION OMORKERS' COMPENSATION INSURANCE (This ucurn need not W completed if the Permit Is fm are,hunartd dollen(ilial) m Itis) I cenify diel In the perfnmhmec of the work for which this Permit is Issued,1 shall mm employ any person i.my--Mr an u In baame subjecl an IM Worked Compeasstide Laws of California.Dau Applicant NOTICE TO APPLICANT:If,amr making this ccnintate of Exemption,you should Income subjection the Worker's Compensation provisions of the Ichor Code,you must Oforthwith comply with such provisions or this Permit shall W deemed mv.ked. 'Z '-" CONSTRUCTION LENDING AGENCY (~ 1 W r by which Nal Vert u a construction(See. 0 7,Cing ageruy far Ne performanm of IYi r Nc work for which thio pem1il is issued(Sec.3097,Civ.C.) Wh Lender's Name �z Lcnderi Aaarru V Q 1 cenify out I have rod this application and We Nn Ne a,,mfomnedon is D, F cmmeL I agree to comply with all city and county Ordinances and sum Tawe misting In 0U building convection,and hereby mthoim rep,eunsadves of this city to crime upon dte �L7] ehow.imatimcd Property for inspection purpous. „gy (We)agree Io save,indemnify and keep harmless the City of Cupertino against e/) IiaNliues)udgmcnts.emu and esaose,which may in any way accrue against said City t)Z in consequence of the granting of this armit. ;SOURCERE PLICANT UNDERST DSANDWILL OMPLL�YWW117MALLNON-POINT Issued b LATIO —XI Y DateRe-roofs nuurtofApPlic m p�H Us IAtS DISCLOSURE Type of Roof Will theapplicam ere lmurt Wilding occupantsoon or handle hanrdom material efined by the Cupenlno Municipal Code.Chapter 9.13,and IW Health and Safetye,Sc.dan 3ss33(a)r All roofs shall be inspected prior to any roofing material being installed. ❑YmpNaWill the applicant or future Wilding occupm use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove t heurdour air contaminants as dcnncd by the Bay Arca Air Quality Management all new materials for inspection. diel] ❑ A, Yes o 1 have real lite hvndmumueriad rarammems unde,ClispW6.95 of die Cairo, artificial"Safcty Codc,Snc.oes 25505,25533 and 25534.1 undimmed institute IOU p // doesnot eormnlly havea um int all it h my res rihilily m notify the oceuPanl la die reyulremcnuw' muslW.at poor Is umccofa 0cau of l'kcupancy. j/ 7Signature 5pivrplicant Date ownerorim nil age., •� a All roof coverings to be Class "B"or better Community Development Department Building Division au City of Cupertino 10300 Torre Avenue CITY OF Telephone: (408) 777-3228 Fax: (408)777-3333 CUPEkT]NO 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 fust obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be performed. 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: lob Site Address: Roofing Company Name: i>,�AL ��� A plicant'sSignature: v Date: �Q Cit/P6INDCJ�1 Greg teel Building Official Revised 1/30/03 Printed on Recycled Paper CITY OF CUPERTINO c3 c> `I° D 3 7 REROOF CUPEkTINO PERMIT APPLICATION FORM APN # Date: 31,�26dd17- © � Building Address: Q Owner's Name: Phone #: Contractor: Phone#: License#: Contact: Phone#: Cupertino Business #: L Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles `Asphalt Shingles X Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings. ❑ Provide I.C.B.O.Report# XTo be Removed ❑ Provide Mfgr.Installation Specs. I Have Read, Understand and Will Com 1 With Cu ertino's Tear Off Policy: Job,Description: Cly S1� �U�i lL ��., S �l .� /� oST Residential Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are an restrictions: LJ Cost of Pro'ect: Type of Construction: Occupancy group: Qty. if A lic le, Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY EnerEEE BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING IV7�.