01070151et' o� euQa6
_ rsuu.on.c DIVISION
.. stoN PERMIT
CONTRACTOR INFORMATION:
BUILDING ADGkFSS:
PERMIT NO.
10350 HENEY CREEK PL
LINDY ROOFING CO INC
01070151
OWNER'S NAME:
APPLICTION UB DATE
SHINGSAN CHOU
5554 HARVARD DR
07%31/2001
PHONE:
(408)269-2025
SANITARY NO. CONTROL NO.
1ARCHfTECT/ENGINEER:
BUILDING PERJMIT INFO
ELECT PLUMB MECH
> N i
LICENSED CONTRACTOR'S DECLARATION
I Job Description
I hereby uffrm that 1 am licenced under provisions of Chapter 9 (commencing
with Section 7") Division 3
p
RE -ROOF
i a
of of the Business and Professions Code, and my license
�,in rel rodeo anile t.
d.
Licens Class Lic. N
w
Dam Comm or
ARCHITECT'S DECLAR
Ir
O
Il V /JOU L51S
S
I undersand my plans shall be used as public recoNs
3
Io
AUG 2 8 2001
LicenxdPro(essional
DECLARATION
J M
-?a
I heresy.(firm that I am exempt from the Cunoas
ma, I a. exempt o License for the
cLawity
following nfseatmmm�s.eaaineaaandProreaamnscoae:Anyaityoraoantr•
Ca
$19350
g F ❑
which requires a permit to centime, alter, improve, demolish. or repair any swcmre
s 3
.prior to i¢ issuance, also requires she applicant for such Permit to file a signed sa¢mem
r a
34 �tJ,
Valuation
Shatheiscurgwitpursumuemeprovisionsofthe
reon,
Smdoaom
the BusiesLicenseLew(Chapter9
is gwllh andlinfAn,'i Code)
_ V07 V. y ,
he ad tDivisioniods,aBusiness
or Sectio is exempt thetefront and the basis far the alleged exemption. Any
'
l person
subjects the applieap toacivil penalty
.of Sxtion ]than file
.or nm more man five nanarm dalima rssofl.
305AEN f1r&i�TE
I"•Fon' :Occupancy Type
°I, as owner of She property, or my employees with wages as their sole compensation,
-
107 INSULATION
will do the work, 'and 'the stowtud,'is not intended or offered for a e- See. 7614;
Basilica. and Professions Cale. The Contractor's License law does not apply to an
601 - ROOF TEPaclOR ' Inspections' C - --
owner of property Who Wilds or Improves thereon and who does such work himself
602 - ROOF PLYWOOD NAIL
of through his own employees provided mm such mmprverena art rte mended or
cRcrMTon tole. If. however, she o sold wnhid one year of
_ ------
_-_, -603r
6 0 3 - ROOF BATTENS - �"
completiono lholeWilding-orSmpmviment
will have Je buNen of pmnng mm he did no, Wild or
dprove
for purpose
top'°°° p°ton se ofbsale.�r
604 - ROOF IN -PROGRESS
- iia "nth l-ic-e-nx- -- rs to
dsr w.n,er o.f'he Property. am e- --es-
al
❑❑G
- - - -- - — - --- - -J--_—-
cothe pe(Sec.TBusiness and rsios Code:) The Conore
License La duet no pply b,a owner properlty who b 'Id. paves thereon,
an hp s15 such.pr j ts-with comrmags) Id p rsuam m the
Co License la
e.
— '
Ia. exempt der Sec B&PCT thisaso
..
'i)
.ruc
wL
. Dae
-- "WORKER'S COMPENSATION DECLARATION
g 1X401
- I hereby affirm under pnuhy of perjury ane or the following declarations:
AUL
° I have and will mainiain 'a Certificate of Consent to self -insure for Worker's
Compensation; as provided for by Section 39U1 of Lahr CnJe, for the
,Sha
Performance ofSwork which this permit is issued..
-;-
By
t�I have and will mainiain WmkersCompensation Inzupn¢, hs icquireJ by Secrioh
]
Llo of the Lahr CMe, fay the per(ormarce of tk work mor which this permiS is
issued. My �'orkcrs Compensation Insurance carticr and Pol' mbar de: "
Cuncc No.:'
._ .._. .. ... ,_- ... 5r
,• 1
.v_¢d—PolicY
"' ;_ E IPICATION OF EXEMPTION FRO W R 'a
•.:a. :Oi',
� ' ..e..;'
.... Tllb:'eation edno,WcompletW'f the Permit is for one handled dollen
--------- .._.____..__._......_.__._.._._.____,___._
't I i'f ':<.. .)CC', t',�g
(51 W)or less.)
'I ea (y Ili t in She perfirmorance of the work for which this peemit is issued 1
•. ._ �.... ..
f - •. .• . _ . •,:el. •..
shall int employ any perm in anymannerso as to become subject to the Workers
.. L Yn
Cmnpcna6tion laws or Celifroodia. Dare
._Applicant ' •.:.
r NOT',ICE TOctto APPLICANT after Exemption, you
r!" -
Z
nitCmi&ate the
Wmke,. Compensation
Wdekers Compensation provision's b(Jre Labor Cade, you man
Labor you
bccdwith
(onhWm each
O
coemette
comply with pmvisionsarthispermitsholl be deent rtsoked.
ie ITO 'M,10", CONSTRUCTIONLENDING'AGCNCYI'll
' 1 hereby which that mere i is issued c. lending agency for the perfdmarce
.. - 1 1
r
A
of thi work or which this ' ' (S 3097. Civ. C.) -
G
Lender'i
.- _....._. .___ -
�
Lende'r's Addiess' •_•. . . •
Adkbc
._
4:
certify
.'w lccsonatm�ct PIYrt dthis asy licatbn
pp arm state that the above information is
ramie. l a rete o tom have him all cit and county ofdial. aM sort laws «lacing
V
to building c ion. and heresy authorize representatives ofthis city to enter upon
g
the above-mentioned property for inspection purposes
yep.
_
(W) igme us d mnifyand keep harmless the C'ry fCupeoinn g inst
- CO)
liabilities polgracm, c ... d e.ii wh yin any ay c against aid
�.z
City incn'equentic of the granting of It rod: "
PPLICANr UNDE $AND CO YWITH ALLNbN'POINT'"
='',
Issued by:
ourtr ;cu ,
`
Date
igraem'of ApPli anu omrao .. ...
nate".,..
Re -roofs
M1 s AZAR US MATERIALS DISCLOSURE
-
,• Wllsihm iap;Iiccufilla f t buldi ed and
g papa aha dl
lth
Type of Roof_..
as defined bynthe Caper Municipal .9 1 nil m Health and S f
and
i'
_
.,. _, .. -.. .,5,I., m, •. ..
°Y 5"
a
'p
All roofs shall be. inspected.prior to any roofing, material, being installed..__..
Iwo th e t rLtI bud gocpantLseequipment re 'ceswhch
6.dum
If a roof is installed Without first obtaining an inspection;'I agree to "remove
emit h r d it n ms as d by the Bay Am A Quality NI.m.,emern
District?
all,new materials for inspection.., Applicant understands a_nd will comply with
_
°YI m `9
all non -point source regulations...,,
_I
ha a dead the hazard 'nationals requirements- underChapter ti 95 of the
f..'
Calif aHealth &Safety Code Sectio. 3750525533 and B5341 understand that
if the bolding Ohs monsuarrionlybase . enant that it ismY po-ruibililynd notify the
-
Oc pain for recdoo t. h mut b t pr Lir,o i ane of a Cenifeme of
,a/Wa..as� Lawes %ATM 7
Signature of plicant., Date _..
.
All roof coverings to be Class "B" of better'
o eroramnor d t ants..
"' `` OFFICE
CITY OF
UPEI�TINO
Building Division
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3228
Fax: (408) 777-3333
IMPORTANT:
1. Flat roofs must have a minimum of 1/a" 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 of inspection.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name:
Address:
Reroofing Company Name:
Applicants Signature: _
Q �iG
Joe Antonucci
(Chief Building Official)
6/25/01
Building Department
Subject: Reroofing policy for the City of Cutin -,,A\
1.
nnnn'1
Prior to permit issuance, you must agree t I oniW t AhZ* UBC Standards
and manufactures specifications on reroof
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 reroofing 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) Preinspection 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 that the
proper City inspection can be performed.
IMPORTANT:
1. Flat roofs must have a minimum of 1/a" 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 of inspection.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name:
Address:
Reroofing Company Name:
Applicants Signature: _
Q �iG
Joe Antonucci
(Chief Building Official)
6/25/01
C
1
Building Division
10300 Torte Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3228
Fax: (408) 777-3333
Building Department
REROOF TEAR OFF POLICY
mvised 6/25/01
1. You must schedule an inspection for the tear off the day before the date you
wish the inspection to be made. The procedure is to call the Building Division
(777-3228) between the hours of 8:00am and 4:00 p.m. for next day inspection.
2. When :the roof is torn off, the nails removed or driven in, and all of the dry -
rotted' wood
ry-
rotted'wood has been replaced, then you must call the City Building Division.
An inspector will be there within one hour. There are special hours for this
service: between 8:00 a.m. and 11:00 a.m. and between 1:00 and 3:00 p.m.
3. If you call for the tear -off inspection and the job is not ready there will be a
re -inspection fee of $100.00 charged, which must be paid before another
inspection is made.
Joe Antonucci
(Chief Building Official)