01070152 cBUILDING IVSIONO
DINPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS. PERMIT NO.
10358 HENEY CREEK PL LINDY ROOFING CO INC 01070152
OWNER'S NAME APPLI TION liUB DATE
LAI ERIC H AND JULIA TRUSTEE 5554 HARVARD DR 07/31/2001
PHONE:
(408) 269-2025 SANITARY NO. CONTROL NO.
ARCHITECT'ENGINEER:
w
00 BUILDING PERMIT INTO
E al BLDG ELECT PLUMB MECH
8 h= LICENSED CONTRACT'OR'S DECLARATION Job Description
ZO Z N E I hereby affirm Nat 1 am licensed under provisions of Chapter 9lcomm<nci ae
<MLab with Section]OftOofDivision3oftheBusinessandPmfessi.p,cede,andmylicense REMOVE SHAKES--INSTALL PLYWOOD & LITE WEI
m rs in full force and off t.
z a a License Class . za Lic.N
X 3 u,F„ D0'0 T`�—�f— CDECLA
a
0, ARCHITECT'S DECLARATION memo
,", 1 undemand my plans shall be asetl as public records
se
y
w O O Licensed Profecaonal
x u OWNER-BUILDER DECLARATION
m- 1 hereby affirm that I am exempt from the Compactor's License Law for the
F a following reason.(Section 7031.5.Business and Professions Cole:Any city or county, $15000
4 cp,]t pi which requires a permit m cansuua,alma improve,demolish,or oTha any umdurc
to Prior to itsissuance,also requves Neapplicam far such permit to file a signed smrement
'hath,is licensed pumuammthe provummofthe Contractors License LawfChapmr9
(commencnS wim secion]Bf8of Division3af the Business ane Prfessions Cale) 3.4-N pp'^§1p.C.fte a Valuation
OF that he is'eiimpf therefrom"and the basis for the alligal exemption.Any violation -- - I
of Section 7031.5 by any applicant fer a permit subjects the applicant to a civil pewlry-
'of not marc than five handmd dolLes[P(m), 3 0 5AEN j�fE 1: .:e>, ..o. Occupancy Type
El 1,as owner of the property,ar my emPloye,with wages av their sale compensation, 10 7 -
will sincisthe'work;and the houode:The Contractor's
not intended areofferedLaw for sale apply too; 6 O 1 - ROOF TEA�egCSRE Inspections -
owne o4'and Professions Gdde:The Cves the is t,and w Law does not apply to an „. .
ownerugh his rayow Who loyeeswiovided bar such
improvements
em at intwork ended
or 602 __-_ ROOF PLYWOOD NAIL
o is through his mPIOY Provided th t chi. are of is your or ..._ _603_____
_ - ,..._._
-.bti redfor{I-If how- m will
limp rorty ala vim ,yew of 603 -. ..ROOF BATTENS ^t ,..t .. -
completion,the owner bt ilder will love me burden of proving that he die not build or
improve for purpose of sale.). 604 - ROOF IN-PROGRESS
❑I a er f the P pe ty a
' > construct the project(Sep.7044.Business lly d 'Prop
fe.r ons tCh orW)ThecoCnuotrnatrat ctos rm's
License LawdoW,notapply to an ownr opmpeny who builds s improves mercon, _
- 1L,
and who commas f .projecrwilh.a.comacmclicensed puencot.m me
Contractor's License Law.
'
y _ . Iam mPf -er Sec.' ,B'&P C far his reason .,. ..
--_ own - .. Date .
WORKER S COMPENSATION DECLARATION'
Thereby aRrm once,penalty of pep'y cofine following declaafions:
gI have and will maintain"a'Cenificate of Convent in self-insure for Worker's
C pensat o
Provided
".; pro ded far by Sect J]IXf the Luh Cad f the
performance fihWokfWhich the pend
^^^—
Carr❑I have r- d Will ma Ft isk C Ipet 1 d b;pat
f he LaorCidf th isarafoafhi pris
is aMYW krxC.nmx tq 1 , � PIyM / III
't iJU�� �L�3`Y 2DlJ01
EXEMPTION FROM WOR ER I1
h
-
COMPENSAnONINSURANCE
' (Th se ton ed not be Ecom In d f th —�',-i
P permit lsf h ndrcd dollars e - "
certfy our to the pcf-m6poe of'be'Wittef hch the pormil is
homed:
Compensation
t< ply y pe o any manner p ro became subject to the Wprkem"
C P n. t laws fCalifornia Date'
..
Applicant L_�."_ _.:.. ._ ..._'._. ..... . .._.... ..-.
.......... ... ._. . .._._ __
NOTICE TO APPLICANT.I;Crer making thli Cettificmeof Exemption.you shoalt,
M1ecome'su roup y the stick Ps Colon&Or his psomit shall the xamedCode,you must
Q 0 Tank uhi nilly with:'dA p visions m this peter t shall be domed revoked.
Zti '--.. .-._. _. _.. ._. ._..... .-.... ._. ...... ._-_...._-..
H';ryn r CONSereis. ONLENDINGAGENCY
1 hereby affirm thpe re cited(56 I ndmg a6 Y for he perfomunce' _ I
nitbe kf which thisperm' s¢suM(p" i09]el's Name ,Civ.C)
a�z Led Add espy •. t
C.1 � 1 mfy that I ha e re d this app) t m and state that the above infoi'ma is -
�T- corn . I agree b comply with all city mal Lounty J av ice rst sur 1 (wing
tob Idconsumption,concti n Ih M1yaam p t t c of this cityf t upon
,7'�++,W the proper for p rp,
p _Q. (We)line,ot'.1s:,ndecampy andk ph 1 the Cu}of Cmenino tmin,t
CA liabibilles,judgmentscost,and expenses Which may in any by accme a.in,sa d
U 'L Cty yu nee Rh g T fm
APPLICANT UNDERSTANDS D WILL O'1�+ ITH ALL NON POINT
n num or l QCASLAT, s a . -Type Re-roots
Roof Date
ig t
SAppn rft - t
s ARDOU$ TERIALS DISCLOSURE
W11 the 5p m tureb ding c paten a rh dl ha'ardusmt 'd
us d f ed hY the C0 tat M ni a,Chapter 9.12, ad the H Ith and Safety _ I V
Code St n255J I I r. •,t. +• l;r:
oyes I : No
r ` Qnm ty mm�ag t All.roofs.shall be
inspected
r to any roofing material being instal led.
t
Will the pill Iumrebu Id ngmc p t e eq p «
t pap ts Which If a roof is installed without first obtaining an inspection;Pa ree:to remove
emth a us co t mm is sde' db th Ba AreaA g p �'
District, allnewmaterials forinspection.
pectton Applicant understands and will comply with ..
aes
ll non-point source regulations:.. I. it
P q Y q P sots d Ch pt to anii; ry the l // -l�/�'
yCoda.ah mu b t 53J d255JJ1 nde.mdtht ,. �...__.. __ ,-
1 ha e d the h rd ma t nals t in
Calfm Health&p Safety CW pa 255852553
ifth<b dinge met tau eyha - t tent that t y pin b'ffyi way the - -- -- - `>/_
occ t f the re tri e tb is nee of a Cemficam ofaC+
Occupancy. .. .
.. .\' Signature Of_App]' _ant" ---_" . _ . _ Date _
_.. _-.__ .. Date.. . .... -
ownorm anI O,imd a< All roof coverings to be Class B"or better
OFFICE ..... . .. .. ... . .. _ .. ._. ___ .. _. _ . .. ._- -
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY O U JV� 3 `l 2 Fax: (408)777-3333
1
IUPEkTINO e
Building epartment
Subject: Reroofing policy for the City of Cupertino.
1. Prior to permit issuance, you must agree to comply with 1997 UBC Standards
and manufactures specifications on reroofing.
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: —9W64 40
Address: _ e��� [in
Reroofing Company Name: ,
Applicants Signature: t Date: 7�C
Joe Antonucci
(Chief Building Official)
6/25/01
Building Division
10300 Tone Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
OCUPEkTINO
Building Department
REROOF TEAR OFF POLICY
revised 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 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)