06080050CITY OF CUPERTINO
PERNUT
a� -I"NF' ^'Q
-'C€,0W
BUILDING DIVISION
i4Cx0N5T"sra
r
BUILDING ADDRESS:
LINDY ROOFING CO INC
PERMITNO. 06080050
22140 HIBISCUS DR
OWNER'S NAME:
PERMIT ISSUE DATE
SURESH TAMMANA
5554 HARV
NE:
SANITARY NO. CONTROL NO.
(408)286-9990
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
PLUMB MECHO
l� O
LICENSED CONTRACTOR'S DECLARATION
- lob Description
hereby afnrm dm 1 am licensed under pmviswn of Chapter 9 (cem
mcemli
with Semon 7000)of Dlvlaion 3 atom Busneu W Pmesswn myliameu
"n rmll farce and eat Z(�V
�3
REMOVING THE EXISTING 1 LAYER COMP OVER WOOD.
o:Nn`cl
cn mbr
NSTALLING 1/2" OSB, 30# FELT AND 20 SQUARES OF
ARCHITECTS OECLAR ds
NEW 50 YEAR DIMENSIONAL COMP.
Arse J my plw Nail W used u public records
s.
Liven Pm sonal
BUILDER DE CLARATION
Dat
I hereby I am law for the
that 11. errant form tho Cmmxmh It censeAny
c
maso . sect n Calc: Any dry or county
following mason. (Schon 703 1.5, Business and Pan,
which squirts • derfl repair any mumure
re construct, alley. firierMfor
h pcmit t
such
atm mQo the NC app11CNf for each perm". b file a signedstatement
pylar b its e, Ar
ceps Conuacwrillansu law (CMpm9
Sq. I. Floor Area
Valuation
d p
Nat heulicenwJpunuantwdm provision of the
l
(commencing with Section 7000) of Divition 3 of ft Business and Pmfussion Code) or
$6000
that he is exampt therefrom and the basis for the alleged exempdon. Any violation of
APN Number
Occupancy Type
Section 7031.5 by any applicant far a perm)t subjehu the applicant be • Civil Pnulty of
not more Nen Bw hundred dollars ($500).
❑ I. as "am of the property. W my employe" with wages As their wlerompenudon,
Required Inspections
9 P
wince Newark andthesuumuretsw.ktended aroRtmA froute(Sec.7011, Butlrcss
and Professors Code: The Contractors Licenn e Law donot apply w an owner of
property who builds An improves thetmn, and wha dm such work herald( or NmuN his
Own employes. provided Nn such impmvemmts Are, not intended aro@snd frank. ll,
however, Ne buildingorim, issold within contends Afcmnpteoo, the owe r
bilder will hae the Wrenn of proving thathe did not MW or Improve for purpose of
®�
sale.).
O 1, as owner of One property.700 . B nness and conuami AS with DeemedN=Wes ra
ronWtl da: Talnl (Sec l0sa. Business and Pro(esdons Cade:) The Crouuwrs U•
who Wilda orimpmves thereon, and
e
yO P®
/�, (@A_
,Arte law don not apply w An owner at property
who contracts for aueh pmjeeu NN a menuacwr(s) Heart purawnlwNe Canuanots
N el ,�
License law.
ppp , n
❑lam ezemPwnmr See fm this moan
Data
owner DateWORKERS
�j.
COMPENSATION DECLARATION
1 hereby callers under penalty of perjury one or the following mdwoan:
I ham and will maintain aCeNOcem of Cumemw elf-Inure for Workers Compcn-
etlan, n prodded for by LOA 3700 of the labor Code. for On performance of use
wart for which this permit is issued.
❑ 1 have and will maintain Workers Compemalion Interest u required by Samoan
3700.1' the labor Code, far the performance of Ne work for which Nu permit u luted.
MY Workces Compensation In n, . and Policy nu W L5
ctmier. ��sht'.'� ,. Poll No.: ✓
CERTIFICATE OF EXEMPTION FROM WORKERS*
COMPENSATION INSURANCE
nhisseNon need m. W completed lithe permit Is farrow hundred dollen ($100)
or less)
1 certify that in the performance of dm work for which this permit u Wood, I shall am
..Play my person in m menet u to betoma subject to the Wrolooi CampAeauon
Lowaaf Califomla. am
Appliom
NOTICE TO APP!! . If. after making this Corollate of Eumpllan, you should
becomes b N ah s Compenadon pmvulmu of the labor Cede, you mem
forthwith comply with such Provision or this Permit 111111 he deemed mmked.
CONSTRUCTION LENDING AGENCY
1 hereby aRthi thet there is lending agency for Jen Imrfannance of
est (Sa.30
the work for which this permit ts issued (Sec. ]09'i. Civ. CJ
'
Lenders Name
Leeders Address
j 1 mainly that I have read this application and sum Nat the above Information Is
' conmcL. 1 agree to Comply with all city and cwmy oNinen CS end Aute laws relating to
Wilding construction, and hereby authorim represenatiw of this city of enter upon the
ahovomemiunmd propcny far imPccuan Purposes.
(We) agree to save, indemnify and kap harmless the City of Cupertino agaiest
j liabilities. judgments. coats and expenses which may in my way acerae against aid City
.
• in consequence or the granting of this Nook.
' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT
Issued by: Date
SOURCE REGULATIONS.
Re-roofs
Type Of Roof
Signuurt of ApplieanUCanRDOU Dam
HAZARDOUS MATERIALS DISCLOSURE
Will the applicantt As Wilding mopapt amrt m handle insertions mamris
mfuran
Health
As mOed by dm CupeNro Muni 1 Code. Chapter 9.13, and the Health anJ Safely
Cam, Section 2553Hg7
All roofs shall be inspected to any roofing material being installed.
❑Yrs No
prior
If a roof IS installed without first obtaining an inspection, I agree to remove
Will the applicant (move Wilding Occupant use equipment a devices which
emit hwardnus if ton rants u ncd by the Bay Area Air Quality Management
all new materials for inspection.
District?
❑Yes u
Ihow &SafAlthe hu mamuW5533rt cntsmnmr Ch fti[he Glucan-
ria a Cam, oes Wilding
emly
Jars m. cunendY hew a v"a"h Wat 1. u my mspomlhililY w notify the cecupan f the,
t An, that it i my resnd7753d.1 Andcmmd a accop
roquimm uwhich must he met priarw issuance ofaceru0cal. car
ter`
$ attire Of Applicant Date
O
All roof coverings to be Class "B" or better
owner. ,hml ad.,m, Date
06m 3 of
CITY OF CUPERTINO
[� ��I:i51*1■:7�[�1�FM�1Y
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 32602026.00
DATE ISSUED.......: 08/08/2006
RECEIPT #.........: 35550
REFERENCE ID # ... 06080050
SITE ADDRESS .....: 22140 HIBISCUS DR
SUBDIVISION ......
CITY .............: CUPERTINO
IMPACT AREA ......
OWNER ............: SURESH TAMMANA
ADDRESS ..........:
CITY/STATE/ZIP ...: ,
OPERATOR: amyw
COPY # : 2
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 6,000.00 126.36 0.00 126.36 0.00
BSEISMICRE VALUATION 6,000.00 0.60 0.00 0.60 0.00
TOTAL PERMIT : 126.96 0.00 126.96 0.00
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT :
•
AMOUNT
------------
533.48
------------
533.48
NUMBER
------------------
1986
5
CITY OF
CUPEkTINO
•
JOB ADDRESS:
OWNER'S NAME:
GENERAL CONTRACTOR:
Buildin
Wi
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
am not using any subcontractors: It
Signature ,>6 M
Please check applicable subcontractors and complete the following information:
0-
Owner/Contractor Signature
Date
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
0-
Owner/Contractor Signature
Date
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
qUPEkTINO
Telephone: (408);777-3228
Fax: (408) 777-3333
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 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 and the 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: �C.0/I', %-�1)1Ynan�J
Job Site Address: cp �' �l j4; b / S C u S Dc
Roofing Company Name: l I'X 0(3-9 Co
Applicants Signature: J.�c.� � to _ Date:
Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
E
U
CITY OF CUPERTINO
a REROOF
CUPERTINO PERMIT APPLICATION FORM
APN # SW--M--62J_0
„ / jp_ 'U'G Rte, --6�
�„
Date:
8- 7-ob
Building Address: o? �i0 b%SCU5 per.
Owner's Name:
L30—r-e� '��rnrnana
Phone #:
?o8 -80S.3
Contractor: Phone #:
L,laxd 2oa� a86-�F90
License #:
aIs8l(b
Contact: Phone #:
Cupertino Business License #:
Q,* -,a r6 o
Type of Roof Covering:
Existing: Proposed:
❑ Built -Up Roof ❑ Built -Up roof
t)t Asphalt Shingles .e Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report #
_L
gZ To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Polic :
I Job Description: ren.oUWVS e>C-.sj-:5 tiy-rr-0a , of
20 S tAreS he(J 70 ear D�wensro (�bvn
Residential Commercial Q
Fire Zone: Yes ❑ No ❑ Confirmed with Planning De t. if
there are any restrictions: LJ
Cost of Project: Type of Construction: Occu ancy group:
0000 re _%_-J n I CQ,
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