01090008 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
LUILDING ADDRESS: PERMIT NO.
10551 JOHANSON DR. LINDY ROOFING CO INC 01090008
OWNER'S NAME: APPLICATION SUB DATE
Ak 5554 HARVARD DR 09/04/2001
PHONE: SANITARY NO. CONTROLNO.
(408) 269-2025
O s Z ARCHITECVENGINEER: - BUILDING PERMIT INFO
00 L ELECT PLUMB MECH
�✓= LICENS ED CONTRACTOR'S DECLARATION Job Descrip on
emhy submit that l am licensed under provisions of Chapter 9 lcorrompang REROOF.
wF with otos]OD01 of Dnuion 3 of Rhe Business a.d Profasion>Cale.and my lironx /
allfa can _y�G �' T/0 TAR & GARVEL &
s is Icns Lic.p
` "n j J Culture INSTALL 25 YR. GAF.
I a C, ARCHITECT'S DECLAR /
I to I undcmand my plan,shall be used as public rtmrds
Licensed Professional
'LL o LL thatOWNER-BUILDER am the Contractors
/
1 M1ercby.(tion on 1 1. .Bovine from Nc Contractor's License Law for the
F z< following reams Permit
to
]onstru Business and Professions Cade:Any city orcounty
E x e which requires a permit re conswe.alar,improve,demolish,fia sig any atruaure
noon t ' c.also requires theapplicant for such pcmtin file signed nmrnmm
math ficehisEdpurs. t R,the pm per q_ Floor Area•. , .,-, ,k .-. .. . atioi ...
snf the Cu,Bund L L (Ch.t v S FP
or that .g . o serf ont a r Division J robe BaaNeq_ rp m r roes l Liam I_(r, .. 1'.s r_s s r•.1.., -,. $5 2�'
or mai ne is exempt Nercfmm3na me basin for me auagea enempdon.Any violation
of Section]OJ
t ornot m try any dll for a permiR subjms the applicant to a civil pewlty-
marc N.n Bse hundred
rea d.Lina.ISSBB). 3 7 5S"Mt8nbgr0 ( " Occupancy Type
❑1,us owner Lilts.pmncny,or my emplayeo with wages as theirs"Ie comp<maion, t
'%ill'do the work:'and the structure is not intended or offend for sale(Sec:7044: 3 O S - FRAME Required Inspections--
Business and Professions Code:The Contractor's License Law does not apply to an Q p
owner ofprclpanY who n ld imp—en thereon.andwnoa n work himscir 307 - INSULAT
or through h': ,ply p I.provided 0 h.' p I rc e IO
e
d d or _(.-.....
Liffe d.for talo.If,now fl thudding- _ - t t is IJwithin are -- 1 _- - - N
-� � - - -
completion.the mncrhIdrwill naveebmJenofproving that hedid not lwildor 601 ROOF TEAR OFF ' '-
improve for purpose ofwle). 602 - ROOF PLYWOOD NAIL
• p i.an .wo a;of nig orap<nr; it, im im<n.<d Liotm<tnrn m -- - - �-�603- ..- .ROOF--BATTENS.. .
- _ onswct the project(Sea.7044,Business and Professions Cua<)'rna Courtrai 604 - ROOF IN-PROGRESS' ' " i '
s : ad who
Law bats not appy'w.j owner aI a comy who builds nr improves thereon
he
. and who comicns for such prnknz wiN.a coneranons)liccnml Pursuant to the
am a,m License taw,
0 1 nm ,exempt under Sec. ,B&Pic for m
his ason Jt'I- l.;'"'1[711• '
- _ Owner Date'•• .
e WORKER'S COMPENSATION DECLARATION
1 hncny afftm um)cr pcnalry of perloU of No following de daral
F O 1 haae'and ,Rl'mainmin a Ccnilicalm".f Con:cnt 16 o,IF r%mm for Worker's
-Z Compensation. asProvided for by Section 37W of Ne-labor Code, for the
_ 'perfomance of Ne wort(or which Nis permit is issued.
❑1 have and will inumled Workcr's Cninpeidalnn Inwrunce,vs required by Scclian
3700 n "e Labor Code,for the performance of the work for which this permit is
isms yWeaker a Co pc i '1 umme carver end Poliy be
Gl GUg[licrNa:�G�/7B�J�/S7 t 'I
CERTIFICATION OF EMPTION FROM WORKER ir : " • 'y ' •
7'COMPENSATION INSURANCE' _,.,_ �r_.r
"' flTee'sehion need act be completed Bloc permit in for mom hundred dollar t C
IE R10)or leas.)
. ._-..._.. .......-_� ._. ._..- ..i, . ..._ .e.. .. . ...... . ... ....
I ar f"l"at i,N per('mane'l f Ibc k'( which th pc t s.ucJ,l ( '' L :1
"ball t
employ
any person m any nmmm t become db"a i ,ne Workers
Cmhpenshtian Liws of California:Date '
Applicant : r .. ... _.. .. .-
'NOTICETOAVPLICAN] Ilafta king N'.Cnfcate ofE pl' ,you ah mlJ,
0 been bl int the Wok 'C' p p .of th lahi Cute,you null
fob lh ply nh ch p i- m th pea t M1.II bed d Liked.
FV] ' ' - %'CONSTRUCTION LENDING AGENCY
�' 1 h mby runt that there a conVoulmoo<i rba.,for th f erf mom t
> 16wok for vbi,hmi,I .if is ...ad lS 'aIIW .
C C)
I'spder'`Name
........ .. ..n_ ., ,...u. n... .... - .... .. . . . ..
tsnde'r'.Address' .• 4'.` 1., tet"e
U-0 1 certify that 1 have read this application and state that the nMve information is
ka:F. anneal.-1.Stec in comply with uli city and county,ordinances and acne laws relining
0 �) m building construction,and hereby authorimrepresenmtivfs of Niicitym eme,upon
}.ry Nebo ed proper)for ins,sectimprp"re
F..0. es g to sa a maem Ty ridk pharm, i theC .of ermas ovgmnst
Cty ib ) dgm<ts, n d expect.es h h y n any ) ecru .gains said
V z City e4 n earth gfog flhi t '
1PP1 AN SDERSTA NDSA 'ILLL COMPLY N'IT'H ALL NON 1, Issued by: Date V
U �T
Si nature ofAmdk. man, . . .Date - Re-roofs
m d fi den hNc HAZARDOUS MATERIALS DISCLOSURE t'
pi cat f t w Ire' g a< p' t R handle n m -material Type of Roof . .. - - -- .. - - ;..,. - ..: -
y C pen n Municipal Gale Chapter 9.13 d theHealth and Salary
Code Se<im,25532tv17ry .s' s{ '' t''3 .J f. ,1 - s ` -
ave.. ❑ria: All roofs shall be inspected poor to.any roofing material..being installed... ... ..
I';s Will the zp,dimm,orfuture balldittgo cart lu,eegalpmeniorde'r,",wed<n If a roof is installed without first obtaining an inspection, I'dgree'to remove
emit mous air conoommova fM dbi/the Bay Area Air Quality Management
DBtlte - all new materials for inspection. Applicant understands and will comply with_.
oyes
ON all no of a source regulatio
,I.1 ha.=read
tic h r d ,'m tc al rcy 1 t.'u td Chant 6.95 of the' r
Calf Hcahn&Safey Cod S a ns 25505 2553]a d 25534 I d tend that
N Id'ng does otc�nedh mount thtR responsibility mifyN1
p t f q it ems which must t Prior,.issuance of a Cenef¢me of
09..?a. � � Signature of Applicant Date
%. All roof coverings to be Class "B"or better'
aro whorized.gene � �- Dae.
'-..: w ......... . ... : :.... .. n. - OFFICE