0807015600
z r_
CITY OF CUPERTINOa"'g
-
BUILDING'DlVISION PERNUT
CONTRACTORINFORNIATIQ.N.�S
BU1Lr5)1�sgD�IESJOHN DR
LINDY ROOFING CO INC
P�08070156
OWNER'S NAME:
PERMIT ISSUE DAIS
MICHAEL TTMPANARO PERROTTA
5554 HARVARD DR
07/22/2008
NE:
SANITARY NO. CONTROL NO.
ARCHMICM/EiGINEER:
RE -RF RMV WDSHK: RF INSTL
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTORS DECLARATION
thereby allies deatlam licenm0 valer provisions orChapu9(mmmuaing
-""'--�— -'—••^_ f.--_....__.. _Jeb Description
wide Semon10010 of Div)son 3 ofdm Buercss and Professions Code. and my license is
In con roue aM en« 2 t 5�(lQ
Li....a Lle.d
Dau Contracar rN�fi YiGr
RCHMICTS DECLARATION
1 untenanted my plana shall be used as public rerords
Licensed Poefesri ... I
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am emorpt from di Conumctors License law for the
following moon. (Section ]0313, Business and Pmfecsions Code: My city or county
which requires a Permit in rnnsWc4 alar. improve. demolish, or repair any structum
prior to its issuance, also requires dee applicant for such Permit in 01e a signed summem
that he is licensed purwam to the promiot, of the Conuacmrl U.. Uw(Chap= 9
Sq. Ft. Floor Area Valuation
(commencing wide Sector 10DO) of Divnian 3 of the Business and Profsuiov Cade) or
that he u emmpl thwarnece and me basis for the alleged eaemptoa My violation of
Secdon 70313 by any applicant for a permit subjects the amputated m a civil penalty of
APN Number
O ccu Type
M mane than five hundred dollars ($.5130}
parc y
1, as awrmr of to Property, or my amployers with wags u their sale eompenation.
will do Ne work, and the stratum isnot intended or offered for sale (Sm. 10x4, Busirau
and Professions Cade: The Camracmr's Lluam law data an, apply m an awn« of
Required Inspections
Property who builds a I mpoves thernon, and who does such work himeel f ter through his
ownemployeta, p osided that such imprevements tie not low nded aoRemd for sale If.
however, is building or improvement is mid within arc year of completion, the owae�
build« win have the buNeo of paving that he did not WiW or improve fa purpose of
sale.).
0 1. as owrcr of the Property, am emlusively contracting with Hammed contractors in
conatrvcl dee project (Sec. 7W. Business and prolamines Code) The Conlrmme's U.
ecus, Law data not apply m m owner of pmpeny who hands or harpooner thehon, and
.be contras for such projects with aconuacmrts) licensed pursunt m the Contractor's
Neve law.
0 I are esrmp under Sea . B A P C fa mss rend.
Owns+ Data
-
WORKER'S COMPEfILCRON DECLARATION
1 hamby affirm under penalty of perjury duo of the following declaauav:
I have and will maintain• Cutifiau of Covent to self -insure for Waiter's Cnmpn-
-
aeon. u provided fur by Seaton 3100 of the Labor Code. gar dee pAomanm of the
wady for which this Permit is Lube&
❑ 1 have sad win maintain Worka" rampns.do. Inmran¢. as at wred by Section
3RD of dee Ube Coda, for dee psfomsrme of dee work far which this Permit is i .... M
My Workces Compevadon ivunnceJcuns um Pei number are/'�
carrier. S?TAQ!s FIU NGL policy No.: 3;F' , Iv
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This mNoa used ant be canph and it the permit n rcum a hunthW dollars morn
Or less)
1 coni(y dot in the Performance of the, work far which this permit u issued, l sha11 cot
emPlay arty person in my mmmrm as m became abject m the Workers Compesadom
Laws of California Dau
Applicant
NOTICE TO APPLICANT. IL after making this Cer iOeale of Eaumplion, you should
become subject in the Worker's Compounder pmvhem of dee labor Coda you mus
roMwith comply with such povisioes Or this poll shall W deemed motes.
CONSTRUCTION LENDING AGENCY
I hereby atom oat them is a cemmctim leading aFne, for to performance a
um wart rat which this Amit Is named (Sec. 3097. Civ, C.)
L Occas Name
"
Lenders Address
I certify deal l have read td. application and sate died the above efamatian u
camel 1 agree m comply with all city and county actin erem and mule laws relating be
Wilding caatmuion. and hereby mthorive representatives or thin city in== open dee
andre-mmtiorhd popny fa inspection purposes.
(We) agree m save, indemnify and lamp bamkn the City of CapeNm agaim
Ilabiliucs, judgments. cons and espvu which may In anyway mean against said City
in eonsespeam, of to grand, of this pmn.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH A NON- OINT
SOURCE REGULATIONS.
-i
2
Issued by: Date Z -
w--•- 21j��
Re -roofs '
Sngnause IicanmConrmar o.te
HAZARDOUS MATERIALS DISCLOSURE
Type of, Roof
Will dee applicant to future building actvpmdsmre orhandla haaNdus material
as dellned by to CupeNno Munici al Code. Chapter 9.13. and IM Halm mJ Salcey
Coale, section 25532(a)1
�Yta No
All roofs shall be inspected prior to any roofing material being installed.
will dee applicaut or fuom building aoupenl em equipment or deHcrs which
If a roof is installed without first obtaining an inspection, I agree to remove
It bnrallov air emumivnu sa fined by the Bay Ama Air QWidy Mmagemcnt
all new materials for inspection.
DWM17
❑yes No
I hats mad Ne hamdous materials requimmenu under Chapter 6.95 ofta califa-
OiaHcaWhSafety Code.S«uau 25505,25533 and 25530.1 undcumnd der if the building
LAi ./C^I' �/2-2_ f�
currently
does not cunty w a octant thal it h my re,conibility m notify the occupant of dee
(, u
mquingmraswhich mus Wesel priaro hansom ofa Cerin^of occupulay. /
OF
Siknature of Applicant Date
All roof coverings to be Class '%?." or better
Owner or mthmi.ed agent Dmm
• 2 ITEMS OF 4
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 36934027.00
DATE ISSUED.......: 07/22/2008
RECEIPT #........1: BS000005542
REFERENCE ID # ...: 08070156
SITE ADDRESS .....: 20064 JOHN DR
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
VOICE ID DESCRIPTION
----- ----------------------
601 ROOF TEAR OFF
604 ROOF IN -PROGRESS
•
VOICE ID DESCRIPTION
---- ----------------------------
602 ROOF PLYWOOD NAIL
605 FINAL REROOF
OWNER ............:
MICHAEL TIMPANARO PERROTTA
ADDRESS ..........:
20064 JOHN DR
CITY/STATE/ZIP ...:
CUPERTINO CA, 95014-4415
RECEIVED FROM ....:
LINDY ROOFING CO.
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
IBSEISMICR
VALUATION 10,000.00
-------------------- ----------
1.00 0.00 1.00
----------
0.00
1REROOFRES
SQ FEET 29.00
377.00 0.00 377.00
----------
0.00
TOTAL PERMIT
---------- ----------
378.00 0.00 378.00
----------
0.00
VOICE ID DESCRIPTION
----- ----------------------
601 ROOF TEAR OFF
604 ROOF IN -PROGRESS
•
VOICE ID DESCRIPTION
---- ----------------------------
602 ROOF PLYWOOD NAIL
605 FINAL REROOF
CITY OF CUPERTINO:.
,:..REROOF.-'
PERMIT APPLICATION
os 07 C) / �
A.PN # z W ?3 ,
Date:
Building Address:
Owner's Name:
(h Cho 6vz) P4200-4—
Phone �0_ 7P
C tractor:
Phone #:
Fax #:. (10
Cupertino Business License #:
Con acto Licens
Type of Roof
Covering:
Existing:
Proposed:
• Built -Up Roof
• Asphalt Shingles
CD Built -Up roof.
X Asphalt Shingles
Wood Shakes
0 Wood Shakes
0 Wood Shingles
0 'Wood Shingles
C] Other (Specify)
Number of existing coverings - --------- 7-
0 Other (Specify)
0 Provide I.C.B.0, Report #
To be Removed
0 Provide Mf&. Installation Specs.
Job Description: 'A
Residential O
Commercial
Fire Zone: yes 0 No
Confirmedit
Confirmed with Planning Dept. if
Valuation:
thereare=anrestrictions: 15P
restrictions:
I Have Read, Understand and. Will Comply With.Cupertino'sTear-Off Policy:
V.
Signature ('>'
�to "
CITY 0,
�UPEkTINO
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
Building Department
JOB ADDRESS: aooy
�IQj1/1 pr
PERMIT #
Og0 p
OWNER'S NAME: f Chgtl
Tr oro erra
PHONE # v Y - 7 ( 'C7
GENERAL CONTRACTOR
L n oo-f-nf
FAX # d -0-66 - Y a 7 g
I am not using any subcontractors: "-1
ignature Date
Please check applicable subcontra s and complete the following information:
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
Owner/Contractor Signature
Date