06080049 CITY OF CUPERTINOas -
BUIL-0IA'C DIVISION PERMIT 49 i1V `QtMAa'Tj:',N
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Bu1LDINGADDRESS: LINDY ROOFING CO INC PERMIT N0.06080049
7532 KIRWIN LA
OWNER'S NAME: PERMIT I%'UE DATE
MARTIN DONEZ 5554 HARVARD DR 08/08/2006
NE: SANITARY NO. CONTROL NO.
(408) 286-9990
ARCHITECDENGINEER: BUILDING PERMIT INFO
BLDG EO PLUMB MEOCH
;op LICENSED CONTRACTOR'S DECLARATION
iU 1 hereby af0m teas I Am licensing under prmiaan+nfchepter 9(mmencncing Job Description
with section 70(r)afDnisim 3ofthc Beat.And Prat um Cade, my Ike—is
in fallforee And est REMOVING THE EXISTING 1 LAYER COMP OVER WOOD.
LicenuClw Lle.N A oy Pea 1z' INSTALLING 1/2" OSB, 30# FELT AND 28 SQUARES OF
Lie Lic.0_mr
cxlTEcrs DEcuaA
�� ,r�wPlanawlle�bl��reea,m NEW 50 YEAR DIMENSIONAL COMP.
oLL Lice s(wiana7
mH OWNER-BUILDER DECLARATION
IM S I amso aRsm m 1 1. ,Bums from the Cemonge o License c Law far Ut
.p o following ressan.(Scetim Tor Id,Bwinw and Re.dem w Cede:Any em or county
j$ which mqulma issuance.pumis r cerca the pplic)t(or su demuru0.m repair ed umeneestractiont
Priormiuensedppursuant
reto the Ute inion of far Con Permit on ale asigaedmmmem
< NathclslkunsedpunuanlloNcpmvisiomafthe ConuacloriLi¢nmLaw(Chapter 9 Sq.Ft. Floor Area Valuation
zC� (commencing wish Section 7000)M Division 3 of the Business and Profwiam Code)at $11000
3$ That he h aumpt therefrom and the basis far We alleged esamWon My violation of
SWUM 7071.5 by any appliaanl for a permit sobjecu the applicant m a civil penalty of ApN Number Occupancy Type
not mom Zhao five hundred dalhn($50)).
❑1,As owner of Ne property,at my employees with wages u dtir sole compewdon,
will do Unwork,and the altumum is diumnded or a@sed forsate(Sa.7044.Business Required Inspections
and Profesalo a Cade:The Conuacuse,License Law does ret apply le An owner of q p
property who bis lid.or improves themun,and who does auch work himrJr or through his
awn amployen,prMded,pmwm mpsovemmt an vol iw of�moeered fu ale a,
baweer vNe buil theorimprowmanlg cold w did not build will have Uu burden of proving Wt a did not build or improve for puryoso of
isle.).
❑I.As owner of the property am exelwiwly contracting with accused COMMKlma m
consumer be Profen(Sec 7044.Bwinw aM Professions Cade:)The Cmir eS Li-
caw law does not apply As an Owner of property Who builds or Improves thereon.and.
wa.organa for such Pmjece with A can grommr(s)heaved p oximal m the Contract n',
License TAW.
E]IAsn esempr under sec. .B h P C for Osla....
Owner Data
WORKERS COMPENSATION DECLARATION
-1 hereby affirm under pewlty of perjury am of the fellawhil dalandam:
I ham Ond Mil mai.W..CenirIMW of Cownl trial!-insure for WaftezCompcn-
slaim,as provided for by Section 3700 of the Labor Cade.for the performance of the
work for which this Pmmit is issued.
❑1 have and will maintain Worker's Compensation Imuran.,As required by Section
3700 of the labor Code,far the perfmmanee of the work for which Nu permit is Ismer.
My Workerr's m madon ms este'r end Polity num r 1 .^001
Cartier. �_TT�s6�v.NNa.CC, Policy No.: L�/�Q
CERTIFICATE OF EXEMPTION FROM WORKERS' ^
COMPENSATION INSURANCE
(Thu union need not be completing If the permit Is fare..hundred dollars($100) ,
of It
I certify shoe in the performance of the work for which this Permit Is issued,I mall net
employ any person in my manntrAn As W become subject m thewuan
Laws or Calif
Appixmd
NOTICE TO AP IT:Ir..1 r making this Cartiricae of Exemption,you should
become ubjal m e Worker's Compensation proviUms,of the Tabor Cade,you mess
.J O forthwhat comply with such provisions or this Permit shall be co mal cooked.
z N CONSTRUCTION LENDING AGENCY
Fv 1 hereby apirm Use Otte is!camuuNnn lending spency rr the perform...of
ISI the work for which this permit is issued Isis.301 Civ.C.)
GQ I<rdcY.Nun.
.7 z Lander.Mideast
U C I oeNfy that I have o ad Thu application and mu this Use Above information is
TL F correct.I agree to comply with all city and county ordinances and sun laws telsting to
0U building construction,and hereby authorize mpresentrums of Nis city to enter upon the
alwve-mentioned property for inspection purPous.
(We)agree to ave,indemnify and keep humlw the City of Cupertino agaiml
rF.t r'/1 Ilabilhimajudgmins.emu and eapeuu which may in any way scerve against said City
U 2 APPLr conseof the quence
UNDERSTANDS ANwans of this D WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
Re-roofs
HAZARDOUS
signum uo(AppliaData
HAURDODOUSMATERIALS DISCLOSURE Type of Roof
WIIl the applicant or fm building arupantnomoranile haardow moral
es deri cd by the Cupenino M mipal Coda.Caput 9.13.and the Health and Safety
Cade.Seed.37732(.)7 All roofs shall be inspected prior to any roofing material being installed.
Yes No
Wile the epplkans or future Wilding mcupam sou equipment m devices which If a'roof is installed without first obtaining an inspection,I agree to remove
emir ct? far air contmiwnis de0ned by the Bay Area Air Quality Management all new materials for inspection.
Dis ct?
❑YCO No
IluwreadC neer ma N5.25qui 25534.1..aPmd6 ifOt balding (
nim Health&e noulthath sMiun2Lcda mqu am12553n.Iumkrnand.95 fthc Wiring
d.a not currently hew a team Out h u my resperssihility to rwdfy the Pmt tic G
m rc whlehMustbemetpriorinissuanceofaCestiOcetea� Sig eofApplicant Date
Lr.
Owmelia .adagent Da All roof coverings to be Class"B"or better
CITY OF CUPERTINO
m 2 of 3 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . I . . . . : 35923002 . 00
DATE ISSUED. . . . . . . : 08/06/2006
RECEIPT # . . . . . . . . . : 35550
REFERENCE ID # . . . 06060049
SITE ADDRESS . . . . . : 7532 KIRWIN LA
SUBDIVISION
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : MARTIN DONEZ
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
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
EE .ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ------ ----
BPERMFEE VALUATION 11, 000 . 00 180 . 36 0 . 00 180 . 36 0 . 00
BSEISMICRE VALUATION 11, 000 . 00 1 . 10 0 . 00 1 . 10 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 181 . 46 0 . 00 181 . 46 0 . 00
Community Development
10300 Tone Avenue
Cupertino CA 95014
Telephone(408)777-3228
aC10F Fax(408)777-3333
46UPERTINO
Building Department
JOB ADDRESS:
V4m , � �� PERMIT #
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR FAX#
am not using any subcontractors: ' `-'tom "`— S3 b(P
Signature Date
Please check applicable subcontractors and complete the following information:
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
Community Development Department
Building Division
f City of Cupertino
10300 Torre Avenue
CITY�F Telephone: (408),777-3228
Fax: (408) 777-3333
CUPEkTIN0
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 andthe 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 nninimum of " per foot slope and demonstrate
that there is no ponding.
2. An 1.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.
Homeowners Name: F l�r`h n Don-eZ
Job Site Address: o,w t/1 t—Yl -
Roofing Company Name: Li/�GQ e{ ljzoo f2 w
Applicant's Signature• ,til (�Q . Date: 0. 7—Deb
. Greg Casteel
Building Official
Revised 11/2/03
Pnnted on Recycled Pepe -
- - L .
CITY OF CUPERTINO ( WMAq
"a REROOF
CUPERTINO PERMIT APPLICATION FORM
APN# 213--
^n 'MDate:
Building Address: —7 � W Ln.
Owner's Name: ZY763g)
P1prfiin �oy)ez 88 �_a3a�
Contractor: �d Co y T� c, License � SSBI/
I
Contac :J Phone#: Cupertino Business License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ 'Asphalt Shingles �NC' Asphalt Shingles
']:<Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings j ❑ Provide I.C.B.O. Report#
X To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description: Yerty✓ rvr2 't- &+-'i-15 C/ c4de_- Woo S 4ira.. r00 f, fn rl�
f yt' 6 C_n d. ;Ll? (Lve S f^at_) 20, Q1r-,aA54a-C--Q-
esidential Commercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with Planning De t. if
there are any restrictions: LJ
Cost of Project: Type of Construction: Occupancy group:
/ 000
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