06080179 CITY OF CUPERTINO
'BUILDINS DIVISION PERMIT COI�tTR�CTOR.INFOT,2MATIAN
BUILDING ADDRESS: LIDY ROOFING CO INC PERMrr N0.06080179
10377 LAS ONDAS WY
OWNER'S NAME: PERIA TESUEDATE
Ak SATISH MENON 5554 HARVARD DR 08/22/2006
E: SANITARY NO. CONTROL NO.
(408) 286-9990
ARCNRECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
Z 0 (� � 0
�i•Op LICENSED CONTRACTOR'S DECLARATION Job Description
bemby afRim Nn 1 am IlmnwW under provision of Chapter 9(commencing
8 sth Section 7000)o1 Division 3 of the Bud.and Profession Code.and my licenso4
in full fmaand TEAR OFF WOOD SHINGLES. RESHEET 1/2" CDX ADD 50
.m
,8: ame $�9 Le..
Dam Ja//T iia V Ganuuna! COMP SHINGLES .
¢¢¢� D �ARCHITECTS DWLARATIPN
1 understand my pians shall W=it as public records
t
Oy Licensed Propositional5 OWNER-BUILDER DECLARATION
i 5 I hereby a?rm that 1 am exempt from Na Commutes License Law for the
.o O following wan.(Section 7031.3,Busmen and Profesdun Cade:Any city of county
B which requires a permit to constwer,alga improve,demolish,or repair my Mercer
Iiyprior m in issuance.also requires the applicant for such NMitao File a signed statement
0 NatheislicensedpurisonttotheprovisionofLastConuscrur'sLiccaselaw(Chapter9 Sq.Ft.Floor Area Valu ib19651
f $ (commenting with Section 7000)of Division 3 of the Busloom and Profession Coca)or
-�
than he is exempt therefrom and the Dols for de alleged exemption Any vlolal(on of ppN N b
SecWn 70313 by airy applicant for a permit wbjecu the applicant ana civil penalty of 3 6 9 2 9 8er 0 0 Occupancy Type
not mart than five hundred dollars(2300).
❑I,uawna of the psopaly ar my employees with wags utRir vele compevation,
will do the work.add Lieawmamisnot Incomes!aroffered mrsde(sec.7044.Business Required ecti
and Pronasion Coda:The Conuacai License Law does tet apply a an ower of q P
property who belles m improwa mance s,and who does each work him mif or through his
awnemplayess,provided dam coves ImVhownumta art not hi mtlnd moRered fm ode IL
however,she building or improvement is sold wirhinae year of completion.the owrcr
builder will law the burden of proving Wt he did not Wild m improvefor puryoso of t�
ale.).
❑1,as ower of Ne property,am sachisivelyand
contracting CIN:ceased mnuacea e
cameras de projem apply
toB44,whir of and Py,who to cam:)The Contramon.Lid
whocommcontracts law done am apply e u owner of progeny who seIWs or improves Neeson,end. 6
wbo mLaw.for such projeer with atonuawf(s)Ilaned pmsum m the Gnrramors
Licu0fare Law.
❑Lem sweeps under See ,B&PCfor this won
Owner Dam
WORKERS COMPENSATION DECLARATION
I family Wires under penalty of perjury me of the following declarations:
I ham and will maintain aCeNOau of C.sumnt to self-iuum for Wormes Compen.
ution,an provided for by Secdon 3710 of the labor Cade.for Ne performance of the
work for which this POOR is road. '
1 haw and will antitumor Worlues Compensation forename,as mquimd by Sermon
.1the Lab"Code,fm Ne performance of the work for which this permit is hued '
My Workers Com nude ce carrier and Polity number are:
Grrier. S- Policy No.: 185 4 i8 9
CERTIFICATE OF EXEMPTION FROM WORKERS' _
COMPENSATION INSURANCE
(This section need ret be completed if de permit 4 foraehundeal miters(2100)
or lens)
1 unify that in the perfarmane of the warts for which this permit 4 isacd,I dull not
employ any person in any mannrw as to became wbject to the Waftor Compensation
Laws of Califorria.Dam
NOTICE
ret
NOTICE TO APPLICANT.Work If.after making this CeniOae of Exemption.you should
became womp a it Workers Compensation proWions of d a labor Cam.you menu
.J O forthwith comply with such provision or this permit shall he deuced revoked,
Z CONSTRUCTION LENDING AGENCY
[n I hereby spired Nat there is a constwctiem lending agency for the perfu,maec of
0: > de work for which this permit is issued(Se.3097,CN.C.)
aQ Landers Name
0.Z Leodeh Amw
U Q 1 sonify that I have rend this application W sum dist the above information 4
Iy H cones.I agree to comply with all city and county miJim nm and sum law,mating in
0U building convection.and hereby aurhorim representetiws of this city to enter upon the
W m.w.mentiuned pmpeny for inspecdon purposes. .
(We)agree a ave,indcmnl(y and trep harmless tbe City of Cupertino against
aF„fv0 babibua.judgmenu.casts and expenaa which may in any way accrue,against said City
O Z in cmtequi nm of the gearting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALI NNOWfOINr Issued by: Date 8
SOURCE REGTI(IDfS.'� Q p�j_ /
1�./�L�� Y��/•J•�°G Re-roofs
Signature ofAmplicaud/Comoodim, Dam of Roof
HAZARDOUS MATERIALS DISCLOSURE Type
Will the applicant Lir future Wilding omvpanluome arlu ndle huardow material
as de0ond by the Cupertino Municipal Com.Chapter 9.13.and the Health and Safety
Code.Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
❑Ya %2-tbl—
Will Last applicut or future building Occupant use equipment or device which If a roof is installed without first obtaining an inspection,I agree to remove
emit havNou cif containment as deRncd by the Bay Area Air Quality Management all new materials for inspection.
Distinct?
pees &"T--
I haw mad the himandousmincrials requirmorcrus undercharder6.95
"T —
IhawmadthehiaodousmamdclsequimmcnuunderChepur6.95 ofthe Califor. w
n1aHa1N&SafctyCodegcc6=2550.5,25533and25534.1undemudlhulNe Wilding sK Z LJ u
does Out curmndy haw a moan.that It 4 my reaponthllity a tetify the occ Lit of dm
aquimmenu 'fmuuhmm 'armiuuaecof.cmuliumof co Signature ofApplicalt Date
Owner or agent Dam All roof coverings to be Class nBn or better
CITY OF CUPERTINO
em 2 of 2 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36929038 . 00
DATE ISSUED. . . . . . . : 08/22/2006
RECEIPT # . . . . . . . . . : 35715
REFERENCE ID # . . . : 06080179
SITE ADDRESS . . . . . : 10377 LAS ONDAS WY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SATISH MENON
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED_ FROM . . . . : BONITA JENKINS
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 18 , 000 . 00 255 . 96 0 . 00 255 . 96 0 . 00
BSEISMICRE VALUATION 18 , 000 . 00 1 . 80 0 . 00 1 . 80 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 257 . 76 0 . 00 257 . 76 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 576 . 92 VISA
TOTAL RECEIPT 576 . 92
•
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
• 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: a�-
Job Site Address: /0,37 -) 4 an n1
Roofing Company Name: 2_lWu'X-^`9
Applicant's Signature: Dater 6
. Greg Casteel
Building Official
Revised 11/2/04
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
�PEk N�IA'O Fax(408)777-3333
r (510)5-38 - 3282 - PoaH%*Q.
Building De artment
JOB ADDRESS: PERMrr#
/O3 77 L%O
OWNER'S NAME: `7yl a ytoP PHONE # _23q - 9320
GENERAL CONTRACTOR FAX # y�ff
I am not using any subcontractors: �& a
Si"� Date
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
El ral
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
CITY OF CUPERTINO
REROOF
• CUPERTINO PERMIT APPLICATION FORM
APN# ,3A— 2-q--b733 I
Date:
Building Address:
10377 LQ-ai Oir.cQa-o-- L40
Owner's Name: /) Phone Z,3 V - 73 7 O
Contractor: ` License#: ?,I S&/ 6
Contact: Cupertino Business License #:
Type of Roof Covering:
Existing: Proposed:
Cl Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles X Asphalt Shingles
C. Wood Shakes ❑ Wood Shakes
X Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report#
Y_ To be Removed ❑ Provide Mfgr.Installation Specs.
• I Have Read,Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description: l�itnA ; )X,,pt y •c b f,. 0,_kA . SO jA a.,a o&,
Residential Commercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with Planning Deft. if
there are any restrictions: U
Cost of Project: IcType of Construction: Occupancy group:
/? 451
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
•