08020115 CIT-YOF CUPERTINO `at;y.�.*s "+�5
BUILDING DIVISION PERMIT C01VTRt1CTORANFORMATION,
PERMITND.
BGaDlWMEBLINDA VISTA DR LINDY ROOFING CO INC 08020115
R'S NAME: PM MUM ISSUE DATE
ANAT-GILLER SACHS 5554 HARVARD DR 02/19/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHnECrfENGINEER: BUILDING PERMMINFO
e RERF,T/O EXST WDSHNGL,RESHT BLDG ELECT PLUMB MECH
300 LICENSED CONTRACTORS DECLARATION O O
rd 18b Description
1 har by alliin Nat 1 am Rsnred under provi tts of Chapter 9(mmmencing
^tl with Seems 7M)of Division S of Ne Business and Prefeulav Code.and my license is
] in full roma and clT l L�.g /
C�3 Licen
E Dam Comnc ,
an ,hall CI'S uNbiic=nI
I undenunJ my plans shall be useJ u public lecorN
5a
g nasi Licensed Professional
5 OWNER-BUILDER DECLARATION
gm I hereby.Rein Nat 1 am1. exempt from Ne Contractors License taw for the
C§� fallowingu , (anion RD1.5,Business and Pmfcaiva Code:Any city vcounty
whichitsissuance.
ssrequires a permit r conatrvct aimr.nt forw de permit t ri mania ay strocwm
iy tiormiu iensedpmmut W doatM+ppliant be Conell penni'mcensele Law
x< (hues us licensed puawantN Nc provisions of tin Connector's License law(CltspuT9 Sq.Ft. Floor Area Valuation
5 9 "hs"'s exempt
Section 7 and use iv is for of the B ed exam d ul.Anynvi Cork)of
�3.� Nat hs"i's eampl therefrom and use basis for the alleged eampto.Any violation of
Sudan 7071.5 by my applicant for a permit subjects to applicant lo a civil penalty of APN Number Occupancy • e
not mart Nan lin bundled dollars($M. P y •T 7 P
❑1,u owner of to property,or my employees win wages u Nab sole eampensadon,
will do the wort and the awnwe is not intended or offered ler sale(Sce.7044.Business Required Inspections
and Profession Code: nnm owee ns The Connectors theme Law does not apply an r of q P
property who builds a impamea Nemort and who does ass h work himself actrough his
own employees,provided that well improvements ma not intended oroffamd fesaW.If.
however,to building or hopmnmat is sold within am:yev of comp roma.the owner-
builder will hsse due h u km of proving that h did not Wild ons impure for Purpose of '
sale.). .
❑1.as awner of the propeny am exclusively contracting with licensed antnnon m
construct the project(Sec,7044,Business and Professions Code:)The Cust o ms's LI-
co em law docs not apply m an owner of propeny who builds or Improves Neuron,and
who contracts for such pmjects with a conwcmr(D licensed persons m the Contr+cmr+
License law.
❑I ern eaemp,mmo See ,B d P C fes the won
kner. Data
WORKER'S COMPENSATION DECLARATION
1 hereby,aiOmm under penalty of perjury,one of tse following daelaaWoa:
❑1 have and will maintain a Certificate ofC...,m self-insu a fa Workers temple.
sa on,u provided for by Seaton 77x0 of the labor Code,for can performance of the
work for which Thin perms is issued.
1 have an will maintain Worker's Compensation Iourence,as required by Section
700 of Ne Labe Code,far the performance of me work for which Nis permit W imued. '
My ked La
Worker Co pe on wrance ani.and Polity number
Cartier. Y/:I Policy No.: �e�y �O S
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
Claus satNn neednotbecanpl.ed ifthe permit isfaom hundred doll.D KB
or lea)
I ard(y Nat in me performance of use wart f.which this penin,is issued,l shall nasi
employ any person in soy manerw a m become subject w the Workers'Comp anode
Laws of California.Dam
Applicant
NOTICE TO APPLICANT.If,after making this Ceninam of Exemption,you should
become subject m the Worker'.Compensation provisions of Ne Lahr Code,you am
.,O irritant comply with such previsions or this permit mail he demand reveled.
y 0 CONSTRUCTION LENDING AOENCY
[amu 14 I herby affirm Nat Nem its construction lending agency for Ne perfurmmceuf
C > to wart for which his permit isissued(Sec.3097,Civ,C.) '
W Landers Nene
MZ Landers Address .
V Q I mairy Nat I ban mad Nis application and sum Nat the above information is
U. ^ comm 1 agree to comply wit all city and county eminences and some Ilea minting m
C SV' building construction,and hereby wNonm representatives ofthis city to cover upon to
W above-mentioned property for Inspection purposes
(We)spree to ave,indemnify ad kap humless he City of Cupertino against
,y IIA Iishilides,Judgments.costs and expenses which may In my my accrue agaim,aid City
V in consequence of the gnodng of this permit.
APPL19044T UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
sou ULATIq�+S.
f,3gti,lL L 1"44as-o 8
sigrmule of dian amrecmr Dam Re-roofs
HAZARDOUS MATERIALI DISCLOSURE Type of Roof
NIII tla applicants,or to,.building occupant aore whamile havrdoo material
as de0ad by the Cupenio Municipal Code.Chapter 9.12.and tin Haus and Safely
.k,Section 25572(x)?
❑Yes All roofs shall be inspected prior to any roofing material being installed.
@Ne
Wil me applicant or future building occupa ,tax equipment v devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit haamnus air contaminants as de0ned by the Bay Ama Air Quality Management all new materials for inspection.
DWrim?
Yes
I hart read Nemamriatsrequlremuts un1crChmmr6.95efNe Califon
ntaH.IthkS9cty Code,Socd.u25505,25533 and 25539.1 urvtntand maifdve building
does not currently ban•moat.date It ii my responsibility an notify the oceup.,of live
requirements with a=be met prior w issuance ora Ccrdfism of Occuparuy, Signature of Applicant Date
Owner or+utharined agent Dam All roof coverings to be Class"B"or better
09DA o 11D
Q- _ CITY OF CUPERTINO
REROOF
ITY OF
CUPERTINO PERMIT APPLICATION
APN# XDate:
5(0 l 14049. o� �-� � 9- z C.)o F
Building Address:
Owner's Name: Phone#:
leq Ii — (y I Ile O f— ZS 3-- yS �13
Contractor: Phone #: ;�/p f_
c/ Fax #: 017'e— 2f6 /P 7J,
Cupertino Business License#: r Contractor License #:
Z/�
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles �K Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Descriptio/n:r/O . J L1)� S� �c /�{e/��tt--/ 05ej 3v/� -�e_
UIl / /i0 fje, I•n� ( �YI�O W�c Y�J1 Wlld Ci �c�� - �GSf14-
Residential 5ir Commercial Lj
Fire Zone: Yes ❑ No &/ Confirmed with Planning Dept. if
there are any restrictions: LJ
Valuation: . S� -L '
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:.
04
Signature t
CITY OF CUPERTINO -
"ROOF
CUPEkTiNO FEE SCHEDULE
Number of
Squares Fee ID Fee Description Fee Group Permit Type
REROOFCOM Re-roof Commercial B COMML-ROOF
BSEISMICOM Seismic Commercial B
REROOFRES Re-roof Residential B SFDWL-ROOF
I BSEISMICRE Seismic Residential B
REROOFMRES Re-roof Multi-Family B MFDW.L-ROOF
BUSLIC Business License B
•
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 A
pp g 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: /r!' -' / r GG S
Job Site Address: �� (� y L ;A dc, (/i S 4 �, .
Roofing Company Name: L7✓� dOc �«
Applicant's Signature: d, . G Date:
Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO -
2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35614049 . 00
DATE ISSUED. . . . . . . : 02/19/2008
RECEIPT #. . . . . . . . . : BS000003981
REFERENCE ID # . . . : 08020115
SITE ADDRESS . . . . . : 10846 LINDA VISTA DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . :
OWNER . . . . . . . . . . . . : ANAT-GILLER SACHS
ADDRESS . . . . . . . . . . : 10846 LINDA VISTA DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4749
RECEIVED FROM . . . . : EDWARD A GREGORY
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
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 15, 502 . 00 1.60 0. 00 1. 60 0. 00
1REROOFRES SQ FEET 30. 00 390:.00 0. 00 390. 00 0. 00
----- --- ---------- ---------- ----------
TOTAL PERMIT 391 . 60 0. 00 391 . 60 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 391. 60 MC
---------------
TOTAL RECEIPT 391. 60
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
605 FINAL REROOF
•
E
- Community Development
10300 Torre Avenue
1' Cupertino CA 95014
Telephone(408)777-3228
lUEkTINO Fax(408)777-3333
fC 1 Building De cutment
JOB ADDRESSy6 /N d f/ f'1 �� PERMIT #
OWNER'S NAME: 0�V- _ g.r Sr .4 s PHONE #
GENERAL CONTRACTOR: ; FAX #
4J
I am not using any subcontractors: (i/z9il , ",.
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
a . Z/q— 0?
Owner/Contractor ignature,��, Date