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05080277u_Yis (VZ n? n� F pito DL `LL 0 0 FF ' CITY OF CUPERTINO LL T BUILDING DIVISION PERMITCONTRACTORANFORMATION sE,tts"z b. �g6iea3 s BUILDING ADDRESS: LINDY ROOFING CO INC P"""°05080277 OWNER'S NAME: STEVEN WANG Scic;4 HARVARD DR PERMIT ISSUE DATE 0 Z31/2005 NE: SANITARY NO. CONTROL NO. (408)286-9990 ARCHITECr/ENGINEER: BUILDING PERMIT INFO BLDGELECT PLUMB MECH _3t� Z p LICENSEDCONTRACfOR'SDECLARATION JobDescri 1 hereby of iren that I am licensed under provisions of Chapter 9 (commencing p [ion with Section 7M(ft of Division Sof the Business and Prufessiom Code, and an, license is c. in full mrecand cerate, Z(� �j( REROOF-T/O SHAKE ISTALL COMP. SHINGLES i Liccnx CI ( Lic. g r p Dam Conmxmr RCHrfECI'S DECLAR ION 1 understand my plans shall W used as public records U wyg _ G Licensed Profe uonal 3 OWNER BUILDER DECLARATION ti i I hereby (Slim o n 1 em exempt from We Conine Cot : Any c Law for the O following massa (Saito ]all1.3. Business and Rofessiom Calc: Any city or county .� . which a m enosuuet, alter. impmw, m any nmemrit permit mpsig Gv. 1 0 0 0 0 its bera h N.iit I p601 oheissiensedp,alsumgo Bot thehvisios of for smhPetor's cense Signed cmcm p(commeningwitpurction7N)ofDivisiu3orWe ft usines'sndProrlaw(Code)or (commencing with Section 7") of Divisionl or We Bulinus and ProfessinnsCMc)tar Sq. Ft. Floor Area �,/%``J1'(} 70o Valuation `a fs''41 $ that he B exempt thomfrom and We basis for We alleged exemption. My violation of Wt� y` i.�. f f , V _ Section 7031.5 by arty applicant for a permit amptin We applicanuo a civil penalty of not mart than Rw hundred dollars ($500). r 0 0 w � �J Occupancy Type ❑I,ummrof0epmpcny,ormyemployeuwithwaguastheirmlecompensalon, �f�/[q/�4 �f /ar IsQ' will do do.oc k and thesuuctone is wt intended or offered forsalc (Set. 70/4, Box. and Professions Cade: The Conuacmr's License Law data not apply N an owner of Required Inspections property who builds arimpmves thaeogand whodaes suchwork himself orthrough his own employees, provided tat such improvements are not intended oro@rtd formic. If. however. We Wilding or iteprowment is aald within tem year of eompleusn, the owner. Wilder will have We burden of proving mat he did not Wild or improve for pmpnae of Sale ❑ 1, as owner of the property. am exclusively contracting with licensed contractors to consumer the project (Sec. 7064. Business and Profcsamu Cade:) The Contrumr's Li come law does not pply m an owner of property who Wilds or improves themon. and who contracts fon such pmjcm with a eontrxmgs) licensed pursuant in the Contractors License Law. ❑ 1 am exempt under Sec. , B & P C for this mason Owner Dam WORKER'S COMPENSATION DECLARATION 1 hereby affirm under pemlty of perjury am of Wee following declarations: I have and will maintain a Cenifleate of Commit in self-insum for Workers Compete rasion, as pmvided for by Section 37M of We Labor Crede, for the performance, of the work for which On permit is issued. ❑ 1 have and will mainNN Worker's Compensation Insurance, u miltAred by Secumi 37W of We Lmor Code, for We performance of the work for which this pemtit is issued. My Weileri Cmirpricantatlosurcrue in and Policy number : Carrier: T ' fi t .hey No.: 15 S 7 artOs I O C) ' CERTIR ATEOFEKEMPI'IONFROM WORKERS' COMPENSATION INSURANCE MIS sectio need nm W eompmmd if the Permit is forone hundred dollars (SIM) or less.) I ccnify that in the perimmence of the work for which this Permit is issued. I shall not employ any person in any mannerm u to become mbjeci to the Workeri Compensation Law. of California. Date Applicant ' NOTICE TO APPLICANT: If, after making this Ceniftmm of Exemption, you should become subject to the Workera Compcmauon provisions of the IaWr Code, you mon Oforthwith comply with such provisions or this Permit shall W deemed revoked. y CONSTRUCTION LENDING AGENCY 1 hereby eRrm that Nen is. Simmmunn lending agcrmy for the perfurmance of Ne work for which this Permit B issued (See. 3097, Civ. C.) 0 Lendcis Name z Lenders Addicas , D I ccnify that I have mad this application and more that the show information is emrco. I agree to comply with all city and county on inerso s and state laws rtlning m U Wilding construction, and hereby auNarice rtpmsentatiwe of this city in enter upon We above-mentioncd property for Impactors W purposes (We) m ssve, indemnify and keep s Nc City of Cupcnit against n., in ipo may in ...... cerae sgunst mid City a inquence fWeeostsang ofpanseemit. NisDWI z inconsegnenee of UNDERSTANDS UNDERSTANDS AND WILL COMPLY WITH A NO POINT Issuedb 3� 6r ULAj1ONS. y: Date ' fGA V` 3t Re -roofs SJ J L, Ngmt IicanUConuanar p m HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future Wilding occupant store or handle hazardous material as defined by Ne Cupertino Mun///icRRM' ��al Code. Chapter 9.12, and the Health and Sof xy cmle.5cctian zss3z(.)) ❑Yes u All roofs shall be inspected prior to any roofing material being installed. 1 the applicant Tuve c Wilding acupam LLQ eyuipmcnt w devices which If a roof is installed without first obtaining an inspection, I agree to remove air con arts defined by the Bay Area Air Quality Management all new materials for inspection. strict?Will rashaiabnus ❑ Yet No Ihave mal Ne hvaNtws materials rcquirtmcnss under Chapter 6.95 of the Cabin aria HcalN & Seel Code, Scetions 25505.15533 and 25534.1 untlerstaW that tribe Wilding dons rot currently haw •moans Nat it u my mspomihility w rotor the mcup t of VY myuimmcros which must the me, pd., m issuance of. ccNRcate of Occ � Ig eof Applicant Date 3f All roof coverings to be Class rB" or herrn Owneraraumad,edagcut LJ 1 � CITY OF UPERTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 Building Department JOB ADDRESS:IO�� PERMIT # 0S'�cP6Z7-2 OWNER'S NAME: PHONE # Lj IS - 7(�cO- --5c/ GENERAL CONTRACTOR �-t o Co _ FAX # L10 8 &- 8 G-' i 7 8 U � I am not using any subcontractors: `�^ •�Q 1� S 36 G Signature bate Please check applicable subcontractors and complete the following information 21 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 CITY OF CUPEI�TINO Community Development Department Building Division City of Cupertino 10300 Torre Avenue Building Department Telephone: (408) 777-3228 Fax: (408) 777-3333 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: STeV e n L,, -)on Job Site Address: I n (,o( (Yl Irl m Roofing Company Name: Applicant's Sign Greg Casteel Building Official 7v- -mkt Revised 71/2/04 Date:Il0i/05 CITY OF CUPEkTINO CITY OF CUPERTINO RE ROOF PERMIT APPLICATION FORM 6S•Ugv Z7 c� APN # //� j 6 4 W47- Date: Q - 3U—GS Building Addrress: �O(QC�S Merriman BENERGY Owner's Name: S F�v�� BUILDING Phone #: LI ti s Contractor: Ph e #: Lin ��.�F BUILDING License #: . 2-5 `a Contact: Phone #: BUILDING Cupertino Business License #: Plan Check Fee BUILDING BUSLIC Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof yW Asphalt Shingles ❑ Asphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) N,�umber of existing coverings 2 1\ To be Removed ❑ Provide I.C.B.O. Report # ❑ Provide Mfgr. Installation Specs. 1 I Have Read, Understand and Will Compi With Cu ertino's Tear Off Policy: ❑ Job� Cr -mom-- ` s i ^� 2 `�(" SJ �¢' r ° ° ♦^! (n Stc IDescription: (nmax y �rL,si(.�n'fi G.� !�� I'll S. Residential Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning Det. if LJ there are any restrictions: Cost of Prol t: Te of Construction: Occpancy group: /OrOUO re-roo-f- • Qty. 1.if11 PPP r)Pcrrintinn Fee GrouD 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