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05080252 ' CITY OF CUPERTINOsx�.- wTtP� BUILDING DIVISION PERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS: LINDY ROOFING CO INC PERMIT NOO 5080252 OWNER'S NAME: PERMIT ISSUE DATE JOSEPH WEISS 5554 HARVARD 08/29/2005 jNE: SANITARY NO. CONTROL NO. (408) 286-9990 ARCHITECr/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH liop LICENSED CONTRACTOR'S DECLARATION O O O O m C 1 hereby affirm Wr 1 am licensed under Provisions of Chapter 9(commencing Job Descr$tion iw with Soeuon7(XXpcfDlvidnn3ofthe Buri and Prafcmom Co .mdmyrice=m iy into" uses and err ,r ;g= ueenm - Lie,, 21'r�ji NO CONDITIONS a'y F Date Contractort^'O pI ARCHITECTS DECLARATION w U I understand my plans shall he used as public records C. ;u.� Licensed Prulcstienal f) c 3 OWNER-BUILDER DECLARATION / �O .�<F 1 wrehy affirm that lam exempt from the Convactafa License law for the 00 fallowing mason.(Sccuun 7031.5.Business and Profession Code:Any city or county M�f j ✓ m which.quires a .it In cmigruct,slur,improve,demolish,nr repair my mecum, 210 0 0 prior In its issuance,also requires the applicant forsuch permit In file a signed statement IiCthat he is licensed pursuant to the provision of the Connector's License Law(chapter 9 Sq. Ft. Floor Area -Z.-.Ow ��/rJ�. aluation tel- (commencing with Section 7000)of Division 3 of NC B usiness and Professions Code)or �(y'yl�rrrA1"tl i $ Nat he u exempt therefrom and the basis for the alleged exemption.Any violation of VVV F4 V Section 7031.5 by any applicant for a Permit subjects the applicanuo a civil penalty of not muse tbm five hundred dollars($500), JAIPTOMMherou ceupancy Type 1,as owner mf Ne PmpatY,a mY cmploycas with wage u their mk compensation, will do the work,and the someone is not intended or offered for sale(Sec.7(164,Business and Professions Cade:The Contractor's Lice=Law docs not apply to in owner of Required Inspections p rowny who Wilds.,improves themon,and who dms such work h imself or 0vough his own employe¢,provided that such improvcm mit..or intended or offered image.IL however,the building or improvement is sold within one year of completion.the owrter- Wilder will have the burden of proving that he did not build or improve for purpose of talc.). ❑1,re owner of the property,am=elusively contracting with licensed commands to construct the project(Sec.1044,Business and Proresslou Code:)The Contractor's Li. ccve law docs not apply to an owner of property who builds or improves thereon,and who contracts for such pmjecu with a enotrmmr(s)licensed pursmm In the Contractors Lkcnm Law. C3 l am exempt under Sec. ,B&PC for this mason 1371W' Date WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury One of the following decimations: I have and will maintain a Cenifi=te ofConsenuo self-insumforworker'sCorepen- on,as provided far by Section 3700 of the Labor Code.far the performance of the rk for which this permit is issued. 1 have and will maintain Wor crs Compensation Insurance,as osl by Sccuun ofNe labor Code,far the perfmmanme ofthe work for which this permit u issued. Worker Compensation rano Cartier and Policy number artM: .-.rrier. yYF�I licy No.:I St 1�O I ' CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE This section reed not W completed lithe permit isforanc hundred dollars($100) nr los.) I ccnify that in the perfmmade of the work for which anis permit u issued.i shall not employ anypermn in any mmnerso as to become subject o the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT.IL after making this CcniOcare of Exemption,you should become Subject on the Workcr s Compensation previsions of the Labs Code,you mug .JO foMwith comply with seen previsions or Nis permit shall he domed revoked. zy CONSTRUCTION LENDING AGENCY F Ihereby affmm Nat Nen,I,....do.lending agency for the perrurmanceur 6! the work fur which Nu permit u issued(Sat.3W7,Civ.C.7 Co L and='s Name U z Lender's Address U O 1 certify that I have read this application and sure that the above information is D, (~' correct.I agree to comply with all city and county onlinas¢es and sure laws relating to 0 building construction.and hereby authodac mpoegmuttises of this city to enter upon the shove-memidirr propcnyfani expenses purposes E'fa/3 liabiliu(Wj)agre 1 save,andenifryisesd keep mharmlon nm de City of Cupertino against y way accrue ageing said City U z A APPLICANT of due UNDERSTANDS ing of this permit. �^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL ON-POINT Issued by: Date ^ P` CE REGIONS. -0�— vq •L� / (! I/ Re-roofs Daf ,Yj Sig fApPlicmUContracmr u HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applitsm or future 'Idingaccupmlstom d ltandk hadNous material as dcOned by the,Cupertino Mum pal Cod=.Chapter 1.12,and the Health and Safety Code,$eellnn 155320)? ❑res No All roofs shall be inspected prior to any roofing material being installed. will thea =cant sur retire wr If a roof is installed without first obtaining an inspection,I agree to remove pp mg arupam use equipment or devices which g P it W,,ardmx air conuminmu ss fined by the Bay Area Air Quality Management all new materials for inspection. Wiel? ❑res IhaveR I the hasaNnusmarerialsn,yuiremcnu under Chapter 6.95ofthc Ca alifor- nim Health&Safety Code,Sccum M2 5,25533ud25534.1un&nr nd that if NC 12mr, wan rrendy have a tenant.Nat it is my rcspouihility a notily du cupant f the Rgabem=m.wm .nn,t x` t teiasr,meC-t—are or' Si 1 re of Applicant Dale 0 no,Or am sarin-----rat D,te All roof coverings to be Class"B"or better a, Community Development i F 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 SUPEkTINO Building Department JOB ADDRESS: /06,-Lc? ©CU< 1��, Q� PERMIT # `T os o � d� -g- 2Z OWNER'S NAME: O&- PHONE # Q08—t;L 70 GENERAL CONTRACTOR p FAX # -� p I am not using any subcontractors: 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 Y� Building Division City of Cupertino 10300 Torre Avenue CITY OF Telephone: (408)777-3228 C O P E kT'N O 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 /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: 76-e- 0-a�S Job Site Address: _ 000- 9 QGt.(-l-eQ-P YOL Roofing Company Name: 4 ) 'd" /W�i1 t Co. Applicant's Signature 1'► L�J�_ 7 ` c y- Date: D orf ps Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper CUPER CITY OF SFR®®F TING • OF CUPERTINO PERMIT APPLICATION FORM APN # Z� ie G s-6 I Date: o _a7�S Building Address: O I0062-C? 0CU1e U4t7r PQC40, Owner's Name: S Phone : �O v � - a 53-V5 79 Contractor: — Phone#: License #: L(n 'jZou-ri �`o��v.1Zt'1�70 o2�S�� Contact: Phone #: Cupertino Business License#: iN,✓•� �iv� -a8�- 'moo Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles <" 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. Al I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑ IMF Job Description: re-w?OL<.. axt57tn3 q,Ifi2 t ns yLdxl n C:o t4," S1„ - E3Jq-,r1- 6rancd Cc an Sergi ResicFenfial rvl' Commerc' 1 ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning De t. if there are any restrictions: LJ Cost of Project: Type of Construe on: Occupancy group: �� -oao rera S.u , Qty. if A licable Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees=' BLULDING BENERGY Ener BSEISMICRE Seismic Fee Res BSEISMICOM Seismic CommeBPLANCHK Plan Check FeeBUSLC Business Licens z� �4