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03060173CITY OF CUPER'I'INO "'� ";: tom. �' "V? ^Y Buu,mNC DlvfsloN PERMIT a CONTRACTORIIINFOlt MATION Ru1L DINGADDRESS: LINDY ROOFING CO INC P ""'003060173 OW NEWS NAME: � 5554 HARVARD DR PERMIT ISSUE DATE ONE: (408)269 -2025 SANITARY NO. CONTROL NO. ARCHITECTIEN'GINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION I bcmby Chapter 9 I Job Description p affirm that 1 em licensed under provisions of (commencing wmSe ti n 7") of Division 3 of the flu i, gand Profess mCode,andmylicense is �af�p� n � T01'i L in full P and cf`ec /— N REROOF can lass Limo _ r RECD ATION' Cam— A0.— C11IThe 7 a JUL 1 O `00�+ usedO 1 undersunJ my plans shall he used as public reenrds � Licensed Professional OWNER�BUILDER DECLAIiAT10N 811L '1 DING 1 hereby affirm that 1 am exempt from the Contractor's License Law for the ✓V IV following reason. (Section 7031.5, Business and Professions Code: Any city or county which mquires a permit to construct, alter, improve, demolish, or repair any structure poor to its issuance, also requires the applicant for such permit to rile a signed statement that he is licensed pursuant o the provisions of the Contractor's License Law (Chapter 9 Sq. Ft. Floor Area Valuation (commencing with Section 7111)) of Division 3 of the Business and Professions Codc) ur ' Not he is exempt Bacterium and the basis for the alleged exemption. Any A.Imion of 3261 80 6 6 . 0 0 Section 7031.5 by any applicant for a Permit &ubjecu the applicant u a civil penally of APN Number Occupancy Type not more Nan five hundred dollar, (S50(d). ❑ L as owner of the property, or my employee, with wage, as their solo compensation, Required Inspections will do the work, and the structure is not Intended oroffeRd forsale (Sec. 7044, Business and Professions Code: The Conweor's License Law does not apply m an owner of Property who builds or improves thereon, and who doessuch work himscfor through his 307 - INSULATION own employees, prodded that such improvements are not intended oro0eed rounds. If, - 601 — ROOF TEAR OFF however, the building or improvement is sold within one year orcomPletion, due owner, builder will have the burden of proving that he did not Wild or improve for purpose of 602 - ROOF PLYWOOD NAIL "I`')' 603 - ROOF BATTENS ❑ 1, a owner the property, emWs and contracting with m no Cconvectors construct ij , Business :) and PmfeoWiCoorOTheConmcmn,and 604 — ROOF IN- PROGRESS does not ao owner of property who build, or improve Ncmon, and law dots not apply who who contracts for such projects with oconvectort .)liunxd pursuant in she Convadob a se L License Law. ❑ I am exempt under Sec. . B k P C for tai, reuon Owner Data WORKER'S COMPENSATION DECLARATION I hereby affirm under penally of perjury one of the following declarations: I haw and will maintain a Cell feels, of Consent t0 xlf-in,un for Worker', Compete .salmn, as provided for by Section 3700 of the labor Code, fer the perfomnance of the work for which this permit is issued. ❑ I haw and will maintain Worker', Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. \My W ricer's Compensation Insurance carrier and Poli umber am: Q3sAEr:QAr Re //a /.✓l, PoIIr o.: CERTIFICATE OF EXEMPTION FROM W ER, COMPENSATION INSURANCE (This Section need not beeompleteJ if the permit is henna hundred dollars SIOKE or less.) 1 certify that in the performance of the work for which this permit is issued, 1 shall no, employ any person in any manners as m become subject n the Workers Compensation Lew. of California. Date Applicant NOTICE TO APPLICANT: IL aster making this Ccnifmam of Escmption, you should become subject to the Worker'. Compensation provisions of the labor Code, you must forthwith comply with such provisions or this Permit &hall be doomed invoked. CONSTRUCTION LENDING AGENCY 1 hereby affrm Nn them is a consuunion lending agency for Nc Performance or the work for which his permit Is issued (See. 3017. Civ. C.) Lenders Name Under. Adtlmas I cenify that I have mad this application and sum Net to above information is ' correct.I agree to comply with all city and county ordinances and state laws relating to buildingennnmclion, and hereby athorvereoses. tiws of this city to enter upon the shove me for inspection purposes. (WC)agreeto sew,indemnifyand keep harmless e) agree to saw. gm City of CupcnstSagainst coming may in esnnit. maynn anyway accrue against Said City incoisesjudgments. consequence of the Bnminguf this Permit. of this A�PLJCANE UNDERSTANDS AND WIL OMPLY WITH ALL NON-POINT SOyRCE GULAT NS. ✓ �� Issued by: Date Re -roofs Signature of Appm nV mnemr Data ZAZARDO MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupanumm or handle NO ueoux matenai an defined by the Cupertino Municipal Code, Chapter 9.11. and the Health and Safety Code, Section 25532(a)7 ❑Ye N. All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building Occupant use equipment ordcvieex which it hmardous air contaminants as Imfned by the Bay Area Air Quality Management all new materials for inspection. District? ,,// ❑Yes j§Nu I have mad the havnrduus materials requirements under Chapter 6.95 of the Califon nix HcalNdt Safety Code, Sections 25533 and 25534.1 undcrsmnd NOtifNC huiWing not curendy how a moans, that it is my nesponsi hit Or m notify Inc mcupenl Of Lh toL reyuircmc hichm pdurwiv rah Ccrdf em of Occupancy. k Signature pplicant All roof coverings to be Class "B" or better O car aamnrived age Dam Building Division OCIO 10300 Torre Avenue Cupertino, CA 95014 -3255 Telephone: (408) 777 -3228 CUPERTINO Pax: (408) 777 -3333 Building Department Subject: Reroofing policy for the City of Cupertino. 1. Prior to permit issuance, you must agree to comply with 1997 UBC Standards and manufactures specifications on reroofing. 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 reroofing 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) Preinspection 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 that the proper City inspection can be performed. t IMPORTANT: 1. Flat roofs must have a minimum of V" 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 of inspection We understand the above policy on reroofing and will comply with this policy. Homeowners Name: Address: Reroofing Company Name: Applicants Signature: Joe Antonucci (Chief Building Official) 6/25/01 • G0� CUPERTINO CITY OF CUPERTINO 6 3 6 ° 73 REROOF PERMIT APPLICATION FORM APN # d 3,z is'oG/ BPERMFEE Bldg Permit Fees Date: Building Address: 0 BENERG Energy BUILDING BSEISMICRE Owner Name:. BUILDING Phone #: Seismic Commercial BUILDING BPLANCHK Contractor: i Phone #: �/ icense #: Business License BUILDING ` Contact: // , / off' Phone #: Cupertino Business License #: 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. Y I Have Read; Understand and Will Comply With Cu ertino's T ar Off Policy: ❑ Job Description: 5 l/ /pC D��rz iii sir r Residential kr Commerci-al ❑ Fire Zone: Yes ❑ No ❑ Confirmed wi an iu Dept. if there area restricts ns LJ Cost of Project: Type of Construction: I Occupan gro S✓ Qty. if App ' able Fee ID FrP DPCrrintinn Rrr (7rnnn 22z'� 0.g / e 6�0 BPERMFEE Bldg Permit Fees BUILDING BENERG Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING 22z'� 0.g / e 6�0