08080135 CTTY OF CUPERTINO t
BUILDING DIVISION PERMIT Wk
CO WITC1I2WIP}I'(172MATIE�N '
3'.r .res...
BUILDING A4DRESS: PERMIT NO.
21966 OAKLEAF CT LINDY ROOFING CO INC 08080135
OWNER'S NAME: PERMIT USUE DATE
HWANG YIHJYE J AND CHENG 5554 HARVARD DR 08/18/2008
NE7'n.nv SANITARY NO. CONTROL NO.
(408) 286-9990
ARCHITECrfENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
o p LICENSED CONTRACTOR'S DECLARATION Job DeSuOD
rd 1 hereby grimgrimNet 1 am Ikened under provisions of Chapter 9(commencing p
nz1 withSmtinn7M)ofDiviaionleftheBetlr�• ftfuaiumCdo,ammylicem:is RE RF RMV EXTNG WDRF INSTL 7/16"OSB, 30# FLT& CLS
in ran forte,nd err S t 5 rG
i83 LI«�-�ue.r A 38SQ ARCH DIM COMP
eF Date
ContractorDECLARATION
s shall'ARCHITECTS DECLARATION
Q 1 understand my plans shell he used as public recnrm
U
5 0
Licensed Professional -
,� OWNER-BUILDER
mptfrm Ce Conor0N
COO hereby•nom the 1 1. uerop,from the Canon;CoLicense MyC Law for the
COO o fallowing rossoa.termite 7031.5.Buaimu and Rotesainm Code:MY NIY or county
$pi labor its Wes•permit a eon•wet•Iter.improv,demnlLdt or i to e a sig any suomum
—zy priaruiuissued pursealso mquires the pravis mor'ant forthe sucContractor',
ohpermr',Lieemlaw(Chap=ned m
IRE< that(come4cingwi ScWonWNepmvisiouofar CBr nmrudPrmLaw(CMpter9 Sq.Ft. Floor Area Valuation
(commencingwthScctionIDW)the burionr of the Buainessandon.An violation of $18000
`<— that hosts eampt therelmm and Lie beer for the alleged licaunon.Any violation of
an[
0Jlsbytoy
undred ollRe,s(LIM na6jeeu the,ppliasntW.civn penalty of Number Occupancy e
moa mom than Ow hundred dollars(SSW). 32618062 .'`ff P Y1YP
❑1,as owner of the property,or my employes with wage,as their sale compensation.
will do the worn and thestruclum is not Intended or offered for sale(See.7044,Business Required Iections
sal Profesain de:oCaThe Consacmana r's LiLew darn e ns tet apply u an owner of q P
property who Wild,or ,im prow,thereon.and who does such work hr'mac,f or through his
more employee,provided that such Improvements sac Led intended uraffered forsale,If.
however,des building w irepmwment 4 mtd within am yce of cmople6on,the owner-
builder will Nes the burden of proving that he did not build or improv fur purpee of
sate.).
❑I.as an=of the property.•m uclwiwly contracting with licensed conwmm,to
cauuuet the project(Sec.7044,Bulnua and Profession,Cade:)The Conbacmr'a U-
cena Law dote not appty to m owner of property who builds or improves desmon,and
who monuacu far such pojecu with•eonuactm(sl Iittnad puravam te the ConlMor's
L came Law.
❑Iom escmpt antler See ,B&PC(ter this moan
Owner Date
40 WORKER'S COMPENSATION DECLARATION
I hereby afrum under pmutay of perjury ane of the following decluWonc
I ham and will mainWn a Certificate o(Couant to elf-lune forWmFds Campce-
sdo t,as provided for by Section 37W of the Labm Code,for tha Performance of Ne
wart for which this permit is issued.
❑I haw and will maintain Worker's Compensation Insurance,as required by Section
3700 of the Labur Coul far the Performance ofthe wart for which this permit 4 Whed. '
My Worker',Co�tna}cmuseun a 'er W policy n bac
Cortin. `� r�Ylnn!✓ Polley No.: O - r
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
rrh4¢cline recd net be completed itch:permit Is phone hundred dal4rs(SIM)
or lest)
I certify Lima in the performance of the wort for which this permit is Wood.I shall no
employ any person in my manncrm u on become subject to the Workers'Compenation
Laws of Calif..]..Date
Applicant
NOTICE TO APPLICANT:If,¢Act making this Cenificam of Exemption,you should
bemme subject In the Worker's Compensation provisions of the Labor Cdc,you moss,
.,O
Cli forthwith comply with such provision or Nis Permit 0411 be decmd nevuke&
'E" CONSTRUCTION LENDING AGENCY -
[—i5: (hereby affirm that them Is•canwction lending agency for dm perfurmmce of
tiLite work fur which this permit is issued(Sec.3097.Civ.C.) '
14 A Lander',Name
7 z Lender's Add.
V�. I certify Wt 1 haw esti Ws aPPliwion and sou Lies du show infotmatiun r
current,I¢rte to Comply withall city and roomy candl es end awe ban eating In
G rV^ building conswdan.and hereby snuodm reprom udw,of this City In toter upon We
[d7 show-menduned pmpcny for inspection interludes.
Ly,G (Wt,)agree to saw,indemnify and keep harmless the City of Cupertino again,
:y N liabilities,judgmenu.costs and upmecs which may in my way acemo against saidCity
UZ in coneegmnce of the granting of this permlL /
APPLICANT UNDERSTANDS AND WILL COMPLY WITH NO -POINT Issued by: Date
50yec�REGULATIONS.
Lam^_ --_Lr — 1k0C Re-roofs
blsulfA 1, HAZARDOUS MATERIALS DISCLOSURE Dau Type of Roof
Will the applicant ar future buil ' acevpantemrt or adle haoudou commi.1
u mood by tie Cupertino Mum Cale.Chapter 9.13,and the Health and Safely
Cam.Section 75532(a)? All roofs shall be inspected prior to any roofing material being installed.
❑Yes No
OWIII the aPpl.0 or factum earl ing acupan,um cyuipmcnt or devices which If a roof is installed without first obtaining an inspection,I agree to remove
IL 1=1 ter uminanu u �ncd by the Dry Area Air QuW"I Management all new materials for inspection.
District?
❑Yes u
Ibswd the lessm wd.l.rtpenamems unmr Chapmr6.95 ofthe Califfer.
He
riaalth&Safaty Cam,Sacduu255U5.25533ad25534.lur4 ddmifthe Wilding
lora nm curendy haw a tenant,dot It r my me,em ihlll,y m odry da eupmt nr tha
which mutt to met prior m issaaruc of.Cmdrinte of Sig a eof Applicant Date
Owner hmiredagent Date - All roof coverings to be Class'A"or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg .
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32618062 . 00
DATE ISSUED. . . . . . . : 08/18/2008
RECEIPT # . . . . . . . . . : BS000005820
REFERENCE ID # . . . : 08080135
SITE ADDRESS . . . . . : 21966 OAKLEAF CT
SUBDIVISION . . . . . . :
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . . -
OWNER . . . . . . . . . . . . .. HWANG YIHJYE J AND CHENG WENDY
ADDRESS . . . . . . . . . . : 21966 OAKLEAF CT
CITY/STATE/ZIP . : CUPERTINO CA, 95014-1137
RECEIVED FROM . . . . : LINDY ROOFING CO
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 18, 000 . 00 1 . 80 0 . 00 1 . 80 0 . 00
IREROOFRES SQ FEET 38 . 00 494 . 00 0 . 00 494 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 495 . 80 0 . 00 495 . 80 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 495 . 80 . #3664
---------------
TOTAL RECEIPT 495 . 80
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
Community Development Department
Buildmg Division
City of Cupernno
I0"{00 Torn' Avenur
'I'i�lrphonc: (.05) 777-321S
Fax: (408) 777-3333
Building Department
Subject: Re-roofing policy for the City of Cupertino
I Prior to permit issuance, you must agree to comply with -1997 UBC Standards
and manufacrurers specifications on re-10011[111.
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.
=I. 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.
D. If plywood is installed, a plywood nait inspection is required.
0. 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.
T NOT[: If you call for a plywood nail inspection and the job is not ready,
you will be charged a re-inspection fee of $776.16. '1 he re-inspection fee Hurst
be paid before another inspection can be scheduled
IMPORTANT:
1. Flat roofs most have a minimum Of " per foot slope and iiemonstrate
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.
Flomeowner's Name: JetC(C Wz d �,1JGtV�
job Site .Address: ( UJ �g
Roofing Company Name: 1L(r\Gt �U-A/�q�
Applicant's Silnatur M Dare:
Greg Casteel
Building Official
Revised II/2/04
NOW CITYOF. C;UPERTINO
• `RE OOF`. .
CUPEkTINO PERMIT-~ADPL'KATION
APN # � (P/ nv (D � • � � Date:
Building Address: CT
i
Owner's Name: Phone #:
7�0
qb
Contractor: Phone #: U
L
Fax #: .
Cupertino Business License Contractor License #:
Type of Roof Covering:
-t
Existing: Proposed:
❑ Built-UpRo f
o�, O : BPilt_Vp roof. . :,
13 Asphalt Shinglgs' Asphsit Shingles
Wood Shakes C) Wood Shakes
O Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ ..Other(Specify)
Number of existing coverings- ❑, Provide'I.C.B.O.Report #
fl✓To be Removed ❑ .'Provide Mf&, Installation.Specs,
Job Description: re M 0 U/fj X r S 7*)n 5 Gw P /-so rrl
o
ResidentialCorrimercia]
Fire Zone: Yes ❑ No Confirmed with Planning Det. if
there are an restrictions: LJ
Valuation:
/ � � Ute.. .... . . ..::. ... .. :,7777777 :.
I Have Read, Understand and.Will Comply Y,*' Is Tear-OffPolicy:
Signa r
t
i
r - - Community Development
�# 10300 Torre Avenue
4 ! 1 �, V Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408) 777-3333
'04UPEt�TINO
Building De artment
JOB ADDRESS: 0 C(-/ q G/ PERMIT #
OWNER'S NAME: Q Qf 9t 2/14L, PHONE # U �C
GENERAL CONTRACTOR U
/ 1 FAX #
I am not using any subcontractors: CCN �J
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
j Sheet Rock
Tile
Owner/Contractor Signature Date