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05070161 CITY OF CUPERTINO BUILDING DIVISION PERMIT �ICONTRACT,ORINF�ORMATION BI;moINGADr,REss:. LINDY ROOFING CO INC PERMITN0.05070161 7765 ORTON LA ER'S NAME: PERMIT ISSUE DATE GEORGE CUAN 5554 RD DR n7/2e/2oos PHONE:" i SANITARY NO. CONTROL NO. (408) 286-9990 ARCHITEC 'ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 tips LICENSEDOutIamCONTRACTOR'S DECLAR TION (Chap orq 1 hereby affirm Out L am licensed under nd Profess of Chapter 9(commencing Job Description 4iW with Scaian]Of11)uf Division3of NCBusinenranO Professions Code,and mylicutsc is n<n. in full forte and ��® ;q"= L,cm, uea��' REROOF-REMOVE SHAKE .ROOF/IN 'f� Dam RCHITETSDacte, ATION SQ MONIER LIFE LIGHTWGT VIL A id u` �uMa 4u `puns sh l as nubli�ea a G U,maed P (anal lY-.2005 ro 5 OWNER-BUILDER DECLARATION <Y , 1 hereby affirm that I am exempt from the Conuacmr's License Law for the OO following mason.(Section 703 L5,Business and Rofeatluu Codc:My city or county 5§V which rogoires a permit OF cnmstmct.alter,improve,demdirh,or repair any structure 81)11 F2,ghlez z y prior tit its issuance also requires the applicant for such Permit to file a signed statement ESC Oat he is licensed pursuant toNcprovisions ofthe ContracturiLicense Law(Chapter 9 Sq. Ft. Floor Area s� (commencing with Section 701 or Division 3 of the Business and Professions Crude)or i Nat he is eaempt themfmm and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant o a civil penalty of APN Number Occupancy Type mot mom than five hundred dollar(S300k 36218043 . 00 p y Yp 0 1,as owner of the Property,OF my employees with wages as their sole compensation, willdothework,end Ne swciumisnotimm�dedoroRemdforsa (Sec.]044,Business and Professions Cade:The contractoras s Liam Law donor apply to an owner of Required Inspections property who bas ilda or improves thereon,end who does such wort h imsel f or through his own employees.provided that such improvements rte not intended oraRered forsale.If. however.the Wilding or improvement is sold within One .of completion,Ne owtrcr- builder will have the burden of proving Nat ha did not build or improve for purpose of sale.). 0 1,as owner of the property,am exclusively contracting with licensed contractors to coutwct the project(Sec.7044.Business and Refusions Code:)The Conuamora Li- cense Law dais not apply to an owner of property who builds or improve,thereon,and who contracts for such projects with a conuacmr(s)licensed pursuant to Ne Contractor's License law. 0 l am exempt under Seca - .B h P C for this season Date WORKERS COMPENSATION DECLARATION • ' -" I hereby affirm under penalty of perjury one of Nc following declanuans: ❑I have and will maintain a Certificate of Consent to self-insure,for Worker'sComper- satiom,as provided for by Section 3700 of the Labor Cade,for the perforri of the - work for which this permit is issued. - -- 0 1 have and will maintain Worker's Compensation Insuran¢,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Work Ks Compensstio nsumnce eartiu and Polity number are: Cartier: I 7✓ro.7 Polity No.: Z SS Its t�� CERTIF GTE OF E%EMPnON FROM WORKERS' COMPENSATION INSURANCE (This rection xcd not beeomplemd if the permit is for one hundred dollars(SIM) or less.) 1 certify Nat in the performance of the work for which this permit is issued,I shall not E any,D�tauQm any manner soumbceome subjauo NC Wortrni Com 'on r Laws of Cablst '`OLE T.�✓-�— Applicant \h NOTICE TO�ANT:IL after making this Cenilicatc of Exemption,you should became subject to the Worker's Compensation provisions of Nc labor Cade,you must .Jz forthwith comply with such proviums,Or this Permit hall be deemed revoked. z O CONS fRUCf10N LENDING AGENCY [-+ IMmby eMr.Nat then is a eanstsuetinn lending agency fm NC Performance of (Y the work fur which due permit Is issued(Sec.]09],Civ,C.) QLenders Name =z Lcnder's Address f,Q I cerify Nat 1 have read this application and state Nat the shove information is ' t-" caeca 129=to comply with all city and county ordinances and sort laws relating to O V building construction.and hereby authorime mprese erivcs of this city to enter upon Nc r G mhovc-menuoned prop urlyest for Inspection purposes (We)agree m save,indemnify and Nett,harneWil the City of Cupertino against Z judipoures,Of the costs and expenses;which may in any way accrue againnsvd City V z inconsCAN'r of UNDERSTANDS of thispermit.WILL " APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOU DNS.kO �/L F /?aY1Vk a g�t�. �.�----a � Re-roofs St1gnau Iiamucim"anor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will On applicant Or future building oacupmts me or handle hvardou material as defined by the Cupertino Mcmi p 1 Code.Chapter 9.12,and thc Health and Safety �nd SD y.ion 25512(a)? 0 All roofs shall be inspected prior to any roofing material being installed. Ye o If a roof is installed without first obtaining an inspection,I agree to remove Will rbc applicant (satire bas' mg acupant tau equipment or devices which g p ' emit hii.dous air contaminants fined by the Bay Area Air Quality Management all new materials for inspection. ,suis] C Ycs NO Lban.fctyC ,a ous d.amrialsmqui 255ents undcr Chapter6.95ifdm Wilding for ria Hulth&Safay Cad e,Sections anti myrsnd25534.1 it orsmnde result building dors not currently have a tenant.thas it is my responsibility m notify the occupant of the mywhicItmuubemet MOTOFissuance ofaccnificatc041 maty. tureofApplican[ Date owmr rout ricdagent D All roof coverings to be Class "B"or better i Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 Cl OF Fax(408)777-3333 �UPEI,TINO Building De artment JOB ADDRESS: O� �N PERMTT# OSa -7ol� / OWNER'S NAME: PHONE # 8 l GENERAL CONTRACTOR: Ll FAX # 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 CITY OF CUPERTINO I 1 of 3 PERMIT RECEIPT OPERATOR: suem COPY # 3 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36218043.00 DATE ISSUED. . . . . . . : 07/26/2005 RECEIPT #. . . . . . . . . : 30514 REFERENCE ID # . . . : 05070161 SITE ADDRESS . . . . . : 7765 ORION LA SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : GEORGE CUAN ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014- RECEIVED FROM . . . . : . LINDY ROOFING 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 ---------- ------------- -------.--- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 10, 000.00 169.56 0.00 169.56 0.00 BSEISMICRE VALUATION 10, 000.00 1.00 0.00 1.00 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT 170.56 0.00 170.56 0.00 • Community Development Department Building Division City of Cupertino • � 10300 Torre Avenue CITY OF Telephone: (408)777-3228 Fax: (408) 777-3333 CUPEI�TINO 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 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 complywith the above stated, policy on re-roofing. Homeowner's Name: (�� cj U A-y\ lob Site Address: ��(� J ©a colo Le Roofing Company Name: 0 iQ& G , Applicant's Signature( Date: • �l Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper CITY OF CUPERTINO On REROOF CUPERTINO PERMIT APPLICATION FORM APN# 362 1 Q Dat��a 5-o S Building Address: �7 - I o5 co-, Cv tares Owner's Name: Phone#: e CLka r1 ti - 3(rco o4 7So Contractor: � License Ccs . � � SBI Contact, U�l a _q 9 9 O Cupertip_ u ess License #: w Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles `a Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles � �.. ❑ Other(Specify) -At Other(S pe c i fy)C Number of existing coverings Provide LC.B.O.Report# ❑ To be Removed Provide Mfgr.Installation Specs.rr'WQLAl114Z, /t '1 ltle-1 if V!I • I Have Read, Understand and Will Comply With Cupertino' Tear ff Polic Li Job Description-jkemtrU/! - e2Xt n5 AT 4n tel tr7 re Z U mc:•, J I 1 r *,T Lt AQ Reside tial Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are nnxi restrictions: U Cost of Project: Type of Constructio Occupancy group: O CIC] e rub /n CR_ J&S Qty. if A licable Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY P—_1 BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING s �