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08070157CITY OF CUPERTINO CONTRAGTORANFORMA.TIt7!N BUILDINC'DIVIStONPERMI Bu"oTSTTES�LUM TREE LN LINDY ROOFING CO INC PER 08070157 OWNER'S NAME: PERMIT ISSUE DATE S HAIDER 5554 HARVARD DR 07/22/2008 WYED E SANITARY NO. CONTROL N0. ARcxT1ECnENCINEER: RE–RF RMV EXTNG WDSHK RF BUILDING PER O BLDG ELECT ELECTPLUMB MECH 0 0 0 0 LICENSED CONTRACTOR'S DECLARATION 1 Immby afrrm that I am lisomed under previdom of Chapmr 9 (commeneing "' ^ ^ " ^" "^ - ^ ^"— Job Description with Scenon 7010)ofDivision3ofObo Business and horevsbans Conde.ant my lice u in full foss aMc Zt btay License Clms Co. Dem ComaECL CHiTECPS DECI.lic N records 1 undcrdaml my Plass Nall bo used m Public mcaNs Licensed Profession. OWNER-BUILDER DECLARATION I hereby anion Net I am exempt from the Communes License Law for Ne following moon. (section 703 1.5. Business and Pofesdam Codc: Any city or ..my which requires a perish(to construct. slun. Improve. dcmalab, or mp¢Ir my someone prior to its ismarax-slot mqutma 0m applicant formch Permit to Rm a signed sammcnl that he is licensed pursuant On dmProvisiomof the Conlracmr's Lice. Law (Chapter 9 Sq. Ft. Floor Area Valuation (commencing with SuNm 7000) of Division 3 of the Busitmssand Professions Code) or that he a cruapt therefrom and the Was for the allow exemption Any violauan of Section 7031.5 by any applicant for a Permit subjects the applicant to. civil peoalty of APN Number Oe Occupancy ZYP set seam than rw Wanted!Wanted!dollars ($50470.ccu I. as awmr of the property. or my employees with wages u Nen mm ompevatinn, will do the wodt and flue structure isnot intended or offered for sale (Sec. 7014. Business and Prokssiaru Cada The Countesses License Law don not apply to an owner of Required Inspections propenywho Wilda mimproves Wewn, andwho danamchwork hivuelforthmutb his awocmployces, Provided that such improvements ere ms intended oroBered forsala If. . however, this Wilding or improvement is old within one year of comPkuon. the owner. builder will hoe the urden of proving thus k did out build ar Improve for purpose of samJ. ❑ 1, as owner Of thin pmpeny, am excluuvcly contracting with licamed ronuactms to comwct the project (Sec. 7004. Business and Pro2sdom Cade:) The Contractor. W- «ve law dose not apply On an inner of property wine Wilds or impmovm thermq and, who contracts for such Mjc= with aCnlnrY.lan(f) holland pummnt to the Contractors License Law. ❑ lunuemptunder See ,B&PCforthureason Owner Date WORKERS COMPENSA770N DECLARATION I hereby drum under pemisy of pedury case of the following decimatia¢ 1 haw and will maintain a Cen neon of Consent to self-insure for Wwkce3Compen- uIlon. as provided for by Section 3700 of the Labor Code. for the perfomwrce of the work for which this permit ts issued. 1 have and will mtlr am Worker's Dampeacalion IIISnrNn, as required by $CCYon 3700 of um tabor Coca, for the perfomance of the work rorwhich Ones Permit is hated. My Wwkees Comemoo "Poliyn�mE�,r�(�s, core,. policy No.: . CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE This section need Out be, completed lithe Permit Is foroc hundred &if=(sIBD) or less.) 1 oenify out in the performance of the won for which Nis permit is issued, I Nall not employ any peraten in my mussuarrm as to become subject to ft Woriters'Compcosadon , Laws of Caliko ia. Date Applicant NOTICE TO APPLICANT: IL after making this CentOcam of Exemption, you should become subject to Ne Warted Compcmation provisions of the labor Code, you most Forthwith comply with such providom or this permit shall be decmcd mwte4 CONSTRUCTION LENDING AGENCY I lemony dorm Nat Vert is a comtrucder lending upon, for use perfomane, of thte work for which Nis Permit is court (Sec 3097, Cir. C.) Lender's Name lander( Address I mtify Nn 1 have read this application and mute Nat the above mfomauw is c9rreR 1 agree In comply with all city and county andira. and sum laws minor{ m Wilding conwuction, and hereby authorise mpremnmiwa or this city to enter upon we ahave-mcnudgm property forinspectionpurposes (WO) agree ss Som indemnify and keep hammas the City of Cupcnino sgdmt ts,cosu and esumes watch may In any my arm against said City encs in consequence Or of the granting of Nis D WILL A APPLICANT APPLICANT UNDERSTANDS AND WILL COMPLY WITH A ON INT Issued by: Date SOURCE REGULATIONS. '—1 - � 11 vel 22 Re-roofs use a(Applinnw'Conummr D HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will 0m applicant or futum Wilding occupotsm¢ or lundlc hassock, mamrid m dented by Ne Cupenino Municipal Code. Chapter 9.11 and flan Health and Safety Cote, section I5532(a)7 [3 Y. All roofs shall be inspected prior to an roofing material being P P Y g g installed. Will thin aMlkaft r sumo Wilding account use cquipment w devices which If a roof is installed without first obtaining an inspection, I agree to remove hsraNnus dr contaminants dcfmmd by theBay Area Air Quelisy Management all new materials for inspection. DiiI Ihave, read Lh,Code. SMoun,=.5533amcnuurulerCNpOnd.95of the Olt Health h Sdeyyave. /O� thin u dtilding Wilding etiamritit docs Oros cumnthy have a amanm, Nd it u my mspoviNlisy m nothfy ecu to dm is my responsibility to our, _ ".eroFnu� bometpdarmuaan¢oft ecnrmayyr2 re of Applicant Date \\ �- ` .��` Ir O� Al l roof coverings to be Class 'At" or better Owne6pAdoodred agent Dam • 2 ITEMS OF 4 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: B1k:,Lot: APN ........: 31633015.00 DATE ISSUED.......: 07/22/2008 RECEIPT #.........: BS000005542 REFERENCE ID # ...: 08070157 SITE ADDRESS .....: 10310 PLUM TREE LN SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OPERATOR: patg COPY # : 1 OWNER ............: SYED HAIDER ADDRESS ..........: 10310 PLUM TREE LN CITY/STATE/ZIP ...: CUPERTINO CA, 95014-2019 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 91000.00 -------------------- 0.90 0.00 ---- ---------- 0.90 0.00 1REROOFRES SQ FEET 27.00 351.00 0.00 ---------- 351.00 0.00 TOTAL PERMIT ---------- 351.90 0.00 ---------- ---------- 351.90 0.00 METHOD OF PAYMENT AMOUNT -- REFERENCE NUMBER CHECK --------------- 729.90 -------------------- #3634 TOTAL RECEIPT --------------- 729.90 VOICE ID -------- ---------------------------- DESCRIPTION VOICE ID DESCRIPTION 601 ROOF TEAR OFF -------- ---------------------------- 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF 0 ` g' CITY:OR.CUPERTINO.. REROOE PERMIT APPLICATION Q�07015 7 APN # 31 i,,3 /� . 0 0 Date: Building Address: % 0 310 Owner's Name: S ecQl �-erD Phone #: �- 72G-S�t Contrac)to : Phone #: Fax#:. Cupertino Busi License #: Contractor License #. (3 l Type of Roof Covering: Existing: Proposed: ❑ Built -Up Ropf IJ.. Built -Up roof ❑ AsphaltShingl4s ,� Wood Shakes .❑:,- Asphalt Shingles ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles O Other (Specify) Number of existing coverings ❑ Other (Specify) ❑ . Provide I. C.B.O. Report # Q/ To be Removed ❑ Provide Mfgi. Installation. Specs. Job/Description: vo alC� (up 1 y� sf l� I tt 1 2. 3 7 Residential Commercial Fire Zone: Yes ❑ Note Confirmed with Planning Dept. if Valuation: � � r � U O there are an restrictions: LJ I Have Read, Understand and Will Comply with Cupertino's Tear -Off Policy: CITY OF �UPEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 Building Department JOB ADDRESS:/ Q 3 p/U� SUBCONTRACTOR PERMIT # d OlS OWNER'S NAME: c (a er PHONE # GENERAL CONTR OR:P1 -4Ov /1 FAX # p a I am not using any subcontractors: �� - L o QA, Signature Date Please check applicable subcontractors and complete the following information: Owner/Contractor Signature Date 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