08010167 (2) CITY OF CUPERTINO �.+vx«�mk;5 tra.t"x'� �.s }'pfir?%+= `
BUILfW,G DIVISION PERMITCONTRAC�TUR INFOI,tMATION y
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BDILD1NGgD 666 TONW00D DR LINDY ROOFING CO INC P08010167
NfiSWSCNAMEE U1 PERMIT�UEDATE
STIRRUP KEITH A AND SONJA M 5554 HARVARD DR 01/30/2008
PHONE SANITARY NO, CONTROL NO.
(408) 286-9990
ARCHf1ECUENG1NEER: BUILDING PERMI f INFO
BLDG ELECT' PLUMB MECH
�00 LICENSED CONTRACrOWS DECLARATION lob Description
1 hereby affirm Wt 1 un Iimmed under provition of Chapter 9(mmmencing
wif li f IXltp ofpiHdonlofWButlnmaM Fofusiov epfe_,ndmybanmk RE—RF,RMV EXTNG 2 LYR COMP, INSTL 30# FLT & NEW
nj, in full aC—andc d-iIP
��3 ucenmctw — q t3c.g 2.I 5" 30YR COMP.CLASS A
DamCamrumr N
CHffELTS DECLA A ION
e O I un erwnd mw y plNall W used u Public recnrds
Mu
h tad Licensed Professional
y OWNER.BUILDER DECLARATION
F I W.by taTimi Nn 1 am camp,from W Conuscters Leen Law far Me
00 following town.(Section 7031.5,Business and Profession Calc:Any city at county
which rcquita a pcmdt m convect.alms Improve,demolish,fir mpNr any stmcm.
Zi print to its issusme,dm require the applicant for such permit ve rile a signed Moment
< that he is licensed pursuant to the provision of the ConlncmN License Law(Chap=9 Sq.Ft.Floor Area C Valuation
5g (comms ncingwithScdon7000)of Divisim3ofthe Buslnmmd Pro@mons Code)or $7000
that he u nsempt denim.and the Buis fur W allegro ase eptioo A.,violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty ofNumber O
ant mom than nw hundred dollen($5001. 3 6 917 )3 9 t?� Occupancy P y 1YPe
❑1.as owner of Me property,or my employees with wages u their sole compounds",
will de W work,and the structure is not intended oroRered for sok(See.7014,Business
and Prafesderu Cade:The Contractors License Law dos ms.1 apply 0 as owof Required Inspections
property who builds or improver Wmon,and who doessuchworkhlmself or through his
own empleryces,provided that such Improvements art not intended mo0ercd farads.If.
however,Me building or improvement is sold within oro year of completion,the owner,
Wilder will have Me When of proving that he did set build or improve for purpose of
1,as caner of Me property,am aeludvely carousing with licensed contractors to
contract Ne project(Bice.7014.But..and Prefoome Code:)The Contractor's U.
come Law dos not apply m an owner of property who Wilds or Improve Wrcn.and,
.W moms,for mch projecta with a annus tors)licensed parson.,to tW Concourses
License Law.
❑I aremanapt under Sec. .B&P C ferthisanon
41 nv Dam
WORKER'S COMPENSATION DECLARATION
1 hereby arms under pealty of perjury,ore of Me following declandon:
0 I ham ass will maintain aCeNBeamof Consent to self-inum for Workers Compen.
wain,u provided for by Section 3700 of W Labor Code.for Me perfoi e.of W _.
work for which this permit is issued.
❑1 have and will maintain Workers Compensation losmance,w required by Section
3700 of W Labor Cods,for Ne performance of W work for which this Permit u issued.
My Workers Cnmpenedon tau m eartJ, and Polity numbk,7:/
tinier.. !1'7B 1 Policy No.: l (
CERT3FICATE OF EKEMMON FROM WORKERS'
COMPENSATION INSURANCE
Miamed.need nvbeconplcted Ifthe permit is faro.hundred dellwe(5100)
or las.)
I anify Wt In W pvrormauce of W work for which this parrots is issued,I Nail not
employ any person in any summer so as in banned subject o the Workma''CompennWn
Laws of California.Data
Applicant
NOTICE TO APPLICANT.If,after making this Certificate of Exemption,you Mould
become subject no W Worker's Compensation previsions of W Lahm Code,you am
.JO raMwith comply with such Provisions o this Permit Awl W gmmed revoked.
CONsTRUCf1ON LENDING AGENCY
[—t IWreby affirm that there is a constructions Icndingalnmy for the Perrmmana of
W work for which this Permit is issued(Sec.3097,Civ.C.)
Q fenders Name
D z lenders Address
V Q 1 codify that I ban read this application and sum than the man information Is
0,� cortot I alta to comply with all city and county oNiwtas and sae laws relating to i
.C) Wilding construction.and hereby authorise representatives of this city to enter upon ft
fbl ahove-mentioned property for inspection purpovs
(We)agree m save,indemnify and kap harmlm the City of Cupertino against
n-t Qn liweili0es,judgments,costs and expenses which may in my way acoue against said City ,
V 7 In cavegnme of the gnndng of this Permit.
•7 AP UNDERSTANDS AND WILL COMPLY WITH ALL NON-POIW Issued by: Date
Re-roofs l�
Signuurc of AppliaDO Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
WIII the applicant or future Wilding tacco,parmstore r 9.1 u handle Halton mamriai
de0Sed Section
W Cupertino Mum I Code.Chapter 9.13,and the Health and Safety
.Scedon:ss32(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yrs Ne
MI]n W amWmt forum Wilding mmP.nt use equipment er devise whish If a roof is installed without first obtaining an inspection,I agree to remove
emll lovudnua d,ma I
raniand by Me Bay Area Air Quarity Management all new materials for inspection.
District?
❑Yes
I ban.adW requirements underChapter 6.95 of the Cattier (::; �\ . -_mss
nla Halth&Safety Cade.Secdon25505,25533md25534.1un owdthatifW Wilding
doer not currently ham a mnanL Wt It u my aarnewhilitY tomaty oaupan f the
.qui n mus metpdor to isseanco of a Conroe..of Sig of Applicant Date
Owner or w d agentDsue
All roof coverings to be Class"B"or better
n8o I o� c�`7
> CITY OF CUPERTINO
Q" REROOF
• CUPEkTINO PERMIT APPLICATION
APN # 3 `P l �O C7 Date: t _ bV
Building AddrecG d
s
o i CDT)o"itoOj�
Owner's Name: Phone #:
t-rrr4 cfoN ,4 —TTP u/
Contractor: Phone #:
k pjb °�DF/ Fax #:
Cupertino Business License #: Contractor License #:
2l5�!(P
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
Asphalt Shingles ,z" Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings 2 ❑ Provide I.C.B.O. Report #
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
Qiptvlo,rr-j( V-rl- 0;T jn,f lel Lq..Yt,<,. C�*_.... � 1
Tzzb Nl:w 3Nb7R COT
Residential Commercial
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation: �j
"7
•I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
CITY OF CUPERTINO
• REROOF
C1 or
CUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
2S, 1RER00FRES Re-roof Residential B 1SFDWLR00F
/ 1BSEISMICRE Seismic Residential B
1RER0OFMRES Re-roof Multi-Family B 1MFDWLR00F
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
•
• CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: " Lot:
APN . . . . . . . . : 36917039 :00
DATE ISSUED. . . . . . . : 01/30/2008
RECEIPT # . . . . . . . . . : BS000003809
REFERENCE ID # . . . : 08010167
SITE ADDRESS . . . . . : 889 COTTONWOOD DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : STIRRUP KEITH A AND SONJA M
ADDRESS . . . . . . . . . . : 889 COTTONWOOD
CITY/STATE/ZIP . . . : CUPERTINO, 95014
RECEIVED FROM . . . . : LINDY ROOFING CO.IN
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 7, 000. 00 0 .70 0. 00 0.70 0. 00
1BUSLIC FLAT RATE 1 . 00 110 .00 0. 00 110. 00 0. 00
1REROOFRES SQ FEET 25 . 00 325 .00 0 . 00 325 . 00 0. 00
---------- ------- ------ ----------
TOTAL PERMIT 435 .70 0. 00 435 .70 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 435 .70 #3418
---------------
TOTAL RECEIPT 435.70
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
605 FINAL REROOF
r —
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408) 777-3228
Fax: (408) 777-3333
Building Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to perm t 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 comply with the above stated policy on re-roofing.
/
Homeowner's Name: /��r -e-t' A OV Sidnya, 5-Ar�ru)O
Job Site Address: 961 C'p 1-�a,-) W oo ct pI^
Roofing Company Name: b tld \ /ZU 0-9n4 CU p
Applicant's Signature: Date: /— 2- / -o 0
r Greg Casteel
Building Official
Revised 11/2/04
Community Development
10300 Torre Avenue
ao
Cupertino CA 95014
Telephone(408)777-3228
f _ OCITY OF Fax(408) 777-3333
UPEkTINO
Building De artment
JOB ADDRESS: Q 0 q C`L7 .T--0n waQ� PERMIT #
U l _ o ( o ( d7
OWNER'S NAME: e, p s PHONE #6a5 0- ( -
GENERAL CONTRACTOR O �. FAX # —
I am not using any subcontractors: �.. Z 9'-` L. / &
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