06080198 (2) CITY OF CUPERTINO �° ar idrnc"Po??"
BUILDING DIVISION PERMIT RCUN It'A a yTNPO" , ATT ; ,
BUILDING ADDRESS: LI ROOFING CO INC PERMIT N006080198
20968 FAIRWOODS CT
OWNER'S NAME: PERMIT ISSUE DATE
REBECCA ZHANG 5554 HARVARD DR 08/24/2006
NE: SANITARY NO. CONTROL NO.
(408) 286-9990
ARCHITEC1ENGINEER: BUILDING PERMIT INFO
0 0 0 0
aQ LICENSED CONTRACTOR'S DECLARATION JOb Description
S 1 Mreby af0rm Nu I Am licensed under previsions of Chapter 9(commencing Job
IN Section 70M)of Division 7 of Lae Business and Profession Code.and my license is
'1 n
fall forceand e a1,.3 Z� S Ute( REMOVING EXISTING WOOD SHAKE ROOF & LOW SLOPE
Lm'" INSTALLING 1/2" OSB WITH RADIANT BARRIER, 30# F
RCHrtEcrsD�FcuxnnoN 33 SQUARES OF LIFETIME COMP. CLASS A
i < 1 undcnund my plans¢hall W umd u public records
'w
u In Licensed Pm(cssional
t03 OW NE R-BUILDER DECLARATION
'm I hereby a(Rmn(Section n 1 em uemps from Lae Cssum. od License Law for Lae
O O following rcuon. ¢moott7031.5 osm Businessoreand PraImprove,
dem li Cale:My city or aunty
'9 m which mquireaMU•permit w in=t L situ.i t for Rich
demolish,m repair naY awetum
liy past aihesl icnwdpua nlqui ftpmapiounf rsuchpermit m Rlea Lw(ignal swemenl
G tsetheisllccnsedpurRuntrotMprovisiouofdmCanummr'sLiceucfaw(Clupmr9Sq.Ft. Floor Area Valuation
I� (eommeming wish Section 70W)of Division3o(tbe Busineu and Prafrssiam Code)or '$20000
3 Nat he u exempt Laercfrom and the bub far um alleged emmpdm MY AOMMA of
Section 7031.5 by any applicant for a permit to applicant to civil penalty Of APN Number Occupancy Type
not more dun Rw Wadmd dollars(SKID).
❑1,uownmor the property. rmyatimcmde for Aide
mm.Band n,
will drLaewaek.endure heCombwes Licmara.do farwapply 7014, iiMu Required Inspections
Add property
who u Cmc:The Cemncmrs and
who Law dare not apply if r L owner of q P
ownenywho s.pmicd m es suchIm rove who Arm net
hende himslfarLarough his
awne er.We Wilding
T Improvement
i mid wit tie oat Intended aroRerm for Ole.V•
however,um building orded o pervinb mid within am yeti ofcampleua r Lae owner.
"Is.). M0 haw the WNm of proving that Ire did not build Or improv for propose of
nale.I.
I,u Owner of the property.am exclusively contacting wits licensed cantrmmn b /
coutrom the proJen(Sec.7044,Business and Profassiou Code:)The CoMMUMA'4 LI- /
acne law does sot appy in an under or property,who Wilda Or Improves Mareon,and. L/
who contracts for such projects wits a canvactor(0 licensed purswnt mum Contrxmrs ^v
Lleeue Law.
0 lamuemptundesSec .Bh PCfar Oismuan
weer Deb
WORKER'S COMPENSATION DECLARATION '
hereby affirm under Penalty of perjury ore of tk fallowing declmatiou:
I have and will mamunin aCeNOcam of C..AIin selM1luum far Warner.Compen-
nation,as provided for by Section 3700 of to Labor Code,for the performmca of de
work for which this pamit is issued.
w add will madonna Workers Compensation Insuee ce,u ruquired by Section
700 of the Labor Cade.far to performance of to work fur wbich Lab permit is Wted.
My Worker Compennation I�°nca 'ar end Poll nr��` '1 Q
Carver. -T 1' Policy No.: Antic CJS 2 B `D
CERTIFICATEOFEX PILON FROM WORKERS'
COMPENSATION INSURANCE
(This mcdm need mtbecompleed if tie permit is faranc hundrcddo0an($10n)
or less.)
I cenify That in Me performance of Lac work for which this permit is ivaed.I shall net
employ mypenon in any mmner an in as become abject to tie Worken'Compensation
Laws of Califomis.Dam
Applicant
NOTICE TO APPLICANT:If,afar making Nb Certificate of Emmptiou,You should
became aubjm in the Workers Compensation provWom of don lahar Codeyou mut
�z foMwitscomply with men pmvisiouorflus Permit shall IM deemed revoked.
.zi O CONSTRUCTION LENDING AGENCY
[-i1 lurchyaflirm that Nen ie a construction lending agemy for Lac performance of
'X•7 Lae work far which Lala permit Is Issued(Sm 3097,Civ.C.)
QLenders Name
z Leaders Address
U Q 1 anify Nn I haw rad his Application end sum Nn the AMw information is
D. F torten.I agree to comply wits all city and county aNlnueesend sum laws mladng m
�U building canswction,and hereby aunharim rcpm=nuoivca of Nis city to cmcr upon the
r W above-mentioned property for iupeNon purposes.
a (We)agree to an.indemnify and keep harmless the City of Cupertino agaiut
rFu rA liabilltica,Judgments.costs and expcues which may N my waymcme againstmid City
U z in coasequmme of the granting of Laic permit.
CANT UNDERSTANDS AND WILL COMPLY WITH ALL NON- INT Issued by: Date
SOUR EGULATIONS. N
`". ^--- (e 2 Re-roofs
rc o
HAZARDOUS
Dem
HAURDOUSMAng Occupant
DISCLOSURE Type Of Roof
Will ft applicant m faun Wilding nccepant smrc or handle huWou mamrisi
As
OeOned by the Cuperti7Muni Code.CTeper 9.11,roti tie Haalts and safety
Cada,Suction 15531()? All roofs shall be inspected prior to any roofing material being installed.
❑Yu will Lae applicanding acupeu use equipment or tkvlara which If a roof is installed without first obtaining an inspection,I agree to remove
emit Mi.Rdous air cWtuniewu Hoed by Ne Bay Arca Air Quality Management all new materials for inspection.
District? .
❑Yes Nu
I haw read Nc hvuGsumamridsrequircmcrosundcr Gepmr6.95ofue Glifor-
ria HcalLa@ssfeLYCOde Semau15505.15533uv13l534.1taxerpowdidualf, Wiinldg VVV l(J
data mi currently haw a Meant,Nat It b my responsibility to nodfy the occupant of to
m whk�`be met priormiuu�o1 jemscam qfa pan<y. Sig eof Applicant Date
Ow umarvadagent Dam All roof coverings to be Class"B"or better
CITY OF CUPERTINO
Oem 1 of 2 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35913109 . 00
DATE ISSUED. . . . . . . : 08/24/2006
RECEIPT # . . . . . . . . . : 35750
REFERENCE ID # . . . : 06080198
SITE ADDRESS . . . . . : 20968 FAIRWOODS CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : REBECCA ZHANG
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
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 20, 000 . 00 277 . 56 0 . 00 277 . 56 0 . 00
BSEISMICRE VALUATION 20, 000 . 00 2 . 00 0 . 00 2 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 279 . 56 0 . 00 279 . 56 0 . 00
•
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
CITY OF Telephone: (408) 777-3228
CUPEkTINO Far (408) 777-3333
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
r 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 rrurdnnum 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'sName: �e.loeC_c.o-. Z,
Job Site Address: �2wi(aS F-GtrU aos GT
Roofing Company Name: L--tr%G&e.t Co.
Applicant's Signature: 'til k k _� Date:
• Greg Casteel
Building Official
Revised I (/2/044
Printed on Recycled Paper
CITY OF CUPERTINO
REROOF
• . CUPEkTINO PERMIT APPLICATION FORM
API# 3tR^
Building Address:
Owner's Name:
Contractor: Acne#: License #:
L.n UJ7 1 u . &ld-
Contact: P ne :Cupertino Business License #:
wendy8 quo oz 1,5 8
Type of Roof Covering:
Existing: Proposed:
O Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles W_ Asphalt Shingles
Wood Shakes ❑' Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
Other(Specify) l o w sl d p2— ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O.Report#
�1 o be Removed ❑ Provide Mfgr.Installation Specs.
I Have Read,Understand and Will Comply With Cu ertino's Tear Off Polic :
Job D seription: rem0.0,n3 ��si.%+} +Ve Shag � a cow s epe-, (-S c_ *�J.
636t"'�i¢al..,fi(iaswr.;r 3oFa-
Residential Commercial ❑
Fire Zone: Yes ❑ No,0L Confirmed with Planning Dept. if
there are anrestrictions: LI
Cost of Project: Type of Construction: Occupancy group:
20 000 4-� —Cc^5t-a—
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
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