02060065 (2) CITYauiLDING DIIVIISIONNOPERMIT ! CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
20693 GREENLEAF DR LINDY ROOFING CO INC 02060065
OWNER'S NAME: APPLICATION SUB DATE
CHOW RAYMOND ' L AND HEIDI N TRU 5554 HARVARD DR 06/12/2002
PHONE: SANITARY NO. CONTROL NO.
(408) 269-2025
O O ARCHIfECUENGINEER: BUILDING PERMIT INFO
FF BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under pfovisiona of Chapter 9(commencing Job Description
yt� with Section BOB fD' isr in3of the Business and Ploteesions Code.end my he...a REMOVE SHAKES, INSTALL 40 COMP. SHINGLES
in tall forte and a act,
:0,L) License C ss �z9 Lia.can,
-e a, Dae SDECLAR / Y FIIIV I�
r a O t4 A CHITECT'S DECLARATION
g 1 understand.,,I...shall be used as public records t
T
3 i o Licensed Professional -10
OWNER-BUILDER DECLARATION JULZOOZ
w I hereby uffnn the(1 am exempt from the C.m."tu a License Law for the
t: < following reason.(Section 7031.5,Business and Profaeionn Code:Any city or count
{{ D which requites a parmo m construct,are,improve,demolish,or repair any strarbam $13000
i�73$ pdortoits issuance,also requites me applicant for such permit m file a signed statement
_.. ..
that he isficabind pursuarim thepiovisions ofthc Contractor's License Law(Chapter 9 n,-�- .�c�p. F r-{�[Qa- 'f r. Valuation
(commencing with Section,70 )of Division 3 of the Business and Professions Code)
or met be is exempt therefro....d the basis for the allege)caemptbv.Any violation
-of Seniom]031.5 by any applicam for a pmnit r the all the npplizznt to anvil penalty �t �y
I of not more than live hundred dollars($500). 30SAPN 1N Wlft rt'.:1 Occupancy Type
01;as owner of the property,or my employees wish wages as their sole compensation, y i TT
,will do the'wmk,'ard-the locctum is not intended or offered'for'at(Sea:70,14, Ins QChODS"
'Bus ss and Professions Code:The Comructor's License Law does not apply to an 601 - ROOF TEI�gOyP P
Business
of property Who builds or improves thcrmn,and who does such work himself 6 02 - ROOF_PLYWOOD NAIL
owner
or through his own employees.provided ma such improvements within
net intendedyear of
oRered'for selcaL however,the building or imProvemcm is sold within one Year of . ...
completion,me owner-builder will have the burden ofpmving mat he did not build or 603 - ROOF BATTENS - " -
improveforpurpoaenfaalea. 604 - ROOF IN-PROGRESS
OLasowner ofthe pmpenYom exam ly
contracting ith live.%d eto
t nm
C construct me project(Sec.]044.Busine d Professions Cml:)The Contractor's yi 1
e
License Law does not apply .an owner of property who adds or i npowel t lmom -
:: .send who comruct,,mr.,aelr.pmjeciawith iiconunemr(s).licensedpunuant lo.the ._.... ............ .. .. ..._.___._,. _.....- _.._ _._ A
_ Combouto s License Law.
O lam exempt under See.'i ,B&P C for this reason r ,., 0!- "Date e -
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury,onc of the fMlowing declemtions:
❑ I have and will maintain a Certificate of Consent to self-insure for Worker's
Compensation, as provided for by Section 3700 of-the Labor Code, lot the
performance'of the work for which this permit is issued,
01 buyer told will maintain Worker's Compensation Insurance,ai required by Section
3700 oCtbe labor Code,for:the performance of the work for which this permit is
it raJMyW kers Ccurn,yortho Insurance carrier and Policy numberme:
Cam �hs Polic)No: c
r •.CE AI NO .EXEMPTION FROM WORKERsi' 'A� F l,'� sls ^.k� vNY Fv r ` k 1.1 t) I 1:1'C�
•
..0 t COMPENSA-TION INSURANCE --------- .. . _
d. t(fms sebfonn door M1e co nplded fthe pennl isf ¢hundred Jnllsrs c
($100)of less.)
I comfy that in Person
pert ret 7 ar in
h h u pt to t a Iss ke 1 f .. -. - -• ..__:. _.
shell not employanype son m any manner so as in becomdmblen to the Workers
Compensation Liws of Califdmie.'Dam'
NOTICE TOAPPLICAN-D If,W,i aftermakingthis Certificate of Labor lode,you must t•.. :- ,
O Z b¢h forthwith
comply n theta h fa Colons ondnpr lions ore Loo CWe you must
ith h provisions or N perm t shell b dimmed revoked,
LF.� !(' a - i"' CONSTRUCIONLENDINGAGENCY
ai - • I h by affirrit that them is a construction lending agency for me pelf ion ence ,
of the work for which this perm tis slued(5 3097,Ci
me
Leder%Na '.._t.
Lender's Address
V'0 I ernify Nat I have read misapplication and state that me above information is '
roved 1alumina
g e to comply with
all city cand county se
nd enc d state laws relaing
to budding construction,and hereby monsoon representatives of this c ty to mer upon
he ab e e)m oned Property speuon initiatives.
(We)agree m a t ranify l/-/'////✓�„P-1 S/
^ ^
and keep harmless i me Cuy of Cupertino to at,[
V] Ct liabilities,3udg cots,costs and xppnses h h may n any y gamst saiA
V City to uq coca of thegrsnung of this permit.
APPLICANTCNDERSTANDS NO WILL LY WITH ALL NON-POINT'" 6
SOURCE ULAT1 + Issued by: Date
&v•i7_Dn
Signorina,[Applic sec cor •"- - Date ',: Re-roofs
• AZARDOUS A7ERIALS DISCLOSURE ^
aweous mationd Type of Roof,,
as defined io me32m),Cupertino Municipal Cod Chapter 9 12,and the Health and Safetyt -
Will a c t orhtt
❑Yes i,-:a4 m u ng occupam store 1 t i n .
P
Code Sttu n 25332(
__ All roofs sFiull,be.inspec[ed.pnOr to-any roofing materia] being,installed.._
w n m appli a t ,t building- occupant me equ im t device%-wh eh If a roof is installed without first obtaining an inspection;II'agree't96 remove
mutt sero is air conundrums as defined by the Bey ArtaAr Quality Managcmrnt
r,ah
bowl all new materials for ins ection. Applicant understands and will comply withYea ONo .._ _ - - -
all non-point'source regulations :k,,,, -1 he mad me h>a dour materalsrequirements'and r Chapter 6.95'of the
f iota Health&Safety Code'Sectiors 25505 25533 and 25534 I understand that'
f theWldng dries notcurrently hve a tenant that n is my responsibility tonnify the' -- '- •- - - - -
accup t f the re,h menu worth most so m iss n e of a Canape of
Occup
1 " Signature o [cant Date
owner or aatnonae t- Dae All roof coverings to be Class"B"or better "
-OFFICE-
Building Division
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
ICUPEkTINO
Building Department
Subject: Reroofing policy for the City of Cupertino.
1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards
and manufactures specifications on reroofing.
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 reroofing 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) Preinspection 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 that the
proper City inspection can be performed.
IMPORTANT:
1. Flat roofs must have a minimum of 1/a"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 of inspection.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name:
Address: P. 01
Reroofing Company Name: G i [� . �i 1111��e
Applicants Signature: Date:
Joe Antonucci
(Chief Building Official)
6/25/01