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06090012 (2) ------------ CITY OF CUPERTINOa,,wyyw tt +f'�° BUILDING DIVISION PERMIT � col! 1j AC e Tt T1 BUILDING ADDRESS: LINDY ROOFING CO INC n_ PERMIT No.O6O9OO ZZ 10366 HENEY CREEK P OWNER'S NAME: FERMITLSSUEDATE FEN CHOI 5554 HARVARD DR 09/01/2nn6 NE: SANITARY NO. CONTROL NO. (408) 286-9990 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH o p LICENSED CONTRACTOR'S DECLARATION lob Description b 1 heroby affirm that 1 an licensed under Pro small of Causal (commencing with Section 70M)al'Division 3 often Business and Profeaiav Code,aro my license is ,�„ Inraliracewder RE-ROOF - REMOVING EXISITING SHAKE ROOF, ISTALL Z Lice Clsss Lle. �� �� !�� oafe��ca�,aca 1/2" OSB WITH RADIANT BARRIER, 30LB FELT & LIFT I understand my plug shall Aused ss Public mcnNr n shall he seuDEC mnON DIMENSIONAL COMP SHINGLES CLASS A ��< myU �ij Licensed Professional OWNER-BUILDER DECLARATION i0 1ft hereby ,zy farm that 1 efrom Communes Law far he •Oo following mea..(Section7m1.4 Business ad R ewc:My Cly Of county $onwhich require•permito musical,alloy,i -demolish,lir cash rwthe priormiuiasmncc.alwfcquirestheapplieutforsuschpcmi(to0leasgnedsulemen' Valuation < that he is licensed paac ment to due provisions of the Contractor's License Law(Cluper9 Sq.F[.Floor Area js a (commencing with Section 7010)of Division 3 of the Business and Preamm"Cnde)or $17000 15. that he u attempt dica chroln and the basis for the alleged eemptart Any vl.1=)a( Secdw 7031.5 by any applicant far a pewit subiccu the applicant to a civil penalty Of APN Number Occupancy Type not more than five hundred dollar,($300). ❑L,ummusrafte Property,or my employm with wagesss theirsoleeampewtion, wiildoLhe"6.�tasnwtumiswtintewedarmreadfofame(SW.70".Bumas Required Inspections ad P cfeasae Code:The Conuactara LKena LJw does Ml apply M sm Owner of 9 property who builds or improv thecon,and who does awh wolk himulf or trough his own employed,provided that such improvements ss at mucaded araaered fors le.IL however,the building or haprovement is told within ane Sear ofcompieuon.ons owner. builder all have the burden of proving tat he did w,build or improve fur Purpee of oak.). ❑1,as owner of the property an exclusively celfrct its with Ikensed contactors to construct the Project(sec.7044.Business and Professions Cade:)The Comome rs U. came Law dean not apply man owner of propertY-W WilEs ar improv thefcan,and, who contacts for such projects with a conumetor(s)licensed pursuant to the Comractoh L'aense Law. ❑1 an exempt under Sec. .B At P C far the wan ownerData W ORKER'S COMPENSATION DECLARATION I hereby aBhm penally ally of Palms,one of flue fallowing dalaram.:d I have mal will maintain a Certificate of Counsel to self-inwm for Workers Compcn- adan,u provided for by Secuan 3700 of the labor Code.far to perforassnce of the were for which this Permit is issued. 1 have rod all maintain Waiters Compensation Iruaruce,as squired by Semon 3701 of dle labor Cast.for tat performance of the wart forwhich this Permit as Issued. My Wark1ces Compensation Insurance artier and Politynumber sc: ........7ng•Y-C 4:11),10 Policy No.:!%S4 ZB�9'-0.6 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE ('Thu awed need nothccompleued if robe permit is fosse hunamsdallm($10) or less) 1 certify that in the pefa..me of the work far which this pewlt is innucd,I shall nem employ any person in any muneru as m became subject to do WortrrY Compensation U.of C.Mifomis Data Applicant NOTICE TO APPLICANT:If.after making this Centfiam of Exemption,you should becalm subject to the Worheh Cumpntsadon provisions of due labor Cade,you most .J Q foMwith comply with such provisions or the Permit Nall he accrued ranked. z tiCONSTRUCTION LENDING AGENCY (-n Iheabyaifnm Nal them u a cemmfuctlnn lendingageney far the periarmuweuf IY> due work ser which the permit is entad(sea 3097.Civ.C.) W�tj lenders Names z Loaders Added U Q I anify that 1 lane read this appliate aro ruse that oc Obote infomudun I- U Uf P correct.l agree to comply with all city and county ordinance and stale tan coming to 0 U buildiagconswction,awhecbyautho6mfcpnuenulivof Nischyloenlarupnnoe a above-mentioned property for inspect.purposes. (We)agce to U. indemnify and trop harrnlrss the City of Cupertino against ,F-m r/1 liabiliuesjodgments.costs awexpensu which may in any way morose 1,10.1 aid City ,'Z U in consequence of the granting of this permit. l ,..i APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. ) 'ln I S`–a.— - - C� Q—l-(�o Re-roofs Saingund of AppliantlCoolractor ale HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building=put stme,orhudle hmaadou material as de0rued by sue Cupertino Municipal Code.Chapter 9.1;and tit Health and Safety Code,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes A)4 No a cuwIf a roof is installed without first obtaining an inspection,I agree to remove Will the applices,or fugue,building ,at use opm m,a devices whim .mit IwaNne air cmumiwu at defmcd by the Bay Acs Air Quality Mwgcmet all new materials for inspection. District? ❑ye a-$N. 1 here fcwd the hnardouammdae cquimrucnu underCMpuer6.95 ofthe Cdifor. ne Health&SafetyCade.Seetiens ZS5o5,25533aod25534.1udsmaodthatlfthe Wiloing does not cascOy haw a memos,tat it is my responsibility to notify sue occupant of due mequicmenus which must be met pilar to issuance of a Ccrefcsse of Ocwpanry, (_ Signature of Applicant Date G' -! All roof coverings to be Class"B"or better O uihofvued a,cnt Dam 7' Community Development 10300 Torre Avenue aClOF Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 toUPEI�TINO Building De artment JOB ADDRESS: 1 03 6 G en QY Cc-4,c tc K. PERMIT# O OWNER'S NAME: G o r PHONE # qQ tr-,;IL86 -F97(0 GENERAL CONTRACTOR: c ' o ri FAX # I am not using any subcontractors: _C� 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 Community Development Department Building Division City of Cupertino • 10300'Torre Avenue CITY Of felephone: (408) 777-3228 CUPEkTINO Far: (405) 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 and written approval from the building uispector. 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 utstallation. 11 plywood is unstalled, a plywood nail inspection is re,uirLd. 6. Any roofing which is applied without first obtaining an uspection, 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 mininnum 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: te^ lob Site Address: Roofing Company Name: LI��C/i U?7i�iGr Applicant's Signaturef J � c Date: `d� ' Greg Casteel Building Official Revised 11/2/04 Ponloo on Racycled PVer CITY OF CUPERTINO �m 2 of 2 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 34248032 . 00 DATE ISSUED. . . . . . . : 09/01/2006 RECEIPT # . . . . . . . . . : 35888 REFERENCE ID # . . . : 06090012 SITE ADDRESS . . . . . : 10366 HENEY CREEK PL SUBDIVISION . . . . . . : CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . : OWNER . . . . . . . . . . . . : FEN CHOI 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 17, 000 . 00 245 . 16 0 . 00 245 . 16 0 . 00 BSEISMICRE VALUATION 17, 000 . 00 1 . 70 0 . 00 1 . 70 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 246 . 86 0 . 00 246 . 86 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ CHECK 406 . 52 2215 TOTAL RECEIPT 406 . 52 •