08040073 (2) CITY OFC UPERTINO
BUILDINDIVISION' PERMIT A+o1l+l �QA� C.}Y,Z. ta.TTf)� "
PERMIT NO.
BU"'YWRTE'LINDSAY AVE LINDY ROOFING CO INC 08040073
OWNER'S NAME: PERMITffiUEDATE
NEWTON DONALD E TRUSTEE 5554 HARVARD DR 04/10/2008
F— (408) 286-9990 SANITARY NO. CONTROL NO.
ARC HITECTIENGINEEK: BUILDING PERMIT INFO
BLDG EIYCf PLUMB MECH
0 0 0 0
woo LICENSED CONTRACTORS DECLARATION Job Description
1 bunchy arrive that 1 am Ikaned under provisions of Chap cr 9(commencing
n
willb Secdon7")ofDivision 3 othe Business and Prorcumns Code.and my license is RERF, INSTL 30#FLT 28SQ CLS A ARCH DIM COMP 30YR
in full race am e8
jy. Wcenso
e W Dam Canuect.r
LS ARCHRECI'S DECLARATION
e 1 understand my plana shall bo used u N1,11!mord
1y
B red Licensed Professional
S N OWNER-BUILDER mDECLARATION
0 1 hmu .(Sero than 11. exempt s a the ContractorssCoLivens Law for the
5❑9 following mum.(Section 7o L3,Business tad an.demolish.moll Cade:My miry or county -..
$ which m-yulms a email re cnmuun,dime.improve, ormiLLor mesh ed nnoutum
Z_Y pn.aiucensecc,alsontto to the
ovisiapplicant altar ouch crmLicaasLadatatemem
that he is licensed pursoam to to provision,allude Connector',Business $7000 Law(Chapter SQ.FI. Floor Area ,7000 Valuation
(commencing with Section 7000)mf DiH,ian Sof Ute Busine4 and Pro@uiovu Code)or
.. than he is exempt therefrom and Ue basis for the alleged exemption.Any violation of
Section 7071.5 by any applicant fora permit subjees the applicant a a civil penalty of -
yy7af Number - Occupancy Type
hat man than Eva hundred dollars(6300). 3691201,!V CI'
❑1,u owner of to property,or my employees with wages as their solecompewtion,
wind.the work,and thesbucture iaa,inended..R.ed forsake sax.7044.Business Required Inspections
and Profession,Coda:The Comments License Law d.not apply a an own.of til p
property who builds.improves thereon•and who does such work haself or through his
own employees,provided that such improvements are notintended ea@rod f.ule.if.
bowevea the Wilding or improvement is sold within ane year comnitled.e,thd urnal
Wilder will have the Wreen of proHng mat he did ant Wild or improve for purpose of
Limy
❑1,as owner of the prepany am emulatively convecting with licensed contractors a
c.asinM the project(Sec.7016,Business and Profession,Code:)The Conuaeer's U.
«ne law does not apply he an owner of property who Wilds or improves thereon.and,
who contracts far such pajecu with a corma ctugs)Keened pursuant in the Canuacmrs
Lkene Law.
❑Iamesunplund.sx ,BAPCf.Ihtseasan
Owner Data
WORKERS COMPENSATION DECLARATION
I hereby afore under penalty of perjury aro of Lou rollewing declandons:
I lux ve and will noaintsin a CeNftcate,of Contest o.1 Wash.for Worker,Compere
satire,as provided for by Section 7700 of the labor Code-fm the pevfarmence of the
work for which this permit is issued.
❑I base and will maintain Workers Compensation Insurance,a required by Sudden
3700.1'the labor Cade,rear to pevfemace of the work f.which this permit Is issued.
My Workers Compeasadas Imsunalrtie�r sand Policy number
CERTIFICATE EKEMPI70N FRo.: RKERS'
COMPENSATION INSURANCE
('Nis sectim need not be completed if the permit is for attic hundred dollars(5IM)
or Mss.)
1 certify that In Lou performance of the work for which this permit u issued.I shall net `
..play any person in any msonerem as m become subject a the Workers'CompensWon
Law,of Califomis.Data
Applicant
NOTICE TO APPLICANT.If,after making this Ceniftcau of Exemption,you should
become subject to tW Workers Compensation provisions of the Labe CtHe,you most
wJ 0 (oMwilh comply with such provision,or this Peed shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I,)
[—h Iherehy afRve tut Nen is a commuednn lending agency far the performance of
CYi> Lou work for which this permit is issued(Sec.3097,Civ.C.)
lyl 0 Lender's Name
z Lenders Address
V 0 I certify that 1 haw read Nis application and sum that the above Information is
w f� comom I agree m comply with all city and county ordinances and Ilse laws RINn6 t.
Wilding construction.and hereby authoned representatives of this city to enter upon the
4i7 above-mendoxd property for Inspection purposes
LL (We)agree to taw,indemnify and keep harmless the City of Cupertino against
ww cal liabilides,Judgments,casts and expected,which may in any way served against said City
t.)Z in consequence of the Boosting of this permit.. Date
H APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL N N-POINT Issued by: P
SOURCE RE ULATIONS. r
C—T� Re-roofs
sigleftuattrApplicanvotearractuar JD.tc --
HAZARDOUS MATERIALS DISCLOSURE Type.of Roof
Will the applicant or future building uccupaul.e arhandle in Mous material
as de0ncd by the CupevOa Municipa rods.Chapter 9.13,and use Health and Safety
Com.Sued..M5334)? All roofs shall be inspected prior to any roofing material being installed.
Yu a
Will the applirat or forum Wuildiog occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
it huNus
emsic cmeminan"u fhned by the Bay Ama Air Qualify Management all new materials for inspection.
District?
❑Yes u
Ihave read the h donsMriatsmquand255undert]ourod d93afthd Wilding
ria HealthkSalelyCode,sredms otitis 3A 3and753J4.landentade occupant
tofthe
does not currenllY Nos a IenanL Nu It u my mryon,ihiliry a notify�¢cupanh of the
requirements which must W metpd.rta measurers Certificate of 10 Pan SI of Applicant Date
L_
,�,��•--- 0 All roof coverings to be Class'n"or better
honored agent m
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36912011 . 00
DATE ISSUED. . . . . . . : 04/10/2008
RECEIPT # . . . . . . . . . : BS000004436
REFERENCE ID # . . . : 08040073
SITE ADDRESS . . . . . : 10369 LINDSAY AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : NEWTON DONALD E TRUSTEE
ADDRESS . . . . . . . . . . : 10369 LINDSAY AVE
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4517
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
1REROOFRES SQ FEET 28. 00 364 . 00 0. 00 364 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 364 .70 0. 00 364 .70 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- -------------------- .
CHECK 364 .70 #3497
---------------
TOTAL RECEIPT 364 . 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
o�u� 003
CITY:OF C,UPERTIN_O.
-. REROOF !:
CUPERTINO PERMIT APPLICATION
APN # � � O � � � � Date: —yam o
O
Building Address:
10-369 Linclsa fie:
Owner's Name: Phone #:
T6AG , LID 49- .3h(�?- 6aS8
Contractor: Pho e #:
(!�� �v6f7✓) Co Fax #: o _
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed: '
❑ Built-Up Roof _ ❑,,.,Built-Up ,roof
W Asphalt Sh nglgs "Built
Shingles '
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles - ❑ -Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings�_ ❑ Provide I.C.B.O. Report#
rql To be Removed _ ❑ Provide Mfgr. Installation.Specs.
37 -0 / -Job Description: I-eMGZ /_
(nsl4/lrn5 3a �`l (� Ct�d , a8 Syvare� Djc- Gt.e"�
Residential Commercial
Fire Zone: Yes ❑ No ,� Confirmed with Planning Dept. if
there are an restrictions: [5
Valuation:
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
La
Sigtatide
CITY OF CUPERTINO
REROOF
�UPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
Z� 1REROOFRES Re-roof Residential B 1SFDWLROOF
1BSEISMICRE Seismic Residential B
r
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF .
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
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 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 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:
Job Site Address: +[03 h
Lf
Roofing Company Name: L—I n a L1 R p 6 4/l d -
Applicant's Signature: Date:
Greg Casteel
Building Official
Revised 11/2/04
x - Community Development
k✓ 10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
UPERTINO
Building Department
JOB ADDRESS: / 036' / �� PERMTT0 � k o DO-)-3
OWNER'S NAME: :7-6 /7p L ,0W PHONE #
GENERAL CONTRACTOR: L j hO G FAX #V0
O -
C� 0
I am not using any subcontractors: .Lo Q C_._
ature 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
J�
Owner/Contractor Signature Date