05070162 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT e CONTRA5TOR INFORMATION
BUILDING ADDRESS' LINDY ROOFING CO INC PERMIT NO-05070162
7759 ORION LA
ER'S NAME: PERMIT ISSUE DATE
STANLEY FUNG 5554 HARVARD DR 07/26/2005
PHONE: SANITARY NO. CONTROL NO.
(408) 286-9990
ARCHITECI7ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
°00 LICENSED CONTRACTOR'S DECLARATION O O
til FF 1 Wmby affm that l am licensed under provision of Chapter 9(commencing Job Description
with Scotch 7")of Division 3 of the Business and Professions C de.and my licence is
nodinfIfnmeand y ���toj(� REROOF-REMOVE SHAKE . ROOF/INSTALL 30
Licmna Clu Lio N
-ro Dam Comrteto ��/ �� SQ MONIER LIFE LIGHTWGT VILLATILE
n� ARCHITECT S DECI.AR ION
uu ndcrst �py,plan,atoll
'.,:1 Licensed ' sal_\ FIIV
Oat lam exILDERempt
DECLARATION A ®
.�<a 1 hemby.('firm on 11. exempt from Ne Canons C License Law for she ayyvTSY
p o which ng mason. arch t 71131.5,Business and Prouwe.de oli h.or Any city m roomy
which rtyuires a pcmih m construct,alcor,improve.demolish,Or repair any avucmm
prior on its issuance.also requires duct applicant for such permit to file A signed moment
ESNarW islicenu)Pursuamno the previsions of Ne Conoamri License,Law(Chapter 9
Sq. Ft. Floor Area 105 VaIUI��OOO
91-0 (commencing with Section'7")of Division 3 of the Business and Professions Code)or
y Nos he is exempt therefrom and the buss for the 9legcd exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of APN NumberUIL r% ccU
Type
not more Nan five hundred dollar.(ssoo). 36218044 . 0
� Pane y yP
C11,as owner of the property,or my employees with wages as their sole compensation. LJ Go;
Will do the work,end Nc structure is non intendfoed or offered Bomb,(Sm.704,1,Burow
and Professions Cc&:The Contractor's License law door not apply to an owner of Required Inspection
property who buildsorimproves,hemon,and whodaes such work himliefor through his
own employees,provided Nat such improvements tie not intended ofoRered formic.If,
however.the building or improvement is sold within au year of completion,the owner,
builder MU have the burden of proving Nat he did not build or improve for purpose of
salt.).
❑1,as owner of the property,am exclusively contracting with limnsed convacmrs to
consumer she project(Sec.7014.Businw and Profwions Code:)The Conoamrs Li.
more law doss not apply to an owner of property who Wilds or improve Demon,and.
who contracts for such projects with a eomnnorta)licensed pursuant in the Commoner ....... -
Liccna raw.
❑1.m exempt under See. ,B A,PCBur Nis
.r Date ,.. .
WORKER'SCOMPENSATIONDECLARATION -
1 hemby a lm under penally of perjury one of Ne following duNatiou:
❑I ham and will maintain a Certificate of Consort to ulf-ituum forWorker's Compen- -
sation,as provided for by Section 37110 of the faWr Code,for the perfomance of the
work for which this permit is issued.
❑1 have and will m.inmin Workers Compcnsmio r Immom e,as¢q.imd by Section
37W of NC labor Cod,for tW performance of the work for which this permit is issued.
My Workcfs Coompc�naatio numoccaricr end Policy rlrumW art:
Gorier. �'ISW A YL�hVrllq Na.: `� w
CERTIFl TE OFEXEMPf10N FROM WORKERS'
COMPENSATION INSURANCE
(This action need our becompleted Vitae permit is Torun.hundred dollars(SIB))
or less.)
I certify Nat in the Performance of the work for which this permit is issued,I shell not
employ any person in any manner an as in become si to the Workers'Compensation
Laws of California.Dam'
Applicant
NOTICE TO APPLICANT If,after making this Cenifican,of Eacmp,ion,you should
become subject In the Worker's Compensation provisions of No Labor Code,you must
.J ,z roothwith comply with such provisions or this Permit shall W deemed revoked.
z O CONSTRUCTION LENDING AGENCY
F+ IMreby.(Tom hurt Vert iso rnuvucunn lendingagency for the perfwmance Of
a rte-.
the work for which did
e permit is issued(Sec.3097.Civ.C.)
A Undcr's Na oc
.7 z Lender's Address
U Q 1 ccnify that 1 have read this application and tram the,the above infometiun is
Lz f' correct.I agree to comply with ill city and county ordinances and sum laws mining b
0 U Wilding construction,and hereby Authoim representatives of this city to enter upon the
[g1 ahovcmenuoncdProperty
est fm inspection purpowhich may
y, (We)agree to ave,indemnify and keep harmless the City of Cupertino.,.lost
h intones, mOfth,costa and expense which may in any way accrue against aid City
V z A consequence of UNDERSTANDS
of AND WILL
.��� GST
^ APPLICAN UNDERSTANDS AND WILL COMPLY WITH AVL NON-POINT Issued by: Date
CER GULATIONS.
�" 7 2 Re-roofs ,Zt
S;g amrc ApphcamU omranor am
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future Wilding Occupant store or handle hsutreous mammal
as defined by the Cupertino Monte, I Code.CWPmr 9.13.and she He ld,and Safety
e. y. zss3z(a)+
❑ , All roofs shall be inspected prior to any roofing material being installed.
Ye
Will the applicant futhre building oaupium tea equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hanrdous air contaminants u fined by the Bay Area Air Quality Management all new materials for inspection.
,iatric' P
QYes No
e.
Iha ,get C Aon nomm Ma.25533 Z5n .der ChoPmr6.950fthc Califon
ria Hcoltcomemc,y Cade,loomr, hatitUs my
indcrsmndlhm scup Wilding
dma oto ndy Moa meant.that it i<my mspouihilitytonutify do acupans or the
moi xm` rpoor toiaa aervcamor ma ey. atureofApplicant Date
`� Z4
ownerdi-inns dyedsent D,te All roof coverings to be Class"B"or better
aTYOF
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
09UPIINO Fax(408)777-3333
Building Department
JOB "OMTq O I-1 D/�1 �..9 , PERMIT #
( � DSo-7a/6- 2
OWNER'S NAME: Trtwt PHONE # OLO-RR
GENERAL CONTRACTOR: FAX # /
I am not using any subcontractoi's:_�
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
CITY OF CUPERTINO
, m 2 of 3 PERMIT RECEIPT OPERATOR: suem
COPY # 3
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36218044.00
DATE ISSUED. . . . . . . : 07/26/2005
RECEIPT #. . . . . . . . . : 30514
REFERENCE ID # . . . : 05070162
SITE ADDRESS . . . . . : 7759 ORION LA
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : STANLEY FUNG
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-5000
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 10, 000.00 169.56 0.00 169.56 0.00
BSEISMICRE VALUATION 10,000.00 1.00 0.00 1.00 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 170.56 0.00 170.56 0.00
Community Development Department
Building Division
City of Cupertino
r^ y 10300 Torre Avenue
CITY OF Telephone: (408)777-3228
CU PEI�TINO 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: f�S�A-YU L c �
job Site Address:
Roofing Company Name:
Applicant's Signature r �j.�—V� Date:
• Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
CITY OF CUPERTINO
(11 ZK_ RFROOF
CITY OF
�CUPERTINO PERMIT APPLICATION FORM
cv,3 & 1
APN # 3(f//� / ,?a / ate:
Building Address:
-7.7 5'7 Orlon Lan-e,
Owner's Name: STPo7 j L 7� Phone#^d 55- (
Contractor. Phone ULicense#:
1 � Q _"D a 58'/
Contact: Phone Cupertino Blisiness Lc
e
nse#:o&-on , qoz
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
�d_ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles � "� � ��,,,,
C3 Other(Specify) ,' Other(Specify)CSftCXcete_ Tt CQ
Number.of existing coverings ❑ Provide I.C.B.O.Report# n
El To be Removed A Provide Mfgr.Installation Specs. M07I.0-11A
ANAI //0.7
I Have Read, Understand and Will.Com 1 With Cu ertino's Tear Off Policy:
Job Description: reMCIVP- ^`� fro zn in 30 gC�areS
(S � M01Lerh.R Gr h n 0- kV/O--r,1, 96CC -no Skt. --r4„ WCA 44-
Residential f5r, Commercial ❑
Fire Zone: Yes ❑ ' No ❑ Confirmed with Planning Det. if
there are any restrictions: LJ
Co to Project: Type of Const ction: Occupcy group:
/0000. Ov ge
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