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10090003 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7647 SQUIREWOOD WAY CONTRACTOR:LINDY ROOFING CO INC PERMIT NO: 10090003 OWNER'S NAME: JOHN POOLE ,<76 W TAYLOR ST DATE ISSUED:09/01/2010 ;R'S PHONE: 4082572613 SAN JOSE,CA 95110 PHONE NO:(408)286-9990 (� LICENSED CONTRACTOR'S DECLARATION 3UILDING PERMIT INFO: BLDG ELECT PLUMB r License Class Lic.# Z 1 5 10 MECH r RESIDENTIAL r COMMERCIAL r Contractor L t7 ZC"Z�i ti` Date f 6 I hereby affirm that am licensed and the provisions of Chapter 9 IOB DESCRIPTION:RE-ROOF TEAR OFF,NO RE-SHEET,INSTALL OWENS ORNING (commencing with Section 7000)of Division 3 of the Business&Professions MASSIC CLASS A 23 SQ Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: 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,for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$12266 permit is issued. APPLICANT CERTIFICATION APN Number:36227011.00 Occupancy Type: I certify that I have read this application and state that the above ffiformation is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 4�� ` I f� Issued by:, i'"" Date• % -(v Signature Date LL OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, ' Signature of Applicant: Date: Business&Professions Code) / 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Safety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must Owner auth nt e. > forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save -�mnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address s,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. � I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 36227011 .00 DATE ISSUED. . . . . . . : 09/01/2010 RECEIPT #. . . . . . . . . BS000011348 REFERENCE ID # . . . : 10090003 SITE ADDRESS . . . . . : 7647 SQUIREWOOD WAY SUBDIVISION . . . . . . CITY CUFERTINO IMPACT AREA . . . . . . OWNER JOFN POOLE ADDRESS . . . . . . . . . . : 7647 SQUIREWOOD WAY CITY/STATE/ZIP . . . : CUF'ERTINO, CA 95014 RECEIVED FROM . . . . : JEFF RAINEY CONTRACTOR . . . . . . . : RUbIFORD, LINDY LIC # 3921 COMPANY . . . . . . . . . . : LINDY ROOFING CO INC ADDRESS . . . . . . . . . . : 47E. W TAYLOR ST CITY/STATE/ZIP . . . : SAN JOSE, CA 95110 TELEPHONE . . . . . . . . : (408) 286-9990 FEE ID UNIT QUANTITY lAOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- -- -------- ---------- ------- 1BCBSC VALUATION 12, 266 . 00 1 .00 0.00 1. 00 0 .00 1BSEISMICR VALUATION 12, 266. 00 1 .30 0 .00 1.30 0 .00 1REROOFRES SQ FEET 23 . 00 299 .00 0 . 00 299. 00 0 . 00 - --------- ---------- ---------- ---------- TOTAL PERMIT 301 .30 0 .00 301.30 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 301 .30 VISA --------------- TOTAL RECEIPT 301.30 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- --------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPAR--MENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O.,BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•building@cupertino.orq PROJECT ADDRESS �/_(�� � �l I . ,�--� /_ . '4PN it OWNER NAME PHOP E E-MAIL STREET ADDRESS - J� CITY, S C�^E:QIP`2--7wo C,� 7 s./4 ENFAX CONTRACTOR NAME LICENSE NUMBE3 /D LICENSE TYPEG3 BUS.LIC# lii n�D I -Z-1 COMPANY NAME 1/ `✓( I E-MAIL FAX _. /--7 STREET ADDRESS / I '�i/�/ f`-�^ � CITY,S^j E< C/7 J PHO Q �!'jo�- C?Cl'a 7 I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a mini num of one day before the requested inspection date. Please schedule inspections online or call (408)7 77-3228 between 7:30-3:30 (Mon-Fri). 3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof is torn off and all the nails/fasteners have been removed. Any and all dry-rotted wood shall be replaced prior to this inspection. A building inspector will be availabl,-within one hour. There are special hours for this service: 7:30 - 10:30am and 1:00- 3:30pm (Mon-Thurs); 7:30 - 10:30am and 1:00-2:30pm (Friday). 4. If plywood is installed, a plywood nailing inspection is required. 5. In-Progress roof inspection is required. Call for an in-progress roof inspection to verify building is weather tight after installation of approximately 25% of the roofing material. 6. New roof coverings shall not be applied without first obtaining all inspections and written approvals from the building inspector. Any roofing which is applied without first obtaining an approved inspection will require the removal of all new material dow 1 to the sheathing so a proper inspection can be performed. 7. A final inspection and approval shall be obtained from the building inspector when the re-roofing is complete. To receive a final sign-off, the following items will be verified: a. Flat roofs shall have a minimum of per foot of slope and must demonstrate there is no ponding. b. Listings from approved testing agencies for all pre-manufactured products used shall be available on-site to review at the time of the inspection. c. Proper spark arrestor installation. 8. NOTE: If you call for a tear-off or plywood nailing inspection and the work is not complete, you will be charged a re-inspection fee of$126.00. The t e-inspection fee shall be paid before another inspection can be scheduled. By my signing below, I certify each of the following i� true: I am the property owner or authorized agent to act on the property owner's behalf. I nders d d agree; to comply with the re-roof policy stated above. Signature of ApplicantJAgent: Date: ReroofPolicy_2010.doc revised 05/17/10 U8/'2b/Zd119 1U:Jb 9154190251 HVAL 1J1-1-ILL FAbE t7Jiee .uab 9616 w w.v'T v-n,.... ....... trt Ivl UO-4-01 V+ N.1 1 04/2412010 15:36 19169303439 SHIPS PASS 81 f ' t1m Cellyflt�t�i of Cam isncti:ftsidatt i Remo C ,�R-At.T a oaf FrolmAdfimm-?�0 P-2 Glimatte Zone o% !te'7W'INti PROuUM(COOL R00,F111;! kM1R gatlprltll' igrf5cp t0 t?X!lbtlJ 6 t!f lrN1 Vxjftyn9 Poll Gr1s%arm ,1Nflfoh=r-jA!rlaq,tlta now �!!A/sya ply tNtlet flte reo?ltfg tbCt'1�a1 Rapf".n Kerents o�¢lS,t(ait7Wl,t ilfY�,or152(bJ7t'flfi ttlegt appgeeW'atha+r+ hra or r!ta4+pt h Inuu I(thra root alllrsttan is c,:a opt tram lh0 roo11r Q prt►tltxt"Chet RoarrrX{urteiriengo, L7 Coal moth jId t%Wrad Is ClIelatt s?times 1-1114,and 18 VAh a low Ula Sod taxi p"0490 of 5;13 pitch)- Cool roatlLatragfdr+rd in CGrniatdx 1.bnee 1-®�and 19 with aatf:go-efcpdf ronhi rgrealAtnibdt ff+an 2;121 and ptodil+d waighl IMS Ihstl etltifR'. 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Slgnet tic Neeyn1`s 1 r`�et'— vote: z t Ccatloeny, rr_G1 l.rcense. l�d ?D drcae: �l1.GC•r Q,.�� I/e sa 7 ?6"70 J Hot147:a st: -sdar -�3eo. �orRaalattaaa orgriwd"flaMge?r/lttg the Ell"Standan$s�r-wtart tha l?MWY I ' -jecei.ved on 41,4/2010 7:33:49 PN.' 1 Received on 9/22/2010 10:36.:38 PM I Building Department City Of Cupertino ELI] 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: �7 PERMIT# ILS 00UJ OWNER'S NAME: r'ott,j QOI.r PHONE# OV - 2-5 '7-Z/0/-3 GENERAL CONTRACTOR: t-iA)V BUSINESS LICENSE# ADDRESS: 5 R CITY/ZIPCODE: 4,0 -�)-O C *Our municipal code requires all businesses working it the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTFACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: C/ /�a - Si;;n u Date Please check applicable subco ctors a c mple a the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/ Carpeting Linoleum/Wood Glass/Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile '�Y wn ontractor Sig a Date CJT� OF CITY OF CUPERTINO Is REROOF CUPEt'TINO PERMIT APPLICATION APN# �, , 7 0 Date: Building Address: 7647 Squirewood Way Owner's Name: J o�,i 0_� ) E Phone#: HOA: Yes ❑ NO408-257-2613 © If es, provide letter from HOA Contractor: Phone#: 408-286-9990 LINDY ROOFING COMPANY Fax#: 408-286-9978 Cupertino Business License#: Contractor License#: 215816 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ® Other(Specify) COMPOSITION SHINGLE ® Other(Specify) COMPOSITION SHINGLE Number of existing coverings ❑ Provide I.C.C.E.S. Report# a To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: Reroof - Tear off/ NO Re-sheet/Install Owens Corning CLASSIC Class A. 23 squares. Residential © Commercial ❑ Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist& attach it to the application or if there are any restrictions: ❑ applicable, include in plan set & the sheet ine.ex. Valuation: $12, 266 I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signator r_,,O',�r Revised 02/05/09