07110155 CITY, OF CUPERTINO
BUILDiNG DIVISION PERMIT �����������������`
. ;,>: ... ,..: . :.
i>` . :: ,.
BUIL I PERMIT NO.
��.���.AINBOW DR LINDY R�)OFING CO INC 07110155 .
PERMIT ISSUE DATE
iNER'S NAME:
WANG STEVE K AND LESLIE L 5554 H:�RVARD DR � 11/28/2007
PHONE: SAMTARY NO. CON7ROL NO.
(408)28�-9990
BUIL.DING PERMIT [NFO
ARCHI7ECT/ENGiNEER:
BLDG ELECT PLUMB MECH
� � � �
u p Q LICENSED CON7'RAC!'OR'S DECLARATION JOb DeSCflpU0i1
� v C t hcrcby �cm tAat I am licenscd undcr Qrovisiona of Chaptcr 9(commencing
Z�� with Secdon 7000) ot Divi�ion 3 of ihe Business and Pro[cssions Codc, and my liccnsc is RMV S H K & I N S T L � S B 3 �# F LT , ARC H C M P , C L S A
�� y in full force and cf � ���` �
� ^ Licenac CI L�. �
� F„ O Datc Contracbr�,��j�
� � A CHITECI'S DECLARATION
� I understanJ my plans s6a11 bc wcd as public rccords
�yU
i Q y Liccnscd PtuCcstional
y � OWNER-BUILDER DECLARA'CION
' I►�ereby afGrm that I am exempt Gum ihc Conuanor's Licenm Law for thc
� p O following icaton. (Sccdon 7031.5, Businest and Professiont Cak: Any cily or wunty
K$ Pi which rcyuiccs a pcmiit to conswc4 a�tcG �p►ove. dcmolish, or icpnir any strucwm
y Z� prior �o i�s issuancc, aLsu requires ihc applicant for such permil ta filc a signcd su�mcnt
�_ � thal hc is liccnscd pursusnl to thc pmvisions o( ihc Conuactor's Licensc law (Chaptcr 9 Sq. Ft. Floor Area Valuation
� F- (commencing wiih Section 7000) of Division 3 of ihe Busincss and Profcssions Codc) or � 14 4 3 O
i�� thu he is uempt theaetrom and Ne basis for ihe allcgcd exempdon. My violation o(
Section 7031.3 by a�ry applicant tor a pem�it subjecu the applicant w a civil penairy of 3 6 6 5101 �:� Number Oeeupaney Type
not mote �han fiw 6undmd dollus (5500).
❑ I, u owner ot ttie propaty. a my cmploycea with wages u the'v so� compensadon,
will do ihe work, and the swcmre is not intended or offeced for sale (Sa. 7044. Businesa Re uired In s ections
and Ptofessions Code: The Conuactors License L.aw doei not appiy to an owner of 4 P
property who 6uiids or improves thereon, and who das such wocic himself or through his
own employca, provided that such improvements ue not intended or olLered for sala 1f,
however, the building or impmvement ia sold within one year o[ compleGon, the owner-
builder will have ihe burden oC proving that he did not 6uild or improvc fw purpose of
sakJ.
0 I, u awner oC the propeny, sm exclusively conuacting wi�h licenxd rnnvactars to
constnut the pmjen (Sec.'l044. Business and Professions Cade:) The Coa�ractnr's Li-
cense Law docs oot apply w an owner of propeny w6o builds or improves �Aemon, md ,
who convacts fo� such projecu wiW a conuactor(s) licensed pursuant to the Convactor's
Licenae Law.
' I am exempt under See. , B dc P C far this rcason
.,wner Date
WORKER'S COMPENSATION DECLARATION
I hereby �rtn under penalry of perjury rn�e o[ �he folbwing declarations:
❑ I have and will mainuin a Cenificate oC Consenl to self-insme far Worker's Campen-
sation, u providcd for by Section 3700 of the Labor Code, tar the performancc ot �he
work for which Ihis permit is issucd.
❑ I havc and wiil mumain Workcr's Compenaadon lnsurana, u mquired by Scction
3700 0( ihe Labor Codc, (w ihc pcdormance of Uu work for which this permit is issued.'
My Warkers C Ins� car�jer and Policy nu�� are:� �� � �/
��y t
c,n;u: � �A'�� n�0�' Poucy No.: 'S v
CERTIFICATE OF EXEMPlION FROM WORKERS'
COMPENSATION INSURANCE '
(This sectian necd not bc completcd if the pecmit is far onc hundred dollars (S I00)
or less.) �
i cenify �hnt in t6c performancc af thc work fw which ihis permit is issucd. 1 shall not
employ any person in any manncr w as w bccome subject ta the Workcrs' Compensation
Laws of Califomia Dalc
Applicant
NOTICE TO APPC.tCANT: If, aMr making Wis Ccrtifica�c of ExcmpGon, you should
become subjm w �hc Worker's Compensation provisions of Wc Labor Code, you muu
, O fonhwiW comply with sueh provisions or this permit shall 6c dccmcd icvoked.
z ""' CONSTRUCTION LENDING AGENCY
E- �-�+ 1 he�eby affirm Nat �hete is a constcucdon Iending agency Cor the perCormance uf .
�Y„ � �he work fur which �his permit is issued (Sec. 3097, Civ. CJ
� Q Lendcr's Namc '
� z L,ender's Address
V � I cenify that 1 have read ihis spplicuion and suic �hat �he above informatiun is
w�" cortccL I agrce to comply wiUi all city and county oNinances and sute laws reladng to
p U building consuuction, and hercby amhoria reprcsentaGvcs of ihis cily to cntcr �pon thc
� W aAovc-mcnGoMd propeny for inspenian purposes
a (Wc) agra a ssve, indcmnify and kecp harmless �he Ciiy af Cupertino against
�� IiabiliUa, judgmcnis, cout and expenscs which may in any way accruc againsl said City
V z in consequeMe a[ the granting of this permiG �
►'� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by; Date _'L� 2r�
REGULA170NS.
` � t � Z � � Re-roofs
S' Applicant/Contracwr Da�c �l�
HAZARDOUS MATERIALS D[SCLOSURE TypC Of P.00f
�11 the applicant ar future building occupan[ swrc or handlc ha•raMous matcrial
defincd by Uu Cupenina Muni ' al Code. Chap�cr 9.12. and �hc Heal�h and Safcty
_� Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
❑ Ycs No
�11 thc applicant � r���rc ilding occupant usc equipmcnl or Jeviccs which If a roof i s installed without first obtaining an inspection, I agree to remove
cmit ha air conuminan Jcfincd by the Bay Arca Air Qusli�y Managcmcnt all new rr aterials for inspection.
Disuict?
❑ Ycs ❑ No
1 havc rcad the haiardcws ma�crials �equiremenu undcr Chap�cr 6.95 of ihc Califor- t� � C"` ���
nia Hcal�h dc Safcty Codc, S�ctions 25505. 25533 anJ 25534.1 undcrsund �hu iC�he building _ r Q
d urtcntly havc a tcnan4 � it ia my responsi6ility to noufy thc occupant of �he
• rc • cn3 �ch muu be met prior w�ssumcc o[a Ccnificatc otoc pan .-7 Signa Applieant Date
�,. �,.�.� j
Owner or authorized agcnt p„� � All roof coverings to be Class ��8�� or better
�� �� �/�5�
CITY OF I�UPERTINO
RE]E�OOF
C�-�P�t�TINO PERMIT APPLICATION
APN # 3 ��� ` � � � O� Date: j/ Z 7�
Building Address:
2r �7� 1��,�,��� ���.
Owner's Name: Phone #:
� f �U � f.��ic.�' 4�'� �11 " `� ���
Contractor: �-,� Phone #: ��� 2 br'G� —`�'��I f)
.
� t �tl � �l,v . � ° Fax #: �}U�f' 281� ' ��`� �
Cupertino Business License #: �� � � Contractor� ( � s�e #:
��
Type of Roof Covering:
Existing: Proposed:
0 Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles � Asphalt Shingles
� Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
� ber of existing coverings �_ ❑ Provide I.C.B.O. Report #
� To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
I�L°YrioVt� ��Yl� .��=� rtcc. t>S� �b�f�-i ff �� ��r
Residential Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: L�
Valuation: ' � ���aw
I Have Read, Understand and Will Comply with Cup �rtino's Tear-Off Policy:
�-� .. -�.,�--
Signa
: w�, CITY OF C UPERTINO
�-����' REROOF
CuP�r�TiNO FEE SCI�EDULE
Number of
Squares Fee ID Fee Description Fee Group Permit Type
REROOFCOM Re-roof Commerci �.1 B COMML-ROOF
BSEISMICOM Seismic Commercial B
� 9 � REROOFRES Re-roof Residential B SFDWL-ROOF
(
> BSEISMICRE Seismic Residential B
REROOFMRES Re-roof Multi-Fam: ly B MFDWL-ROOF
BUSLIC 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 (�ity of Cupertino
1. Prior to permit issuance, you must agrE�e to comply with 1997 UBC Standards
and manufacturers specifications on re-roofing.
2. New roof coverings shall not be applie 3 without first obtaining all inspection
and written approval from the buildin;; 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 an�� roofing installation.
4. To receive a final sign off from the City, the following steps are
required:
1) Pre-inspection and/or tear off appr��val.
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 :�irst obtaining an inspection,
will require the removal of all new mai:erial down to the sheathing,
so a proper City inspection can be perf �rmed.
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 �aid before another inspection can be scheduled.
IMPORTANT
1. Flat roofs must have a m;nimum 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 abovf� stated policy on re-roofing.
Homeowner's Name: ��� V� �ff � �
Job Site Address: 2 r ���� '�l � � � � '
Roofing Company Name: �<<''� �j r�f � -
Applicant's Signature: � � '��—° � ~� Date: � l 2 ��c� �
Greg Casteel
Building Official
Revis��d 11/2/04
�,: ' 'r
Community Development
10300 Torre Avenue
•r '�;s� . Cupertino CA 95014
: •�;. � .
Telephone (408) 777-3228
CITY OF Fax (408) 777-3333
CUPE(�TINO
Buildin De artment
JOB ADDRESS: PERMIT #
2� ZV�7 c� A��� �c� ��' � ��7�� a r.�.��
OWNER'S NAME: S ���' PHONE #
GENERAL CONTRACTOR [,,��r� � � Co . FAX #
I am not using any subcontractors:
�,, "�"` i ---�\� 1.--�..
� Si;;nature Date
Please check a licable subcontractors and com �lete the followin information:
SUBCONTRACTOR BUSIrTESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Fini.shing
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
'°�.
'�--` .-
er/Contractor Signature Date