06090234 CITY OF CUPERTINO e &artgwt �Pw � �fu>?� �r <.>-g':;
BUILDING DIVISION PERMIT TqCONTRAC.�TOR Nk, ORMATgIq 14',,
RUE DING ADDRESS: ING CO INC PERMITNo.06090234
19905 BAYWOOD DR
OWNER'S NAME: PERMIT LS DATE
LILLIBRIDGE ED W AND CAROL 5554 HARVARD DR 09/25/2006
NE SANITARY NO. CONrROL NO.
(408) 286-9990
ARCHTfERYENGINEIA BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0
los LICENSED CONTRACTORS DECLARATION lob Description
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Nat I am E,On uer pw.ivms of Chaper 9(commcm mg P
�+ with Scctim riYlO)afDilYm Sof NC Bntirt¢faa�Prat c�d��admYBccoau
r 0, inruurma de e 3� GREROOF- REMOVE EXISTING WOOD SHAKE ROOF, INSTAL
1/2" OSB 304 FELT AND 31 SQUARES . CLASS
CA CHRELTS DecuRAnOn
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p OWNER-BUILDER DECLARATION IS!
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:pc w1(W)win,remora(Semlan 703 13,Budrcv and Rafeviow Cade:Any Eby c cmuy E7
f$_fi hick mquima,Paris rc c«Wmc4 aha,m for sat dcmduh.«mpair am muomc
Zy pd«miss inwns.,uo rtgWtm Nc,pplkantfor such pvmltm Ric ail{rcd satcmrnt
EE < dudhlslka�dpa�mmNaPm•ian¢arNacanuaa ondcodm9 Sq. FC Floor Area Valu
e�a (emunesin{wiN Scaion T000)NDivuinnJ ddc Bumbau and Pm(r�am Cock)«
r R— that bc 6 e emp demfmm rad the bah for the alk{d¢a pda,Any vidadae of
s danmJlSbyayapp�rf«.p mane Ne.ppk,nlra. upmalyo , '1 / Occupancy Type
om mart duv❑w Wdca dallva Q5W} 3 V U r Q 0 CCU araC
❑L u owner of Ih praPOaY•a my emplo5ea with n{m u doh vle e«npemadoq
and
dda
ppoiNncichm CuamdNe:eT,hme uCrvPmasixaomafaam¢LlnadmWa«Law
¢rara,mrapply.mroanad.:Brna,of Required Inspectionsections
Koeny
cm lobobuild,i iA doves Ihrtnn.and who doesloch„mth®rJfar duoa{h hu
bcw Onpb boipwlddrm Im Is sold it sae WImo.f .PROM f«vle If.
toEdar doad da,«Il,m of provin1,hat did meyeu at Oa Id,me Plot of .
bW ld veld haw Ne hvden of poHn[Nat k did tam hdd«impmw for payor d
vk.}
❑L u Owner Of Ne Pro"Y•w"dual"mnuaain[with IkemM cmu.Oara m
cow the pmjm(Sec.T01u.Bwinea,ntl Profm,ku Cede)ire CmucdPr',Li.
awe IAlo as s,dapplynan Eba napaaPesY w'haacd p« mudws Nemon,and. .
lobo concuss r«sure Paoleeu lo W a mevaetv(,)dtOaad p«mant m Ne CmvacwYa
Lieeas lir.
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WORKER'S COMPENSATION DECLARATION
1 bercby,Rua mala PmWY d allay rme Of the fdlowin{AM.r.dm�
I a,c and w01 malnaln•Cwfio of CamentIll-U-1ncfmWddi&lComPm-
adm.a pravbca for by Scstion lro0 d the Lab«CaOe,fO the performans of th
wmk which NU Pemltu ismrd.
1 baw and wad maintain Warta,C«npcwdod I..u rcqmred by Salm .
3ro0oftheI Coda.fm NcpOformarca Ne wak f«whzh Nis Permh uLnud.
My Wml,cls ComPdoWmbtm articrPolicy maobO arc'
cm,,, STOACVL= c+ti..kBd,No.: 18�{2S`1
CERTIFICATE OF EXEMPTION MOM WORKERS'
COMPENSATION INSURANCE
(Tris calm asd tmt bccampktd ITNc permu u f«one huMcl dads,($100)
«Ins)
1 cerdfr thm IR to p.fomuvx of do wort r«which Nis pans U ivmd.I mall n«
cmplvymy permn in my mansrmu k hodme mbjaa m Ne WmkaY ,
Law,a Caliromia.Dac
Applianl
NOTICE TO APPLICANT:If,:flu matin{Nia Cettirroac ar Eaanpdm,Yo'a should
Occurs mblcct n Ne Worker'a Compeandan pmvldom of Ne u Cody,you mvn
.J O rcrhwith comply wldt such pravubm o,Nu permit"I h drOnad m,dtr
Z" CONSTRUCTION LENDING AGENCY
a � do wok for which duat NpuOmdsitreu uiaa«mAtm(5rcac.d3
m097.Cir
agc«r f«dr pmf«man¢of
C.)
QL<nd<fm Name
7 z l<ndcrs Address
U O 1 cvdry tat I a,e t¢d dd,spoxvim and:tale that Nc above idamadm u
U. E-' cmren.I not m comply with all cky and county ordina.cud sur Ian muting In
OU buildin{c«uusdm,and hmbyauNatiae rtpmunudvca ar Nu city m rncr.Pmt Inc
r W abow-mendoned pm,Orty W impaction ry+rywts.
(M)agcc m v,c,indemniy and kap armies:Nc City of CuPutiw-{aunt
F' y lubllld¢.Iucgruw,ca:u and eaprum,which may M my ray accruc a{almt mid Clay
U,x In eamequeoee of dmc{canting of this parm t
APPLICANT UNDERSTANDS AND WILL COMPLY WITH A NONPO Issued by: Date
SOURCE REGULATIONS. -
�• Re-roofs
Dan
Iw.a U S MATERIALS DlsnDsu RE Type of Roof
ME N,appllam«ftmae Wikm{oc-.pm nme s banAe haaNws nwetul
u derumd by dte Cupcnitm MunMpal Code,Chap cr 9.11,and dx Hnhh and Safely
Com.saaon M5J](U' _/ All roofs shall be inspected prior to any roofing material being installed.
D Y¢ &�"
ME doe,p,dlcm ram,building occupant as Pgdpmevt a da.I¢,which If a roof is installed without first obtaining an inspection,I agree to remove
,mir busNow air coottNu ac by ftBay ArcaAir QualitymanaValent all new materials for inspection.
TwkT
❑rw
Ill.r¢d do Ev mmm•t.mW^Onms tmlk,CmpuT6.95 ardc Caliror.
N,Nahh a SafcyCda,S v«u MM5,25577 md!MM.I udemad Na itNP building /y'E•��L ��
ds,not caculy ha,eammnL that 1,u my ma,m wily n nudry dr 96.,amo lr—i
mrvi\o^.tx° pd° . -1 c-1 ature of Applicant Date
✓`--
All roof coverings to be Class "B" or better
ow «m ,{en Dar
CITY OF CUPERTINO
!m 1 of 3 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 31630017 . 00
DATE ISSUED. . . . . . . : 09/25/2006
RECEIPT 4 . . . . . . . . . 36196
REFERENCE ID # . . . 06090234
SITE ADDRESS . . . . . : 19905 BAYWOOD DR
SUBDIVISION . . . . . .
_ CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : LILLIBRIDGE ED W AND CAROL
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
EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
----- - - - - - - ------------ ---- - - - --- -- - ----- -- --- ----- ----
BPERMFEE VALUATION 15 , 000 . 00 223 . 56 0 . 00 223 . 56 0 . 00
BSEISMICRE VALUATION 15 , 000 . 00 1 . 50 0 . 00 1 . 50 0 . 00
TOTAL PERMIT 225 . 06 0 . 00 225 . 06 0 . 00
Community Development Department
Building Division
City of Cupertino
10300-Torre Avenue
' Telephone: (408) 777-32228
CITMGf Far: (408) 777-3333
CUPEkTINO
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 coveruigs shall not be applied without first obtauning 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.
• 3. If plywood is installed, a plywood nail bnspection is required.
6. Any roofing which is applied without first obtaining an inspection,
will require the removal of all new nnaterial down to the sheathing,
so a proper City inspection can be performed.
7. NOTE: If you call for a plywood nail inspection andthe 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: cd,,,,Grc�_ Co.Tdk L% 1`"rtclu ,e
Job Site Address: J I Il_O_fS, �IuzaDL. Or .
Roofing Company Name: L tnc(Al �O041 CO•
v v
Applicant's Signature: 4 . CA-)Q _ t,% Dater-2
C7"
• Greg Casteel
Building Official
Revised 11/2/04
Pdnlod on Recydod Paper
i
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
WUPEI�TINO
Building Department
JOB ADDRESS: PERMIT #
-1 "I u O'2-3'�-
OWNER'S NAME: PHONE #
G CONTRACTOR: FAX #
am not using any subcontractors:
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 aVO
REROOF
CUPERTINO PERNHT APPLICATION FORM
-' APIC# �1 ' Datqe
� -as-c�
Building Address:
Owner's Name: no e : (�, 7
Contractor � P g�_q q� erase Is a(
ro
Contact: Cupertino Business License #:
8
'Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles N=-Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings�_ ❑ Provide I.C.B.O. Report#
kTo be Removed ❑ Provide Mfgr.Installation Specs.
I Have Read,Understand and Will Comply With Cu ertino's Tear Off Policy:
Job ppescri tion: r'e rv_� •e,�ec -t • w,�o J aIC¢_ r-oo ; r n 54-&� 2 r1 QS
8; � , 'U aJ� 31 ,
Residential JZL Commercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if
there are anY restrictions: LJ
Cost of Project: Type of Construction: Occupancy group:
l5- 06D
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