05110076 CITY OF CUPERTINO
BUILDING DIVISION
PERMIT rV
BUILDING ADDRESS: LINDY ROOFING CO INC PERMIT` 05110076
22467 SANTA PAULA AV
OWNER'S NAME: PERMIT ISSUE DAM
JAYA GUDA 5554 HARVARD DR 11/15/2005
NE:
SANITARY NO. CONTROL NO.
(408) 286-9990
ARCHTTECTIENGINEEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
lad,
!0, LICENSED CONTRACTORS DECLARATION
ou I bar,by Job Description
.0 .1,Sec.. afirm that I wo becamidt tirade Of Chapter 9(Commonefing
�R TXar)ofDheiaom 3.fth.Bounnowand proloccuumn,Onle.and my]I,...is
no, mr-lif d If REROOF--T TILE, INSTALL COMP. SHINGLE
�iz Lwat L 2i5&-1 (.
Contractor aaaea.,A�maawac,,
ARCH A�TJW
to
Imuleoriand my plans that]x it.public ownins,
yyU
coy Licessual Professional
OWNER-BUILDER DECLARATION
I hereby affican that I am exempt from th,Contra Co License Law for the
20 following Mason.(Section 703 1.5,Business and linror�imw dc:Any city or county
.9 which requires a permit to construct,alter,imporne.damilim.Or repair My scruchine $13295
vo prior to its issuance.arm requires the applicant for such permit to file a signed suateriont Sq.Ft. Floor Area Valuation
(ban he is licensed pursuant to the provision of the Commatar's 1-acconto Law Chapter 9
rFo (commencing with Section 7000)or Division 3 of the Business and professions Coat)or
Nat he is Camps therefrom and the hub for the alleged resemptions My violation of
Section 7031.5 by any applicant for a permit subjects the applicant 10 1 Civil perniftY Of :rm mr?bbr U U Occupancy Type
not...than five hundred dollars($500)
C]
will do the work.and the structure iscum ansisdad.r.fTenol foraide(Sec.7W.Bond.
and Poeffessums,Code:The Cramosecon's License Law does net apply to an owner of Required Inspections
property whe Wildscournproves thereon.and OelmdiOuchworlihimself.,through his
mummapd.,ses,provided that such improvements art notimanded oroffered forsals.If.
however.the Wilding or impmwmwt is sets within one year oftemple nion,the owner-
builder will have th,thourthen of proving Chat he did net Wild or improve for purpose of
tile.).
0 1.as.ner of the, .,ny.wn excanively owesamig with licensed emmucturse an
commuct the Mica(Sect 7044.Business am preficamoms Code:)The Contriessar's U.
case Law does wo apply o an Owner of property who Wilds or improves thimem.and.
who contracts for such projects with.amurraction(t)ficaused porous to the Ounaracuor's
Uwns,Law.
0 1 am exempt under Sac ..B&P C for this Mason
Owner Data
we
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury ow of the following declarbasome
ham and will nommu.a Certificate ofCwwm in serf-mitioc pbowsoulme.C.Capa.
Was
union, provided for by Section 3700 of afte Labor Code,for Ne performs.of Neo
wort e&for which this permit is issued.
`
have and will Continua Workers Compensation Insurance,ast required by Section
of the Labor Code.for thc ricrionsourec of the wort for which this permit Is issued.
My
Woorar's Compensation losensince carrier and Policy number are:
Cartier.—Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thissaflon wed mtwcmplcwd if(k permit is for we humanailallars($:W)
or im.)
I carry Not to the"peramoo Of the ivroic for which this permit I.issued.I start not
employ any person in any manner so um ewbjecuo Compensation
Laws ofC
Ap
NOTICE TO APPUM If,after making this coaffina,of Exemption,you should
C Weis
baccono a Wodnar's Compensation provisions of the tabor Code yen in=
Oforthwith comply with such provisions in this permit mall W deemed terminal.
z CONSTRUCTION LENDING AGENCY
4 1 thereby affirm than there is a consuractirm lending agency for the performance of
> the woric for which this permit I;issued(Sec.3M,Civ.C.)
Landes Name
z Landers Address
U 0 1 certify that I have read this application and won that out move intormation is
Ly P comcL I agree he Comply with 91 city and county Ordinances and saw[am mutingto
C)U building construction.and hereby women representatives of this city to enter upon the
m.,n,-awwi...d limitary for inspection purpose,
(We)agree to cars.indemnify and loop thermos;dic City of Cupertino against
liabifix.Occ.judgments.costs and expenses which may in my way.cmc against said City
Z in consequence of the granting of this posenit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL ON-POINT Issued by: Date
SOURCE REGU
ic Re-roofs
Signature of Appliant/C—
contractor D.
HAZAIRDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicator or future Wilding occuparststore or handle bassidous material
ttfiZ�,Ib.y.ft Coge "m Municipal Cods.Chapter 9.12,and the Health and Safety
All roofs shall be inspected prior to any roofing material being installed.
M ye, L�-
Will do,applicant or future building accuparit use,equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
anaft b.,nemin air caustraftiousts at defincal by me Bay Area Air Quality Management
DimiCil all new materials for inspection.
0yes
I b.Mail the haucanhuts materials requirentericiode,Cha,wrii.95ofthe Cables.
rias not SafetyCoda.Soco.25505,25533 OW25534.I unsterstand thatifthe Wilding
does not currently ha,c a E,out it 4 My res,quenbiloy M notil y the occupant Of me
Mquacrucomi tic se t From as�?. r C It (a"'"" "Pil" i Signature of Applicaul Date
Owner.1 mon,ried alp Dam, All roof coverings to be Class "B"or better
` x Community Development
10300 Torre Avenue
. S ✓' Cupertino CA 95014
Telephone(408) 777-3228
CITY 0, Fax(408)777-3333
I
UPEI�TINO
Building De artment
JOB ADDRESS: PERMIT #
OWNER'S NAME: a , PHONE # q o € Z 8'C -c q q o
GENERAL CONTRACTOR: / _ /l ,�p FAX # /
I am not using any subcontractors: / -A /fie
Stgnatur , 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
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
CITY OF Telephone: (408)777-3228
U����'�O 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: ca... G l.t-t'SCa�
Job Site Address: a a- q6, 7S ,/J L c f Gt - ,,
. ,c
Roofing Company Name>�1� L q
Applicant's Signature: i Date: �� 15 OS
Greg Casteel
Building Official
Revised 11/2/04
Printed an Recycled Paper
CITY OF CUPERTINO
' REROOF
CUPERTINO PERMIT APPLICATION FORM
IMF APN # Date:
3 5 1 0 `� v So
Building Address a y1� 9
Owner's N Phone#:
Contractor: / l' Phon2-S6 _? etc/J License#*
Contact: Phone#: _ Cupertino Business License#:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles )Z Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
NOther(Specify) ��Qp_ Other(Specify)
13mber of existing coverings t ❑ Provide I.C.B.O. Report#
IX To be Removed ❑ Provide Mfgr. Installation Specs.
AIL I Have Read, Understand and Will Comply With Cu ertino's Tear Off Poli
Job Description: Tp CL-OX, S0y1
Residential Commercial
Fire Zone: Yes ❑ No J�j, Confirmed with Planning Det. if
there are any restrictions: LJ
Cost of Prject'. � Type of Construction: Occupancy group:
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
31113