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09080414 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10762 LA RODA DR CONTRACTOR:LINDY ROOFING CO INC PERMIT NO:09080414 OWNER'S NAME: WENDY WU 476 W TAYLOR ST DATE ISSUED:08/31/2009 IER'S PHONE: 4088578333 SAN JOSE,CA 95110 PHONE NO:(408)286-9990 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT f— PLUMB G/ ! License Class C r I /� Lic.# 2(5 V f(p MECH r— RESIDENTIAL F COMMERCIAL Contractor -IAV D ROQF7 Date 'i 30 q I JOB DESCRIPTION:RE-ROOF REMOVE(])ONE LAYER WOOD I hereby affirm that I am licensed under Are provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions SHAKE ROOF, INSTALL 1/2"OSB,30#FELT&26SQ OF 40 YR COMP, Code and that my license is in full force and effect. CLASS A 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:$9400 permit is issued. APPLICANT CERTIFICATION APN Number:36934039.00 Occupancy Type: 1 certify that I have read this application and state that the above information 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, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non_-ooint source regulations per the Cupertino Municipal Code,Section 9.1 . —V1Date �3� 0� Issued bye, ------"'_'e— Date: Signature LI 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 1,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, Business&Professions Code) a of Applicant: ` "1 Date: 1,as owner of the property,am exclusively contracting with licensed contractors toconstruct the 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 Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain 1 have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. 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,l 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 mu ner ora horized a ent: forthwith comply with such provisions or this permit shall be deemed revoked. Date: CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is fl 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 rnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address 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. 1 understand my plans shall be used as public records. Signature Date Licensed Professional CITY OFCUPERTINO cqci 0�t q RI-1,1ROOF CUPEkT1NO PERMIT A PPLICATION APN #��9 5 0 e L Date: Q Building Address: I b 7(a2LA Ro DA b1Z . Owner's Name: tt,Lvu w U Phone #: HOA: Yes40 k- $15-2 ❑ No If es provide letter from HOA Contractor: Phone M (4,08-) 2&&, E I A) 10 1?CVX/�V� Fax #. ( � Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Asphalt Shingles XWood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings _ ❑ Provide I.C.C.E.S. Report# XTo be Removed ❑ Provide Mfgr. Installation Specs. Job Description: Rev"VC Ii LAI L mood 9H-A-k.6' 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 index. Valuation: � G� 400 I Have Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09 CITY OF CUPERTINO '- REROOF CMDFFEE SCUEDULE T CUPS 1NO Number of Fee ID Fee Description Fee Permit Type Squares Group 1RER06FCOM Re-roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee IBSEISMICO Seismic Commercial B 1 REROOFRES Re-roof Res Tential B I SFDWLROOF 1BCBSC Cal Bldg Stwidards B ALL PERMIT TYPES Commission Fee / 1BSEISMICRE Seismic Residential B 1 REROOFM EES Re-roof Multi-Family B 1MFDWLROOF IBCBSC Cal Bldg Standards B ALL PERMIT TYPES Commissio:l Fee 1BSEISMICRE Seismic Re:;idential B 1BUSLIC Business L:.cense 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 City of Cupertino 1. Prior to permit issuance,you must agree to comply with 2007 IBC Standards and manufacturers specifications on re-roofing.All roofs are Class "A"per Cupertino municipal code 16.04.080. 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 Ciiy,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 na it inspection is required. 6. Any roofing which is applied withou:first obtaining an inspection, will require the removal of all new m aterial 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/ "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: to L—�d`T w L Job Site Address: !IL-7(o 2 LA Roo,4 Roofing Company Na "D Po / Applicant's Signature: �'' `�� '�`-"^ Date: Greg Casteel Building Official Revi ied 07/30/08 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 City of Cupertino 1. Prior to permit issuance, you must afire( 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 nspector. 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 :•oofing installation. 4. To receive a fugal sign off from the City, he following steps are required: 1) Pre-inspection incl/or tear off appro�al. 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 fust obtaining an inspection, will require the removal of all new mate-ial 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 o $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 " F er foot slope and demonstrate that there is no ponding. 2. An I.C.B.O. report is required to be on th?job site at the time on inspection. I understand and will comply with the above s:ated policy on re-roofing. Homeowner's Name: �►1cC Job Site Address: ! � � �Gti- 40 0, /- Roofing Company Name: fn d /�-l� CIO. Applicant's Signatur W ate: U � � Greg Casteel Building Official Revised '11/2/04 Community Development 10300 Torre Avenue fi Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 CITY Of XPERTINO Buildin. De artment 1�d6r k PERMIT # JOB ADDRESS: `U ct� OWNER'S NAME: �V b w PHONE GENERAL CONTRACTOR: FAX # 1 am not using any subcontractors: �` '' '�'�-'� Signature Date Please check applicable subcontractors and complete the followm information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing plass Carpeting / Wood lazing ing Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Date owner/Contractor Signature