02020057 CITY OF c DPEsiONNO CONTRACTOR INFORMATION:
PERMIT
BUILDING ADDRESS: PERMIT NO.
jpgqn BARNHART AVE. MAX BROWN CONSTRUCTION 02020057
OWNER'S NAME: APPLICATION SUB DATE
DEBBIE STEFANKO 702 S DANIEL WY 02 15 2002
PHONE: SANITARY NO. CONTROL NO.
, (408) 260-1260
µOµ,,O O ARCHTECT/ENGINEER: BUILDING PERMIT INFO
14 BLDG ELECT PLUMB MECH
[ H OSCII z LICENSED CONTRACTOR'S DECLARATION Job Description
0 i_G I ncreby uffrn that I am licensed under provisions of Chapter 9(commencing p
m,(_u w'ith Sectio 7000)of Division 3 ofthe Business a ad ipma,,iore Codeand any license
rms� iamran force and arcV REROOF.
z z'¢ License G ce Lica O
i 3°I�tu- Date Contra
T/O & REPLACE 30 YR. COMP .
Et O< Cr'5 DECLARATION -
I underam d my plans shall be cud az public records
Y�y-
x n 0Licensed Professional
c:atOWNER-BUILDER DECLARATION
u a I hcmby affirm that 1 am exempt Tom the Con¢znor's License Law for,he
t_? following reason,scene.7031.5.Business and Professions Codi Any city or county
E x�o which requires o permit t0 consumer,alter,improve,demolish,or repair any shucturm
n3x 'Pnonuitsion-maM alsoxquiecstheapplicsnt fofsuch pc.it ofle.signed statement
that he s 1 fiend Pursuant to the Po j ns of,he Convenors L cenx taw(Chapter9 S Ft Floor-fta',
(cammencg th See 7000) fDivision 3 of the Roderic,and Professions Code) 1i)•�o k�f�:9fil:i. ation
s
or that he iii thercfrnm end the bass for the alleged esemiciIA Anyviolation
- `
of Section 703L5 by any applicant for a Aaron subjects the applicant to a civil penalty-
;.(nm moa,...five hundmd douma(s5of), b it b;v Occupancy Type
❑l er.rtn raid fl ny ormye is a., ni rpen-70o,
'will d '0 rk .nd A t , ", t" t d d' ((crcd f dlc'(Sec'70J4, - -" -' ---- --- -
'Brrinatsa
and P f s -Code,Th Contractor License L d ,apply man Mired Inspections' ! •-
r..
.w rp pony Who nild,-1 cap to lheram,and he ideas such weakhmself 307 - INSULAT
m through his employees.provided,h, h improvements' t intended or
-ofre-dm I If.however,to b '1a'g - p em t . la in .nerewof ._ .-._ 6.01.. .-_...ROOF---TEAR--OFF ._..._ ._ ..".
`c.mplei on.thcownsce-budderwillhave,heburdenofprovingthathedidnotbuldor 602 - ROOF PLYWOOD NAIL' -
improve for puryme of sole.).
aol,a.gwner.rthe Prapear.amexcmaivelfcontracting With licensed contractorsto" ". ._ .._6.03 ._._.ROOF_.BATTENS------i_ .
consume m.pmjact(See.num.Business and Profession.Codi)The Contractors 604 - ROOF IN-PROGRESS -
❑1 em excm ,under r such
improves,hereon, '-
-- _ caner Date'` pursmm no.the ------
Commencer
_
. .� ? GOnIR[l.Is Li en claw. __.."
License Taw doeno,apply to an r of propeny who builds ori
end who.c.ntncts for such proj s with a commuters)licenud
- 3 in z - • .B&P C for reazon
D
WORKER'S COMPENSATION DECLARATION
I herchy a1Brm under penalty cf perjury one of the following declarations:
- ❑ 1 have ad will tern mn'e'Cenjfcaa of Consent to self insure her Worke's
Compensation, as provided for by Section 3700 of ,he Labor Code, for the
perfonnanie af,he work f.�which this permit,s issued.
O I have and'will mainrrin Worker's Compensaioh Insurance,as inquired by Section
3700 of the Labor'Cod for the Performance of,h'work for wh ch this'perm t
esu d M \ kcr' C F"I^ I .oa all dPbl y tic
r� -0-d __._.
rale l CE OF,EXEMP<ION FRsrrva.. enS +. v 1�\ L ti. ..a r 11. (h�'f AI's a 1
COMPENSATION INSURANCES
IThia t-'li' need not h completed if the panni,is for one hundred dollars
(SI00)orless.) on
i, cent y that in,he perfonny neem the work foawhich this permit it -
'ch
Act employ w, Person in any manner so as m become subject m,he Workers'
Comion lawn of California:Date '
NOTApplicant
-NOTICE TOAPPLICANT If aft makinghusi f of fEp, y 'she Id
z beensubject, ,h Workers C Compensation you
:f Obo Code Y u t'i Q fart l,h ply h, hp posh pr ,.h 11 be
1d drevoked.
ICOt here TIONLENDING AGENCY I, - "'-
�. 1 h ttby whichfil at th s a o S n n7'ng agency forthe performance : I,
Leah k 1 r which th perm,a slued(S a 3097 Civ.C.) - -
�^ z -Lend Nm _ ... '.,-._ _.
Lend Add ss'• . . _". . .. ._... . .... !_ ... _ _ _ _
- V 0 Ices ify,hat I have mad has application ane stat.,hat,he above information is
'collared.I agar to eomply.wi,h all city and county ordinances and state laws rcla,ing
P'V to Inarldingc< ,ronion and hereby immonzi,rcisenralivcs ofthis city to enter upon
Nebomentioned impaction purproses.
cot rale) g e t Propensity
m fy and A p harm) the C ty f C pert no,.a..
p3 liaCis is judg w cos, d pe xs h ch may any w y ante against said-
Jz Cly oc q mer ofdi gvnt'g ml penny "
'APPLICANT UNDERSTA\DSA\ 5'ILL COMPLY N'ITHALL NON POINT ' I /5 D
S tURCE G Io s. /.r Issued by: Date
p,u omme �.•( c
f PP gorcupan,lime handl hazard" material,
Re-IOOfS
wB she r had g .-Type of Roof
HAZA S MATERIAL$DISCLOSURE Dat
bold
def cd by the C pc no M n c p I Code Chapter 9 12 and the Health d Safety yP Code. ---
Codc ser,. 2sSi2O rY.H r r rl l t}1"t\: ',t 9 ( h Fria
❑Vc /3No t t ! 1
I/ All roofs shall.be inspected poor to.any roofing-material being installed.
Will,"dna ire , all b Id_ g occupant q e met If a roof Is installed without first obtainin an ins ection;Qlagree to remove
r,iit h l ha read,hfh z d us aleriale-'bireme u p APr Oddity Management m g p
c 17
all new materials for inspection Applicant understands and well comply with
cal 611 non--poiitf source regulations g
n hr be 10 d &Safety C e Sam q ander Ch pier 695 f the
Section,25505 25533 ad 25534 1 d rsta d,har _
ft - s no,currently have a gnat Nat , y responsibility to miff the' '-'- ' - _ - --
H al,h
auP fg rel. meal $h' uz,ba ell Prion 1.isle a feCanfnne of Y �//�
ant
t 2: Date
Ownar or aunt
Si tore o A t
- - _ ant Dnte. � All roof coverings to be Class "B" or better
r OFFICE
S � Lj
• o r'e '.x
F7e Edd.Ye- lrnrs��ertui.Fgrmat fSgttwds.Look y+vdaw yelpZ
� �Ly4 V' � "iY1 �t v`'I �1f:',c��,\ 2� Al �4% �.�i I�IIY � ��� lSi L��IQ ' .•:.... 1" „ �� ."•�
SEA
Input Permit_Number,: 51408 •�•
PERMIT#: 51408 ARCHITECT: VALUATION: 13688
APN: LICENSE p: ISSDATE: 32
SITUS STREET: BARRANCA SUBDATE: 3R/98 PLCHKDONE:
SITUS NO# 10857 TYPE. RSA LATE CODE:
AVE CT,STAD: O
N,S,E,W: DESCRIPTION: REPAIR PATIO BLDGDEPT:
NO# ENGDEPT:
CITY: PLA14DEPT:
ZIP PLCHKREO: N CMA:
CATEGORY: CTRFIRE:
LOT#: O DATEDUE: SANDIST:
ID: RK Commercial HLTHDEPT:
OWNER: Cp.iapllp. STR TOTAL,
OWNER CE ,0 TOTAL:
ADDRESS: ONap#II#' INSPHOLD:
CITY,STREET21P: Residential rI� I
RN-sn#II#: !�
CONTRACTOR: RE-sR#IIU:
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10857 Barranca Drive
c Cupertino, Ca. 95014
c/e` January 4, 2001
I�
City of Cupertino �70
Building Department �v
City Hall
10300 Torres Avenue �V t
Cupertino, Ca. 95014 `C/
t v
Attn: Jo Antonucci, Building Official
Subject: Building Permit No. S 1408 C�\
Issued March 26, 1998 v
Dear Mr. Antonucci,
In response to our telephone conversation this morning, I am requesting
• that you consider the above valid, so that construction can continue on
my addition.
I secured this permit on the above date with the full intentions of
moving ahead with the addition at that time, however, the bid which I
received was more than double the estimated cost of $13,688 as stated on
the permit, so I had to reconsider my financial situation.
I have now secured a building agreement and wish to be allowed to move
ahead with this project.
I do appreciate your kind consideration of my request and hopefully the
inspector will be allowed to return today for the inspection which he
came to do this morning and at that time, I became aware of this
problem.
Yours truly,
Charlotte York
408-245-1090
•
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