03030012 ;8Ufi.DINO
TY OF CUPERTINO `"�""'n"°' '`^*
BUILDING DIVISION PERMIT
ADDRESS: EASTMAN CONTRACTING, INC PERMITNO.
10148 C SS PL p2n-Anni ?ER'S NAME: 1418 DOUGLAS ST PERM1TISSUEDATE
KUZNETSOV VLADIMIR AND TSIA
"E (4 0 8) 971-9000 SANITARY NO. CONTROL NO.
ARCNI'IL'LT/ENOINBER:
BUILDING PERMIT INFO
BLDG ELECT' PLUMB MECH
Q Q
app LICENSED CONTRACTOR'S DECLARATION JobDescri tion
I hereby&film tied I am licensed under provisions of Chapter 9(oamo entlng P
with Section 701111)of Division 3 ofdm Business sod Profession,Code,and my Ikeme is
n� in ruRfREROOF .
SIX.• .
fp De mac T/O ' PANEL SHAKE, INSTALL PLYWOOD & LIFETIME
ARCH5 understand my plans"I bpubiic�r°m PRESIDENTIAL SHINGLES . F',NJALE®
SUD Licensed Professional
OWNER-BUILDER DECLARATION
1 hominy AM.
that 1 am exempt from the Contractors License law for tie MAR 1 8 2003
O O following reason.(Section 1031.5,Business and PmM fmaloCode:Any city m county
$(ai which requires a permit m construct.alter.Improve,demolish,or repair any stmcumt
km priorm its ksuence,alaumquirtaaeapplkanl forsuchpamitm Bleasignednammem
�< thathe is licensed purcurom the previsionsofthe Contrecter's Umn¢Law(Chapmr9 Sq.FL Floor Area ffln
zCC (commencing with Section7000)MDlvision3ofthe BusineuandProfeulnmCode)or BUII.
N 1
a et he h exempt Nuefrmm and do basis rm the alleged exempdm.My violation or
Section 7031.5 by Any applicant for a permit subjects the applicant to a civil penalty of APN Number X7B31Q)&Qy Type
Act mere bun fin hundred dollar;($509).
� I,uvwmrof the
❑ the
hwhhwwguutieh anis compeMineas
And
thewon,Cc :Te Comlanotkmweaefommas nt apply 7044.emimaa Required Inspections
end enywh mu Cede:The COnuutm,Licensendwho 4w doss or apply lf ft owner ofpropq P
mum enywho Wlldigor mbled that
ach Improvements
Amssuchwde Mmuloul formic.
ht. 305 — FRAME
awn employees,provided this vemimprowmw t ere m year ore m ledon.for Ales if.
builder.Nebuilding orimprovementhholdwithinoroyev ofcanpst,for the purpose
of
W nese will low the burden of proving that W am not boric m improve for purpme or 307 — INSULATION
sets')' 601 - ROOF TEAR OFF
m �a �i� Bnn: osC : e`an"t" Licooitu (Sec.7W.Business nrdoode)Thfpmuecte - 602 - ROOF PLYWOOD, NAIL
ceme Law docs not apply to an owna of property who Wilds u lmprow,Nemon.and. 603 — ROOF BATTENS
who eomncu for such pmjeeB with aoamrmter(s)licensed pusstssm to the Contnaon
License LAW, 604 - ROOF IN-PROGRESS
❑I em exempt under Sao. ,B&PC for this reuan
Owner Deb
WORKER'S COMPENSATIONDECLARATION
1 hereby Linne muter penally of perjury ane of Be,following decimations:
I Mw and will maintain a Cem6cem of Consent m self.uum for Worker',Comport-
L30"a1010
n,u provided for by Section 3700 of the Labor Code,for the perfonna.of the
far which this permit i,Issued.
haw and will mainWn Wooers Cempnsigon Insurance,u required by Section
ofthe labor Code,for the performmccof the wmk for which this permit b Ismed.
W ce,Co�mps tionI uranceICATE OF tinier er licynumber.:
fN3-)'^'�-fpai(c�No.:1 tD3L1�{}.790 CPr10N FROM WORKERS'
COMPENSATION INSURANCE
(nds secdennced not W eomplemd if led permit l,fmrone hundreddollam(SIt9)
or less)
I«rdfy that in the performance of the work for which this permit is issued.10,11 not
employ any person in any mannerso as At become subject to the Workero'Comirc utlon
Laws of Chef rola.Data
Applicant
NOnCE TO APPLICANT.If,After making this Certificate of Exemption,you Mould
become subject to the Workces Compensation pmvhions of the labor Code,you must
.,O forthwith comply with such provisions or this permit Mall be deemed revoked.
CONSTRUCTION LENDING AOENCY
[r4 'IWreby AM.that Nert is a comuuctkn lending agency for the performance of
C?y tho week for which this permit is issued(Sec.3097.Cih,C.)
Q Lenders Name
]z Lender'.Address
O Q 1 eeNly that 1 haw mad this application and slow dot the eWw Inrommion Is
LU correct.l agree to comply with all city and county ordinances and sum Ism relating It
Q ICJ building construction,and hereby authorize unutivas of this city to enter upon tho
W alwn-mendoned property he Inspection purposes.
(We)agree to taw.Indemnity and kap harmk.s the City of Cupertino against
faq liabilities judgmenta.eusu and expenses which may in anyway&come MAiMI mid City
U7 Inc Uwe of the ' tof this P"nob.
F7 AP ICA UNDE $TA S A ILL COMPLY WITH ALL NON-POINT Issued by: Date
S ULATION .
G I/ Re-roofs
of Applicorwonuactm I Mm
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
WIII the applicant or future building occupant srore rehandle bueNom material
as defined by the Cup aero Municipal Code,Chapter 9.13.and the Health end Safety
cede, yu fNe
zss3zt25532(.)?OAll roofs shall be inspected prior to any roofing material being installed.
Yex
Will the applicant or future building Occupant use equipment Or device,which If a roof is installed without first obtaining an inspection,I agree to remove
it haumnm air mnumiMnu as defined by f Bay Arta Air Quality Management all new materials for inspection. -
District?
❑Yoa 11No
I ban road the be anther.materials requirements under Chapter 6.95 or ft CAlifor.
nla Heal%&SafctyCode,Sa"iau 25505,15533 and 25534.1 underhand that irde building
does no by hen A ren that It responsibility An nedfy,the occupant or thn
im cm, khmuhbeme buton,Amcor cnficwcr =. Signature of Applicant Date
owns thedsed a antDine All roof coverings to be Class "B" or better
Building DlYidon '
10300 Tore Avenue
• Cupm*o,CA 950143255
` Telephone: (408)777-3228
C 0 F= (408)777-3333
CUPERTINO
Building Department
Subject: Reroofing policy for the City of Cupertino.
1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards
and manufactures specifications on reroofing.
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 reroofing 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) Preinspection 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 that the
proper City inspection can be performed.
IMPORTANT:
1. Flat roofs musthave a minimum of'A"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 of inspection
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name: U 1 a A•I m i t V,1 n 0
Address: 1040 Cis SS I?IA U-� C'!.r .G1M rLn
1;eroofIng Company Name: F C,+WU4',, ( isyl:l Aa r fiV1�-
Applicants Signatures Date: ()
Joe Antonucci
(Chief Building Official)
6/25/01