Loading...
06080054 CITY OF CUPERTINO i�-"r`tk sc�":,hn"T«s '" t�b: 4c.ass•°' ',' BUILDING DIVISION PERMIT �ONTRACTOR�'INFORMATION H3.°f;xut i?�$"" .,.4aF.,s: •d =.'u 1: ' B UILDING ADDRESS: MIROSLAU DRAGOJEVIC pERMITND.06080054 955 PEAR R'S NAME: PERMIT ISSUE DATE MIROSLAU DRAGOJEVIC [AROCHMCT(ENGINSER: NE: SANITARY NO. CONTROL NO. BUILDING PERMIT INFO BLDG EUCT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION O O O F 1 hereby a1Rrea that I am Incensed under provisions or Chapter 9(commcn m9 Job Description ;¢ with Secdmi7")of Division 3 of the Business and Prafcesiuns Code,ad!my license is « I.full forceandeff«I. REVISION TO ORIGINAL PERMIT 06060033 Datc Class Lk.a REVISE ARCHITECTURAL - STUCCO, TILE ROOF, CHANG o Da¢ ComDECL ARCHITECTS DECLARATION wndemane my planamu Wnsed sspaM1Oe mmrds � � ENTRY, AND SIDE SLIDING DOOR Rau C Licensed professional 5 OWNER-BUILDER DECLARATION if I Wmhy.(Sero Nal 11. exempt from IM Contres;Cod :A.,c Law for Ore -❑o following mason.(Sado.103 1.5,Business and Pm@ssions Code:Any cityS county $w which t reyuea issuance.pmmit re convm4 pplic improve,tle ermit i ri mash any swnuro .zs that het itsensedporti requires Novisiosofant for Such permitm Gane,le a Law(Cha ned mem Nat Lam is licensed pursuant to Ran of Dision3 of ConummrandlifLaw(CMper9 Sq.Ft. Floor Area Valuation (cd their(commencingwithtSmdm 70nd of basis For rth glan eed examp on.m vi Code)m $274822 Nel W u exempt IWre(rom and tW basis fm the alleged exemption.My violation of Section 7031.5 by any applicant far a permit subjects the Spit to a civil penalty of APN Number Occupancy Type not mom than fine,hundred dollars(S50)). Lupeanuk.Nm beamty,mmyotimanceswiNwaga un,Sei:. .Bhusition, will dofewort ande: he Contranot NtenMtl Lawddsnot.(Sec.70th,Business end artywh bu Cade:The minnocent, t License Law dots not apply lf rt owner of Required Inspections own am who Wildsmireprevvchimpoandwha are no,am ended altrer@mugh his awn employ building Nm such impmvemmts are not inmced moBemd(male. r. however.Nebuilding mcen of mml is Sold withinarcyear ofmmpkeforNeownm- builder will love Ik burden o!proving that W tlitl nm build m improve for purpose of Sale.). 0L.td,— er of IW am ucluivelY conuaming with IittmW ronuxiors to conswnprop c.] Business and Prefesdons Cade:)The ConuaemrS U. L, Tat ply m an of propcny who Wilds or'unpava IWseon,anewhoconn for sir RejecN Na cormaebKs)licer@d pursuant in Ne Contractor's Liceuamin tun ,Bit PC fm thisrecto Data ER'S COMPENS TION DECLARATION J'�iclbad by affirm rpevlsy of arc of be following leclaradoon: ❑Ihawill main in a Certlficautof Corue.tinself-insure far WorkefsCompen. satin., fm by Section 3]00 of Ne LaWr Code,fm Ne perfmoutn.of Ne .arkfokNispermitisissued. 0 1W will maintain Worker's Compntsadon Insuran..as reyvirN by Secdon 3700 of the Labor Code,f".perform...of be work for which his permir is issued. My Wmixt',Compensation Im.a ..mint and Policy number are: Carrier, polity No.: CERT GTE OF E% PITON FROM WORKERS' COMPEN TI INSURANCE (TTusedon enol been plmetl if permit u(mane hundred dollwai(SI00) or kssJ I cmdfy Nat in Nc o e o Ne Int which his permit I.issued.l shall nes employ any person in u o o e u 'en to lW Wodrzn'Compeaaion Laws of California Applicant NOTICE TO APP 1 :If,aR .king this Ce (scare or Exemption,you should become subject N the orker's Co nsadon provisions of the Isbor Cade-you moa .JO foMwithcamd with nth pmvida or dupermit shall W deemed mmkcd. z2 ONSfRUCTON LENDING AGENCY (--� Ihemhy affirm that Ncre iso coatmctinn leading agcnry for the performantt of CL> the work for which permit u issued(S.,3097,Civ.C.) 0.Q Icndoes Name 0, z ress Leder.Add V C) I wary that 1 have ro Wes application and suN that Ne also information is correct.I agree to comply w all city and co Ninances and sate laws relating m O C.1 Wilding conscuction.and yauthorin pnSm imsafthiscitymenterupnn Ne ahove-mcntiuned property f r t spection pt 1. F G (We)agree to save. J reify and p harml the City of Cupertino against (n li.bilio.J.dgmcnts,c.as n e .secs kh yi. .,act.ag,iiStaid City of he U APP ILCANTCUNDERSr D NSDpar IL C L WI ALL NON-POINT Issued by: Date SOURCE REGULATIONS Re-roofs Sigrid n rotor xazA ru MA DISCLOSU Type of Roof WHIne.ppifcamou uturc Wilding pant store or hack harslmd,material used by the Cupertino Municipal Cade,Chapter 9.It-and Ne Health and Safety Soedan zss3z(,)7 ❑Yes No All roofs shall be inspected prior to any roofing material being installed. ❑ If a roof is installed without first obtainingan inspection,I agree to remove Will theapplicant or future building occupant use equipment or Wvims which � g emit It.P.n s air conuminan defined by Ne Bay Area Air Quality Management all new materials for inspection. Disvict QNo ad dmhu ausmamria n uimmcnuundcr Chapu:r G95oftWCalifor. .is Nest ctycole. to Z55505.25533 and 25534.1 undennand thin if dm Wilding does Inst ly hoes t to my Hili,to notify Uc aavpant of Ne require tit tit el to of.Geminate Signature of Applicant Date Gwn.ra ,uthori>edag t N All roof coverings to be Class "B"or better