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CONTRACTOR INFORMATION:
DING PERMIT
BUILDING ADDRESS:
PERMIT NO.
1131 S STELLING RD
BARTUNEK CAROL R
02050194
OWNER'S NAME:
APPLICATION SUB DATE
BARTUNEK CAROL R
05/31/2002
PHONE:
SANITARY NO. CONTROL NO.
ARCHITEC (ENGINEER:
BUILDING PERMIT INFO
O
0
BLDG ELECT PLUMB MECH
z LICENSED CONfRACPOR'SDECLARATION
Job Description
1 hereby aRem that I am licensed under provisions of Chapter 9lcommencing
wwithSeetm.70g1.fDivisi.n3o(theRu.ainessundPro(cssiansCode.andmyliccnse
NEW ROOF
is
'' m full force and effect.
Claes
U
�'
Dam Contractor
ARCHITECT'S DELLA
DECLARATION
� I unJemmnd my plana shall he used as public reenacts
Ikm,1Wse
JUN 0 6 2002
Licensed Professional
OWNER -BUILDER DECLARATION
1 hereby affirm thin 1 am rsrmpt from the Contracmr, License Ww for the
following masoo.(Section 703 I.S. Business and Professions CWc: Any city or county"
O improve, demolish,
BUILDING $3000
which requires a pemtit to construct, alter, or repair any sumo urt
poor. Its issuunee. also requires the applit ant far such .it file a sigrad stammem
— that to is licensed pupoemo the provldons of the Contractors License Law (Chapter 9
Section.]M)of Division 3 the Business Proffcumis Cwlel
�n� pEt� F11{gou�+bea
Valuation
rcommeiic'ing wait of and
or that be is exempt he}afr'um'and the basis for the alleged exemption. Any violation
.i,-ONTB62ar"1.01 JI'0Itl
-of Sre1i.nr03P.5byanyapplicon fore permit aubjeets the applicam mvcivil pcnalry
;of nm more than five hundred dollar. (ssW).
103APNUr
==c•:,r �:.: Occupancy Type
❑ ].as owner of the property. my employees with wages as their sole compensation,
- - d Inspections
will the structure is not intended 9lHa,"
eredLaw foes not
theand
prkpand
a applSecy
Business and Professions Cone: The License Lew Jas not apply m an
ne
and
107 - POOL / BO1 S'APUf� p
rovestContractor's .
w
owner ofh his ow Who builds or improves thereon, and who encs such work himself
.rthroagM1ha.wnhoweveemployer, archon cook,
ROUGH- --- —
yearof
-offered ,the ildedmmsachimprayrtnsol e rof
sale: If; however, building br urden ki,mot is sold he a.,
.__. .-_._30.1_.-_.
''N" 1 xv1",�1.
did Wild
nmplction. rite owtrcrhuild<r will have the burden orproving that he did not build or
le,im
304 - ROUGH ELECTRICAL"
improve far Purpose of vie).
502 - FINAL PLUMBING ENERGY
❑ I, as ownerMthe pmpewy area 1 vely of i g lit l' d tracwrs to
_
503 - FINAL MECHANICAL ENERGYif J:"[:
- onswct the project (S 90 1 Business d P of . Cad ) ThContractor s
.woe
- License Law does not apply t a r of property who builds or improves thereon,
506 - GAS TEST
:.. and who.commets fLaw. .Prolttu wi@.a. contractors) bcenuJ.pursuam to. We-
._.__.__._ _
SIO' = FINAL PLANNING -'."77 ---
ase._._
c.ntmctm'aL«am< w.
:'slam m anger ser..' " .B�Pef°e tri. reaa.a
_ +..�;:.crl,: :on
511 FINAL POOL
PI
516 - FINAL BUILDING
It]N DECRRR�N
f" Ihereby affirm under penalty ofperjuryphc,of the following declarations:
01 hoW,knd isili' mainiein a Certificate of Consent to self -insure for Worker's
Compensation, as, provided -for by Section -37W of the Labor Coda- for the
performance of the work for.which this permit is Issurd(
❑ I have aria will mainmin Worker's Comprniaiion Insurance, hs required by Section
39W of the Labor Calc! for the performance of the work for which this permit is
issued:My Worker's Compensation Insurance caller dna Policy number am: "'
C>m (tCERTIFICATION
�j CC
a\ F i s• F"' S'� d p7 s 1 1..i I4 J 1 f I� `•: l . ,,.
5------
:OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
,,,,,-. -,�
"-
"' jrhusseeuon need not be completed it the µnous( one hundred dollars
I l'tt • t .1_
ISIW) I )
I rtfysht' tit pe�fmrqomen y)�°r tb kfor wb huh d 1
-.hill
,i ', ,Ii'.IJ.'Yt1 S41t '
ttop dsiss
It e pl Y i Y R w in yuan ur6i.p' Deaggq. hl Lit to (ha Worke
C mpcnsuvon v f a to _Q✓'•!�/�I\
of erJi
ACETO C makingthis Cenlficmcuf Exemption. you should
•-`^
hcebm s bjeet to the W k opens t pct ion.. of thr I,@wr Cade; you must
fdrdivuli comply with h p ions or tNs pertn t shall br deemed revoked,
y i'nr:..I„_-cv,.r• CONSTRUCTION LENDING AGENCY.
I hereby affirm that there in a cimstruciion lending agency for the performance'
-
'
yof the work for which this permit is issued sic. ]099, Civ. CJ :�,..
.... .. .
Lender's Name -v. o......-., .....:.: .-.:.. ...,,, - ._ .. .. .:..
.._ ._..._ ._.. _ __... ._ - .. ___ ._._.. _... ... ........
-
C'areer'sAdareshat ,.
at
1 have read this application mrd stoic thin the above information is
1 certify ad
to
octet tr comply with altciry and county su nam laws relating
1.m
natives oand
;J Willi phis airy to enter upon
theaboingconumed propenc�rtby,peclii2eecposcnmtives.f
the aMrvrmeminneJ property for insp¢tion purposes. ,
y,1 1Wel agme ui save, indemnify and keep barracks rite Ciiy of Cupcnino'against
A liabilities,jag ms. .L dcapenu hchmay to any y' ugain.t.aid
z Cityya co meq e ce of thegranting of tit penult.
\PpLM1NTWDCRST\NDSANDIVILLCONIPLYATHALNGN-POINT”
$OL 'tLGUL. r t'
Issaedb ! Date
y
.D
Re roofs
ig Ap macer et e j - Date. -
_ HAZARDOUS MATERIALS DISCLOSURE
applicant ft thudding verupotstore oeWr haallousmam 1
Type of Roof.
yp
as der, ed b she Capem M 'p Cad Ch it 9.12. J tit H, Ith end Safety
-
• -
'• \ g S'j•" 7 •, 21�
Cirv1e S<c(od25581 j t m..,.
1 ''- r
f - t ;•. 1.
roofs,gtiall,be,inspected poor to any roofing ma[erial.being.installed,
_ •
wu m npplw t r tar ba'dei g p' t rrq p t d ce, rich
.All
If a roof Is installed without first obtaining an inspection; I'agree`to remove
emti d Informantsas de0ndby tit ByAreaArQ Quality Management
District?
all new materials for inspection Applicant understands will with
°Yat ANN\
_and _comply_
all non-point--sou[ce regulauons... .,
1 have mail dhe Mckmaku, materials requirements under Chapter fi95 of Ne
California Health k Safety Code: Sections 25505:25533 and 25531 1 unde Wi nciMas
-- - - - _ }
-if the building does not currently have a tenant. that it is my responsibility m modythe
r �7 f d >
rccupam of the requirements which must he ren prior m issuance of a Cmifinre of
.;
�-
;' Occ ancY..: ...
.-: - -
ignature,of pplicant Date
All roof coverings to be Class "B" orf better ' �.
oat circa agrm. , Date �
..OFFICE-
CUPEkTINO
Building Division
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3228
Far: (408) 777-3333
Building Department
Subject: Reroofing policy for the City of Cupertino.
1. Prior to permit issuance, you must agree to comply with 1997 UBC Standards
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 of inspection.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Nam;A P i
Address:
Reroofing Company
Applicants Signatu:
Joe Antonucci
(Chief Building Official)
6/25/01
�"Y/
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.
6.
If plywood is installed, a plywood nail inspection is required.
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 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 of inspection.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Nam;A P i
Address:
Reroofing Company
Applicants Signatu:
Joe Antonucci
(Chief Building Official)
6/25/01
�"Y/