08090046BUILDING DIVISION PERMIT
WAY
eNER'S NAME:
GLUMAC GEORGE J AND EMMY B
PHONE
ARCHI'IECf/ENGINEER:
1 hereby affirm that 1 an licensed under provisions of Chapter 9 (commencing
with Section 7000) dDivision 3 of des Busineosed Professions CMA.AM my I'xense is
in full fora AM effect.
License Class Lim. a
1 undersand my plas shall be used as public marls 3 ' ,
Licensed Professional
OWNER -BUILDER DECLARATION
1 hereby Affirm that I an exempt from the Contractor's License Law for da
following mason. (Section 703 L5. Business And Professions Code: My city or aunty
which no uiw A permit m Construct, Aker. Wprove. demolish. m sa
repair any clme
prior m its issuance. also requiw face applicant for such permit to file a signed sak,mcat
that he is licensed pursuant to Ne provisions of the Comruter's License Law (Chumar 9
(commencing with Section 7000) of Division 3 of the Burins end Professions Code) An
that he is exempt therefrom ad due buts for the alleged exemption. Any violation of
Salon 7031.5 by 1"aPPImaE fora permit subjects the mplient An A civil penalty of
not mart than five hundred dollars (SSW).
❑ I,uowner of the pmlany.amy wplayw w'mh wgasastie4 role Compcnsstion,
ad nd Leask. and due rwctme ts at s LnGA a it.
Apply A, a, Bulneaa
and Professions Code The Canuamr's License law sive rot apply b an ower d
however. Ne building orimpreveraent is sold within mm year dcompkuon. due owrcry
Wilder w01 hove the boors of moving that he did rot build or improve for purpose of
sale).
0 1, as owner of the property, an exclusively contracting with Becomes contractors An
amwct the pmjca (Sec. 7044. Business and Professions Code:) The Conaker's V.
cense law dons not apply An an owner of property who Wilda or improves duerem. and
who Contracts for such prejects with a esoracmr(s) Ilansed pursuant w We Contractors
Liccme, law.
O lunaaemptunder See .Ba PCfothisreaam
Owner Date
WORKERS COMPENSATION DECLARATION
1 hereby affimt under penalty of perjury ane of the following dechum moor
0Ibaa ahaw01 for
aCon 37M of the Labor
for fa Winter's Ga mm ons
abort, r poviMi for by Salon 3]W of the talons Cede. far due performance of the
work for which duns permit is ivued
0 1 have And will maintain Wartch Compensation Insurance, as imputed ted by Schon
37W of due labor Code. for the perfannarae of the work fowhich Nu permit is iaued
My Workers Compllenwion Imurarcs curia and Policy number are`
COMPENSNION INSURANCE
(Otis acnim recd rot be completed Uthe permit is for. hundred dull. (SIOq
or leu)
I terrify that in the Performance of the work for which Nis permit u issued. l shall m
employ say person in my matter As m become subject to the Warton Compeuadon
Laws of California Dae
Applicant
NONCE TO APPLICANT: If, after malting this Ccnificae of Exemption, you should
became subject An the Winker': Compensation provisions of de lobar Code, you must
.J forthwith comply with such provisions m this pew
nit shall he demand revekcd.
O
Z CONSTRUCTION LENDING AGENCY
j -r I hereby affirm that dam is a construction lending agency for the perfoman of
C the work for which this permit is issued (Sec. 3097, Civ. C.)
6Wi Lender's Have
Z Lcndee. Address
U O 1 Certify that 1 have rod this applicatim and sae dust the Above idmm,lm is
g4 ^ comms -
I age a Comply viN All city ad county aNauha
insasuer laws rom
tating
O IS.^! Wilding construction. ad hereby authada tepwenudves of this city m emuupnn due
W above-meManed property for Inspection pdrse
paa
(We) Agee be save. indemnify ad keep harmlw the City of Cupertino against
H h Iiabilidcs,judgments. costs ad "Across which may in my way acemMaine, said City
U Z in Consequence of the grade, of this permit.
t—' APPLI:ANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
HAZARDOUS MATERIALS DISCLOSURE
Will tie applicant or fume building oecupatrmre or hack, henardons material
defined by tier Cummins Mu 'riPal Code. Chase, 9.11, and due Health ad Safety
otic, Section 15531(+)?
0 Yu o
Will the Applicant ar future building occupant use equipment or devices which
amlt h®afdom Air concerti nana u &fl.d by the Ray Arta Air Quality Mate,emcm
Dlsuim7
0Ym IN No
1 have read the hvallouQstmaerials mquirtmenu under CTepW 6.95 of the Califor.
nine Health&Safely Cade, Sued.. 73505.25533 uN 15534.1 unArsund Aatfret building
does on curremly have A been, And it u my ne,dre i,huy An but tle neeupat of da
QUALITY WINDOW & DOOR
3597 HOMESTEAD RD
INSTL 9 WNDWS, NON -
Issued by:
Re -roofs
Type of Roof
08090046
PERMIT ISSUE DATE
09/10/2008
SANrIARY NO, CONTROL NO.
BUILDING PERMIT INFO
Required Inspections
Date l�Y
All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtaining an inspection, I agree to remove
all new materials for inspection.
Signature of Applicant Date
All roof coverings to be Class 'V* or better