02040149 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDNG ADDRESS: PERMIT NO.
r 10637 FARALLONE DR WESTERN REGION ROOFING 02040149
OWNER'S NAME: APPLICATIONSU DATE
RAZNATOVICH BOZIDAR A AND JO 231 N 12TH ST 04/292002
PHONE: (408) 360-9111 SANITARY NO. CONTROL NO.
�OD ARCHITECT/ENGINEER: BUILDING PERMIT NFO
BLDG ELECT PLUMB MECH
u r-I L. l u
LICENSED CONTRACTOR'S DECLARATION
z 1 hereby affirm that 1 am licensed under provisions of Chapter 9(mmmencing Jab Description
with Seetion7 )of Division3ofthe Busing red Professions Ccde.and my license REROOF
yf_ is in full ^ end^`t p 1/2 " CDX 30# FELT, COMP.
z m Li¢nse C ss Lir.x
uok� DK Comer°rq 30 YR ELK.
O G ARCHITECTS DECLARaq 1
H5 5 1 understand my plans Ehall b,used as pubi'?!TIF
a p O Licenced Pray euionel
l$ OWNER-BUILDER DECLARATION
so I hereby off tat shot 1 on stomps from the Contractor E License Law for the
h? following mason.(Section 7031.5.Business and Professions Code:Any city or county
3O which requires o permit to construct,alter,improve,demolish,or repair any structure
$ -priono in issuance,,also requires applicant forowl,permit to File a signed summers.
Nei ha is Jimmied pursuomsolhe p/asiuons of the Contractors License law(Chepter9 ,S Ft_Floor Area ^ - q��s1 anon
(commencing wvh Smtion:7000)of Division3ofshe Businessand Professions Code) I '• it Cl•. .1 .} 12 CG'0
or shat he is exempt thertfiothand the basis for Ne alleged Edmption.Any violation
of Section 703 1)by any applicant fora perms subject the applicam m a dvil peralty,
for WE roue thin No hundred dollars(5500). 36691 �411I1?eIJ0 o•o.f'+O Occupancy Type
❑].as owner of the propeny,ur my employees with rages as their sole eomp o salon,
-wi0"do the'"dark.and the awvic.is not intadN or-ofered'for sale(Sm:-7044;- 3 05 - FRAME
Business ond-Professions Code:The Connector's License law does am apply to on Required Inspectiohsr` `t I-
owner of property Who builds or improves nhemon,and who does such work himself 307 - INSULATION
or throwFor
h his...employees provided that such mprommems art not intended or ., .. „__. _ _ r -s
,'offered fo sale N howevcr,the build ng o t pm anent is sold wuhin one year of 01 - ROOF TEAR- OFF •'..:" „ .,, 0.'•
complad n rhe ownerbudder will have the burden of proving that he did not build m
improve forpurpartofeale.). 602 - ROOF PLYWOOD NAIL
-ROOF-BATTEN
cc 1.as owner,r the property,oro cadiness a contracting with licensed,:)The
to - - n..i i•(' .1\ V r
conswm the prolan(sec 7toa,Burnes and eroruz ora Cod,:)The Contecto r, 604 - ROOF IN-PROGRESS' ,,c
License Low docs not apply m an owner of pmpeny,who builds or improves thereon, "
.end -----------
Consumers
:cense Lanw. prolecu.wiN.e covtrana(s).liceved-purtusnt.to.Ne
-_ Contraaala IJsenu Lew.-. t.d .
❑lam exempt under5ec:";� r:'�B'A PCfee M
0" One
WORKER'S COMPENSATION DECLARATION \s
-I hertbY effirn eMtt penalty Nyerjury,Nes of sbe following jf. -ka,'.
moi' ❑ 1 hese and will'mainla d N Cmific.le of Conuni so ulf-insu /C°mpevgtion;n provided for by Senion-37t70 of the Labor n 1 I
_ performance of the work for which this permit is issued. J]U )
❑I have'and will mainuinWorker':Compeuation Insurance, ti required by Section
3700 of she Labor Code for the rformo ce of the work fa,which
Com mud Insurance carter roil Poli numtier
P
er IY ,C�E rf w s. _ c_.
ds,Poli
smell M�Wmke/a
.IS OR 3'
IF7C TION OF. O ON FRO .WOR[(ERS1
^ - CQMPENSATION,NSURANCE] .-. I. _(l _ _
It''' rrhis sennan need not be cmuphai"d of the
p perosis is fm one hon client
15100)or less) A
'hill
r' I ttnifgwt in the pert anormann the is t for which the,perm t e oared I ..t s. ''n' -r1 r;..,r•,• .-__,_..._. .....-,.
shell en employ any f Cann m a. manner,u is to become subject to the Worker' '
r
Compensation l" L ICelifomial Detq
-Apple t CA _e,nuck.. . -...__.. .: ._. _..._. .. _.
+NOTICE TO AP LICANT.If.ahcr makin this C,nificme of Excm tion; eu shovld; •"'! l <-: ',..
Z become subject so Ne Worke7s CompensmTon provisiaru of the Labor Code'you muss
Q O forthwith comply with sucA'provisions or this permit shut be damM revoked.
I-'
v� j., CONSTRUCTION LENDING AGENCY -
a 1 hereby affirm that N m r a eon uucu n Ian y agency for the pierficarnpne ''•t 7
of(be work for h ch sirs� acres I,I. (Sec 3097 CN C 0 -Lmdr'stheme" . _ .:....... - _ _ .. ..... .- _._. ..__ ..___ __ _. .._. ..._ ..._.
t:Z. Bider Acklm's';•.. - _ r.. it
U y. , I certify that I have reed Nis applicesion aM nem tin Ne above information is •- -
fa-[r corrkna agree to comply with allcity and county mdinences and nate laws relating
0. so building construction,and hereby,suthorieerepusttndivasuf this city to enter upon
the above-mentioned property for inspection purposes.,,
L,6a (Wei agree tosave,indemnify and keep hamdcu the City of Cupertino si unn
h lies.1 i 4 jacipm enu,costs ab upete.which may in any way some,against said
Chy in consequence of the'granting of Nis Permit.
APPC CAhT:[hbERS YANP NTLL CI
Q PLI`51I ALL'NOif-PdCd` r
soma E'R n ArI S: , I ro Issued by: Date
. .. nrappyexAlARlmugMATER16LSDISCLOr�- Dase7•`I" Re-roofs
"'. SURE - -+rlt
dIN� hart reruns Wildingoccupied smteorhnidle haxWausmncnu .Type of Roof
de Chapter 9 I3 and the Health and Safety
as d, by she Cuxn no Mumnpu c -
CodeStttion 5371e)7i �^ F . � ' ' '" 'a
era.. /4'f\"°,: , w All.roofs shall,be,inspected,prior to any roofing material,being installed. _
Will ft..pp0eant nr PoturtW d all minimal pm equipmentat choice wh¢n If a roof is installed'without first obtaining an inspectiom'I agree totienlove
emit h ncardous air contaminants u defined by the Bey Am Air Quality Management
Dismn^ all new materials for inspection.„,Applicant understands and will comply with.
- _. _.
_._
11:,
( °Ya. lie. 9; ° '..i all nOn-point SOnrce Iegulation5 t.,,:.t
4 ace ant di d e not cur tly ah muss en a dermis o� df•Co!ori to e” - ' "
Cu ramie H T&'Safer Code Sections 25505 8533 and 2553, I urdeemN N e
n
1 hi 'ad the herudas mn,rius rtgmrtmens under Chapter 69Tof - -- -- - _
/ i/Web building roes not currently have urnent.hats um e^ nbnht oto rani( the .. ��_`l O-2
P Q ., m P f.. q ,. li-r
S g ature of Applicant _ ...Date..-
y
• e or uthsmumnggm:r•.` r one All roof coverings to be Class "B"or better
.. ..._;::r . .,a .''';.. ,. t)., . . ,_.. ... ', . . ..--OFFICE ., ._-_ ......... . ... .._... . _. .. _ _ .._ ... ... ......... ..... ...._ . .
-t
Building Division
10300 Torre Avenue
a Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY 0FFax: (408)777-3333
CUPEkTINO
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 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 Name: J o w I` z it, A-Toy/ c (n
Address: I D6 3 7
Reroofing Company Name: �JJ �i... 12 eS;ui `IC o44
Applicants Signature: Date: 9 ja�g—
Joe Antonucci
(Chief Building Official)
6/25/01