00110020CITY OF CUPERTINO''3^iN
i'Y' 3A :."
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BUILDING DIVISION ''
CONTRACTOR INFORMATION , '
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PERMIT
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BUILDING ADDRESS: v - ! -
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PERMIT NO.
,t �• 3
06p—
OWNER'S NAME •.
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APPLICXUON SUB DATE
ft
LQR1 C-
500 AIRPORT BI 11
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SANITARY NO. CONR L
ARCIIII'ECI'IENGINEER
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- BUIIAING PERMIT INFO
RLDC '- ELECT PLUMB MECII'
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I�,I ... Imo:.
LICENihD CONTRAC I O125 DECLARATION
is
,. i Job -DCSCrlpflon 'd^
' 1 herehy oflvnn that I' licensed ed J p f Chapter 9 (commencing:
with Secfon 7000) of D on 3 of the Hu and Pa.[c..inns Coda and my license-
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fail f and dicer. ..
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Data - C mlmacr -
ARCHITECT 'SDECLARATION
REPLACE. 50 GAL, WATER
I nndereland mr'pmna sn,dl rte asap ax pnmia record.
-FlEATER
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Licensed Professltnol �• •
. OWNHR-BUILDER DECLARATION
1 hereby affirm that ['am c nampl from the Contractor's License Low for the
foil git (S I 70319 N s dP r n Code Any Lify or county
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which q r p I t 5 It pro e, deradish, of repair any su more
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prior is asuance alsorequires the applicant for such Pernrmanicured,lo file asgned manicured,
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Sq.'FCFloorArea,
_
Valuation
math slicensedp d Precision, —iftheCo,tractori (Che,ter9
(co ,cnelagwith Seeian 700dot' Division 3 of the Business.,dProvisionsCode)
or (hat he Is exempt fl erefnia and the basis for alleged exemption. Any violationof
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally.
that five bundmafdowas(s5W).-
APN Number
:'Oecupanc zy�e
of not more
9"
,
, .8 00
13 1. asownerof the properly, tarry cumloyeei with wages as lhcirsolecompensalion,A
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❑Ired Ina eckon&
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will it,, he work,d the structure is ird unfurled rff rml for sale (See 7044._
.Bu: t P f . Code Th Contractor's 1 ,, 1 ew does nm apply It an
r of properry Who builds or improve. Iherwt Ind who does such work himself
,. ?2.F,1 092. t '
ar irm"'It his own employees. provided that such improvements ore not intended ars
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offered for sae. If. however. the building o� Improvement is sold within one year or
.
mempletion,the pwner-builderwill have the burden ofpmvmgthal,edidno, haimm
�0c'--FSNAL PLUMBING"'ENERGY
ap..ve for purpose of aolc).- a
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•. - • 506-- GAS. TEST - -
El 1, e d he Property. ant a,aiusi ly candlonatirg who f I de toratn
m I_ l the p, I (Saa,7B94Business d Princau.is Code :) Tire Contractor's
907- FINAL PLUMBING
License L w does nut apply to an owner f pmpery,ho builds air improves theremn
and who contacts for such pr,acuk with a commetor(s)" Imen.al pnrsuanl to the
Contractor's License Law.-
❑Iamexempt under See .' :R& P Cfnr this me, at
f
Owner Daw
• WORKER'SCOMPENSATIONDECLARAIION
.. "
- 1 heavy affirm under pempy of pcirm mm of the following declarations:'
-
I h' and W ll- nu nl. n a Ceq'I'c I f C t It : Ir' I Worker's
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', apensafo, as pr J d r I y Sc t 3700 f II Labor,Cade, for Iha
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Pit, Hance of line work for which this permit 's,,uW
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Oil ... cardwill mm.I i. Wu k,r', Ctr,c... ion lnsmance, as requfrea Section
37W of the Labor Code, for the perronnance of the work for which this permit, Is
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med.My Worker's Compensation Insurance carrier and Policy Humbert are: -
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"Carrie' ' Policy No.:
CER'IIPICATION OFEXEMPTION FROM WORKERS'
COMPENSATION, INSURANCE
(This section neeA nm he enmpineJ if the pem,it is I'n(nne hundred dollaro
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($100) tr lux.l ..
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' l ierfy that in the Performance of the work Ra h'hthis Permit sisued1-
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sS
shall note employ any p y as d hoc are subject ui the Wnrkets
s
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. Conpe,smon Lows of California. Data
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NOG CHIO APPLICANTIt ft k bah' C YI t dExemption ynushould
become k -,C fabor Code'yau
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sbYrt to theta 0 :I provstns tf the mum--
fonhwthconplywlh me., mcoi,iran, or this pconjush.11 be deemed rescuer.
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CONSTRUCT ION LENDING AGENCY
I hereby affirm that Ihem ba construction lending agency for the perfamaince
work for which this permh is issued (Sec 309], Cie CJ
e, � _
Lender's ,
Lend : N
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vo
land r. Address
- lh lipplat1 Iry mat dal tin nh hinformationrs
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., 1agreet c ply int II. citymal county onfincences and state laws relyng.
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mmullingcon,lia,lior. andhereby mahrepresentatives fth' city treater upon
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the antve-or,m mm.
ea property I pecton p,mt,es,
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(We)agree It) save, indemnify and keep harmless the Cifyof Cupertino against
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liabilhies,odgmens. costs and aspen... which may in any way accrue r,iird suit
City In consequence of the granting of this permit, •' .1 •. r
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
Issued by: c- Date
SSLIeY• Dafes
SOURCE. REGULATIONS
'Stew rear APNicanvcomrador' -Dole -
'MATERIALS
Re -roofs
- HAZARDOUS DISCLOSURE
Will he apidwern Fannie building oceuprnt'arse or ba,me nasi min medal
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Type of Roof."
undefined by the Capen'm Munc'pal Code Chapter 1). 12, end the lleallh and Safety
_
,C<We, Seel un 25532G)R - _.-•.,
't .t e _ '�
' °rex - v EdNo,'
All roofs shall>be in prior idany roofing'material being installed.
Will the applicur; at future occupant use equipment or devices which
If a roof is installed without first obtaining an inspection; I agree to remove -
rand Insertions air conmminanls as defined by the Bay Area AiiQuality Managenmm
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iadc,1
call new materials for inspection., Applicant understands acid will comply'wifh
oNn
all non -point source. regulatioris.'
1 hwe rend the h J I Is redo mmmols t ode Chum,, 6,95 of the
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Cul roma Health & Sat Iy Code, Secdnns 255(15 25533 and 25594. I undrob Ind that
Blue building 7;e not cuO qtly have t terent, that it b,bc,pmd0tvfiI, In ao ify the.
cc pant of the reguimpr m: li ch must h t p' to issuance of a Cera fcato of,
Occupant, - :,t, ' f `
Signature of Applicant • Date
p
All roof coverings to be'Class "B", or better'•
Ow t aumad,ed agent D,le
OFFICE
NOV. 1.2000 4:56PM NETCLERK INC N0.969 P.1
= ' TO:'EPERMITS
720 Dubuque rermit
q Ave., South Sen Francisco, Ce. 9 080
!; °i'h1]:i',4'y 1il,i,aV„i�lh^� Government Services: 888-330-17774 Application
•' ^ ' r _ Fax: 877-846-5888
i11n�"I� 'iPYu�.,a:..�....m.duv
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To: Cupertino
Building
City Hall 10300 Torre Ave
Cupertino
CA 95014
4087773333
Permit Handling Instructions
Mall
The city will mail the approved permit to contractor.
Contractor Information
Company: WATER HEATERS ONLY, INC.
Address: 970 E. MAIN ST. #200
City: GRASS VALLEY
State /ZIP: CA 95945
Phone: 5302743001203
Fax:
Email: H2OHTRONLY@AOL.COM
Worker's Comp Carrier. STATE FUND
Worker's Comp: 1516265
State Contractors License:374573
Business License #:
Credit Card Information
Credit Card Number: 4678037179990 Visa: 0
Expiration Date: 1 /2001 Mastercard:
Card Holder Name: John P McGee Other:
Pre -reg: YES
Payment: VISA
Agent Authorization: YES
ORG❑ NOT❑ FV.[—]
Project Address: 22323 BAHL STREET
Comments:
N o t e s
Attachments:
WC ✓❑ SCL ✓❑ SASE RV AA ❑✓
Permit Type:
Permit to: 64181
Exp. 04/20/2001
Exp. 05/31/2001
Exp.
Exp.
Exp.
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qeem�
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59
1TOV. 1.2000 4:56PM NETCLERK INC
NO. 989 P.2
CITY OF CIIPFRTTNl7
CONTRACTOR
BIMEADtO DIVISION
INFORMATION:
13T.(t WG AD50RES5:
PERMIT NO:
22323 BAHL STREET
WATER HEATERS ONLY, INC.
ONNPRS NAtvffi:
Ai'PUCAT(ON ST)1B DAM:
j JOHN WETZEL
970 E. MAIN ST. #200
j [i SONE
SANITARY NO. CONTROLNO.
408/733-9109
GRASS VALLEY 95945
ACFRThCT/PNO)NPffiC
M=INO PIIIeMIT INFO.
5302743001203
DL15c LIscr. PLit(vfH R.max
LI�mCVDR's
1 bhtely -ff.,hb4 1 aro bvenewadw undo pmvui0m of Chepl,r 9 (rommeoenN
Jdf Dnutlpdon
with Sued. 7004 of Division 9 of dx Drrinaa not Pmbaeiuu (kda� red my liomi
b m bd f1f1��
REPLACE 50 GAL WATER HEATER
bona
I.:,ww�ti ear., 334573
11/01/2000
Dna: CpaUAMA — .
ARclnrzcrsnerxARAnon
. /.-fid _. Y Ohne.bill be mm m p:lAl ora e.
,A. rto.wotonvl
0wN9R_lyUMDERD9CW INTj0N
❑ 1 henry tae
.umn 1 Am vawtpt Dem be Conmtew'- Urpaa Law fa be
Sq. FL FloofAm
Valuation
blbwle, amm, (Sada 70113, Ruth= and PaefetNm Cede My chy R ae":ny
700.00
wbieh "rem i parent le MA64 ma. impm.i, dboloul:, or rtpec Any mupum
to m" peendeist n®�
pda m ki 4u pee. roe to it, dr l aft
bA1 tE S IiitnKd p:WiMt b bi pbYibel efOC CmV%1w'i lima U. ICmNef 9 (femmMnQ
APN N,—mKe�N /6 /� 11I
R� 'a j1 "I: CAI
Ocaupapry Type
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wilt oen-,risen I of pa Eudr® anti a 1.0 he u ump maan
iQ tN' W
reo wl7000)
ON Ne ebb torte charm "Impalon,m My .l I" a peCab)
r. D A far
70113 by my ailor.
A ,
i ba aP ie a 0 pertly clam mere (r
am thin fin (5500).
torea
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1, w W. Ab to pm4 a he cede vehm&.d aAel
a my, anab Amer wave p duo nob em,pmedw5 wI11 da
Reipdred INPOieION
Ca w"N. and IW Wv1 Y eon ml
t Bem ROQYiW
(a We Gelape Rel. Fi,
Cadek N dy. A Wm
[VeeIon dorm gpyetmwonofpmpey. nee hwlma liz
1[ "1A
ono dee iwp Pmeeek ,ha 2
Amba
nlmiaid R. ,mown Be 0.* ambo
mr,wi mu oft Amo
h.the V� diodd�bAill
oinPo`ao6
atem�o�onla�W- e�uilde"i
T proving tiav he did non b,iM
impfe`C Rt mfpeu of
❑or
t Be wva .1 pro'c moment, le
eml. A m,b,edtta with le)
(6m 1a A,
on 76, , l and Ry t Cade:) The evem
rownea da arej T
a a' I Yea ora',
Lew dmf vel opp(y Ip m newt of pwpmy wee bona or Imprnm beat.
ANvol
who N. fa fab pmjww wioh a oonoeuoa(,) liwvwd pmmiN m Na
C.
C.anvmmr, UwaM U.
Iam mompweder sue P&PC to Nb Nwo4
Oan OA1e
WOR CDaty nQCLAluTYON
undar erpAT1ON
mmdapoly,[ Cardenear at, ndwlemaam
love and will
❑Iew. A d a Cmidmra of Cpam
ment mor, Workm
eaor
a dwmaimel.
Compamaliory u pto.idW fon by Semim 0700 Of N, Leber Conry ft be
a Co
an none Aeda work adetlt ddapmovb bored.
I ms om willmtmew WakaY CemNwubn fmwws w pPtieN by 8eidon
K
or IM 14hmr Code, be da prefomimw or Ne work (m .1da thin earth It
,
Enloe. My WRA4Y Compenwtlov ftaurmw mtrbr and Polioy mmbw an:
con a STATE FUND Palley Na1516265
CQRTIpICATIO OTAX104 (0 eeOMWORiZERV ,
CON[PrEhli T ON INSURANCE
('ILie «atmmadet be(N p ifow its ler Polon(QI00) hAleen.)
1 rpUfy bon w Ne pub,nNna or
ole offor
utlek br wteh NII pmnN n Wwd, I
se
net m�by my, alcor ht ata evince m u m bxme atyh,t to 0w Wotkpl
O ,Law of CBllfoonb.
Ci
1/ 01
D�11/01/2000 n
NOTICE TO MPLICAhT. It nike aakin Nb C4AJ6w of Evmpoer, yon Aimed
baa® wdrjmh w her mdkeY Cmym— in. of ow IA. Cab M rm,a
ntIIwIN cN ab wilb nen W-11100 a NN Intone, fhnl be dcema aeroked
CO.NSTRUCIION LENDING AGENCY
1 hareley Aro but Jtpe Is n ammoedw Imdivg apmry 6f be pudhtm me
ort.. mark IN wbim bit pmt, le i0ndd(See 3097, Civ. CJ !.{-,;-pu;t�
--
Lomifr No
Unde'c Adherent .
I imlp' Eat I an rod Lill, #pDlianda, ae pew Np to vbe. Inhmaem e
remote. I icon, At womb wkh Oil CAP trod ewAly oralimlkee end case low, awdng
m building rembtadp6 AN bahhy noted. mptmeaiw, N bit any mala mon
Ne appvewntlpAod poop try the hepaden Purpoeev
(We) Itha w Ove, ind iry end kap wfmlW doe City of CupmWv mallo,
kablda, ludewanc emu and Ao m ebiei Be, m Any wq oma akAinft chid
Gy Mmaepwew clones
"ofm4
APPLICANT "••' '. EOCO
I f y wDACO COW LY wrtN nµ NONpINTCM
RRCTIONs
VLI `f.•"._: 11/61/2000
Rbmo4
Typos n"t
9igneryN OfAgllcmtl cAnaMta - nee
ISAZUIDOUS MATERLUS DISCLOSURE
Will to WE. a dam bondmg maxima Amon or head. hAzpdom rmtviu
INP phlN m an Mi� emmrial being INmRed.
NI m0fl abaLL be eared Y Miffing 6
u mRnm by fm Ctonadm Mb,ki Cede, N 9,1; and doe SVM nod Sn*
Cade,saNNISDb(v)7 Ye,L No
If a all 14 ieifalled Witham filar Obtaining Am beepol l agme m lafawe
all a m mer¢Itr for Impaction. AppRoam Ndeeremds and will comply with
Wil the Valium of fUum buiidiat camp,, Ne m*Nbm% or owlmi ebla,
all ep -Beim murce RpnW10N.
pe Am wnaminwiw{51�L,Qd1aalead by BAY Da Dion Air Gwiu Memepaa
MardnI
11/01/2000
1 love food ma . waiwinei�mqulaavam ,oder Caveat O.QS of the
Colif eek Roll t urgy Cede, Senior, 35505, 25413) oM 05106 1 Neonate BOB,
U be bpgitt_ hew • mme Ido It u ry mapme bully N a ry oN
SipNbpe Of Appimrl Dye
mculed p�'h mop be men pier m home of v Canifivam of
All radfur lf�r Be be Clan OB" NbdRer
0 --pa r,11101/2000
OPPtCR
o.wvaaulSer®daw h Dow