01110032 CITY
DNG n vatic NO -CONTRACTOR INFORMATION:
PERMIT
BUILDINGADDRESS: PERMIT NO.
7828 CREEKLINE DR JUST WATER HEATERS INC 01110032
OWNER'S NAME: - APPLICgqTION S�rBDATE
AM GILBERT NANCY AND CHEW ROLLI 1764 NATIONAL AVE 11/ 06/ 2001
PHONE:
(510) 293-9901 SANITARY NO. CONTROL NO.
Metz ARCHITECT/ENGINEER: BUILDING PERMIT INFO
kC m❑❑ BLDG ELECT PLUMB MECH
LJ
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LICENSED CONTRACTOR'S DECLARATION
.5 y� Job�Descri tion
I hemby affirm that I am licensed under provisions of Chnpmr 9(commencing P
iN1.� with Secsion]o00)of Divisien3of the Business and Professions Code.end my license REPLACE WATER HEATER.
n fall force dad eBect. (5 0 GAL GAS)
O�U Liccme Class tic.e
i 3c.y Dae Contractor
a
ARCHITECT'S DECLARATION
.u.O; I undersmad my plans shall be used as public reeards
j W T
0 6 O Licensed Professional
or
' OWNER-BUILDER DECLARATION
nm,
1 hereby affnm fha 1exemmm
pt from the Cocmr's License Law for she
3< following reason(Section]o31.1.5,Business and improve.
de io demolish,
Code:Any easy or county
O which d,i&saapermit re construct,alley,im For such
demolish,or repair any arcmrc
3$ -Pn f l al ij 1. .fa pplmans for(7mmurm'sit Lice se Law,d wammeno
Mahe.rawith Se niso'0e pconlisinf she of the Business suit
Law,fCh Codd) � 'y [}� 15` F,,.Rloo Aea f('+•-, Valuation
fcmmn'tgwnh Sect chatid the basinothe.Buenessandbah.Any vi Code) (.�( �11Y LL4i-,9'. l fyw p- t.y,y t(ly�-b,'�yL�,-t
or that he is 31.5ibytany applicant
m"and the basis for she subjects
th a eaEmant to Any violation
of Secs ion]031.5iv anyapplicantfora50m,itsubjectssheapplicantmacivilpenahy36217nriz on
-
crnntmot<manBvenamreaanuars($sw), _ APN Number v.t OcwpancyType
111,as owner ofthe property,or my empleyees with wages as their sole compensation, 502 FINAL PLUMBIN ENERGY
_;Busine s and Pro;and the strucode:The
Contractor's
not intendedor' License
foes aleno (See, toaam 507 - GASFINTES&aqui INGspections,'"
owner of arid Professions Code:The Com thereon,
License ow does nota 1 to an -
ow
er of progeny Who builds or improves thereon,and ve does such work himself
offere ghh employees.provided Nf h,improvements are not intended f
offered f she If h thebuilding-orP i sold within one y of -- - - - - - - "- r-
cb pleuon,the o nc buildu wdl have the burden of proving that he did not build or
improve for puryose of sale).
---------- r
_....____.... ...._._.. - _... .......
DIesowner,nepenYe exclusively contracting with licensed contractors fo
�
v ,
�;
construct the Impel(See ]oda Business d Professions Code)The Contractor's FINMLED
License Law docs not apply man owner of property whoIds or improves thereon, H i
and-oho contractsnaafis a such acts.wt tmrs) m licensed Pursuentto he
pf D_C'n,Contractor'sL
$ B&'P C fi :-
C
Owner., n`Dme ... ,. n p
WORKER'S COMPENSATION DECLARATION _ BUILDING
Phercby affirm under penally of pe ryry one of the following declarations:-
❑ I have into will inainidiri et�Ceni arch,of Con: eni 1.self-asum for Worker's
Compensation,-as providedforby-Section 3700-of-she'Labor Code; for-the
performance of the work fur which this permit is issued.
q i bitea mol will noWnin.Worker's Comp nsat on,l I asmrsince,iis roquired by.Section
3700 of the'Labor Code,for the,Performance of the weds for which this permit,is
_' itsed MyW ke 'C payor 1 Ity n .. .. ....,...,__.... .._.__.__................_....
.. .W a. .. aP ' be
-
Crhon
r i 11 r:. Pdlc Nor
I',
o TIRB� 61CATION OA,HXBMPI'ION FRO
(This secitb'n nenoPEorSAT10N'IN$URA
ed CE lT
r`� I Plated tf the permr ix forone hundretl dollars 'S'l'' "'t '--
($100) Ic 9 i_ 3 l
.r. - __..___._,......, ..,_ .., .__.. ,..,...-
1 cett l 'skyn Ne perform c bhh work for which thisof 16 t e is tied 1
Compensation II t I any pe o any manner o as so bechme ugeet to sh'e'Workers'
pLa of Calf Date�s
-A beam ''-:! . _ ."
f .
- .- rmnanan bed arevoked. -._.._..... .__ . .._._..._ _.. _...."
NOTICE TOAPPLICANT,eWitur`If after making this Certificate sof E' ps on;yoq should'
tier m 3 bre a the Wd h resi m u or
on pro 'i of s, ee ba Code,you most
CZ forth 'h ply l'h hh pro mons o fh s p on
dr_:,CONSTRUCTIONhattheishesLENDINOACIENCY l
1 h by aB' I hi
hi N re is a conssma o led g C y f th p rf mss ce t
Q Leatl Add f th perm' s ss ed(S 309] Cie_C)
'fN kfowhch
Ire dr NmE - ._... _. _... ...... ._ _ ._ _ _.. .
C.) r 1 cert fy th t l h a ad fib applicat o d state that thaboveinformat 1',f/ /) pk
Law [.a tortes' I Brce to co pay wit all,cit and county ordinances d state laws relating -�+r-/.. 1'�- ---'.r f-„�•��. - - _........
fab Id gconstructt and herebyadfXnm representatives oftnis city to enter upon
F-k� the CO ibo e;eB ed, n f stioaCsyof Cupud oegames
Fr es j gen io save,'in demmfy'anU keep Patrol
mE REGUCATTbN$iscasts anset �chy ma in any ay ac against said
APpLICANT,U$'DEkSrAND$AND
WILL COMPLYilHTFi ALL NON-POINT o° ”
C.> Z:
city consequence of the gra tngo('0j fs nn
66UNCJSSlled by: � Date - -
Signature ifApplcam/C nvattor f Dna: Re=roofs
W...
HAZA
i Type of Roof_
Co der OYes the Cupetin Municipal
ode,Chapter
hap r9.12,URE jk
na{alEna a All roofsshall be inspected prior.to.any.roofing.matenal.being installed.___._ _.-..
FP l al Cod Ch t Y 12 s a theHcafM an Saf fY
asd fin b N Cupertino Muna
Ot tt`tq Yes i* C1 No Ing occupant equipment devices which if a roof Is Installed Without first obtaining an inspection 1 agree.to remove
imtr h'ite a'do s aircontaminants
applicant mf m bmld' by aar vain Management t' all-new materials for inspection Applicant understands and will_comply with
m f a defnedb th B Arc
l i -'h 211 non-point souIGO regulatlon6 r.t_':�l A s t r .':'i s ,l sS.
a reed rhe Safety
does m tions s re u 25533 tiedmFler255 4.Chap understand
6 97 of NE '
Ca efbuiamg do&Safety Code;Sections25505;t it
end25536:.iitytonand that'
'f Nab ldngdoequircurrentlywhich
east be that t my responsibility to okay,of _
'occupant f she rego'v mem wh¢h faun be met prior,fo ass anceof Certifice[eof
Signature_ofApphcant _ , Date
.. �.. .. .. _ _. ..._.__ A..__.,..._.... ._..._ - _ ._. ._. _ _ . ...__ ...__ __..
Owner raanpn daB f� D.p All roof coverings to be Class"B"or better
,_ t ,_...___..OFFICE_.--- - 1