01070031 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
7485 DE FOE DR JUST WATER HEATERS INC 01070031
o�yuiFg'YTBTERRY 1764 NATIONAL AVE 0711�Nf 128001
1
PHONE: (510) 293-9901 SANITARY NO. CONTROL NO.
i
Mea O ARCHITECT`ENGINEER: BUILDING PERMIT INFO
Emp�,j BLDG ELECT PLUMB MECH
G6 LJ I_j
LICENSED CONfRAC'fOR'S DECLARATION t
Z y' 1 hereby affrm that I am licensed under f CM1a [ 9(commercia 7� b Description
°_Ft9 with Section7000)of Division 3ofthe Business andProfess"ioreCode.and mylicense REPLACE GAS WATT HE%TiER.
6 Y S is in full force and eReel,
or,
'0 < LieenaeGlaas �IIVALED
O m Dam Comnfid,
ARCHITECT'S DECLARATION
t_— 1 understand my plans shall be used us public records
adao Licensed Professional JUL 2 3 2001
e. OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor License Law for thefiellow1 7 5 0
m
f'M o which g tudi (Sectiont70315 Bus and Professions Code Any cin or county
which re perm[desmetheapp -improve,demolish,orresignedutBUILDIN
„.( oto'w, gwnth sect J00o the Sof the Bunn uo fl e 'gned statement
a 3 m P req PP Pe
of
firth; being tedp nt 10000 pro Division fN t Business
LwlCs pt 9 t 1 a p „ Valuation
f and Professions cod) p', 3 5 t0 9oF30QP eG ;'e`iS t t S:
or that he ii exempt thlrcfrotn and the bass for the allegro
pexemption.Any violation
-ofn703L56y any amrmitsnbcc¢ he ap1om ma<vil penalty
tprirramum than five handled dollars($50o). 502APNPITN21 PLUMBINq ENERGY Occupancy Type
111,as tuft:an thesornrye is
intended or wages frsale(Se.704,1,
506 - GAS TEST
ownc
-
will ne me wr 'Professions Code:n is naammnaLi en e Law doe axle(sec.lou, 5 0 7 - FINAL PLRR W(7ns I ctions .. "
come,of and ertyW b Code:The Contractor .ad n Law does no[apply to m
r of h his ow Who builds or improves at such aro who dyes such wank himself
o !
" gh h n employee p d d that h improvementst'intendedyear of
_..
offeredr l If,h- ih buildingimprovement . . Irl thn one year of .. _.._...-._..__ .._.____ ........ 1.,.,t .
�completion,for the ower-bu Iden will have the burden of proving that he did not build or -
mprove far purpose of sale.).
1
❑I a4 owner pf the ro .. .. . . . ........... ._....___.... __.._..... .._.._ ... _ _. . _.. __
in lice d ismarbacto.t"
vmr�trmnth plt(See. Business and Profession,Cdr)The
Capht
License Law does not apply
toaownerof,nodperty who improves thereon,
,
and-who [ [ f such_projects w tha comracmrs).lidensed pumsuant
to the
-
Connector,atm/s L cense Law
"�-
❑I at inmtnde Sc " ',B&P C for his mason :'.j la.' '.'qp
Oesner p
- - WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury nb of the following declarations
❑ 1 have and will mound--'Certificate ofConsent m self-instar her Worker's
Compensation, as,provides-for by Section 3100 of the Labor Code, for the
turf mance of the work for which this permit is issued.,t,
_
111 have and"will maintain Maker's Compeleaiion Insurance,as required by Section
3700 of the Libor Code,far the,performance of the work,for which this Permit is
is d My Wanted r C pe drumInsurance a y P Imurder„„ ..._
....., .. .:
rlierPolicyo.
CERTIFICATION,OF.EXEMPTION FROM WORKERS(.
COMPENSATION INSURANCE ^ _
'(This section new tat be complemd f the perm t rs for one hundred apllnrs r ' ^ t : I°d
B lao>pn lua.)
. ..
tc ` 1 ciatifY thin I.the pormannance 4the kfar- 'hl tette Pe mit isissued I ....,...•- .:....-..•. 1., .•._ -::� •. ........ ..
shall not employ any person n any barrel a.as to beepme sublenm the;Workers' ” !' •f. ,sv
C tap n ion Laws of Collfo '.a.Dale =
._.. ...... ..._. _. ___. . _.. ._....r. . . .
QNOTICE TO APPLICANT:If. ft ' ]ht Certificate
t bfE yau'should
Amsere6 . th W kr C ns mp.,ii of'he de,you most
Q forte th c. ply with M1 provisions o this p nishal b deam J revoked. r
- - -
..
LaY"Q~is d CONSTRUCTION LENDIGAGENCc; Ih ebY'fleadingag y for the
�fonnince ._........... . _.. ...._ .._ _. _ _... ._ ...!ji
._.of thek for which thPt ... d(Se 3097Civ C l
I.e sN ...
_.. . :_.__ .. , ... .. ..._......_.. . __ __ . ..
L d Add ass; r
V 1 codify riot ihave read his application and suite that bo information is
c' " I agree to complywich all cin and county deflumuces and state laws relating
to building construction,and hcmby authorize representatives of this city to enter upon
the h i d perepi f - 'do' P W
(We)ounce tndemnify addkeep h 1 ss the City of Clip,mir.against
V1
liabilities,jtdgme to [ and expenses h h may in any y gni t laid
City to consequence of theg i got his print '
APPLICANT UNDERSTANDS AND WILL COMPLYINIT
SOURCE REGULATIONS , I ALL NON POINT issued by: Date
1.
SlourptimmAppicaurCentrai:.,; para- Re-COOTS
HAZARDOUS MATERIALS DISCLOSURE
W i0c eCbuilding pant store o handle h .M, pictorial Type Of Roof--
defined b thu en Municipal Code,Chapter 9 12.andthe Health and Safety
a
F tya Cade Section 255 .. _
.`Q{.p!pa I
All roofs.shall be inspected pnorto any roofing material being.installed._. .... ...
Wll fl I t rft b'IS tueceu t dwhich
-. it - g e n y pIf a roof is i'dstalled'without first obtaining a"n'iuspectloti!�I(agree'to remove
emth dtsarcot he Bay Air Q Ip Management.
nu as def elbyt
st toY s a No
- all new materials.for inspection,._Applicant understands and will comply with
all non-point source regulations. .,
I have,read the h d us mom I. oplaniumenflumide,Chapter 695 of the
C I fima a Health'&Safety Cade,Section 25505 _5533 and 25536 I. nderstand that.
meth bildingdnesnms tr tlh e t be telf't.Inyrepoeof,.0 -aify the
ii cupant or the mqu em's roti rte do t b met prior.m i--uan of a Certificate of
eeP ey';,,.',; _""'' e 'r . .,.SignatureofApplicant Date
Owner mor:w agent : ;. iL
Date All roof coverings to be Class,"B"o^r`b'etter
. _. .OFFICE—...
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