06020106 CITY OF CUPERTINO
BUILDING DIVISION PERMIT ' ONT,9WCTOWINFCIRMA'�ION
Wll> ,..ha'w's
BUILDING ADDRESS: JUST WATER HEATERS INC PERMrr No.06020106
DUMAS DR
ER'S NAME: PERMIT ISSUE DATE
OWN
TERRY CHENG 3400 INVESTMENT 02/17/2006
lop NE: SANITARY NO, CONTROL NO.
(510) 293-9901
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BO EPLO MECH
O
�0o LICENSED CONTRACTOR'S DECLARATION Ib Description
I hcmby affirm That 1 em licensed under proOaSCrIP
visions of Chapter 9(commencing
with Sector,7")Off)vision 3 of de Business and Piofessions Code,and my license is
n seClaand=BecL REPLACE WATER HEATER
Lice
z L full r sus and effect.
Date cor,uv]et 65 GAL GAS
q ARCHITECTS DECLARATION
22 1 uMenund my plans Met he used u public records
`yC
Licensed Pmfcssional
OWNER-BUILDER DECLARATION V -
00 I hereby maso affirre secton 1 1- exemptfromtie Contractor's License Law for 1W r
p O following mason.(Section]iD stn Buainess endow,demolish,
Code:Any city or county O
$E which myusresapermit70aresme alter.improve,d=cant for such ermitt ore A sig anystructure
4!2 that heor to st ienersec,dp eLwnt to the thovisiosofmc Contractor's Ocoee La td summons
ESC
thathepursuant 70th)of Division
ofmc And Prts sionC Code)or Sq.Ft.Floor Area '� 4 Valuati 550
zng
(commencingwithSection7000)And
Divislon3of theegedcasnndon.Myons Cede)or u(i
.. tut io u 31.5 b Ibertfmm and the Eesti it the alleged esempdm.Any violators of A
Section]0313 by any applicant for a permit wbjeeu the applicant to a civil penally a! .t7 eta nes
not more dun fir hundred))liar,(M). APN Number 35925047 . 00
vY Ty(�
❑1,as owner ofthe property,or my employces with wages s their sole compensation,
will do the wok end the structure Ormtinunded orolfcn,d fessm(Sm.70",Business Required Inspections
and Profession)Code:The Contractor's License taw does not apply an an owner of q p
property who builds m improve thereon,and who does such work himself m through his
ewnemployme,provided Nn such inprewments en,nal Intended mo@rod fmsak.IL
however,the building or Improwment is mid within one year of tnmpledon,the Owner.
builder will haw the burden of proving that he did not Wild or Improve for purpose of
sato.).
Cl L a owner of the property,am exclusively contracting with licensed rnnuacton In
construct the pmjecl(Sec.7044,Business and Professions Code:)The Contra uses Li.
cents taw does not apply to an owner of property who Wilda or improws Newton.and,
who contracts for such projects with a conlreclorfe licensed pumwnt to the ConeNtoh
License law.
❑lameaemplunder See. ,B&PCfmthumamn
Owner Dau
WORKERS COMPENSATION DECLARATION
I hammy aBime
under penally of perjury one of the following declarations:
l low aM will meinuin a Ceninam of comeni mtslr-inaum rmwmimescompen-
sm on,As provided for by Section 3700 of dee labor Code,for Ne performanee of the
work for which this permit is Issued.
❑1 haw and will maintain Worker's Compensation Insurance,As required by Section
3700 of the Lamm Code,for the performance of the work for which this permit is blued.
My Workefs Compensation Insurance carrier and Policy number am:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(TTutsetica need not W computed if the permit Is forma hundred dollen($1011)
or mss.)
I cenlfy dial In the performance of the work for which this permit It Issued.i shall not
employ any person in any manner an as to become subject in tie Workers'Compensation
Laws of California.Das
Applicant
NOTICE TO APPLICANT:IL after making this CeniRau of Exemption,you Mould
become subject m the Worker's Compensation previsions or Ne Labor Code.you most
.J .z forthwith amply with such provisions or this permit shell be donned soaked.
Z Q MmCONSTRUCTION LENDING AGENCY
(-t Wmby which
tut thenisace (Sec.construction lending agency for tte Performance of
a ti the work(m which Nb Permit Is issued(Sec.31197,Civ.CJ
W Q Lender's Name
z Lcnder'sAddrw
U 0 1 certify,that I haw mad this application end sum th,l the Mom infmmathm u
L.F coven.I agree Id comply with all city and county ordinances and sum laws n,laling m
0 U buildingconstruction,and Mmby authodm repr=unmiva of this city 70 enter upon the
[$7 ahovo-m)ntiuncel property for hupccton pugrosea
py (Wc)ages re sew,indemnify and keep Nameless tie City of Cupertino against
to liabilities,judgmenm,coats and a.penw which may in an,way seems.,,last Wd City
U,'Z In consequence of Ne granting of this permit.
^+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
Re-roofs
Signature of ApplicaDem
HAZARDOUS
US MATERIALS DISCLOSURE Type of Roof
Will tiro applicant or fumm building e.Chapter
eros=or handle h Health
a d Safety at defined by the Cupertino Municipal Code.CMpmr 9.13.roti the He,lth end Safety '
otic,Sec ten 35533(,)? All roofs shall be inspected prior to any roofing material being installed.
❑Yes ❑Nu
Will the applicant or forum Wilding Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
It h 7,amlo s air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Yea ON.
I haw mad the bxnrdousmeterle,requirements under Chaper 6.93of the Califor.
nia 11"I"Semycade,Savour 23305.35333 and 35334.I understand demirthe Wilding
does not currently how a tenant,that it is my respomihili y to notify the occupant of the
requirements which most be met prior to issuance or a Ccrvncau of Occupancy. Signature Of Applicant Date
Owner or aurhotaed agent Dam All roof coverings to be Class"B"or better
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
aITYOF Fax(408)777-3333
IPUPEkTINO
Building Department
JOB ADDRESS: PERMITc# /
7655 Dumas Dr. b I
OWNER'S Terry Cheng PHONE# 408-313-9716
GENERAL CONTRACTOR: Just Water FAX# 510-783-6360
Heaters 1
I am not using any subcontractors: 0-"d-M 02/17/06
Signature Date
Please check applicable subcontractors and com lete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
. Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting / Wallpaper
Paving
Plastering
Plumbing Just Water Heaters 591329
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
02/17/06
10/28/03
• t7 C� d ( o � v C�
City of Cupertino Building Permit Application
E-Mail
Jobsite Address: 7655 Dumas Dr. Date: 02/17/06
Owner''s Name:---Terry Cheng
Phone No.(408)313-9716
APN# 359-25-047 Project Valuation: f 1,850.00
Building Permit Info: Bldg Elect Plumb___X_ Mech
Job Description
Replace 65 gal gas water heater.
Contractor Information
Company: Just Water Heaters Inc. Phone: (510)293-2012
Contact Name: Dulce Fax: (510)783-6360
Address:3400 Investment Blvd. E-mail: permltdeptesbcglobal.net
City,State and Zip: Hayward,CA. 94545
State Contractor's License# 591329 Exp.Date: 3/31/06
Worker's Comp#: 1626288-05 Carrier:State Compensation Insurance Fund Exp.Date: 4/1/06
Credit Card Information
Credit Card #: 5474-6390-0047-8660
Name on Card: Just Water Heaters Inc. -3 b
Expiration Date: 06/08 �l p�
Visa MasterCard ® T
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