02030221 ,CITY OF,CUPERTINO. I I
' Dutt.DmGDrvtsion PERMIT ` '4 CONTRACTORINFORMATION: = .- _____ ' :. _. _... ...
BUILDING ADDRESS -
T PERMIT NO
T818,8 ,EDMINT,ON DR_,- '., JUST_WATER ,HEATERS INC 0203022.1
!. OWNER'S NAME:. .:.. - -_ - .-.
APPLICATION SUB DATE
?•I MICHAEL CIAO 1764 NATIONAL AVE '. C 03/29/2002
.� PNONE:., SANITARY NO. CONTROL NO.
', (510) 293-9901
,µ!0.0 ARCHITECDENGINEER:` BUILDING PERMIT INFO
E"[❑❑ BLDG ELECT PLUMB MECH
oU IJ I= C7
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I
yz LICENSED CONTRACTOR'S DECLARATION p
JU Description
-
i Z_ I hcrcby aRnn that I am licensed under provisions of Chapter eSCrIP
i 9(commencing
IsRh Section 7")of Division 3 of the Business and Professions Castle.and my license REPLACE WATER HEATER.
in full force and effect:
o is in
cross' Lit.« '.' (5 0 GALLON, GAS)
u. Dan - - 'Canute.,
1 u ARCHITECT'S DECLARATION
gI undersmnJ my plans shall W used as public rtcords ' _ _ ,
i p O Licensed Professional -
e'o OWNER-BUILDER DECLARATION
1 Ircmby air,.that I am exempt(mm the Contractor's License law for IW -
LY z a" following mason.(Section 703 L5.Business and Professions Code:Any city or county
C F o which requires a permit to construct,other,improve,demolish,or repair any structure) '
w 3� Porro t issuance,alsona un theapplicantf h permit m Bk a signed statement� - - --
a. Thai la31 ce aavanu "'- -
atsP!po IneProiders race tractors Li.Law(Chaprr9 Sq.-Ft..Floor Area � "
(omn gwtlh sect 1(M)ofDisi t of Business end ProfesurmiCde) ( k1" y.gyry''�f �'• -. - Valuation '
1
:orthat he sesentpt thenfr6an and the basis farthe alleged ex mpoon Any v olium t
S - - — -- ---- —
-i-
-ofoon]031.5 by ny appl t fora panni bjeculNe acmtu
ppl o a av,I pcmlry
of comm ,tae r eon a eamlars lssan A um er7 - Occupancy Type
v - 11. • I t + , P Y YP
y .0 Lmowne rNepmpenyomY employees Nxages as the sol pensanon.l - -
swcture snotintendedser a Law f e sale Sec;]044,[ -
will do Ih o k d N -
_ -'ownerz s ope r..inns cmc The cant t . ,License Law sae:not apply to an •''506 '- GAS TESTequired Inspections'c
'
owner of property Who Wilds or Improves Merton,end who does wch work himself
throughnhiso ply provided Nt n p t. tt ad or, 507 - FINAL PLUMBING '
offercJ frr"'le if howEver,then
bo ldi eZ'r iniproviaracht is sold within one yea of
ompl tion,the owner-laIder will have the Washed ofthat he did not Wild or -` [•' v
mprove for panic.of sale.). Proving
e a sown of the pmPenY m us siv<IY contracting lhI one Cots. to ,•r.. - -- - -
conswn theLaw
nesprojectno(Sec,]044,Business dad Prty w oat Code)The ves tmcmis r
License Law docs ,f apply m an a ts-w of progeny who builds se improves thereon,
Cmdossho conoans�focsuch projecu.wiN.a.coovacwr(s)licensed Pursuant to but. _
C 1 am arcs License Law.
111 am exam lander Sec.: " �99 i/t� I
P :r.0&PCfor this reason - FII I`0!d'-Y IF�I�®
. .1 '% Ovine .rlo_ 'Date
,... .(, ION DECLARATION
WORKER s COMPENSAT
I tiereby offs d 'pc dry of,;ep ry,one flbe inllowt««dcdunuodr MAY 0,1 2002
0 1 have and 11 I d Cen fieri of C t 18'sdf insum for Worker's
Compensation. in provided for by Seen= 3700 of tW LaWr Code. for the
. ,pironnecom filu,"d,forobich,hispermit isisatied.
BUILDING .
,! 01 h e and will memo n Worktt s Compenwuon Insurance,as ragmrtd by Section
3]00 of the Cabor Cade,foi the performance of the work for which this permit is .
'I : issued.My Worke7s Compensation Imannce carter antl Policy numberr a,,
Cameo s M. ,S . .::.Policy Na T _`, - _ --
t CETCrIFlCATION,OF E%EMPI'ION FROM WORKERS 7 s f' { tw.L ?LAN' {
.r... .Lr t< .. - .. . ..
COMPENSATION INSURANCE - -
"" n(Th tin eednot he'ompleted fth Permit is for hundred dollars' _ )t
r. ....... . ..
I ttn fy thinin' ,arm
in emaj o to .anti u ct -Permit 'coed l - -' •.
hell t ply _ny pe a y ane as m become subject t the workers 1 '
'
Compensation taws of California Dat( ' - ' . ' •
dh such . . ._ ...— .._. ..
O of Ex oho ld . ... ._.... _.._ ... ... .... -. - -.._.
pt on Y ..
Z forthwdiN c 3 ply poo o or N rm t shall h don LaW Cad you most
APPLICANT,AN If aft ki g N C n f le
prom subject Ne Work s C p it ns oI
d m km.
..C6NSTRUCf10NLENDING AGENCY .,. _ ... _. ....... .. '- I _ ... .-..
aa � 1 h by eft that N<rc s a vin ding agency for N pert note -
i.y •of
din
k for which(hs pennii issi sued(S 3097 G C.)
y-Q Leede Nam .!• _ .....
= Z Lordc Add..
V 0 1
certify that I ha mad1sappand statothin the above information is formatonu
[. torten 1 kruset h.11 cityaad ry ordinances eM ime laws mitring lconstruction,
on s tion, d nercby autN pre t tvof lh sc tytheaW%o- t ed poupertyfor inspection npurpose . t enter upon
.. ., ....
-`.
ps, (Wq agree to save,mtler spe and keep hamlesa Nc Cay of Cbpenrno agunst
VI liabilities,judgmenu.ecru andbxpensei which may in any way accrue eptim,said
U Z' City in consequence of lhegranting of this K t " ' . - '
APPLICANT UNDERSTANDSAND WILL COMPLY WITH ALL NON-POINT'"� 'I
50URCe REGULATIONS Issued by: Date
'' .Signature of Appucanucontraor ' -Dare....,... Re-roofs
I'HA MATERIALS 61SCLOSURE'. n1 '1 .�,
:,.mill Ne applicant, fuw building occupant mom m,handle9h tv�enel' Type of Roof._.,
as deOnW by be CupertinoMunicipal Core Chapter9 12 d she Health and Safety r - - - -- -. - — - --- -- -
Cme,Sect on 8532(.)?i
❑Ye s a II ❑N
All.rQofs shall be Lnspected,pnor to any roofing.matenal being installed.
Wrd us oroontapplicant r 12 W magby nos s aro vme t x a wnttn If a roof is installedwithout fust obtaining an inspecnon;'I'agree to remove
e Ih rand a coma.not t asd f dby NeO yA Air Quit ty Marg mem, ,
'°" all.new materials for,inspection. .Applicant understand§,and will tom 1 -with ..
Due) .I ❑N all hon-point source regu]ations.` P Y._
I'h <re J the luoutudmas irI nols.req remelts-ndci Chapter 6.95 of.Ne
C 'fomia H alth&Se."Y CMe,Sections 8505,25533 am 8534.1 uMenum Net -
dNcWdd gdoes dolarmnOY not amnent N t s yrcspo Iblrymnbtifythe
" -
ocrapard of the quirements h ch must be me,pr o t 'ssuen a of Certificate ofCoop
-
ruy
" ' • ' ' Signature of Applicant Date
owder th ¢ea.agem Dore, All roof coverings to be Class "B"or better
OFFICE