02070137 COPY OF CUPERTINO - - ' -
BUILDING DIVISION PERMIT i'CONTRACTOR INTORMATION: '
BUILDNG ADDRESS: PERMITN .
18447 EDMINGTON DR HOT WATER INC 82070137
o EANDREWS 2531 GRACELAND AVE APPLICATIOp SIff72002
PHONE. (650) 298-8494 SANITARY NO./ L.S/ CONTROL NO.
O O ARCHITECT/ENGINEER: BUILDING PERMIT INFO
z BLDG ELECT PLUMB MECH
yad U CJ C.-7 L_J '
i
LICENSED CONTRACTOR'S DECLARATION �] h II
o Iherebyaffirm'hat iamlicensedunderprovisionsofChapter9lcommencing RD'PLACF. WATER HgATgffIption
cot-j withSmion]0001 of Division3 of the Basin<ss and Rofcszinns Cade.Wmy license
O6Uiein(ull forte an ftP,et / ) �� ' ED
¢ a License a Lien l
O i u Da¢ cmurem. -
ARCHITECT'S DECLARATION'
LLO< I understand my plans shall be mud as publicrecords AUGO is ,SQO^
b L L
o O License)Professional
o that I am exempt
DECLARATION
FZ< Igoonsu v(OvoohmI 1. armpt from the Contractor License Law for the �Utt ®�p1/� $500
follw it resort smittn]03LS.Bualte.i and Prof cations Code:Any city or county BUILDING
NG
soO which requires a permit to enanthem alter,improve,demolish.per repair any structure
s- that hi-1 to slidistance.alm require;she applicant o for Inch.m.tpermit,Licenfile.se
ced aw(cha(chapter
- - __
that hi imam,,it pafecti imthepms5nision the Commam:s and Pr low(oss Cod) ..y3,� 12 F.LBEI•A 8a
g with Secoimn40t1n) fhe baris .of In, umd Pm.Any viCode) '' Valuation
(vommcncin o 1•. .t,. 5 :•:L'. ! •. .;!.\..:.:°.! 1.• '
of Shod fie is 31.5 b any applicant
um antl the basis for the subjects
alleged e pliant to Any violation- '
mf Section]031.]iv any hundred
old fora permit subjens 0e applicant ton civil penalry-
mrnor more tWnrehmnareeamlars(ssoB). 502YPN PFdIrML PLUMB N ccupancy Type
01.as owner oftne progeny,per mycmployees,with wages as their are compensation, ' 506 — GAS TEST
,will do the work.end the structure is not intended or-offered for salo(Sec.7(1 _
Bvei;icsv-and Prof..funs Code:The Contractor's License Law does not apply to an pections't _
owner of propeny Who Wilds or impves Shereon.and who does such work himself
or through his own employers.,provided shut such improvements am not intended or
coffered for sale.If.however the Wilding or improvement is sold within one year of"
completion,the owner-Wilder will have the burden of proving that he did not Wild or "'' "11
improve for purpose of sale).
co I as mwnee a the n with ral The Contractor's toProperty,ver exclusively comma::g 1
omwco the prosect(See.]044,Buenas and property
who
Code:)The Conmcto n,
x ..
License Low does not apply to an owner of property who builds or impmves thereon,the
-and who r,Licecontracts for mch.pvjmx wiN.e.contiuom(sylicensed.pursuem-oo the
ContianoYs fr curie Law. S
' .'. ❑lam aempt under Sec " - B fePCfw this recon - �. .,, .•,_qs
Owner''" Dme
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjuryone of the following declarations:
❑ 1 have and will maintain a Certificate of Consent to self-insum for Worker's
y
Compensation, as Provided for by-Section 3700 of the Labor code, for the
perfonnance'of the work forwhich this permit is ismed.
ve vnd'will mamusiA Worker's Compensation Insumnce,as required by Section
3700 of the Labor Code,for the performance of the work for which this pcmdt is
ranred My Worker'.Compensation Insurance carrici and Policy ounbc. a
/
Cam OFFXIIcy NO S-. .r•,. .,. _ _—.
00/
ER_I,I.. TION OF ATION IINS FROM,YORKER S• v.- ) , . ... L��`B +. . .' '` '' "' ''1
s •
::.:...COMPENSATION INSURANCE,__._ -' 4�
ffbii ,. need not be comple¢d if the permit is for one hundred dollars
5100)or less.)
1 -n fy th i n the performs f the k fo me th s ct i s sued I'
shall t employ..xany of Can m any manner so s no become'sub!¢t no the Workcfs'Compensation i' I" of California.Date' -
NcomeETOAPPUCANTIf ft makingoheCenifcmeof Exempuon:You ushould
bail blttuo Itis Wok Compensation pI it shell the Labor ow.ke . muse -"
z Q fonh N comply with such Provisions.,,his perm S shall be deemed revoked ,I
H ." .0 - .. _ __ .. .... _. . .. _
CONSTRUCDON LENDING AGENCY - s, :
a ' I hmbyaffirm that thereseon''structimn lending agency foroh ptolmnince S
. of the work for which this permit is rssued(S 309],Civ.C.)
a.� Lenders Name'_. ...._. - -.,...;
�.z Lends Address
1 comfy that 1 have read this sty acsoion'my some that the above informations mini is
rat-t r t orrtn.l agree to comps,d he all tiny and enemy cr unanees and naa lows enter
spars
0.V m a bovngconsunmion:avd M1ertnyaection uposemativ<sbf this city toenmrupon
,�a-(a7 Ne ebovomenoioned save:ndemify and kepurposes.
L.,A. eWUdgmetsrre to save:indemnify dkaphmay in the City oruCum.,i s,said
rw z liabilities.judgments,costs Joining,
expenses which they in any way accrue ageiso said
V Airy in consequence UNDERSTANDS
R the NDS Ag D this permit.'' _
SOURCANTUNDERSTANDS'A,yD WILL COMPLY WITH ALL M1'O.N:pOLNT 1
: soiJficEREGu1.ATlolvs." `-I'.:.'r:' • ' �=� - Issued by: Date
Signature of Apphcant/ConmatOt' ..": .. .yi .Dor'
Re-roofs
- - s refined 1 by th Copernicus Municipal Code cit pt 9 rz end tar x,Ion.a Sten'i Type of Roof
HAZARDOUS MATERIALS DISCLOSURE .,
Wll the appl cant or future Wilding ore pent stare or Handle blamed 1.
me
Code Section 25532(a)' .afeoy {. . { ..f(. .. .. ..
Yslit
, _ s . .
All roofs shall.be inspected prior.to,any.roofing.matenal,being installed._
Wdlnneapple nto�ldmgby'a occupant .Iqt or devices t If a roof is installed without first obtaining an inspection, I-agree to remove
mu ha dour u comm RRRa t s d fried b,ob Bey Arte Ai Qual ry Manegcmem
°oro" all new materials for inspection. Applicant understands and will comply with
�i ❑Y ,. P _ ...
. t all�non-point source regulations.
" 1 hwe,mad I.Wood...mat rials q ¢cenos under Chapter 6.95 or toe
if the Health&o,Safety cor Cod Sea or 2550525533 and 25534:1 understand that
buitifinebuildingdoenw havee¢nstthettis my responsibility to notify the C �(.J `' � . .._ . .7 ��' ,�
7 �3Det _ ...- ..
l Occu canoe f Nc requirements Ihmh 6 be met o o issue a of Certificate
Pp
r rma sed J?2_. _Signature of Applicant _._ _ Date_
mr
° "'" d All roof coverings to be Class"B"or better `
.. ' . _ ..—OFFICE