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05090079 CITY OF CUPERTINO . err y �,T2!z5' d sulLowc Drvlston PERMIT Yl,NT BUILDING ADDRESS: JUST WATER HEATERS INC PERMIT N005090079 OWNER'S NAME: PERMIT ISSUE DATE VINAY CHANDRA 3400 INVESTMENT BLVD 09/13/2005 NE: SANITARY NO. CONTROL NO. (510) 293-9901 ARCHMIC(ENGINEER: BUILDING PERMIT INFO BLDG� O ECH PE M� 30o LICENSED CONRACIORS DECLARATION Job Description I he affirm Nu 1 em licensed under provisions of Chapter 9(commencing with Section 70(N)of Division Sof the Business and Profcuium Code.and my license is in full to. REPLACE WATER HEATER i g? Dano Clic Lk.N FFFF Dam Licr 40 GAL GAS 3 ARCHITECTS DECLARATION icy I understand my pWs"I M mind as public records qua Licensed Pmfcuianel )) contr OWNER-BUILDER DECLARATION gm 1 Meshy sRrm dial I am esempt(rosem ftConuacrofs License Law for tM E:00 following moon.(Section 70313,Business and Professions Code:Any city or county n$M which mguima a permit in common.alter,improv,demolish,or repair any structure s,Z12 prior to its issuance.alto requires the applicant for such permit in rile.signed statement FF WtMislicensedpursuanttoftprovisionsofdwConmebo'sLicenrelaw(Chapter9 Sq.Ft.Floor Area Val C $ (commencing with Section 7000)of Division 3 of the Business and Proksoma Code)or 3 that he is exempt therefrom and du Was for the alleged exemption.Any violation of Section 7031.3 by arty applicant(m a permit subjects that applicant in a civil penalty of APN Number Oeeu tin not came than five bundmd dollars(M). 32345002 . 00 Y Type ❑1,as owner alibis property,or my employees with wages as their sole compensation, will do the work and theshumurt Is notdnunded oroRe ad far We(Sec.7011,Besineu and Profeulons Cade:The Commences License Law don Out apply in an owner of Required Inspections property who bu Ild1 m improv thereon,and who does tach work himalf m through his own employee,provided that such Improvements am ret intended oraRartd fmule.if, however,the building or improvement is sold within one year of mrepledm.die Owner. builder will have the Wooden of preving that bu did not build in improv for purpose of ale.), ❑I.as weer of the property.am exelusivly contracting with licensed contracmn w conshmt the project(Sec.70ad,Business and Professions Code:)The Contracsefa U. cave Law docs not apply w an owner of Finnerty who builds or improv demon,and, who conuacu for such projects withacontracmr(s)liamed pursuma w the Conuactofs License Law. ❑I am eempt under Sec. .B d P C for this recon - Owner Data WORKER'S COMPENSATION DECLARATION I hereby slBrm under penalty,of perjury one of the following decho tionse 1 Waw and will maintain eCeNOau ofCanum w self-Wort for Wartets Campers- adon,as provided for by Smdon 37M of the Labor,code,for the performance of f work for which this permit is issued. ❑I have and will maintain Workers CompemaUan Iruwance,as required by Section 3700 of die Labor Cads.for the performaree of&w wort fmwhieh this permit is issued. My Workers compensation,Laurance carrier and Policy number art: Cartier: Policy No.: CERTIFICATE OF EXEM MON FROM WORKERS COMPENSATION INSURANCE (This section need not becompleud if the permit Is fmooe hundred clulus(51010 or lest) I Unify that in the performance Of the work for which this permit Is issued.I shall not employ any persen in any manner w as in become abject to tion Workers'CompcaWon Laws of CWHOMIL Data Applicant NOTICE TO APPLICANT..If.aper making this Cenifieaw of Exemption.you should became abject w the Worker Compenudon provisions of f labor Code,you muse .,O foMwith cemply with such provisions or this permit sball be doemed unwed. ?� CONSTRUCTION LENDING AGENCY F+ IMmby aRnm slut Vert iso Wood .nn , agency fortheperformarrce of a's,7 the work for which this permit u iuoed(Sec,3t19'i,Co.Civ.CJ LendNuns, =z sander's Address V Q 1 certify dial 1 haw mad this application and sore that the above information is G4 cermet.I agv to comply with all city and county ordinances and sou laws relining w O building construction.and hereby adhodm representative of this city in enter upon the W ebovementiaoed Property rot imRposes cdon purposes. LL (Win)agree to un,indemnify and keep humus the City of Cupertino agaimt cn liebllitiesjudgmcm,com and expenses which may in anywayxecrue agamosaid Cly C)7 in consequence of the granting of this MMIL . . •^'r APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. Re-roofs HAZARDOUS Signuum of ApplleDateHAZARDOUS MATERIALS DISCLOSURE Type of Roof Will ft applicant or forum boacupantatortor Modic aodousmaterial u defined by the Cupertino Municipal Code.Chapter 9.13,and theHeHealth and Safety cads.Station zss33(a)7 All roofs shall be inspected prior to an roofing material being Installed. ❑Yea C]No P P Y g g Will the applicant or round building occupant use equipment m&-vias,which If a roof is installed without first obtaining an inspection.I agree to remove 7io t hayaodous air commitments u defined by die Bay Area Air Quality Management all new materials for inspection. i ❑Yes ❑No I have mud die Murdws maurisisminflo mcnts underChamer6.93ofthe CeliforHealth&SsfctyCodc,Sections37N13,33333uW2353d.IundsnuM thatifdic building s not currently haw s wnan4 that it u my repomibility w notify the occupant of silo eiremcnts which mum be mel pdorm issuance Ora Cereficate a(Occapincy. Signature of Applicant Date ner or an...... ad ed agent Dow All roof coverings to be Class"B"or better f Community Development 10300 Torre Avenue a Cupertino CA 95014 Telephone(408)777-3228 lCITY OF Fax(408)777-3333 'UPER,TINO Building De artment JOB ADDRESS: PERMIT# 11082 Firethorne Dr.. ojS` c --> 7 OWNER'S NAME: Chandra, Vinay PHONE # 408-737-1687 GENERAL CONTRACTOR: Just Water. FAX # 510-783-6360 Heaters (� I am not using any subcontractors: v `� 9/12/05 Signature Date Please check applicable subcontractors and complete 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 9/12/05 10/28/03 City of Cupertino Building Permit Application E-Mail Jobsite Address: 11082 Firethorne Dr. Date: 9-12-05 Owner's Name:---Chandra,Vinay Phone No.(408)737-1687 APN#: 323-45-002 Project Valuation: $ 657.00 Building Permit Info: Bldg— Elect Plumb____x_ Mech_ Job bescri tion Replace 40 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: permitdept®sbcglobal.net City,State and Zip: Hayward,CA. 94545 State Contractor's Ucense# 591329 Exp. Date: 3/31/06 Worker's Comp#: 1626288-05 Carrier:State Compensation Insurance Fund Exp. Date: 4/l/06 Credit Card Information Credit Card #: 5474-6390-0047-8660 O Name on Card: Just Water Heaters Inc. Expiration Date: 06/08 (, v,;�, Visa MasterCard ® �' I Comments