08090119 CITY OF CUPERTINO - �'�'
BUILDINL DIVISION PERNIIT CONT RACTQRNFOILMATION ;
BUI 1 G 0 FSS: PERMIT NO.
MC CLELLAN RD JUST WATER HEATERS INC 08090119
OW NEWS NAME: PERMIT ISSUE DATE
CLAUDE SOLET 3400 INVESTMENT BLVD 09/18/2008
NE SANITARY NO. CONTROL NO.
(510) 293-9901
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
Thr O 0p LICENSED CONTRACTOR'S DECLARATION O O O O
'.� 1 hemby stili.that 1 w licensed uMer provumns of Chapter 9(mmmcncin& Job Description
=
whin Section 7")ofDivision 3 offt Business and Forced.Code,and my He.=is REPLC TNKLSS WTR HTR
??a in full fora,M effect.
:t Z_ Uamc Clau Lk.Is
t Date Comncur
9ARCHITECTS DECLARATION
1 uMcrnand my
PLarts shall be pad as public rands
J U
�G Licensed professional
5 OWNER BUILDER DECLARATION
1 Mason.
Rion the I i eumpt from the Contraiessimaoh lAn,c tow for the
no following mason.permit
(Section]0313,Business and Pro@adna Code:,oAny city structure,aunty
$ which requires a permit re construct.alar.Improve,demolish,erre a sir try sum ont
puwmits censedpursuntto ftres the appUanl fad nchpumitmfctons,used awpChicm.m
5E€Cm< Nathe mingwidpurnum7M)omvimion3of Caatrac=mdPmf=innChapto9 Sq.Ft. Floor Area (. Valuation
(commendng with Secum]OBO)of 0ivtian3mf the Businevasd Pro2tsinns Casse)ur $4200
S $
assets,t.,t tnot(rom and the bast for the Welted exemption.Any violation of
Section Rn1.5 by any applicant for a permit subjects the applicant m a Civil nada ofNumber Occupancy
net mom than BK hundred dollar,(Ms 3 5 7 0 5 0 61 . Pane Y Type
❑I.as owrw of the proPertY.Cir mY eroplayw wins wgessa Net ole ampensatias.
wit do dmwono Cod the he Consumers rot s scud,Law do roc t a(Sec.Rau.auaines
and rtywhoW Cone:The vennuaemrs Liana Law dna act apply us an awmr or Required Inspections
on em whobusId,adionphotsch impr andwhodoessuintwade,Monsenfadthhmgh his
owerve,tyrss,dwldedthatacsimProwmatsartm ourWedoolferM rad sale,-
however,Ne building u improvement i,sold within ow your of ample for the aworr
builder will low the Burda of pvving that k end not build or improve for pumase of
sat.).
❑1.u owner of the property,am exclusively contracting witA Barst contractors u
commuct the prajoes($e L.]DIA.Buri.and Professions L'Cde:)The emNlemr,U. .
emne Law dom out apply be an.of property who builds or improves dRRon.and.
who amraces forsoh project with acatracmKs)licensed punant m the Compactor,
License Law. .
❑l atm exempt under see ,B R P C for this reason
Owner Data
WORKERS COMPENSATION DECLARATION
1 hereby aRno under pnWty of perjury useof the following dalsndona:
I have and will maintain.Certiframof Cement w serf-iasun for Wortu's Cmnpen-
satim as provided for by Section 31x0 of the Lubar Code.for the Performance of the
wore,for which this permit is issmd.
❑1 have and will maintain Workers Compensation Imarupt,u untamed by Section
3790 ofent Lubar Code,for the pcRormana ofdc wort forwhich Nu permits tsml '
My Worker.Compensation Iran.artier and Policy number tie:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(This seellm reed mtbecmmpictW Uthe permit is face.baseness instar(clad)
or kat)
1 corufv that in the perlears e a the waft fa which Nis permlt is isamd.I mail ma '
employ any person in any manner so u le become subject he the Worker'Compensation
Laws of California.Gaa
Applicant
NOTICE TO APPLICANT:IL after making this Certificate of Exemption.You should
become subjar m the worker,Compensation pmvtions of the raw Cale you most
.J z forthWlth comply with such provisions or this peTit shall be damess revoked.
Z OCONSTRUCTION LENDING AGENCY
[-v vN� Thereby affirm deal then is.,co maclion lending agency,for the parfarrhancoof
eC > the wurt for which this Permit is bspw(Sa.3097,Civ.C)
WI<Mers Name
�
z Lenders Address
U O I Costly that I haw read tnt application row mace that the abuw Womation is .
L2. ^. coarsens-1 agla b Cmmp1Y with all City and camrly aNimNae and mYls turns relating m
C) building construction.and hereby auhonn¢prexnudws of this city to enter upon the
121 alpvc.menupropertycosts
for ex enses purports
t„r 0. (We)M.m save.indemnify and kap harmless the City of Capenim agaiwt
fry inconsequence judgments,conaand of his
which may in ay way uaavgilnslsaid City
t.>z A PLICA nee of the granting of tht penitis
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
Srgnuum of AppliaHAZA HAZARDOUS
pet
Re-roofs
XA,ortot USMAng occupant
DISCLOSURE Type of Roof
Will this a Colo nuafuture sailMunicipal
Co Code.
chapter
stoic oradl t ehn'rardous maodil
W dc0ud by Nc 32(m)? MuniriWl Coo.Glapaf 9.12.aM the Halth and Silcy
Code. Oy.ection zss32(.)] All roofs shall be inspected prior to any roofing material being installed.
❑Ya ❑No
If a roof is installed without first obtaining an inspection,I agree to remove
Will rhe applinnt or(arum building aaupant use equipment or dcvias which p r
.set hacaNsus air cmummanu as defined by the Bay Ama Air Quality Management all new materials for inspection.
❑Ya ON.
I have mad the thessi us mseriatmquimmentsumler Chapur6.95ofthe Cuifon
nt RC4l &SafOYCasso Sm=25505.25533au125534.lundmuxWNnifde building
dos rot Currently have a omit,that it t MY responsibility a notify the occupant of the
sequimmenes which muss be mel prior to issuance,ora CeniBcaa of occupancy. Signature Df Applicant ' Date
Owner or sothomedegenl DA.. All roof coverings to be Class'%¢"or better
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: pdtg .
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35705061 . 00
DATE ISSUED. . . . . . . : 09/18/2008
RECEIPT # . . . . . . . . . : BS000006120
REFERENCE ID # . . . : 08090119
SITE ADDRESS . . . . . : 22344 MC CLELLAN RD
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : CLAUDE SOLET
ADDRESS . . . . . . . . . . : 22344 MCCLELLAN` RD
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2753
RECEIVED FROM . . . . : JUST WATER HEATERS
CONTRACTOR . . . . . . . : GILROY, JOHN LIC # 15128
COMPANY . . . . . . . . . . : JUST WATER HEATERS INC
ADDRESS . . . . . . . . . . : 3400 INVESTMENT BLVD
CITY/STATE/ZIP . . . : HAYWARD, CA 94545
TELEPHONE . . . . . . . . : (510) 293-9901
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 4, 200 . 00 0. 50 0 . 00 0 . 50 0..00
1PPERMITFE FLAT RATE 1 . 00 40 .79 0 . 00 40 . 79 0 . 00
1PRWHEATR UNITS 1 . 00 24 . 48 0 . 00 24 .48 0 . 00
1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 106 . 56 0 . 00 106 . 56 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 106 . 56 MC
---------------
TOTAL RECEIPT 106 . 56
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
518 WATER HEATER
•
• City of Cupertino Building Permit Application
E-Mail
Jobsite Address: 22344 McClellan Rd. Date: September 18, 2008
Owner's Name:---Claude Solet
•Phone No (408)861-125 5
APN#: 357-05-061 , O 0 Project Valuation 34,200
Building Permit Info: Bldg___ Elect Plumb x Mech
Job Description
Replace tankless water heater
Contractor Information
Company: Just Water Heaters Inc. Phone: (510)293-2012
• Contact Name: Dulce Fax: (510)293-2022
Address: 3400 Investment Blvd E-mail: permits®justwaterheaters.net
City, State and Zip: Hayward,CA. 94545
State Contractor's License# 591329 Exp. Date: 3/31/10
Worker's Comp#: C45096282 Carrier: ACE Exp. Date: 4/1/09
Credit Card Information
Credit Card #:
Name on Card: Just Water Heaters Inc.
Expiration Date: 6/11
Visa MasterCard
Comments
Community Development
' 10300 Torte Avenue
�( Cupertino CA 95014
Telephone(408)777-3228
CM PEkT�N� — Fax(408)777-3333
SCU
1"L '�1 Building Department
JOB ADDRESS: PERTY19 D//
22344 McClellan Rd. ��jj
OWNER'S NAME: Claude Solet PHONE # 408-861-1255
GENERAL CONTRACTOR: JustWater Heaters FAX # 510-783-6360
I am not using any subcontractors: 0af.-O- 09/18/08
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
09/18/08
Owner/Contractor Signature Date
10/28/03