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05040105 ;. 7578 ITY OF CUPERTINO BUILDING DIVISION PERMIT 7'1 BUILDING NFORMATIQ ILDING ADDRESS: JUST WATER HEATERS INC PERMIT NUO 5040105 NORNER'S NAME: PERMIT ISSUE DATE LING SU 3400 INVESMENT BLVD 04/19/2005 ONE: SANITARY NO. CONTROL NO. (510) 293-9901 ARCHITEC(ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH �Uto LICENSED that CONTRACTORS DECLARATION YwCr 1 ionhereby70 affirm Ilial I w licensed under and Protna of Chapter a(commencing Job DeSCflp[IOn <ZW with Section an effect. Sof dm Busirw•.aM Professions Code.and mylicertse is Torn°fo 'naeB n REPLACE WATER HEATER S EJ= License ClassLie.N Ego Dam Contractor (4 0 GAL GAS) 44 ARCHITECTS DECLARATION I ?W u understamail my plans all he used as public mcerds Licensed Professional 3 OWNER-BUILDER DECLARATION <E I homey affirm that I am exempt from the Conummoes License Law for the i o O following mason.(Section 7031.5.Business and Profession Code:Any city or county $K which requires a Permit to construes alter,impmw,demolish,or mpair my structure HZaprior i its issuance,also aquims the applicant for such permit to rile a signed statement that he is licensed pursuant o the prevision of the Contractor's Umbe Law(Chapter 9 Sq.Ft. Floor Area Valuatic$)755 €$ (commencing with Section 700(pof Division 3 of the Business and Professiom Onde)or Nat he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031,5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy not mom than Jim hundred dollars(S500). 36617062 . 00 pane y Type 1,is owner of the property.or my employees with wages M their able compensation, will do the monk,and Ne swctume Is not intended oreffered for We(Sec.70th,Business and Professions Code:The Comumrs Lt..Law don ant apply m.n no,of Required Inspections property who bis ills er improves thereon,and who does suc h work himself or dumugh his owncer.too es,provided prsuchimprovementsanenot ewofoor"eerW the forsake. builder .Neave ffigorimprovementissoldwithinmm Wild ofmprove for theose of Owner- builder will have Ik burden of proving that he did trot build or improv far purpose of salt.). ❑Les owner of the property am exclusivelyand contracting with licensed onnews ors i- j Construct the,pmnot apply t o n Business and Profusions Code:)The Conddrora nd cense law cola not apply a an owner of property who builds or improves Commuc red, whocontractsLaw.for such protects with a convacmr(s)licensed purwant in the Cenuacsors License Law. ❑Lem exempt undo Sec. ,BkPC for this moon Owner Dille WORKER'S COMPENSATION DECLARATION i hereby affirm under he of perjury one of Ne following dalarstions: 1 ham and will maintain a Cerlifiam of Conecnt to self-intim fww"rkcrsCompen- xion,as provided for by Section 37W of the labor Code.for the performa=of Ne work for which thi.permit is issued. ❑1 have and will maintain Worker's Compensation Insurance,as required by Section 37W of the fatter Cade,for Ne Pwform.ncc tithe work for which this permit is Issued. My Workers Compensation Inwuance,Cartier and Policy number we: Cannier: Polity No.: _ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This seca tion need not be cnpleted if the permit is forone hundred dollars(SIM) or less.) 1 Cxmfy that in Oc performance of Ne work for which this permit u issued.I shill not employ any person in my romper an as In become subject to tM Wotkeri Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after making Nis Cmdricate of Exemption,you should become subject ro the Worker's Compensation provisions of the Labor Code,you most .,O forOwith comply with such provision at this permit shall bo decreed revoked, 'zy CONSTRUCTION LENDING AGENCY (, I hereby affirm that dire is a co ono lending agency for the perfurmma of 5 murk for which this Permit is issued(See.3097,Civ,C Le Permit Lenders Name z Landers Address U Q 1 ttnify Nat I haw mad Nis applirnion and sum that the about infomuuun is ty F COMM I agree in comply with all city and County Ordinances and male laws misting to C)U building construction,and hereby authoum rcpresenutivn of this city to enter upon the above-menuomed at,cny for inspection puryosea F 6 (We)agree to saw,indemnify and keep hafmless Ne City of Cupenino against rue in consequence Cntr and oapeneawhich mar in any way accrue against said oily U,x A ePLIC NT of the UNDERSTANDS of this permit. ^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. Sngewtnc of AppI CmVComracmr Dam Re-roofs HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will six applicant of future building occupant store or handle haiwO us material as "Iduly the CuNnino Municipal Code.Chapter 9.11,and the Health and Safety odc.5ecuhe 155}3(a)7 ❑Yes ❑Nu All roofs Shall be inspected prior to any roofing material being installed. Will thc applicant or future Wilding Occupant use If a roof is installed without first obtaining an inspection,I agree to remove Pp d P Area Air Qu of Manna which Qi it hasartlnus air mntaminans n dcfncd by cmc Bay Arca Air Quality Management all new materials for inspection. 7docs strict? ❑Yes ONO I have mad the hvaNmumamrials requirements underChapmrd.95 of the Califor- Hcildt h Safcty Code,Scene.15505.35533 md25534.1 unMnand that ifdm Wilding not currently hams a inane that it u my responsibility to beauty dm"ccuPanl of the oiements which must k met prior m issuaoe of a Certificate of Occupancy, Signature of Applicant Date ner or authorind agent n„e All roof coverings to be Class"B”or better Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 IrCITY OF Fax(408) 777-3333 UPEkTINO Building Department JOB ADDRESS: PERMIT # 7578 Normand Way 6T-U lZeq O-5 OWNER'S NAME: Su, Ling PHONE If 408-507-4962 GENERAL CONTRACTOR: Just Water Heaters FAX # 510-783-6360 I am not using any subcontractors: �� '��� 4/18/05 Signature Date Please check applicable subcontractors and complete the followin 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 /18/05 Owner/Contractor Signature Date 10/28/03 PS i City of Cupertino Building Permit Application E-Mail Jobsite Address: 7578 Normandy Way. Date: 4-18-05 Owner's Name:---Su, Ling Phone No.(408)507-4962 APN#: 366-17-062 Project Valuation: 5 755.00 Building Permit Info: Bldg----------- Elect___________ Plumb_____X----- Mech___________ Job Description 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: permits@justwaterheaters.net City, State and Zip: Hayward, CA. 94545 State Contractor's License# 591 329 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 #: 5474-6390-0026-5679 / Name on Card: just Water Heaters Inc. Expiration Date: 9/05 Visa MasterCard Comments