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08030076CITY OF CUPERTINO �' �•?#*s:�z�A+F�.a��y�(•'��'x%'��,'�"��'� `°" BUIL'DINO DIVISION PERMIT (��7 CO1�,fTRA-CT;OI2=IN'O uATIIV F BUILQI[{GlTT'skED FIR CT kC FAST WATER HEATER 1i ri P`RnT30076 , WNER'S NAME: PERMIT ISSUE DATE YUAN, ZHENGYU(KEVEN) 12601 132 AVE NE 03/14/2008 TR ONE: SANITARY NO. COmROL NO. ARCHITECT/ENGINEFA: RMV/RPLC GAS WTR HEATER BUILDING PERMIT INFO BLDG EI.ECf PLUMB MECH LICENSED CONTRACTOR'S DECLARATION lob Descri hOn 1 honey aM m thin 1 am limned under pmvisiaos of Chapter 9 (uom ummin{ P with Section 7l111U)of Division 7 ofthe Banner and prolamines Code dmylle mala - in full forte esti IfI.Icenm C IY.I Dau Canumwr ARCHITECPSDECLAR ON 1 untletwnd my plana WII M used u public mcnrds Licensed Professional OWNER-BUILDER DECLARATION I Mreby aRrm that I am exempt from the Contsacurs License Law for the, following wan. (Section 7131.5. Business and Profesaiom Cale: Any city or =only , whish requires a permit to eomweL slur. impmw, dvmaltsh, or =put, my structure prim It its issuance. amu mquires the applicant for such permit in file a signed uamment is licensed to the of the Concurs Licm,x law tamp= 9 Sq. Ft. Floor Area Valuation thin M puetant provisions (commencing with Stttim 7000) of Division 3 of he Busiess and Pmlasians Code) 0r that he ts exempt therefrom and Ne buts for the alleged eamnption. Any violation of APN Number Occupancy Type Section 7071.5 by any applicants for a permit subjects the applicant to a civil penalty of vel mese Nm five hundred dollars (Iwo). ❑ 1, u awrcr of Ota property, m my anpl%ees used xgex u Netr role c0mpuuadm, Required Inspections dothexrk esti the taw dam est apply lo rt renes of otoluuntledm ave dor act he Connector, and Cade: Conbmurs "ply.70N.B mer of stat Ao, who ep =who chxhbimxel(m through his gopenywho Wiprovidd mrove who but owes employes, provided dins such improvements art not intended mortared rmmle If. that ammo however, Ne Wilding m improwmmt ts mitl within one year or empletion, the owner. Wilder will haw du buNrn of poWn{ that M did ros build or Mprow for purpose of ala). ❑ 1, as owner of the property am exclusively conumUng with licensed entncmra m mmlrocl the project (Sec. 70". Butlnem and Prolusions Cade) The Cmtamur's LL ounce law does not apply to an owner of property who Wilds or improves thereon. and, who conmcta for such pmjccts with a ronuawrtal licensed purmant to tM Cmuacmra 1.'cenm Law. ❑ Ioenuemptundersed ,BAPCfxrNiswan nu Data WORKER'S COMPENSATION DECLAMI10N 1 hereby arcirm under penalty or perjury mad of the following declaratione 1 haw and will maintain aCWOnta of Camera m self-Imam (or Workers Compen- sstlon, 3700 of Ne IaWr Cade, for tin performanou of ted fpoerr wale For mi tSeddon watch this is Issued. 1 have anti will maintain Wmtrra Compewtion Insurance, u requited by Section 3700of Wracluj dcper(ame.aa(the work for whim thin pennittsime4 My Wor a rope as Brim and Policy number e• , Cattkr. Polpcy No.: ER FI PITON FROM W R f � S' OMPENSATION INSURANCE (Thtssecdm cad rot W completed if the permit la Intone hundred dollars (5100) or leaq 1 unify But in the performane, of the work for which this parent is used, i mall not employ any person in my manmrm m to become subject to the Wortrn' Camp• een on Lax of California. Data Applicant NOTICE TO APPLICANT: IL afar making this CeNOcau of Exemption. you should become subject to the Workers Compensation previsions of the lahm Code, you most forthwith comply with such provivtm or this permit mall W deemed evaded. CONSfRUCf10NLENDINGiAOENCY 1 Mr that team is s lending7.Cs. agency for Um performance of ed (See, 30 the work for whleh th4 permit ts issued (sap, 7097, Cis. CI which leaders Nurse ad e: Add= 1 I mniry that 1 Mw mad this application sed sam thin the aWve information Is e coerce. I agree to empty with all city and county Winaecea and sum laws relating in Wilding construction. and hereby mthorim representatives of this city to enur upon he 1 me ve-mcndoned property for inspection purposes. (We) agtxe to saw, indemnify and soup harmless tae Cly of Cupertino aria= t j liabilities, judgments, cow and expenses which may In my way aroma apiest aid City in consequence of the {ranting of this permit. till, AP DEMANDS AND WILL COMPLY WITH AL NON- OINT Issued by:9 Date s. / SOUNS. / Re-roofs J Type Of Roof TI -�z%r- D �-� a�ywum ofA I F1x`mm"OU SATERIAISDISCLDsURE U Will the mPliunt m rutun building o=upant uom orhandle hamrdous maurial as dented by do Cupertino Municipal Code. Chapter 9.13, and the Hnldt and Safety lat 3557x(07 . sectWIII All roofs shall be inspected prior to any roofing material being installed. ❑Yu No If a roof is installed without first obtaining an inspection,agree to remove the applicant or u m Wilding occupant not equipment or deHces which emit hamroma air contaminants as dellned by the Bay Area Air Quality Management .1 all new materials for inspection. District? ❑ Yu u Lis I haw real the hu nequiremenuundcr Chmour6.95 a(the Califor. nu H=IthB Safety Cade. Sections 75505.35577 aa135534.1 understood thatif the Wilding des. c n W a anm1. au is 4 my rexpamlbility m ratify tip. occupant or the regai h mel prior mIssuance of, CW f O Signature of Applicant Date All roof coverings to be Class'A:s' or better Oxer or authors gcnl am' M 0 • CITY OF CUPERTINO 4 ITEMS OF 8 PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35905043.00 DATE ISSUED.......: 03/14/2008 RECEIPT #.........: BS000004161 REFERENCE ID # ...: 08030076 SITE ADDRESS .....: 21113 RED FIR CT SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OPERATOR: patg COPY # : 1 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 518 WATER HEATER OWNER ............: YUAN; ZHENGYU(KEVEN) ADDRESS ..........: 21113 RED FIR CT CITY/STATE/ZIP ...: CUPERTINO CA, 95014-4254 RECEIVED FROM ....: FWH ACQUISITION CO CONTRACTOR .......: JEFF JORDAN LIC # 29100 COMPANY ..........: FAST WATER HEATER ADDRESS ..........: 12601 132 AVE NE CITY/STATE/ZIP ...: KIRKLAND, WA 98034 TELEPHONE ........: (800) 454-8955 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS'REC NEW BAL ---------- 1BSEISMICR ----------------------- VALUATION 449.00 ---------- ---------- 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 1TRAVD0C FLAT RATE 1.00 40.79 0.00 40.79 0.00 TOTAL PERMIT ---------- ---------- 106.56 0.00 ---------- 106.56 ---------- 0.00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 518 WATER HEATER From: 03/06/2008 13:43 #677 P.004/007 4 CITY OF CUPERTINO U 0 U 3 co -7 (p 395950 WATER HEATER PERMIT APPLICATION FORM APN #2 5 O 5b o U o JJ Date. 318!08 Building Address: 21113 RED FIR CT Owner's Name: Phone #: (408)627-9858 YUAN, ZHENGYU (KEVEN) Contractor: Phone #: 800-454-8955 FAST WATER HEATER COMPANY FAX 425-814-9516. Cupertino Business License #: Contractor State License #: 29100 877489 Contact: I Phone #: 600-454-8955 Carol Randall Fax #: 425.814-9516 Building Permit Info: laldg El meet Plumb x Mech Residential Commercial ❑ Job Description: Remove/Replace Gas Water Heater Strapped ❑ C+n Platform ❑ Bonded ❑ New Location ❑ Replacement Valuation: 449.00 Green Building Cheek mast be completed and attached to this application. Green Building Points achieved: �-- n From: 03/06/2006 13:43 #677 P.005/007 0 CUPEft,_ CITY OF CUPERTINO WATER HEATER PERMIT APPLICATION FORM 395950 Quantity Fee M Fee Description Fee Permit Type Group IPCWHEATR Commercial Water Heater/Vent B PCWHEATR BSEISMICOM Seismio Commercial B I IPRWTWATR Residential Water Heatedvent B PRWHEATR BSEISMICRE Seismic Residential B PPERIvIITFEE Plumbing Perrmt P TRAVDOC , Travel & Documentation B BUSLIC Business License B 0 CITY OF °*UPEkTINO 0 JOB ADDRESS: OWNER'S GENERAL Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 Building Department I am not using any subcontractors: X&"&j Si ture Date Please check applicable subcontractors and complete the following information: "OwnifiContractor Signature 03 l w Date 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 Roofing Septic Tank Sheet Metal Sheet Rock Tile "OwnifiContractor Signature 03 l w Date