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08090150 CITY OF CUPERTINO B UILDINGDIVISION PERMIT WQ4�°.Lr��Q1RINF41.iMr1TION PERMIT NO. BulL.gllbVff'hN FELIPE RD 'JUST WATER HEATERS INC 08090150 OWNEEWS NAME; PERMIT ISSUE DATE FERRARIO ROBERT L AND DOREEN 3400 INVESTMENT BLVD 09/23/2008 NE: SANITARY NO. CONTROL NO. (510) 293-9901 ARCHITECT(ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH u O p LICENSED CONTRACTOR'S DECLARATION U 1 betaby af0rm Nat 1 am Ewnsed uwkr Pmvitloos of Chapter 9(commencing Job Description with Section 7M)o(Okision 3 of the Business read Professions Code.and my license is REPLC 50 GAL WTR HTR in full force and cff=L j t2 z- License Class Lk.a Date Contractor n W ARCHITECTS DECLARATION CC 77 1 undcramd my plans shall i e reed u public menthe JyV '.t; Licensed Professional 5 OWNER-BUILDER DECLARATION r� 3: 1 kreby from that 1 am eumpt from the Contractors License Law far the COO rollowing moon.(Section 7U11.S.Business and Por esdom Cade:My city or roomy $ which mr,mrs,a permit to construct,alcor,improw.dcmal'ub,or repair any museum prior to its issuers.also,requires Jcappliant far such Permit to filer signed wvmere < wtkislicensed remount Inthe powisionstafdue cantmeer's�=Law(Charter 9 Sq.Ft. FloorArea Valuation go (cammaacingwith Sevan7CORo(Dived.3artheBusiness and Pmreconts Code)o $1755 y $ that is,is aaempt thrnal.and the basis far Ik alleged est 0 .Any vklation of Section 7031.5 by any applicant far a permitrobjccU the applicant to a civilmhy of act man thaB.ahundred dollars(s5o34222071 .&CrUt Number Occupancy Type 01.uownerofIkpropmy,wmyemploycemwithwagesurmkmolecm =don. willdo IkworLand Nasweumunotinwn doroffmdfarmak(See.7M4,Budwss and Pref s ims Coda:The COn rwtors License Law does Out apply to an cwtxr of Required Inspections prepany who builds m im prom themton,and who does such wort nnrsxl r m thmogn his awn employes,prodded Net such impmwmenB tie not intended aroffend!oriole If, however,the Wilding or Imp ow rant is sold within ane year of completion.the awncr- builder will Acte Ik burden of paving that he did not build err improve far prepare of sure). ❑1,as Owner of the propenY•am eaelmmly contracting with licensed commanders to construct the project(Sec.7044,Business and Predications Code:)The Comncmrs U. ¢nu law does not apply to an mvnar of property who Wilds or improm themon,and who contracts for such projects with a conmctot(s)licensed pursmnt to Ne contrutaM1 License law. ❑I em exempt under See .B&P C for this;ommn Owner Data WORKER'S COMPENSATION DECLARATION 1 kmby a01m water partially of perjury arc of the following decluatlons: 1 hare and will maintain•Cenirote ofComent to self-hum,fa Warkera Canp:m sedan,as provided far by Section 3700 Of Ik labor Code,far Ik prtormwoee of the work for which this permit is issued. 0 1 have and will maintain Worke/s Compensation Instar .as mr moot by Section - 37000rNe laWr Code.far Ne Performance ofthe work far whim this pmol It heated, . My workrs compensation Icwtams anis and Policy number mm: Carver. Poky FROM RfR CERTIFlCEXEMPTION FROM WORS' COMPENSATION NSATION INSURANCE (Thu section wed not W completed if the permit Is fmonehundred dollars(5170) ter buss) 1 certify Nvt in In,parfann.wa of use work for which this permit is;issued,I shall not employ any parson In any mannerse as to become mbjem to lk Worlmrs'Compemauon Law.of California.Data Applicant NOTICE TO APPLICANT:If,after making this Ce tifiau or Esemption,you Nauta become subject he the WorWs Compcmauon pmisions of Ne Labor Code,you mus .J O forthwith comply with such provisions at Nis permit shall k decreedm rckcd. v" CONSrRUCnONISNDINGAGENCY ►I-' I wraby affirm dw sem u a constructim heading a get]for the pertotmana of cL> the wort for wnkn this pmN is iawa(Sec war,air.e) WM Q Lender's Name z Lenders Address V Q I certify Nat 1 haw red this applicant.arta sem dew the akw iWomutiun u LLr — correct.I ages m comply with all city and county oral.and ante laws relating to - .�V Wilding conwuctirn,and hereby mmonre mpresemaum of this city to enter upon tic ( �/1yr(/ / [21 aWw-mcnuawd property for it Anion which purposes. 1/ fY (We)agree to sew,indemnify and keep harmku the City of Cupnko against \\ lin liaCmetaimentC fhecmbwd eapcmataft. may in any way acew mat said City V z m conmgw T Of the granting of Nu permit APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. SignatureO(ApplicmuComrDete Re-roofs HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or(alum buildinge.Chaptstom wand m Health and m derwd c 25 C2(a)? Municipal Code.Chapter 9.11.and Ne HeaiN end Safety Code.Semon lss3l(a77 ❑Ya 0N All roofs shall be inspected prior to any roofing material being installed. Will the applicant or futons Wilding omupam tax equipment or devim which If a roof is installed without first obtaining an inspection,I agree to remove mh hwatde.air cwumiwnu as wfinedby the Bay Am.Air Quell,Management all new materials for inspection. District? P 1-1 Y. ONO I have read the huaNws nmeriau requimnmmt under Cle parb.95ofde Califor- niaHealth&Surety Code.Sceims 25505.75533 wed 25534.1 understand that JNe building does not century Mue a amort that it k my responsibility to rotify,the account of the nqui onams which mac kmet pia,to issuance or.Certificate or Occupancy. Signature of Applicant Date Owner ar mmaired agent Date All roof coverings to be Class')W'or better CITY OF CUPERTINO • 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 34222071 . 00 DATE ISSUED. . . . . . . : 09/23/2008 RECEIPT #. . . . . . . . . : BS000006159 REFERENCE ID # . . . : 08090150 SITE ADDRESS . . . . . : 10511 SAN FELIPE RD SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : FERRARIO ROBERT L AND DOREEN M ADDRESS . . . . . . . . . . : 10511 SAN FELIPE CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-3967 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 1, 755 . 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: 10511 San Felipe Date: September 22, 2008 Owner's Name:---Bob Ferrarlo Phone No (408)257-2554 APN#: 342-22-071Project Valuation .$ 1,755 Building Permit Info: Bldg—_— Elect—__ Plumb_X-_ Mech_—__ .Job Description Replace 50 gal 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/l/09 Credit Card Information Credit Card #: Name on Card: Just Water Heaters Inc. Expiration Date: 6/11 Visa ❑ MasterCard Comments ^� Community Development t, 1 ' 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 SCUPERTINO Building Department JOB ADDRESS: PERMIT # 10511 San Felipe 5 O1? O /5 D OWNER'S NAME: Bob Ferrario PHONE # 408-257-2554 GENERAL CONTRACTOR: JustWater Heaters FAX # 510-783-6360 I am not using any subcontractors: U LjrR. � �� i^--� 09/22/08 Signature Date Please check applicable subcontractors and complete the following information: 21 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 V'Rs� � 09/22/08 Owner/Contractor Signature Date 10/28/03