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05040106 .77 CI BUILDINGUDPEROONNO PERMIT IRON &CTQRiINFORMATION z BUILDING ADDRESS: JUST WATER HEATERS INC PE1eMRN%5040106 '10360 STOKER AV OWNER'S NAME: PERMIT ISSUE DATE 4g 1h DAVID DINELLI 3400 INVESTMENT RT.VT) ONE: SANITARY NO. CONTROL NO. 510 293-9901 ARCHDIC'MOENGINEER: BUILDING PERMIT INFO LDG ELECT XLED PL MFCH o o LICENSED CONTRACTOR'S DECLARATIONJob1 ion 7 afrum Wt l 3 fft Bu under Provision of CNpter 9(oommencin{ In full ullootice And e)ecDivision lO(Jte Budnesaand Profession Code.and my license is _ Iemseameandercet. REPLACE WATER HEATER License Clue Co N Dam Comment. (4 0 GAL GAS) ARCHITECTS DECLARATION _\] 70 2005 3 I undcrwnJ my phos shall W used u public records gq^Jk ,pn�/� 5� Licensed herebyProlesion's m U I L I p � OWNER-BUILDER DECLARATION ay 1 hereby amrm that 1am 1. .Bumps from the fes ons Ca e:Any C taw for Ute O O fallowing meeDa(Section]031.5,Business and improve, de oli Cale:Any tan ores vera $ which mquime a Permit m ennnmm,alter,improve,h iscruit u li e a sir any suucwm FAX' Pnorm itstensed e,alsomquly prom Appos.ftm iedrerme.1.1 Ase U.(etswmcm FE< (Cemei ncingwidiS=tion7 )ofDission3thiCBusi wr'aMftflaw(CMpter9 Sq.Ft. Floor Area Vacua 1285 58 (comme coarept SesUon]OW7 of basis flnftbo Business endon.Anyavi Cole)or Wt W u a.mpt therefrom and the bait for she.Inc{td assumption.My violation of Section]031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy not more than Eve hundred doll.(3500). p y Type ❑I,wmwoftkepmpeny.wmyemploycuwiffimM u ensa theksolecompdon, 32647(]15 ' ()() willdothewOrk,andtheanuctumisnotinwndedoronendfonale(sec.]t11A,Buainus Required Inspections and Profusion, mmw e Code:The COnmes Llan.law Joos rent Apply an owner of q P property who buildsor lm amu theccon,and who doessuchlarkhM.If orthrough his Own employcou.provided that such improvements an,notthtended moneyed forsam,if. hmvever.the building or improvement is mid within one year of oompmtian,the awrter- Wilder will have the burden of proving that ha did no,build or Improve far purpose of Bak.). ❑1,As owner of that propeny,am exclusively contracting with licensed contractors to construct the project(Sec.7010.Business and Profusions Code:)The Conlracmr's Lh came taw docs not apply in an owner of propeny who builds or improv humor.and who contracts for such projects with a eomr.wr(O licensed pursuant to til COnoacwr'a Liana.Law. . ❑1 ins exempt under Sec. .B k P C fa this.0. Owner Date- WORKERS am WORKER'S COMPENSATION DECLARATION 1 Nrtby elllrm under penally of perjury,one of the fallowing declare don: 1 Nae and will mmmad.•Cenifi^,•ufCon.m m.If-insure for Warker'aCanpcn- statlon,u provided for by Section 37M of the labor Code,for the Performance of due work for which this permit is issned. ❑1 have and will mainuin Worker's CompemaUon Irwnms,u raqui ed by Section 37M of the labor Code,for the Performance of the work for which this Permit is issued My Worker's Compensation Insurance caller and Policy number am: Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section rued notbecompleted lithe permit hi form hundred dollars($100) M lass) 1 Certify that in the paformance of the work for which this permit Is Issued,l Mali nm employ anyper.n In any manner an As m become subject in the Workers'Comp mution Laws Of California.Data Applicant NOTICE TO APPLICANT:If.after making this Certificate of Exemption,you Mould become subject to the Worker's Compensation provi ion,of U.labs Cade.you muss ,J O fOMwith Comply with such provisions w revalued.this permit all be doomed revalued. CONSTRUCTIONLPNOINGAGENCY ' rr _� [tip I for by which the thereuamnwni097,Ci,.C.) yfor Urc Performance of /'�'^Y(Ayn✓^`�tJ` ' Ci Le lurk for which thla permit u issued(Soo.7097,Cie Cd dQ Lendcr'a Name .7 z Lender's Address U0 I eertiry,mat I have reed osis application and mos Nat the above informadun Is U.r,••r corte0.I&goes 0 comply with all city and county ordinances and sate laws relating in C)CSJ' Wilding tonwuetbn,and hereby authmies representatives of this city to creta upon J. W above-mami.ned property,for inspection purposes y (We)a3'me As save,indemnify and tamp homeless the City or Cupertino a{aieW y liabilities,judgmereu.costs and expenses which may in any way.ene Against A iu City V 7 In camequence of the granting of this permit. A APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. Re-roofs Signature of ApplicanUCoARDO Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Willy 1.applicant or future WilMunicipal Cg aesupantswro strand t e Health us and Safety As de.Soc by the Cupertino Municipal Codas,Chapter 9.12.and Uw Health and S&Icty Code. SOyu z5532(D7 All roofs shall be inspected prior to any roofing material being installed. ❑Yca ❑Nu Will the applicant Or future Wilding occupant um equipment adevices which If a roof is installed without first obtaining an inspection,I agree to remove II havaNnus air Contaminants as coined by the Bay Arta Air Quality Management all new materials for inspection. 7NAaict? ❑Yee ON. I have mW the huaNrms materials requirements undcrCNpwr 6.95 of the Califor- Health h Safety Cade,Section 25505.25533 atu125534.1 undenused thatlrme Wilding cs not currently haw A tenant,that it u my vpanibility m notify the uaup en of the uiremenas which man W=I Pdarm Issuance ora cenifieate ar Occupancy. Signature of Applicant Date ners wthomcda cm Date All roof coverings to be Class"B"or better Community Development 10300 Torre Avenue ► Cupertino CA 95014 Telephone(408)777-3228 CITY OF� UPEI�TINO Fax(408)777-3333 Building De artment JOB ADDRESS: PERMIT # l / 10360 Stokes Ave. 6 ti ° 6 OWNER'S NAME: Dinelli, David PHONE # 408-725-0401 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 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 UKdj'Q' 3/18/05 Owner/Contractor Signature Date 10/28/03 City of Cupertino Building Permit Application E-Mail Jobslte Address: 10360 Stokes Ave. Date: 4-18-05 Owner's Name:---Dinelli, David Phone No.(408)725-0401 APN#: 326-47-015 Project Valuation: S 1,285.00 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. 3S� Expiration Date: 9/05 Visa MasterCard Comments