02090105Li
`',CITY OF CUPERTINO ' ' -
a:BUILDINc DIVISION PERMIT
CONTRACTOR INFORMATION:
•BUILDING ADDRESS:
PERMIT NO.
7974 SUNDERLAND DR
JUST WATER HEATERS INC
02090105
WY N
6931s`PING L AND MAY H
1764 NATIONAL AVE
APPLICATIONSUB D E
09/172002
;PHONE:
(510)293-9901
SANITARY NO. CONTROL NO.
ARCHITECT/BNGWEERi; �; -
I .�. i
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
L._l
,. LICENSED CONTRACT'OR'S DECLARATION
Job Description
I hereby affirm that l am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of One Business and! Professions Code, and my license
REPLACE WATER HEATER
Is in full force and effect.
(5 0 GALLON GAS )
License Class • Lic. x
.
r�
Dine l . . r Contractor
.,I ` ARCHITECI"S DECLARATION
w �.
-' 1 unaers nd my plans shall be used as public record.
OCT 0 4
'Uacrsed Professional
•'OWNER -BUILDER DECLARATION
..",I hereby iRnr that 1 am exempt from the Cmdracon's License Law for the
2002
following reason (Section ]031.5. Business and Professions Code: Any city or county
rwhich requires o gamut m construct, alter, improve, demolish. or repair any structure
-_1i/ 1• _ ._.
mnoilYiaioarlce also requ'sees Ne applkw for such pemlit mfleosierxd sw¢mem
on
II Sq;.Ft;•Floor Area,"))d 1,'ayy y'„
i��(!y\J A(,'l. a .n. S)''.:1•I .L`a d'k �'':..
auatlon
�thSt Fe islic2nseJ puismn)mtlie prn'vninns oIfIt Comrn License Luw(Chapter9
(commencing wird Section 711110)of Division3of Ne Busineu enJ Pmfcssions Code)
ar 11.al he Is e.QdmpP therefio t, ad Ne basis for Ibe alleged extmWion. Any violation
- oPsmopnn ]031.5 by anyapplicant fora permit subjects th<opplicom to a civil penaby-
'+pr nor mnrt Nan five bararea anyala (sso0).
APN Number
... .. Occupancy Type
til.wici anurthcproperty, orinyemployees with wages astheir sole cnmpcnaednn,
502 - FINAL PLUMBIN
'ENERGY
5506 - GAS TEST 1'•.t F,:`L1
Required
-wismxilhe(workfadd 'Ih Cnm'oa'. intendedoro ida
do I
-�Bi
not apply m an
Law does not ply
if Code The r'n License Law
The Cver
Inspections"
pnBPrty Who
owner of property tuns lona or improves Hereon, and who does neer wink himself
owner Wilds o thi s such
507 - FINAL PLUMBING
t . M1 p manic intended
or through ti n employee proidea tmm�ded
......__.. _.._...__. .. . . ..... .... . .. .... . _.-. _. _.. _ _. __._ ,_ _
- hnot,in
.-'olreied fo ' l< If, h e N b Iding p .-Pts sold wish n one year of
c : within
Icomplction
' . f 1 •'I x
Ne o sro,b rlder will have the burden of proving Nal he did nor Wild or
improve for purpose of sale.(.
O 1, as owner of progeny, am exclusively with licensedcontractorsConowt to
't' •1\;License
ptheroject
a the project (Sec. ]811, Business prop Professions Codes The Commnor's
,-constructd Professions
-i A, :I EI I F M1O •.
tie Liw does nm apply to m owns of property who builds improves
se t On the
Land vectors rads ch. projects wilh.a mm rucmrlsl.licensed.pursuam m lbe
_- ._ .,...._..__.. .............
Law.
Contractors License Law.
• Olam exempt under Sec:' �'s�- 7B&PCfor this reason
- I r
Owner _ .. .I) ,• t . 1:'"Date'
WORKER'S COMPENSATION DECLARATION
r'"" Iberthy vRirm under pcnahy of perjury ori<,nfNefollowing dcdamtions: -
•O'I have"inn;will"maimiin'a'Cenifianm `o( ConuenCio self -insure for Workeri
Compcmotion; as, provided for by -Section 3700 of the Labor Code, for the
per2rmance of the work for which this peon( is issued_ v,.`
O I and will mamiain Worker's Coilipcnvoiion Insurance, tie require) by scclion
. 3700 f N Cabo Cod r Ih pert em ed[ or the k f h heli pe tis
of
is d' M3' W ke Compo h it In: a and r" d P I y u tk
C r•I Y5b ( Irl I yl! tPol c4. No I
r 1,.,.. 1Stb.�?. 4'�i•!'�I'].S,l" n x " � •') i ...-`: tU,t',-.�
^{' t,•si Cl ha. / "..l
'• o tCErtTIPICAI'ION OF EKEMPf10N FTtOM WORKERS -
P P -
INSURANCE �•'" a a �' , r
f.0 t 1t - :- •.l3s.
COMPENS_A_TION
;WI •r fnniunimn`nced n01 be completed if the permit is forme hundred dollars
`'1 �',Y•; .:' •I- •.r
(SIM) nr le".)
it .,,• ,�
'�I TI CM f) Nal n IIIC pClr la C Of NC Or_k f 11 M1 Ih pCrlrl l 1. a 1
r ahall
_ -
f. • 1 {.. \� l �1 .1.1 ) - " •
not empl ry;'any per mi m a ly No I Icr r a t he an a mhfcel m the Workers
-
Co pc t 'La•x ofC lf' Dau '•
' t I^ - 1•
,NOTICETUAPPLICANT It after making Chit Cen bcme of ExFlnption you pool)
provisionsll the Labor Code, you mu<t
M1eeome'suompmthe Workers Comm,m
ton
FoiNwilfi'camply"with such provisions or This pnnit shall be deemeJ revoked.
I 1 ICON�RUCfIO
' N LENDING AGENCY
_ _t
Ih rtby ff he, h ; o a l nJ g b Y for Ih pc (
.: .1 \.
of thew kfwhichth i issued c
(Sec 1097CI.C1
L d N n a.. _. .:..,. -_r ..
._.. - _._ _._ _ ..__ -.- -.
Lend Ada
1
t' •
/ILYVL/�.• I
. 1 certify ilial I base road[ this application and sate that Ne above information is
corien: l a8m to comply with, all city and county ordinances and stall laws miming
to builJing coreruciion: anJ herebySmhoritt reprc<enm;lves of;hii city to anon .,on
dr, above-mcmioneJ n mi inspection
!Wc)igme mPscc'milemnify and laic, harmlcvi the Cori of Coperiom6g3iml
'liabilities, judgment, costs and, expenseswhich may in any way accrue against said
City inconsequence of the granting of this peiinil.,
S?UItcANTON \VICE COMPLY W'ITH•,LLL HON -POINT'
"(':'.",
Issuedb ; Date
y
AITONsNDs'AND
50URCE'REGUL6ROFS..-'r'q. H: �•;\,•
Sib I euf ApplicanVContraaor", '. ::..,", "Datgl',•';
Re -roofs
HAZARDOUS MATERIALS DISCLOSURE
W 111h app( t future Will ng ac pant I or handle bar Wo I
Type of Roof --... .
.-..
M5a(<IY
es ser abyth c pen r Municipal ,l Chapter913 Mtn Health and
Code Section 2533n(l I 1Cade
Oyer, i A !N I
t No
' 1,
installed......
..
I, a - _
_ All roofs shall be inspected prior.to any roofing. material. being ... _...
I •: u;.Will the applicant or future building occupant p.seequipmcm crdevices which
..
If a roof is installed:With'out first obtaining an inspection; I�agree.[o remove
emitict?, us air conmmimnt ddcfned by the Bay Area Air Quality M1fanagcmem'
Divlri.3 .. ...,.,. ,. ;. ,.._ .
all new materials for inspection. ,Applicant understands and will comply with
_
yesI.1.
all Tion -point source re ulauons
,1 have read the hmardcun mu¢ I. ox,ruemems oder Chapun 6.95 of the
Caliromia Health & Safety Cade, Sections 2550.7 85 3 3 and 35534. 1 understand that
___ ..
' ifthebuildin lues not currcna have atenumahat it is responsibilitytonotif me
g t Y
Yan Y
l •. ' s r..
.
occupied of the requirements which must be mit prim to issuance of a Cenifcate of
m
upancY. ,: ;
oce, •_.,,., ..,..I � '" __...:.....
._ Signa[ureofApplicap[— -_. ...._.. _._.._. ...Date ...._..__ _
_
All roof coverings to be Class "B•• or., ett er
0nerror amhorized Date
gem,-
OFFICE — .. --"-------