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05080040 CITY OF CUPERTINO 'X0 �•. 7�,rrI�. �"�'^"' � �*t��"y"' �� BUILDING DIVISION PERMIT v�A�°LG�,dII BUILDING ADDRESS: JUST WATER HEATERS INC PERMITNO.05080040 1032 TULA LN OWNERS NAME: PERMIT ISSUE DATE CLEMENT YEN 3400 INVESTMENT BLVD 08/05/2005 HE SANITARY NO. CONTROL NO. (510) 293-9901 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH I� 1 LICENSED CONTRACTOR'S DECLARATION Job Descriptio 7.-a ft�– 1 Manby affirm these I am of Use Bu under And Prol ss in Catch, 9(commercial1. 9ljAL�—" wbh Secdw nd.fext."Won7of the BudnesaaM Pro(esalou Cods,And mylicensels REPLACE WATER HEATER in cull forte and cRm Debt clw us.« 50 GAL GAS _ Dau ARCHITECTS DECLARATION A()r, I$_ 2005 $/JJ 1 undcraund my puts Pull be teed u public retards a u• Licensed Pmfcuimud (t (((}}} f: 5 OWNER-exempt R at th, RATION ILDH <3! I hereby affirm that OWI R-cxcmpt from the RATION l License Law for Nc a&1 ©y Aq�/�7•� 0 0 following moon.(Section 7031.3.Bosineu and Homaslou Code:My city or county 5$ which requires a permit to eon iuucL alter.improve,demolish,or repair my structure ZKI prim to its iifunce.also requires the applicant for such permit W file a slgneA atstemem 2 < that beis located Pmmanitothe pmvisiomofthe Contrame'slimnteLaw(Chaimr9 Sq.Ft.Floor Area Valuatio 983 (commencing with Section 7000)of Division 3 of the Business and Professiam Code)or that he is exampt therefrom and the bub In,the alleged eaempdon.My Woladan of Section 7031.5 by any applluntforapermWubjecuthe applicant to a civil Penalty of APN Number Occupancy Type not mare than few hundred dollars(SM. 35913098 . 00 ❑I,As owner of Ne property,Or my employe"with miss as their sou compensation. wnlmNework.And the summers bnnmmnded cur aflond(a,Ask,(SM.70",Badma Required Inspections and PtafesYou Cade:The Commema"Limue Law dont net apply to e an owner of q p Property oho bui Idsor hopmw def con.and who don such work Mmself or through his awn employees,provided tha"neh improvements are natimended maffered formle.If. however,the building w Improvement Is sold within ane yea of compladon,the awnea- builder .AIR haw the burden of proving that be did not build Or Improve for purpose of said.). ❑1,As weer of the property,am exclusively contracting with licensed mnuac com to combust the pmject(Sec.7014,B"inesa and Prefmsiaes Code:)The Contractor's LI- came Law does,not apply It an caner of property who builds or improves theman,and, who contracts for such pmjccts MN a comamtor(s)licensed pursuant to Ne Comacto's - Lice=Law. 0 l A..=or under S.C. ,B A PC fm N4 wan Owner Data WORKERS COMPENSATION DECLARATION I herebyro affirm under penalty of pedury aof the fallowing declarmorm 1 hew and will maintain•CeNftcmz of CouenI to MINIMUM fmWarkeYsCompen- vdon,u provided(m by Section 3700 of the labor Code.for the performance of de work for which Nis permit Is lamed. ❑1 have and will mainuin Wakefs Compeuation Inammc,u required by Section 3700 of Ne tabor Code,fm Ne performance of tie work far which this permit is isnned. My Workeei Compensation Inmmme carrier and Policy number art: Cartier: Polley No.: CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (164 section need Mabe conpleuad if the Permit is for one hundred dollars(SIM) or less.) 1 crify that In the performance of the work fa which tibia permit is issued,l shall not employ any person In any mmmcrso As W become subject to the Wurkera'Compcuati on Laws of fDau Applicant NOTICE TOAPPLICANT: T: .nl IL atom making Nb Certificate,n"u of Ewmptlon,you,Auld .,Obecome comm y the Worked Cam ll Or am pewit shif of de laden Code,you must forthwith comply with such pmvWnu or Nia Permit Nall W dcamcd rtwdmd. CONSTRUCTION LENDING AGENCY tom^ I hereby affirm dot Nem Is a conwucdw WdiniMency for do Performance of C4 tie work for which Nie permit is Wcd(Sec.3041,Civ.C.) ' (21 Q Undue.Name z lender's Addw U0 I ttNfy Nat I him read this application and sum dot the,bow Information Is corm 1 agree to comply wit all city and county ordinances and seem laws relating Im ' p trJ' building conmucliod,and hereby mthorim mpruenudvu of this city W emer upon to W above-mentioned property for inspection purposes. LL (We)agree to save,indemnify and keep harmless the City of Cupcnino against wy y liabilities.judgmerm,cats atm expenses which may In my my accrue Miami said City in V his permit. APPLICANTDS eUNDEof the RSTANannit;of tAND WILL COMPLY WITH ALL NON-POINT Issued by:3 Date SOURCE REGULATIONS, Re-roofs Slgnawrtof ApplicanUConuactor Dau HAZARDOUS MATERcupart arm Type of Roof WIII Ne a Cultnt m future building e.Chapter nom m NMIe Heantous natural u dented io the 32(.)? n Municipal Cade.Chapter 9.11.mtl too HeaIN and Sanity aa,Smtian 2553:(q? Ym No All roofs shall be inspected prior to any roofing material being installed. ❑ ❑ Will the applicant or future building occupant use equipment or devim,which If a roof is installed without first obtaining an inspection,I agree to remove It emit mmdna air cmtsminanu u donned by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes No I have mad the husWoua materials requirements under ChaPur 6.95 of the Griller, as Health At Safety Cade,Sucdau 25505,15533 And 15531.1 undcrRand NU lfthe building dam cot ccon,ntiy have•unset,that it b my reapoestality In musty the ocupmt of the requiremm.which MUM baMCI prior in issuance ofaC"dBmWofoccupancy, Signature of Applicant Date Owner or authorized agent Date All roof coverings to be Class"BM or better Community Development i' 10300 Torre Avenue Cupertino CA 95014 CITY OF Telephone(408)777-3228 ' IDC IIAIo Fax(408)777-3333 Building Department JOB ADDRESS: PERM� k� D 10320 Tula Ln. OWNER'S NAME: Yen, Clement PHONE# 408-255-1128 GENERAL CONTRACTOR: Just Water Heaters FAX # 510-783-6360 I am not using any subcontractors: D "—CQ- 7/05/05 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 0-` 7/05/05 Owner/Contractor Signature Date 10/28/03 • City of Cupertino Building Permit Application E-Mail Jobsite Address: 10320 Tula Ln. Date: 7-05-05 Owner's Name:---Yen,Clement . Phone No.(408)255-1128 APN#: 359-13-098 Project Valuation: S 983.00 359-13-102 Building Permit Info: Bldg Elect Plumb__X Mech Job Description Replace 50 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: permltdept®sbcglobal.net City,State and Zip: Hayward,CA. 94545 State Contractor's License# 591329 Exp. Date: 3/31/06 Worker's Comp#: 1626288-05 Carrier:State Compensation Insurance Fund Exp.Date: 4/1/06 Credit Card Information Credit Card #: 5474-6390-0047-8660 SS� Name on Card: Just Water Heaters Inc. 3 o Expiration Date: 06/08mul o� Visa MasterCard Comments Assesor's office has same address with 2 different parcel #'s.