Loading...
05120060 CITY OF CUPERTINO •'•`� as { BUILDING DIVISION PERMIT C,ONTRACTVRANF,ORNUT ONES BUILDINGAODRESS: JUST WATER HEATERS INC FERMI INO.05120060 •10580 WHITE OWNER'S NAME: PEM9T ISSUE DATE FANG WU 3400 INVESTMENT 12 /13 /2005 NE: SANITARY NO. CONTROL NO. (510) 293-9901 ARCHITECT/ENGINEER: BUILDING PERMIT INFO ' BLDG ELECT PLUMB MECH 0 0 0 0 i 00 LICENSED CONTRACTOR'S DECLARATION lu C I hereby"em that 1 am licensed under pmvWora of Chapter 9(cammcheing Job Description til with SectioncDiviven]of the BuvnesrW Profrssiuru Code.and my liceneu rt sPN in full foe arid ndcfferect. REPLACE WATER HEATER ' Dam Clan Contractor k, Dam TSDECr 40 GAL GAS ARCHITECTS DECLARATION I in I unwrwnJ my plats sMll W used u public rtrnNs /�� )yu ✓ c LLo Lictnued Pmfesswnal - 1 5 OWNER-BUILDER DECLARATION Conte ON <� 1 Wmhy,alTirm that I am exempt from the Contractors License Law for the [OO(a D o following mann.(section 70]IS,Business and Profession Code:Any city or county which requires a Permit to eonsmcL alar,improv,demolish.or mpsu my suumure prior to its issuance.Mae requires the applicant for Rich permit to file a signed sutcment Slz ggg Nat he is licensed pursuant to the provisions of the Contractors License faw(Chapter9 Sq.Ft.Floor Area zla'giib 99 e�c (commencing with ScctionlOW)ofDivisionJofthe Businm and Prafrssi.m Cawl err Q'g iib 9$ drat he is exempt therefrom and ths,buffs for the alleged assumption.My violation of !9 l Q� Section 7031.5 by any APPOant for a permit subjects the applicant a a civil penalty ofane pj�N Number Occu e ria mom that fw hundred d.11.($5M). 35905122 . 00 p yTyp 0 1,as owner of the property,or my Employees with wager u their sole compwation. will do the work and the structure u not intended or offered for aside(Sec.7W4,Busircss and Professions Cade:The Contractors License law dna an,apply to an owner of Required Inspections property who Wilds or improves themon,and who does such work himself or through his own employees.Provided that such improvements are net intended aoRend for sale IL however.the Wilding or improvemml'u sold with.az year of mmpledon,the owner- builder win]have the Widen of proving that W did wl Wild or improv for purpose of sale.). 0 1,A owner of the pmpcny am mclmiwly contracting with Banded cenvantom to construct the pmjen(Sec.70x4,Business and Professions Code:)Tim Co desctors U. come law don not apply to an owner of property who Wilda or improves thereon,and who contracts for such projects with a canuaersR.)licenced pursam to the Continence, Licence law. 0I am ucmpt under See ,B&PC for this reason Owner Due WORKERS COMPENSATIONDEC RATION 1 hereby t1Etm under penalty of perjury rine of the following melmuion e I haw and will maintain•Certificate fC...,to self-insure fa Warkefs Courtlier. 7C17)'M in,as provided fa by Semaa]700 of ere War Code.fa the p�Aon .of tW rk for which this permit is issued. 1 have and will maintain Workers Compensation Imuran¢,u required by section of the lobo Code,fm the peRormance of the work fur which this permit u issued.Workers Compensation Insurance carrier and Policy number art: rtier. Polity No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thu section wed nothecomp cu d if the permit is forms hundred dollars(5100) .r ICA.) I certify that in the performer¢of the work for which this permit is issued,I shall not ..•.ploy ,anypeoan in any amerau.u to become subject,.the Wanton'Campensatium Laws or California Dere Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should Weems subject to the Workers Compensation previsions of the labor Code,you most .J O foMwiN comply with such previsions or this Permit that be wemed rtrvoked. Z" CONSTRUCTION LENDING AGENCY (-v Ihereby affrnat that there is a construction lending agency for the performance of Cli the work for which this Permit Is issued(Sec.3097,Civ.C.) C0 lanwrf Name =z Lenders Adder.. U Q I certify that 1 haw read this application and sate that Ne aWw informathon is L eo.eel.I agree to empty with all city and county ordimartcad and sine laws minting to 0 Wilding coosmction,and hereby authanre representatives or this city to enter upon the rte aWwtmcnuawdpropertysc for inspection whichimansima (We)agree to Ave,indemnify add keep humless the City of Cupertino agaimt tU tel in oxpcmu which may In ery wyamue agmnstamd City („)z A PLICArnce of thegranting of thisD WIL APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. Signature of Appliraanter Date Re-roofs HA,AR HAZARDOUS MATERIALS DISCLOSURE Type Of Roof Will the a Cuant or future Wilding aceuperl store handleorhandlehanmate rEans rial u defined by the Cupertino Municipal Code.Chapter 9.13,and!the Hdth and Safety codARLe,sem❑Yes ❑Noen zss]z(o)? All roofs shall be inspected prior to any roofing material being installed. 11 Will tW applicant or More Wilding occupant use equipment a dcvisv which If a roof is installed without first obtaining an inspection,I agree to remove mit hvaN.us air conuminanu a inclined by the Bay Ana Air Quality Management all new materials for inspection. District? OYm ON. I haw mail the by rdtassmatorials mquiremens underchaptcr6.95 of tW("Airory On Health&Sarety Cow.Secuom35505,255]]and 255]4.1 undcrswd thaifdrc Wilding docs tot conemthy have a tenerl that it is my responsibility m ttoufy the occupant of the requiremcmu whim must W met Our tocanonicals cerurmte or Occupancy. Signature of Applicant Date Owner ammarindagent Date All roof coverings to be Class"B"or better 10F Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 Fax(408) 777-3333 ICUPEkTINO Building Department JOB ADDRESS: PERMIT# 7626 Hollanderry Pl. O Z, cruS�� OWNER'S NAME: Janszen, Norm PHONE# 408-314-7374 GENERAL CONTRACTOR: Just Water FAX# 510-783-6360 Heaters I am not using any subcontractors: �� � 12/12/05 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 12/12/05 10/28/03 vJ� 2 �o City of Cupertino Building Permit Application E-Mail Jobsite Address: 7626 Hollanderry PI. Date: 12-12-05 Owner's Name:---Janszen Norm Phone No.(408)314-7374 APN# 362-29-003 Project Valuation: S 993.00 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: permitdept®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/l/06 Credit Card Information Credit Card #: 5474-6390-0047-8660 / Name on Card: Just Water Heaters Inc. # Expiration Date: 06/08 Visa MasterCard Comments