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02050121 (2) CITY OF CUPERTINO BUILDING DIVISION PERMIT CONTRACTOR INFORMATION: B181�41RECSYPRESS CT JUST WATER HEATERS INC PERMIT No. 02050121 ° ,sdXtEM HABA 1764 NATIONAL AVE AP6 1frL17LUU2 PHONE: (510) 293-9901 SANITARY NO. CONTROL NO. t D z Z ARCHITEC rENGINEER: BUILDING PERMIT INFO 00 ' z On� - BLDG ELECT PLUMB MF.CH g< �.TW,Lµ,�I,�r r u u u ,ZZa LICENSED CONTRACTOR'S DECLARATION REPLACE WATER RCPW tlOn Z,_o 1 tion 7 affirm @a 1 vat licensed under provisions nd rfs of Chapmr 9(commencing P =t is in nfectiomean)of Division JofrheBusiness andProfesxiontCode,andmylicenm (50 GALLON GAS) in full force and cficn. i z a License Class Lic.p F.ic a o, Dale Contractor LLO'n ARCHITECT'S DECLARATION I undcrsmnt my plans shall be used az public records i i O O Liexamed Professional m e u .OWNER-BUILDER DECLARATION I hereby affirm that 1 umexempt from the Contractor's License Law for the E?a following mason.(Section 7031.5.Business and Professions Code:Any city or county t E xF p which respond,a permit in construct,alien,improve,demolish,or rcpatr any ancient w5c prix tot z also quirtthe applicant for such Permit to file signed treatmentea. _ ____ mat be s l cc cd p sis a t to the p o f theContractor I' La (Chapter 9 a S Ft:Floor Area�. .x Valuation or mens g with Sect ]ono)of Division i3 of l Business and ProfessionsCode) ( {. ,, ,; �. 6 . i e /. oh S the to315bttherefromand the basis for theass Ocxt Pt nn.AY violation - 31630059 .`00 " - '• . -of eon 903 n iv any dred d ll for a Permit xubl«¢the appbcam m e dvil ercnalry of not mem than five hundred dollars(ssoo) APN Number Occupancy Type °I.de,owner othe proparty,or my employees with wages as their solecompensatmn, 502 - FINAL PLUMBIN ENERGY will,do the work,add the structure'is not intended or offered for sale(See ]014, _ 'Bullus,and Professions Cddc:The Contractor's License Law docs not apply to an eguired Inspections owner of pmpany Who builds or improves thereon,and who does such work himself 507 - FINAL PLUMBING id th gh h own employees, budded that h improvements t bre-intended or 'oticlei late.IL lir .tw Wilding V memn a lh one yearofcompletion,far pur,ec ofodder will have the burden of pmving that he did not build or Imerrova rot ppmate ar tale.). ❑i of prnpeny,'am axdwtivery contracting with licensed damranara nt [��-q-�-- I�QDaibs+�Ll�® --consonanta project(Sec,]00.1,owner and Profusions code)The convector's Licensewh Law tact not apply m an owner of a whir who builds ea improves thereon, t .. _ ,Co cations License such_projecu with a.convvnogs).Ecemed purse,,to.dm. . 131aexe exempt MAY ' ❑IvmexcmPt undcrSm - `:B&PCfor this mason '!) - 292002 , . , Owner'a. D 1e BUILDING WORKERS COMPENSATION DECLARATION B U I LDI IV G \ Fhe bY Rm and. ptIrY f f juryin,c f t following declarations: 01 have and will maintain Clanifical of Consent 1c;self insure for Worker's r1 Compensation, as provided for by Section 37W of the labor Code, for the 'performance i f the work fur which this permit is issued. D 1 have end will maintain Worker's Compensation Ineerince,as respired by,Section 3]00 of the.Labor'Code,for the performance of the work for which this fermit is issued.'My Worker's Compensation Insurance carrier and Policy number art: Cam ltl 'r.'. �)tool .;.ON u C[RrIFlC TION COMPENSATEON(INSURANCE Qk KERS (TI -s Ghon need not be completed if one permit is for one hundred dollars ' ' - 1.' t)...., - (9100)orles.) 'I t li th perfo f r n a. -me Ch s Rat't sso d,l shall ern mploy Laws'pe n m any manes s as m become object to the Work<rs' o Compcnsauon Laws of California.Date` "" ..Applicant' .,.: . .. ..... .emu ._ ..__.. __- __....... ., .. ._ NDTICETOAPPLIeANT If ft makingion Candidate fbarExemption,y - Id — chou y � t Z Fern s noshy theWriter's C pe p '.'onto be Labor y 'st " 0 fonhwnh comply with 'such provisions or this permit shall be d dated makes. 'CONSTRUCTION LENDINGlen AGENCY t 1 he lb,for ffn th t the a civiissued (S on lending e.C.y for thepertortnance' a t-1 W rat I Ili ark for which this pertti r "isxuW(Sec 309) Cie.C) ' Lend ,Name .: ,v'.. .•.• _,n.::. a.. ........ ... _...._.__ _...___..._. _ ...___... . ..._ _ �;Z finder s Aatlres, ' 1 certifyee that 1 he sd alapplicationcity and state that the W information is c 1 g t amply hhall.apt nricounty ordinances d r er upon — C.) )building cs t Y n d hereby.authorize p u sof "x ofrh city t t i pilon ,& tat the abo t etl property f h a t purposes, l%G,9W. l��_ -0. ms,juagree s.coon and expeedynses and keepwho hamlets ilia v, of me ll ag i agmmo Z) City.'tie;,judgments,costs end of his which may in any way eccrve against said City seyucnDERSTthe Biddingod this nnr " SOURCE RE UNDERSTANDS AND\VILL COMPLY WrfH ALL'NON-POIYI'"` ' SOURCE RF,GUI'.ATIDNS.,.� ; ;: p;'� , Issued by: Dale Stgi 111 A APPhcanUCanlmnor Re-CODE$ a1, "'�'-' `.HAZARDOUS MATE RIALS DISCLOSURE'"^\" •' C�defrtWWillb nth Cl can fp 'building phi atm handle haz dour macnal Type of Roof_-. _ a y pen Mu c pal Code Chapter9.12.and the Health d Safety I'. --- "' - oae Secr on 25S\21a _ ' p ❑Y ONO - `All roofs shall be inspected prior ro any roofing.material being installed. ;,, Will the pplicam f t build ng«the r.1 devices If a roof is installed without first obtaining an inspection; I agree:to'remove emit h aardous a c ma is es defned by the Bay Area Air Quality M nayemrnr g Dirvn .. °Y No all new materials for inspection._Applicant understands and will comply with 'i ° i ourceregulations,I ha read the hazed s matcnalall non-point's alifm Health A,Safety Code.Sections 3srreqmenderC . ot lythe Wilding does not currently have eitch 5505.25533 and funderstand that nr - - - - - - that it is my responsibility to notify the Occup, y '�pant of Ne mmh mn or'noees whicust be inprior to issuance of it Ccrifced of •' Data Signature of Applicant Date owns .n mage y to All roof coverings to be Class"B" or better OFFICE' - _. __........_. ....- -- _.. _-- ... .- ..