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02050197 (2) ct seaoirc pN rettONo , PERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS'. PERMIT NO. 7606 ELDERWOOD CT JUST WATER HEATERS INC 02050197 OWNER'S NAME: APPLICATION SUB DATE WANG SITYH-YEE AND DEBORAH W 1764 NATIONAL AVE 05/31/2002 PHONE: SANITARY NO. CONTROL NO. (510) 293-9901 01 O O ARCHITEC(ENGINEER: BUILDING PERMIT INFO U BLDG ELECT PLUMB MECH maz z8R D z y z LICENSE1 hereby aRrso that IDam licensed underprevisionsprevisi ns of Chapter 9(commencingJob Description z— °,dlCto with Section 7f100)ofDivision 3oftheBusinessand Professions Cadeand mylicense REPLACE WATER HEATER he y J is in full fora and effect. o d License ClassLis.a A50 GALLON GAS) u 3 u.n Date Contractor Hp d. ARCHMCf'S DECLARATION r—RhALr' I understand my plans shall be used as public records wd 0 o Licen )Professional JUN 17 2002 n.m a� OWNER- BUILDER DECLARATION I hereby M.that 1 am exempt from the Contractor's License Law for the L z a following reason.(Section 7031.5.Business and Professions Cade:Any city or county' e,F O which requires a permit to conswn,alter,improve demolish,or repair any.structure to 0 _poor to its issuance.also re,ima the applicant for such permit m file a signedsiaement + - thertpe0licensed pq tt'the pmtensofbeContractors License Law(Chepier 9q4.. [., loorArea +c. ; auation (co enc ng with Sect 7000) f Division 3 of the ysginess and Profeons ssiCode) i_¢j, 7 \ ) . . _.Fl a•`L" J.7 1 .S or that be is exempt therefrom and the basis for the alleged exm eption,Any violation 5 of Section 4031.5 by any appbcan{for it permit subjects the apphcunt to a civil penalty lof not met<than five hundred dollars(x500). umberr,:. • : Occupancy Type 0I,as owner of be propenyl or my employees with wages as their sole compensation. will do the work,and'be'structure'isnot'intended or offered for sale'(Sca'70ii." ""' - - -ENENP -- ----- ------' - ---- Business'and Piofessions Cade:The Contractors License law does not apply to an 506 - GAS TESrfequired Inspections'''•" '`i.• owne r of property Who Wilds or improves thereon,and who does such work himself or through his own employees.provided that such impo wetppms ars not intended or 5 0 7 =_.FINAL_PLUMBING ._...._._ ssolawthmonc f- .-_ ._.....-.alas _..-_...- .. __...--_._-.. ,c erect far sale If,howe thebuilding improvement y dmove on,the owner balderw II have theharden of proving 0a hedid not build or improve for purpose of sale.). _. _.__....__...._._-_alas-.__.....lash,..._-_".. __-..alas alas-_—_._lash, ___ >i v owner of the p(Sec,7 am Business Pracii%ios i licensThe C racmrs to --- - -- -- ------- 11. p j----- - -- ---""-"' newel thedue, project(Sec. to a,Business roi m,who Coda:)The Contractor's License Law does eat apply man owner th property who Wild,s improves thereon, - " onl.ta,,License for such Prolttts.with a contracusr(s),Iicensed.pursuanLm she. .__,...__----- lash,_.. ..alas_..._ � ❑lam exec Liccnsc Law.. ....-__--...___.._____.._.__..� ... _.--_----_.._-- _ and,whole _ C rapt ander Sec; , '.,B&PCfrn this reason (J I)£°]I'I•'"t:. 0•.�. " nate. ' "WORKER'S COMPENSATION DECLARATION I hereby affirm unde`pewlty,of pcijury one pf,ihe following declarations: i 0 1 hack and will mainisin'a'Ccnificaie of Convert to self-in mre for Worker's Compensation, as provided for by Section 37W of the Labor Code:for the performance of the work far which this,permit is issued., 01 have and will maintain iVolker's Compcnsaion losumnce,as required by Section 370(1 of the Labor Code; for the peRomance of the work for which this permit is ' = issued.My Workers Cam'pye:sat Insurance ced Policy number me: ' Cam U a:r s1,Y1dPol yNo. - a i ,.. ...-.....�. ..alai u......—.�.. S[ CERTIFICATION OF EKEMPI'ION FROM WORKERS i,' n. 3 i ° a ..", ,t]_ s ':\ I \S A t t. .i .:.i s>; - ., C. :1E SA TION INSURANCE:,••":..:,_. _._._.____.__..- ._...._.. ._...—.__"'..._.._....._.._.—___.—................ ....._..__..-alas -'9hi,action n ed nor W completed if the permit is for one hundred dollars .t I'l l' 'C! ( 1• —� 1$100)as 1 .) , _alai 1 c n fy th n n h pert c of r k forth ct l slued 1 i_c shall not employ any person n any oc her.n as to Wcbne subject to the Worker'- n n Compensation laws of Cd01 a:Diie.' ..Applicant .. ... . .-.. .Ificxu of Q NOTICE TO APPLICANT making this onk gthsCo you should ------- Z hecome subject the k -C pe r t po nsofthLaborC Je y ea maxi forthwith comply with i h privons or hea permit shdR bedecmed - - " revoked. ... .._.._..-. alas_ _. . ------- alas CONSTRUCfIONLENDING'AGENCY da � IhercbY affirm thm rt cheis is commat,imslending agendYf ,the perfonnance _ : Lf ih o k'fo which this pemut n saved(Seca 3047 C'v C) , d.Q Lcndr.N - lash,.. , .... . .. .......__ lash,..-alas -. -..-.... _ ._alas . ._lash, ...... z Lend Addrn.a,• V�� •l ccnify,hat l have read this application and umc In.,the above information is �s,F corz t I grc t comply lh all au:mel ordinances and state I inner upon ,f V io b.v gc tud-p rt M1yamborepresentativesofth' <lyt tarupon i•a„�(/gf/,✓1Y'/ }'11. the b e i uip e:mdf inspectionp pose `�/l. ✓�", Ls,O.' (We) gmeio sa e ' d randy and keep harmless the Cty of Cupertino against (A liabiliiics,judgmems,costs and expenses,which may in any way acme against said ''U'z City in consequence of the'gronting oftMs permit. rr ,?PLICANTUNDEkSTAND$AND WILL COYIPLYWTTH,\LL SOV��POINT" Ir - : SOURCE'InGui.ATiONS:. �.'•r ,.s Issued by: Date signature of Aplicind contractor: - Dme..t ',': Re-roofs / ., HAZARDOUS MATERIALS DISCLOSURE' : Will thepplicanto fi Wilding ranir a,handle w."us,'o�tnal .Type of Roof _. s def ed by th Cupen kii pal Cod pt Ch 9.12.and'he Health and Safety P R-.. . Cad Scto 255311 .y'as : ❑Y i ' ❑N a .. t, 4.� 11s - s � s All.roofs shall be inspected P nor to any roofing_mater,al being Installed'._ AM Will mapp .i snore w la goccupant eqa p t devices which If a roof is mgtalled-without first obtaining an inspection; I agree to remove cmih d coni i. .)bond b5 he Bay AcaAir Quality Manage em Do " all new materials.for inspection, Applicant understands and will comply with ❑Ye ❑N .. ." .- , l -all non-poinCsodree-regulanons •, - - - - 1 have the h x dux merials y cmenuunde Ch per 695bfihe Calif .Health&Safety Cost,Sections 25505 25533 and 25534 l understand that tithe Wilding does not currently have is lemon,that it is no,no,iisibiltry to notify the ._-_- ..._ oc cupans of the.requirements which muir be met prior to issuance of Cenificate of .. 71 Oacupency.�.,: . - - ` Sinature of Applicant_ .- - -PP. an[ Date --_ lass. _- .. . .. . owne ora4tboraed ag nt ' Dole'.. Al] roof coverings ngs to be Class B" or better .: alas ...:.....:..:.-lila. :. •" ';:....,. ._. . . : .._� ..alas ._ — OFFICE