02050197 (2) ct seaoirc pN
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, 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
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z y z LICENSE1 hereby aRrso that IDam licensed underprevisionsprevisi ns of Chapter
9(commencingJob Description
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°,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.).
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>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$100)as 1 .)
,
_alai
1 c n fy th n n h pert c of r k forth ct l slued 1 i_c
shall not employ any person n any oc her.n as to Wcbne subject to the Worker'-
n n
Compensation laws of Cd01 a:Diie.'
..Applicant .. ... . .-..
.Ificxu of Q
NOTICE TO APPLICANT making this
onk gthsCo you should
-------
Z
hecome subject the k -C pe r t po nsofthLaborC Je y ea maxi
forthwith comply with
i h privons or hea permit shdR bedecmed
- - "
revoked.
... .._.._..-. alas_ _. . ------- alas
CONSTRUCfIONLENDING'AGENCY
da � IhercbY affirm thm rt cheis is commat,imslending agendYf ,the perfonnance _
:
Lf ih o k'fo which this pemut n saved(Seca 3047 C'v C) ,
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z Lend Addrn.a,•
V�� •l ccnify,hat l have read this application and umc In.,the above information is
�s,F corz t I grc t comply lh all au:mel ordinances and state I inner
upon ,f
V io b.v gc tud-p rt M1yamborepresentativesofth' <lyt tarupon i•a„�(/gf/,✓1Y'/
}'11. the b e i uip e:mdf inspectionp pose `�/l. ✓�",
Ls,O.' (We) gmeio sa e ' d randy and keep harmless the Cty of Cupertino against
(A liabiliiics,judgmems,costs and expenses,which may in any way acme against said
''U'z City in consequence of the'gronting oftMs permit. rr
,?PLICANTUNDEkSTAND$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
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