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02040097 (2) CITY OF CUPERTINO - BUILDINGDIVISION PERMIT CONTRACTOR''INFORMATI0N i ` 1: BUILDING ADDRESS: PERMIT NO. P12 1-1QQSHANG CT JUST WATER HEATERS INC 02040097 OWNER'S NAME: APPLICATION SUB DATE LU CHANG 1764 NATIONAL AVE 04/18/2002 • PHONE SANITARY NO. CONTROL NO. (510) 293-9901 ARCHITECr/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LJ C_I L.'1 U Z LICENSED CONTRACTOR'S DECLARATION Job Description .t9 I:— r,ax700)oFhniOn3OfenuusinalpandPionsofChepsd..u,dmmlia"a. REPLACE WATER HEATER with Satiorceandefect. onJof the Business and Profesxions Code.end mylicense f is in full force and*effect. a pq5 License Class Lic,sl 3 K rS Data Contractor (40 GALLON GAS) u C J ARCHITECT'S DECLARATION '-E JJJJ I understand my plashall be used public accounts rc y in u O Lucnud Professional OWNER-BUILDER DECLARATION —m '•• 1 hereby uRrm that 1 aim Business from the Commcmrs License Law for Nc F?G following recon.(Section]0315,Business end Professionx Code:Any city or county which requires a permit to-orun,ober,improve,demolish.o,rtwir my reinsure 3� -pdw sq iu iuu.ma.atm m{uim It-a mmfmsmh pemsiuo Ole ui{md wmment. Net bels lisijued punudnttothe provn7'of the Conumtor.Lfcenu tawlas erg _ S - Ft Floor , , aluation q lrommmcipg wiNS_`_' mtiop 9 ).fDivisim3ofihe Bmimu said Profeesin-Code) �i )�\` � Iti y.,lQ•:.l.f ;l . }:' ' or Nai he is exempt Iheicfrom end the basis for Ne elliged ek apiibb.My viohtion "d/Seedon 7W ID by myeppllemt for o pared,subjectnhe.pPdhxm as e dvll peneby- rof tins more than fore hundred dollda lS500). limber =e}i:!:T:r DCCUpaOCy Type ❑1 as owner of the property,or my employees with wage as(heir sole compenmtion. ';iydl'do i�work.-indlhe drvnure is not inunifed or'olfeiea'fa-fi c, c'70Gi.- 'Bdilneu.ad'Prdrasimo Code:Tba Comractm;License Law dee,not.,,I,tom 506 - GAS TESrFequired Inspections 1°`'"'"r" owner of progeny Who builds or improves;thereon,end who does inch work himself t m dtmu h his own employces.,provided that such impro maenu art now intended or_ ., F,ZNAL PZIUMB I NG completion, crude.xIf,howerce he building or improvement is what within one Wild of imfo.for the owner-builder will have the burden of proving Net he did not build or ' Improve for purpose of.IeJ. ' O6 as ownerofthe Property.see achumly convecting wid,licensed contractors N tl.l'C:C,FFiJ! comtmct the project(Sm.7W,Business ane Prefwims Code:)The Contractor's -: and who law docs not apply.en mune of popenY who builds w improves Merton. and wMes License Lam," .pojmu.wiN a.conu.cta(gJkensrd.purtmnr.m.Ne- _ muanors L ttnu ❑tem see pt ndcr,SeeB&P C for thsrtamn t Dne .of the labor CRATION a WOR I KERSCOMPENSATION DECLARnV �® ' 1 hvebY:mrm Merpenalry d �erJ;uY dna of he follovnng dmlarn aim--- MAY , / 7 [• �`.^ ^ ❑ I heve`and will�ivinuin'i`Ccnifireie'6f Couren'to self-insure for Worker's 1 tJ ?002 Compemut n u-'prov dad for by-Secti n 3]00 odefor she performance of the work for which this parous u jx le /j / Q 1 h ve.IM w1ll uuinmm Worktr i Compen.um Inivrnrrce .i required tiy�Section 40/1 O 3]00 of the Labm'Cade (or IM peRmmmtt of Nt wdek fm h ch Nu gamut is Y isive4 My Wohera Compenuu n Insurance cuner,and Poh ,number 4e:""• " Cartier EATIh7 ATION OF.ExEMPIION FROM wp g. r' i`' i \ t i j r I I t Ttr�r 1, t } J '�' t t 1 i�', ,ANON IISIIRANQE, � .c-rc x•1:(rn'+r',...., .• .. I I , P $ '° (fhl Section need not he dm'leicd if the permit is fm one huMrW dollars ')" ' ' ."7. L! .s 1"',:],I)q y _yl;;• '".v JttnJy th tin Ne perforin nee ofhe oh'f hlch Nlspemutrii luu�,I ,N .,,a_ �^r •'„ijt' b'7 5'SL - sholl not empt Y mY.permn In any'snddnei; u m beaolne iub)ea to drc Wgrkeri `-l• - ComPenuuon U sof GI 2mis Dne' .N fCE APPLI A If ober moking thlsC nlfMle pf Exerppuop yqV ahoule .. - becmetub)echo Ne Warlih O Comyensatmnp Lumni bf rhe labor Cad;y must foMw N[ mp1Y�,N oh wch p t loin ar N a perm.shall be demes revoked. lar N t. "CONSTBUGTION, LINOYNG AGENCY I' . a y I2nae sNuma'-+w Nat N rt n.co swtt on Itnd n sgeneY for ht perfonm'ce F - t e V•` � - afNe mLf bleb Ni.pe Runs lhcrcb eR Z � m . b I Ganey Net I have .d hn.pplicet on and sum thauhe ebeve of rmmm - conem 1 egree.to comphy wch all c ry.md county oM ronin end start hws raising �f Q• tobuddmgttnructiain ens hertby wNonxerryrtlenutNti.0(Ous my to enter upon yy;(,� the oboe ntarrulproperryfgim, thnpurpouJ. L Gt IWingreemeve,mdemndy and keep harmle'a Na woof Cupertinost aid U Z t u N dgments.Geese end pensee h¢h coq m any q 4ccrue against avid V y Cl,clry m rontequenfe oP Ne ghnudg of NR permit - APPLS'1.'h.�YC\'DERSTA�'DSM'UN'fI,(,C0�1PLlt�t 1T1{A1.L�`0\IPOL4T'�' r sOL42tE REGUL".AY7G`LS ri':': ,� Issued by: Date Ssgmmic of ApplmyNContee err .t; ir'r DwT,., ❑Yts ^XAZARDOUSMATERIALSDIScLOSURE Is c" r Re-roofs 1 WIII Neeppheml nefutureandaiamupmt Wore or.herlNe hewdwa needed .'Type Of Roof;_ as dtfned by the Cupenmo Mun c pal Cade Chap mr9 12 mtl the Hath end Safety - --'— Code Semen 25532(gnt Jq.rO No....' g,NQgt t r L , ' l law 9 ' s)`.- i) t�( �n)C f !, r_ All.roofs.shall be inspected prior to.any.roofing.material being installed._._,__ x'rs Wdl Ne sppinwntmfurabuilding ser P. I..,quip.ns or as tees which r - crib hazudoueiirconuMnmveideOnW b)NeB.y'Art.Air QWrtyMan.{ement If a to is installed'witliout fust obtaining all inspection`,�I agiee tolremove Dtimrt : .:- - OY,esr,,;1,,1f,li:; {7❑nai_l,,,f; y „ "'' l,t �.; ;i _ uxn r__all-n materials. orms ech n APPcantde startd5 and will.comply with all non-point source regulaaons ..-_,._. ,California {rI he a Lob Ne Safety Codas metedel rtgmrcmenu n 5 Chapter understand ilia it the m.HeaINs SdeYCad4 e.ve as art.thtitis yr op5Je:1ayusiutid that. UNebblldf he,ty nmme.-hecariently Ohiavh uadt be Mltiemyruponslbf.C,nmif3^,the --- -"'_..__. .. _.___ ._._. ..... ... ......_.... ... _ -_._.. - ir;` _ acup.nt,of the requireYnenuah&h most be it prior,.Iuumtt of i Ceitiflde.bf - DCCYPaacy . ? s t � t 4� r .. i•• •. - _.-Signature.ofApplicant__.......... . . __. .._. .. .._ _Date....._ ..._. ... ownee ere�non,.n o`tnt All roof coverings to be Class"B"orlieiier OFFICE ——— ._.,. _ ......... .._. .. _._ ._..__. __ �., 1:S '-„;.. , � ... .• t ata r, ., ,. _ . t