02070138 (2) CITY OF CUPERTINO k�.:..r
BUILDING DIVISION PERMIT .'CONTRACTOR''-M0RMAT+`., f6M 'r
BUILDWGADDRESS: PERMITN .
7596 NEWCASTLE DR HOT WATER INC 62070138
oMMMASUDA- 2531 GRACELAND AVE L.5 APPLICApffyBn�T72002
PHONE: l/ //
(650) 298-8494 SANITARY NO. CONTROL NO.
0!�-Oz; ARCHITEC IFNGINEER: BUILDWG PERMIT WFO
,e BLDG ELECT PLUMB MECH
U CJ L'7 ULICENSED CONTRACTOR'S DECLARATION �]p�I]���T Ihereby affirm hat l am liacnud under provisions of Chapter 9(commencing REPLACE WATER H$'7�Wffiplion
'iLwith Section "d of Division 3 of he Busi.2m,Professions Code.and my licenseu in full farce and en' 2t 3 6/a- ®0 < Licenu C - Lie N
Ly O Dme I �� Comrenar If
O ARCHITECT'S DECLARA7'fOG
I undemm�tl my plans shall be usW az public recants JAN 2003
aO O Licensed Naficxs;nval
OWNER-BUILDER DECLARATION
zI hereby affirm that 1 am exempt from the Contractor's License Lw for the BXPWu'� $500
< fnllawin8 reason(Section 7031.5,Busiin to me ppneu and Proficxdon.a Cade:Any city or county D
whi,in
olums.permit to cmcamo.all,,.improve
0,Or
%
r My Structure
€G (commencfSwih$ectensed on7")fDiviuunf3oheBusinessandPmksonsCodre) ( � 8�' .,�Ib®r• Valuation
3$ pnono a ssuana,alwm uircuhea licant forsuch rmitto file a sr ed statement .—_._...,..-... __._ ._.
c. — !
or th the I,eximitiffiiiefirmA inti the basis for the alleged
of o IS any for v pemut subma me aarlmicAny violaon
....m e civil enalty
:of not mom shen rive hundred dollars(ssoo).
- PN ecupancy -
Type
O1,es ownerofheprogeny, my employeeswithwogcs etheirsole compensation,
506 - GAS TEST
will do hQ-woro Professions Code:
ode:structureis not ctor's Li endc Law doe not apply
1074, _ P�yap
Business ono Professions GMC:The Contractor's License Law tinea not apply to an PeCt10I15
ownerafhpropertyow Who loebuilds or improves thereon,and v.'hv lees such work himself '
or through his own emphowever s.thprovided that such Improvements are not intendednyear or _sive_ sive._.. ...._ sive—..,;._...;n.__.__.._..._..._. _. _
,offered for sthe.whoweverethellbant mimeo of prom sold within not Year of -_"" ""-' _""'"' —' .._..._...._...__ .. ..
cop loon,he is to r n.k.)r will have the burden of '.\'l !. i T. -•.,
p proving that he did not build or
improve for puryose of seleJ. '
.fsive.-.,_ ___ ._. ice .._ .__..._.._... _.sive __ _
... . _sive_ _. . .- _.._._.sive _-.._.____._.._._ ..
DLeust the
aThr pmpmy,am Business add contracting with licensed contractors to I zL91" ;;w;l:.is l:�t+�--"-- -'
conswn the does
(Sec.7044,Business ma Professions Code:)The improves
munor's y H
License contracts docsnotapply t projects
en erof a mortwhoboldsor toImproveshereon, '
..Commerce,
o hense L such p ) u.wrh a ram mmr(s)hcenuJ pursuam to-the. _. - ... sive ..... .... ... ._.....__ - .
Com t h License In _ "'
_ ❑1 a mPt under Sec - I B&PCfonhu reason
���
:. :. .i:i• ..i
- Owner"'-` Do1c
WORRER.S COMPENSATION DECLARATION
'I hertby aRrm under penalty op perjury one of he following declrations:
D I h..'ind will maintain'a'Cedificate of Comsat to salf.maure for Worker's
wz;. Compensation, as provided for by Section 3700 of he Labor Code, for the
performence of the work for which this permit is ramal.
Re'add'will maimam WOdl Coinpenmt m l ''urince'as regmied by,Section
W of the Labor Code,fortheperformance of the work farwhich his pa iml
Cid MW_ rope n Insurance come nil Pol'c/y m art .. .. .. - _- ___
a �h�No .. L�' .v,
MMM
\_' �' t t . .. 1. is S ;1\�.\. s ,,..I,y. •aLGt:"`11 -
artel
CFATIFlCATIONOFFJ(FGNWS FRO WOR
_C a COMPENSATION WSURANCE .. .. _-__.._sive __.. ....Y _...._.......---------
.,I.
_.__ _ _ _
r .,. -,c— .'.n.
+"'bt (1Trs se,I.died non be Completed if he permu is for one hundred dollars sat ••t= -
r
($IM) rloss.) '.
l,,', IIc.r,ifym;dmthspdffmmante of the .. - ....'...._..- .. _-.. _._.. _. .: .. _ ...sive .�...._... .._.
rk for which this permit i " -
M1nll not employ any.R n n any manner so es m become subject to the Worken'
s ,
Compensation Lew$of Califomla,Date
NPOTICE IOAPPLICANT: . .
ICANT If after peaking this C nhcate or Exe ption.you should
Z beeome subject to the W rkds CompensationprayusiOnS of the Labor Code you Must
o pooh th Comply-widi such pmvu o s or th s piano shall be deemed masked —
I
'„�• ' '¢ s ,•CONSTRUCTION LENDING AGENCY I.
k1 hertby elBmi that here¢e copsduo on k d yy eg cy for the perfoimr qe� of h d for hick th s pemli is ssu d(Sec 7097 Clv C.)
�D.Z +II::, .. _ ._.. ...- ' _..,_.._...
1 ren fy Nat 1 he a reed th ppl cat nand not thn the ebo a mformall..is j
Cas..F+ raiien 1 agree to cmmply with ell c ty Nd couniy ordinances and neo leas relating _
0_V to building ronstmnion;end ticmbyauhoriss rtprcunutivee of hiuiry to corer upon
�s=(s7 he above-mcntimetl property for inspcctiov puryous.,_
f,.r 0. (WcTbgrtc td uva'rndemnify ane Krog hertNesithe Ciiy of Cupeniriolist aid'r y liabilu¢s judgmenu,ensu and Rus wh ch may n any way,att agonal d �7 /
U Z City m eontequence df the gra t ng of his'permh �� V v
"•' APPLICANUNDERS`TANDS MD WILL COMPLY NTTH'ALI.NON:POfNT `
3ToveceREGwnntins Issued by: Da
$ 4rvrc of Appb'pcmHAVC7AanRlDrnOaUS MAmT':gE"RotIeuLpSmDtInS-Ct•`OorSUanRe eza- Dness¢tw'+"e
nel
Re-roofs
Type of R
oof ive----
"d _gn '
Ct deRnoi by h Cupenlaa Mun opal Code Chapt 9 12 and the HW h aM Safety -
Cade DYes 9554(e)ortj'1 0 . . t , F 3 T..r ... L y!{ ': r...y,t; •I,tn.'.t 7 s .i •.. \ --j:�:J.'.7
All.roofs shall.be inspected poor to.any.roofing material_being.ins talled.- _...._.
Wil he ePplicamo furore budding accup ruse quipmcm raeviegswhkh If a roof is installe'dlwithout first obtainingan ins ection;'I a iee.to7i'emove
t hexeNous sur conummanu u defined by the Bay Arte Air Quahry Manapemenl p g 1I,
Dh
^°' all new materials for inspection._Applicant understands and will comply,with_.
.,, all non-point source regulations 1 .
caf'"- 1 have rear the hazed s ercrials mrcmenti'uhder Chapw 695'of
if Health a:Sacu Code 5 cutins 25505 15533 end 23574:1 uMentaad het
fine bu Ml gdap na cunen0y hovea un ant fr.1!!e my rtspanabJity to manfly the --
xDean m f he rtgmrtmcnu which must be ma gonna urea ce of a C_cnifizne of ��
Si A .,
7� gnature of PP licant _. Date
o a ram uea agent — „Date All roof coverings to be Class`"B" or_betteir
r.
..•..,....:.OFFICEsive......_ -- _......_ �