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06080001 (2) CITY OF CUPERTINO �r*`>= =� - "'�� - BbILDIriG olvlsloN PERMIT C011iTR VTiI tN1+(T £ . BUILDING ADDRESS: e JUST WATER HEATERS INC PERMIT11006080001 10896 NORTHRIDGE S OWNER'S NAME: PERMIT ISSUE DATE CHRISTINE HUNTSMAN 3400 INVESTMENT BLVD 08/01/2006 NE: SANITARY NO. CONTROL NO. (510) 293-9901 ARCHITECT/ENGINEER: BURRING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 �o� LICENSED CONIRACOWS DECLARATION lb Description Ij 1 bexby afnrm d u m I. limas¢mover provisin oof Chador 9(eaenc mmtho g P with Section 700M of Division 3afOe Business and ProfeWou Code,and my Wense is in full to=Class rem REPLACE 50 GALLON GAS WATER HEA i incense Ctua Lt..N i� Dau Conuuter ARCHITECTS DECLARATION i I understand my plans shall be used as public round, i y G�a Licensed Pmfessionat res OWNER-BUILDER exempt DECLARATION J l i S 1 hereby,IRrm on 11. ,Bugm tram Ne Conommar'sCo License Law far Oe .p o following moan.(Saban 7071.7.Bualness and Pro(esdam Cade:Any City or county $(xi which requires a permit as conRrocL slur.improve.demallm,or repair my urucare 9 88 prier as its Issuance,aIsu requires lM applicant for such permit W file,signed statement €< thatWislicensedpunmmtoteProvisiauoftheConuaclon"LianceLaw(Chapter9 Sq.Ft.Floor Area aluation 9 (commencing with Section 7000)of Division 3 of Ne Business and Professions Coca)or v .. that he is exempt thcrefmm and the basis for the alleged exemption.Any violation of Section 7031.5 by any appliam for a permit subjects the appileanl to a Civil penalty of er Occupancy Type not more Na Bve hundred dollars(53001. 1,u awns m(Uie proprny,a my wployen with wages u they tole eompevatim, will do ties work,and the surmume is not Intended or offered Image(Sec.7044,Business Required Inspections and Proposal Code:The Communion License,Law don reet apply an an owner ar 9 P progeny who builds cr improves thereon,and who does such work himself or thmugh his awoemplmyrea,provided Out such improvements Ise not intended woRerad fantasia,If. however,the Wildingar improvement,Issold withinaw year of caopicdm.the manor. builder ME have the burden of proving ths,be did an,Wild or improve for purpose of ask.). ❑1,as awner or the property,am exclusively emuxting with licensed conuxWn W construct de project(Sec.7044,Business and Profession Cada:)The Communes LL acme taw da,no,apply as an oamr of properly who builds or impmw thereon.and. who cmnuans for such projects with aemuanar(s)licensed pmsunn W the Comammrm License Law. ❑l ore umap,under Sea .B&P C for this on Owner Data WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury most of the falbaing cuclumionc I have and will rummage a CerdBnW of Consent as self.insum rmr Workers Compen- alian,as provided rw by Sado.3700 of the Labor Coda,for the performance of ger work far which Nis permit is Issued. ❑1 have and will maintain Workers Compo on Insurance,as acquired by Section 3744 of the tabs Coda,for the performance of Ute work for which this permit Is Wbed. ' My Workers Compensation Inanrance I.and Policy number am: Carrier. Policy No.: CERTIFICATE OF EXEMFnON FROM WORKERS' COMPENSATION INSURANCE (This section need mon the cwnplererl if the permit Is W.hundred doBaa(SIM) or less) 1 unity the,In the performance of Oe work for which ibis permit Is issued,I Nall not employ any person in any mmrcrm u m became subject a On Workere Compensation Law,of L'allrOmin Dam Applicerra NOTICE TO APPLICANT:If,after maldng Nu CcNRceu of Exemption,you should , Demme subject W the Worker,Compensation provisions of the Ichor Coda,you must ,J Q forthwith comply with such provisions w mit sh this perall W damcd revoked z 0 CONSTRUCTION LENDING AGENCY [+ Ihereby�rm dm On.Is....bourn lending agency for the Performance of �i> the work for which this permit 6 imbed(Sec.3097,Civ.C) W�Q Lender's Name 7 z Lenders Addnum U0 1 certify that 1 have read this appliatimn and mute this Oe shove information I. U.F coma I agree as comply with all city and county ordinmeo and auu laws relating W DU Wildingcensvuction,and hcrebyvuthorim repmxnu,ivesof on,city to enter upon Oe W aWvc.mentioned property for inspcetion purposes LTa (We)acme to uvc,indemnify and kap harmless Us City of Cupertino against Ucn Ilablllties Judgmens.cosy mn and expewhich may In my Wy&=me against add City Z In emasequeme Of the gmating of this permla ^+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON.POINT Issued by: Date SOURCE REGULATIONS. Re-roofs Signatures of Applicant/ConData HAZARDOUS S MATE RIALS DISCLOSURE Type of Roof Will Nm pUbar, Wilding Oaupxl NOa2.ando eHealth IncautiousmaterialSWr61 u defined by tbu Cupenim Municipal Cede.Chapter 9.12 and Ole Health and Safety Code.Section 255324)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yes ❑No Will the applicant future N Wilding Occupant tax equipment w Ocvlces which If a roof is installed without first obtaining an inspection,I agree to remove emll huardau aircmtaminanu as defined by the Bay Ara Air Quality Management all new materials for inspection. District? [:I Yes ON. I have read the huand.maurlalsrequirements under Charter 6.95 or the Califor• ma Hcalm&Safety Code,Sections 25705,25533 and 25534.I understand Oat irft Wilding does not currently have a unana Ila it 6 my Mimmihilily W notify tie Occupant of the requirements which once WWLPrior WWuma,ofaCertificate arOccupancy. Signature of Applicant Date Owner or authorimd agent Dow I All roof coverings to be Class"B"or better CITY OF CUPERTINO �m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 31636019 . 00 DATE ISSUED. . . . . . . : 08/01/2006 RECEIPT # . . . . . . . . . : 35465 REFERENCE ID # . . . : 06080001 SITE ADDRESS . . . . . : 10896 NORTHRIDGE SQ SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : CHRISTINE HUNTSMAN ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : JUST WATER HEATERS CONTRACTOR . . . . . . . : GILROY, JOHN LIC # 15128 COMPANY . . . . . . . . . . : JUST WATER HEATERS INC ADDRESS . . . . . . . . . . : 3400 INVESTMENT BLVD CITY/STATE/ZIP . . . : HAYWARD, CA 94545 TELEPHONE . . . . . . . . : (510) 293-9901 •FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00 BPWHEATER PER HEATER 1 . 00 10 . 79 0 . 00 10 . 79 0 . 00 PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 84 . 02 0 . 00 84 . 02 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------- ----------- OTHER 84 . 02 MASTERCARD TOTAL RECEIPT 84 . 02 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- -------- ---------------------------- -------- ---------------------------- 502 FINAL PLUMBING ENERGY 506 GAS TEST 507 FINAL PLUMBING • Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 �CUPE(�TINO Building Department JOB ADDRESS: PERMIT# 10896 Northridge Square OWNER'S NAME: Huntsman, Christine PHONE # 408-378-9321 GENERAL CONTRACTOR: Just Water FAX # 510-783-6360 Heaters I am not using any subcontractors: �� `—� 07/31/06_ Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting • Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Just Water Heaters 591329 Roofing Septic Tank Sheet Metal Sheet Rock • Tile 07/31/06 10/28/03 City of Cupertino Building Permit Application E-Mail jobsite Address: 10896 Northridge Square Date: 07-31-06 Owner's Name:---Huntsman,Christine Phone No.(408)378-9321 APN#: 316-36-019 Project Valuation: f 988.00 Building Permit Info: Bldg Elect Plumb____X_ Mech Job Description Replace 50 gallon gas water heater. Contractor Information Company: just Water Heaters Inc. Phone: (510)293-2012 • Contact Name: Dulce Fax: (510)293-2022 Address:3400 Investment Blvd. E-mail: permitdept®sbcglobal.net City,State and Zip: Hayward,CA. 94545 State Contractor's Ucense# 591329 Exp.Date: 3/31/08 Worker's Comp#: 044510091 Carrier:ACE Exp. Date: 4/1/07 Credit Card Information Credit Card #: 5474-6390-0047-8660 Name on Card: Just Water Heaters Inc. Expiration Date: 06/08 Visa MasterCard Comments