01110031 (2) CI BUILDING DPERTONNO PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
22050 REGNART RD JUST WATER HEATERS INC 01110031
OWNER'S NAME: APPLICATION SUB DATE
YOUNG GREGORY 1764 NATIONAL AVE 11/06/2001
'PHONE: (510) 293-9901 SANITARY NO. CONTROL NO.
C 9-Z ARCHITECT/ENGINEER: BUILDING PERMIT INFO
,0 C BLDG ELECT PLUMB MECH
ti u u u
urea
S to= LICENSED CONTRACTOR'S DECLARATION
i z=a I hereby oFrm thal I em licensed under provisions of Chapter 9(commencing Job De$Cr__IppIIOn
mC withsenion7")ofDivision3oftheBusinessandProfessionsCode,andmylicense REPLACE 2 WATER HEATI;KS
in full force and effect. (7 5 GAL & 5 0 GAL)
a a License Clmx Lma
:0.`l` Date Caparison,
13 n n ARCHITECT'S DECLARATION
o-"0 4 I undem rnd my plans shall he used a, xi recmde
to
I z o O Licensed Professional
6.d. OWNER BUILDER DECLARATION
u�^_ 1 hereby affirm that 1 am exempt from the Contractor's License Law for the
t-Z< following reason.(Section 7031.5 Business and Profession,Cade:Any city or county
ed F G x'hich requires a Permit m tenons, he,improve,demolisn,or mad,any swcmre
i is act Por.mi¢issuance,also requires the applicant for such Permit file.signed smmmea,. Valuation
wtbe,slimsed putt 16 apr.vlslona of the Cmara<lors Lt...Law(ChaPter 9 L'Floor e - /' '
(commending with sect n 7 ) f Divis on l of she Bu, rZurona once) t'� ,'- .rw9 5 a7 i f 1 x,
or that be,E acmpr thercrm�nA the bmai for thee Bruin. e ti m. fir mmauon t...'.�' .S36602n45 nn
l')a I. i t.L....�,'S_
-of Section 703 IS by any applicant tori Permit subjects the applicant to a evil Penalty
.of a.,momtn..five hundred dollars($500). ... -. ' APN Number "'•r,". Occupancy Type
O Las owner of me property.ser my employees with wages as their sole compensation, PLUMBINih ENERGY
'will do the work:aadlhe-atmclure is not intendedor'offered'f isale(Sec.7614: S O 6 - GAS TE S'➢2e aired Inspections ^` n '
Business and Professions Code:Tli
he Contractor's cense taw does rot apply t.an q p .'
owner of proPeny%%a builds or improves thereon,and who does such work himself 5 0 7 - FINAL PLUMBING
or through his own employees._provided that such improvements arc not intended or _,_.,_
6ffe J f I If-ho Ibe building P cm rs Id ith ooc yc.._ -- - -- --""--- --_.__.- ___. -_.. .___ _
iampl t ,h nor buId will have the burden fvint Ist,did not Wild or
mp f f nneaIMALE® '
..
p1.as owner of the property,am exclusively contracting with licensed contractors top ",\Ir-
- _ construct,he project(Sec.7(146.Business and Professions Cwi The Contractor's JAN 0 '8 2002'' :..
License law does Wo apply to an sews,of property who Wilds or improves menton,
_and whoc.mracts.fnr.suchprojects-wish a.comraamis)IicensW.ficamm.tome-,__ ___._...-.__.__..__-_..__.._._-------
Contractor's
..___.0 ntractor's License Law. ..� ' it-:I .1 - �,:,,, .t:•.�
❑lam xemPt under Sec,' - 1.BRPGfof this reason • .
Ownae .. .�..,Daien.,'.
- ;i;. . ., I. , .. ' BUILDING
x WORKER'S COMPENSATION DECLARATION
" I hereby mponunder penalty of perjury one of she following decimal...
❑ 1 have and will maintain a C<nificzid bf Consent act m1f insure for Worker's
Compensation, as provided for by-Section 3700'of the Labor Code. for the
performance of the work for which this permit is issued.
-- ❑1 have and will mainuia workers Compcnsalon Ins...it.4s allotted by Smien
issa l' the Labor Code for the Insurance
n e p rr the dicy.n h b furs Penna s
issued MY Workers Corientation In ,u • and, ,Pol cy number ode ...._....__-_.._.._......_-_.-...._ _ --
Can 51 tiF extra, el.apoN' tr. .. ...... .INP.., r'•f r , k ._, 111th, i{ 1 a __.'
?_ r--CERTIFICATION OF EXEl eY DON_ FROM W.:O:R'IE- J
COMPENSATION INSURANCE
'�i '-s�� f-^Z t••- t's " [ .'e_f P. ..16... �1��'e
',.;i1'�. l", ' a"5! 17•:(17"I}::.,. ^'"L:. .t 1.is.:Ujralh:y 1,110
iThis seal.n need nm tie complcicd if the pennil is for one hundred dollars
it _ roll. _. ... ..
mf th tin m< of,mance o!Jac wo k f which,h rmir s issue) 1ri
•shell not employ any perwn m any manna as m become x b31''a Ne Workers
Copp of La of C I f Da
A (cam
NOTICE
TO APPLICANT If her making sh,s Ccni17cam of Excon on:you shold
bccom<sub'ccv Y the
Worker's ymepc oution provisions of the fanmc
,Code,you must
Q O fonhwian'com l with such p _ r this lle tFall be deemed revoked.
�3r%) s.r , ',ICDNSTRUCTION LENDING AGENCY
F"'^ 1 lacridby offirm that Jte i(ccustruclion led 8 iii for the performance '' I
offre'vxuarkf which this pemm ix issuedsc 3097 Civ Add .. .. C)
Lender Nnorm
;D-'ZG" QLund Y d. ir�
-„-'a'1'J(/-I✓AV/t`) I1, 4
-
U:0 P I comfy that I have mad this application and state that,he above information is (J
...._Wa comiA 51 to,comply won 411 city and munty,sdinances and.state laws refuting .. . .... ....___.. _.___._.-.._.._.__..__..-... . ._ - .
O-V to building caoslmction;unJ hereby toddarrommpdcsenmtiJcs of this city to enter upon
. �:W she above-mentioned Pori for inspection Purposes.,,,,,_, ._.n,.,
C6 I s 7 igree in save.lnd<mafy and keep haimlGss she City of Cupertino agoing
F-Z liabilities,judgments,costs and expenses which may in any way,accruc against said
U Z City c asequence 6f a he'gmnung.17th pe a _ _
`APPLICANT pNDERSTANDg AND WILL COMPLi'WlmIALLNOD-PCi1Ni ISSUedby:
! Date
_ -SOURCE REGULATIONS. 'll...' '. '- a
Sie'temrc of API¢and/Crinlracmr'•:,1'b't':;'n;.:'� rt".(:,.!.l,'i Dalc Re-roofs
HAZARDOUS MATERIALS DISCLOSURE E I
.. Will da applicant or future Wilding« pant'slope or made a mumal _Type of Roof
: essdfrd by the Cupertno Municipal Code,Chapter912 and the Health and Safety ask:L p'- 1 T` %q [ r T-• .. .,t 1• r' -- -'
Edda $futon 455711x1 3 If t -tim-., f �`4 r 1 I r. .. 4_a _ a t Y r V 9_ YM 1
rota' rx„❑Na;i;a '<` to c.`,'� ... , . - ._. All-roofs..shall.be inspected prior to.any.roofing material.being.installed...___ .
"` .wrilme.none.ntmmtweWiinimgo«awdt�s<eq.ipn,�njmdevme:.mm� If a roof is installed''Without first obtaining aninspectiori;Pagree:toremove
,or,ha,a dour air commune n,as'defined by she Bay Area Air Quality Management
Di Ina - •all new,materials for_inspection,•Applicant understands and will.comply with•• t_
❑Ya p. oN. i - all'non-point source regulatwnsk . ,
n --reod'thc bawd.i,miiahal reg nem m u do 1CM1 pt r'6.95 of the
California Health&Safety Code;Sections 3550.5;15533 and 25536.,1 undemand that
u building
doe nememswhiave a tenant,that it ism __ 'bilis to notify the
if the building Jas not cuaendy have yrcsponal y y
otic p qu' :must h el Isor to issuance of a Cenificate of
cost, y (. ' , ._ . :_ Signature of Applicant. _ .._.. .__._. .. . . _.. _. Date
'! owns modrea reg , y,'.; ,': Data
All roof coverings to be Class "B" or�betier
OFFICE