02040078 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR'INF,ORMATION-
BUILDING ADDRESS: PERMIT NO
Y JUST WATER HEATERS INC 02040078
ONVN'ER'S NAME: APPLICATION SUB DATE
CORRAL BARBARA M 1764 NATIONAL AVE 04/16/2002
PHONE: SANITARY NO. CONTROL NO.
(510) 293-9901
ARCHITECDENOINEER:
O o BUILDING PERMIT INFO
BLDG EIECf PLUMB MECH
<'1 u C_I
t_nova IherebyvlfwLICEhmEDmOMsRACTOR'pSrDEonLARAA�p1er91commendng lob Description
H F., with Section 7000).f Division Sof theEntices,and Profession Code.and my license REPLACE WATER HEATER.
m F
is in full force and effect.
rep�u License Class Lic.Y
Dae Cwmanne
C ARCHITECTS DECLARATION
5 1 understand my plans shall be used as public retards
YE
E c O Licensed Profeulowl
OWNER-BUILDER DECLARATION
1 hereby M.Na I am exempt from the Contractor's License Law for the
C z following reason.(Section 7071.5,Business and Nofeuions Code:Any city or county $S S O
I D which requires a pemtit to Construct,alter,improve,demolish.or repair any structure
u�3$ -priamiu Tuna«e.alt rtquims theapplltantforsah pemuuo Ele.'igrod anamem-
IILII he,1211Rnxd PYRYnM na 1heV t,a.rs of aIle Conlrnrlces License law lGh,sue,9 _ -
(commencin8with,Sy«lice;7Q0W)of Division Joftbe Busincu and Profusion Code) f"( f1If,3 ,!°6V,. T S'T"'-s♦ Valuation
of Na he is even t tmy apdm and the basis for be alleged clam arms.An
p g o r vitiation
of Section 7W3IS by my applicant fa a pewit sbjecu the applicant m'e civil Penaltyecu ane Type
!of riot more than BR Autdrrd dolibx(5500). N
509- � L PLUMBI G 'ENBRGP p y yP
01,as owner of Ne propcny.ter my emp^oytt^xith wvgcsn Neir sole compensaion. _ TpqT
wilfdo tM1e work`arta the nrvaure is a ¢ndid'or orterta'foi'ule'I5 n.704x: - ..,. ._.
!Business and Prolbssions Cade The Connector's License Law docs am apply to an 507 - FINAL
P 1 IIIQSpections'' '-'•�-
owner of property Who builds or improves thereon,and who does such work himself
or thou`h his owneroployess.provided that such mr ra,menU ore nor imendedor_ .____,-__..__.._._._.........
offered for mle:If,however,the building or improvement is sold within one year of "'!;:r• CG. . „ $O --__—�-
Completion,Nc owner-builder will have the burden of proving mat bu
that be did mat or '""
improve for purpose of RIC.).
ntras_.____..____.___..._—.__ _
°1:esct the Of de pmpe0y,a,exclusivda Pnoltingwirdlicensedcnemaotsm '01'EJii[ I:v/------
conswntheoesno(Sec.IDSL,Busies, ro Prufusiona Code:)Theves Contractor" [..C:G - oLl:;iS s;E:g
License law docs not apply to an owner of propcny who builds or improve thereon, -
.;: _ana.who.covtruu.fw.auch ryoj«u-a,ah.e.co 'artsFlittwd.puruunr m.N-- -------
Contactors Lorene Law.
n r r..a �1
❑l Con exempt der Sol, BAPCfa this rcuon Bim® � ...... .It.i'
�INALEO
V
Ower' '�' 1' 'Date '
-WORKER'S COMPENSATION DECLARATION
y:_ ---�.,,e _. .._. ... APR 2 9 2002
' 'l hertb affirm order nit f r'u oa ofth following d«taction:-'
^
Of hive'and'rill'vuinuiri S''cc'mr 1C of Caieimriosulf-inum for Worka'a ��I�D'��
_ Compensmion;ns„-pmvidcd-furby Sne,mm-37W"ahhe'Labor'Code.-for'Nc
perfownc
ae of Newpem
ork for which this at u issued. .
❑1 lurva'itad will maims Wohc a Coro 'not w In u irsc n requ ort bj Section
37W0 of the Labor Code.f the perforinance of Ne work for which Nil Ppmus is
issued.My.Workers Compensadon InsOmae comer and Policy number at
Cimer fv vtt.P(t.kl Ls-Policy No • '' s):'. a ,tf "tu�...q.:'i, I_.) y ._ �.:�,u•lti •u �__ � . .. ..
I BRT�mCAT10N'OF EKEMPTIQN FROM'WORKERS ' ' t t ti.s ,. .
1
'(Tho xmion need not b<completed if the pewit is fa one hundred dollars '- """ -" N"• r
(SI00)o�IessJy, P.cit,;cr . .:,.,..:;-•.. r^..
Com nsel
rsAhnlllrno
untem o on some ma iter oat mb«o sub ant tthe Worlrecl is;'I"ion v;:,fi;'::.^mfl '"-f'+7•'
\ I c m� tMt ink rf wance of Nc ak for h h )
l
PP _._ .. _._...- _ _
:NOT'ICE I'O APPLICANT'.IPvfmr mvl;ipg NUC nifcate of Exemption.you ibduld + - - l.. .
,come iubject io the Worker s Compensmmn prbriiioakof the IAbor Code:you must
Z O fonhwiN codply wird Tubb provisions ar this pewit shell bedttmed revoked. -
_. _. _ _. . ..__ .... ___ ----- _
to r`f t f rt 'CONSTRUC110N LENDING AGENCY � c - .t' �r.'-• ?,^
> ° Ifiercby aRwthat Nf i is nswCto lending agency for Ne peRomi nee' �� _ l -. .,.;'tri d
of N ork for hl H N s pcw8 li ssuea(Sec 3897 O C) �(\J�/�t�� 1
._
W �
•I«nRY that I have xaa Nis'vpplirnlon and nate Nn Ne above mfownioe is
W F(r coire2i:PegrR'm comply wrN ell city grid copmY;q!dinerlas ena sane bwsr npog
�=,CJ mbuilding conntuchon:end hertby'amhorixe seprtseotaliJcs of Nis city io enter upon
the above-mcmioned property for inpecdon pulox;..,, ,
o ag,_ ._.
[..-d' IarClijue tb save,in cion!!y antl keep harmicsi Ne City'of Cupcninainst
-W lubilities.judgment.tmuand upenxs which may in any way,accrve�against said
t)'Z Ory n consequence of the giant ng of Njf permit '
`" APPf.1C'A'\T 4tiDERS7A\'DSa\[)t77).1.COxIPLV H'('j7{ALC°\O.... r
SOURCE REGVLATfO\Sf Issued by: Date
Sigramtt of ApPhcanVConwtlor 'l:` ^T' v Dm ' nn':"
H RDOUS MATERIPLS Dl5CLOSURE�+1 I ''� Re roofs
Wil the'pplicaut ce(terve buddej ompst mart o haMte heutdals t nal _- . .._. ....
a,deft d by the Colman Municipal Code Ch pt .91Z a the Nulty and Safety --Type of Roof_ .r - - tt. • - .=..^ . _ . _ -__ _ .._ ._
Code Section 255321e)i \ 1 t s. f. f i i` 71 °', t,C;f':Z s,e, t i.+ • l• s•rlf `f LCII-_- -. ..•... .
All.roofs.shall.be inspected prior,to any.roofing material.being.installed....
Win the applicants orf mum buildingRcupant use equipment ordevices which If aroof is insfalled'without first obtainingan,ins ectidn'la Tee'tolreihove
ml
t heaudous nr comi mtrnno u defined by Nr Bey Arta qct Quality Management P g
DtWn •. _ ' _a _new materials for inspection..Ap n rstan _ wcomply.
._ IOY r' °)N- o�li all non-point source regulations:
pl. ` .derr.}' d d will, ._._ ....
_ lea tun with
y liha a lad Sge'Y rdo s nouns!, ,25533.M 255 Chepur mund Ne
Califowa HeelNkSafety,Codd,«dons 23303.235]7 aM 233Ja,lundmund tMt ....._.._ ._ ....... ._. . .......
JNa bmlding do«not cumcntlY bsve a tenwe Nab it'u my.rtnrtsibiliry to entffy the
«cup t of the rcqu rcmenU h ch musi be ma poor scant,Of•CenlBate'af
QR<upencY _
Signature_of Applicant_-.._ ._ ......_ . . _ ..Date_. _ .
owner a.avmeruca agent la „ - Dat , All roof coverings to be Class"B"or;better ' ,
t
_ _..
.OFFICE---- - - -._._._... --- ..
.. "-- -'-' -' .. .