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08070110 (2) CITY OF CUPERTINOr e ,,,„�n.i5-:a BUILDING DIVISI=ON PERMIT CQN_TRA@TOR INFORMATION' BUI I G ESS: PERMIT NO. TRINITY SPRING CT AFFORDABLE WATER HEATERS & 08070110 OWNER'S NAME: PERMIT ISSUEDATE JOY YANG 24707 RAILROAD AVE 07/16/2008 NE SANITARY NO. CONTROL NO, AacHnEcrfENGiNEER: BUILDING PER O RPLC 50 GAL GAS WTR HTR BLDG ELECTPLUMBMECH 0 0 0 0 OC Z LICENSED CONTRACTOR'S DECLARATION �W Otul] Ilrcmby affirm lh.rl,m lkcved aMcr prevision of China 9 c=ommencing Job Description n� ]IXkBDivieonlof thuressan(pd P2rof7ca3om�Cvade ,and mylkea is in full to=and offset, 0. c U=., ' F=F Dam -a,. f A..0—nFCTS DECLARATION IaAn W 1 uMcrnanJ my plans still ba ux0 as public reroda kCt Licensed Pmfcasimal `m5 OWNER-BUILDER DECLARATION <2 1 hereby affirm that I am exempt from she Contractors Conctors LicLicenseenLaw for the OO following mare..(section RD1.5,Bust.and Ptofovdmes Code:Any cay or caunty K 9 which requires a permit m commmct.ear.improve,demoluh,or repair any structure aZT prior to its issuance,also mluires the applicant for such permit in file a signed statement ss< cast he I.ficamsedpunuanttothe Provisions ofthe Communist's Lim.Law(Chapmr9 Sq. Ft. Floor Area Valuation z1 (comenuming with section 7000)of Division l of the Business and Pref�iom Cdc)or y5g that In u exempt tMaefrwe and use basis for the dkged cas mpuon.My violation of SCNon 703"by any applicant far a Permit subjects the applicant in a civil Penalty or ane APN Number Occupancy pry, nm more than five hundred doll.($50% P y •7 Pe wi I,a owner of tie ympcny,m my employee wish rode u umv sue onmpenauon, will da the womb,and c: 1.Com u not s License Law aid somata(Sec.7014,Business and Fierceness Cade:Thr mthimmora Lkenx Law d.es net appy 1f an owner of Required Inspections propown enywho buildsorimpmveu t imparmnd who an, suchact in work himuerand learroughformle his awnftcn,providedthat such Impmvemmtsartretimm�dodora0ertd for ocean, Wilderhowever.the in,umodeling m den of pmrnt Instead that within et year of mmpauoq she ow.ar- builder ,vi11 hate um hde.of proving flat ba did net dsill in improve For puryox.f uaJ. 1,as awxr or the propmy am exclusively contracting with licensed mntacurs in commas she project(Sec.7044.Business and Professions Cade:)Tam Contractors V- mar Law 4.act apply to an owner of limper who beilds or impro e,them..,and, who contacts fmaueh p njrcts with a mntracii licensed pmnuanr in the Contractor' License Law. 0 l are saempt malar See ,B&P C fm Nu mason Owne Data WORKERS COMPENSATION DECLARATION 1 lcrtby enro under penalty of perjury erre of the following docluations: 1 have and will maintain a Certificates of tartans to self-insure fon Worters Camper cation,as ProvidW for by Section 3700 of the Labor Code.for the performance of me, work for which this permit is issued ❑I have and will maintain Warkah Compensation Imurance,in required by section 3700 of Ne Ladner Code,for dm performance oftm smile for which ahs panmixis issued ' My Worker.Compensation Insunroe am.and Policy numberam:u Cartier 7i H LPolicy No.:?b 67p CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Ih'uxedon med rosbacemplekd ifshe permit isfaroue hundred dollars nIOU) or iter) 1 certify that in Ne Perfamunca of she wort far which this permit in issued 1 abet not employ anyperxn in any mmnerm as to thecoma subject to the Worims C.mpemdon Laws of California.Data Applicant NOTICE TO APPLICANT:If.after making this Cenifrem of Eaampuoa,you shmW become subjm in the W ss c s Compensation Provisions of tM Labor Code.you mina .`y z foMwimh comply wish ash prommans in Nu permit shall he amount mvpkd. - ?O CONsmucnON LENDING AGENCY [-r ^ Ihereby aff.sham ft.I..mmmeturn lendingagency for the if..or Q4..-r tic work mor whim saw permit u issued(sec.MTI,Civ.C.) Q Lenders Name Z) z Lenders Address U Q 1 certify duns 1 have red this application and sum than be above iNomuuun is LL cmiee6 l since as comply with dl Clty and county aldixlarKe and sum laws relating in Wilding mnsweton aM hereby munice reprtxnuives of this city to corm upon Ne above-mentioved property for iapemian Perp si (We)agree the aa,indemnify and keep harmless the City of Cupolaso,gaimt r/I liabilities,judgments.toss and exp'"•"•which may in any way amine agdmt aid City V Z in consequence of the granting of this permit. _ APPLICANT VNDERSTANDS AND W LL COMPLY WITH ALL NON-MIM Issued by: Date SOURC TIONS. ,� / -71/616 Re-roofs Stgnarurt of ApphoHAZARDO Data xnzasrun= MATERIALS ars aosuRE Type of Roof Will the a Cinsm m future ipallCo e.Casper nam m handle Health makrie C deBrcd the 32(a)?re Municipal Code.Clupkr 9.12,and tm Nedsh ad Safely Con`'Section es2ss3z(a)T Oaks- _ All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining ins ection,I agree to remove �i hu,mmm air conaustrants�u defined by the Bay Area Air QualityWill Ne applicant or furore building occupam tax equipment or devices which us an plty Management all new materials for inspection. sai pees 91 I hate red the hvaNmma M.x.mqubcmemaumar Chapkr6.95ofthe Ceifor- -i- ce104Seery Code,' .25505,25511ad25534.1uraamtand Nairtm building dna rpt Carmody Na a mnme.ton Is is my ra sonsailisy m=rout,dm ea Want of the requirements wh' /in kmetpalortalam ar,urt6.,k.ramPwxy./ p Signature of Applicant Date Owner or au hod7zd agenm oak All roof coverings to be Class'�T'or better CITY OF CUPERTINO . 4 ITEMS OF 12 PERMIT, RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36653028 . 00 DATE ISSUED. . . . . . . : 07/16/2008 RECEIPT # . . . . . . . . . : BS000005480 REFERENCE ID # . . . : 08070110 SITE ADDRESS . . . . . : 11823 TRINITY SPRING CT SUBDIVISION . ... . . . . CITY . . :. . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : JOY YANG ADDRESS . . . . . . . . . . : 11823 TRINITY SPRING CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : EDDIE D NALLEY CONTRACTOR . . . . . . . : LEONCE ROUX LIC # 26850 COMPANY . . . . . . . . . . : AFFORDABLE WATER HEATERS & ADDRESS . . . . . . . . . . : 24707 RAILROAD AVE CITY/STATE/ZIP . . . : SANTA CLARITA, CA 91321 TELEPHONE . . . . . . . . : (661) 259-7131 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL --- ---- -------- ---------- ---------- ---------- ---------- IBSEISMICR VALUATION 1, 200 . 00 0 . 50 0 . 00 0 . 50 0 . 00 1PPERMITFE FLAT RATE , 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00 1PRWHEATR UNITS 1 . 00 24 . 48 0 . 00 24 .48 0 . 00 1TRAVDOC FLAT RATE 1. 00 40 . 79 0 . 00 40 . 79 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 106 . 56 0 . 00 106 . 56 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 518 WATER HEATER , • -� CITY OF CUPERTINO rCCC- WATER HEATER CITY OF CUPERTINO PERMIT APPLICATION FORM APN # Date: 7 Building Address: 118x3 T�,�;�y Se��g Ct Owner's Name: Phone #: Contractor: Phone #: (,b 1- 15-1 - 713 1 f}Ffor-dable Wafter Heaferi Fax #: Wof - ,ISy - 9556 Cupertino Business License #: Contractor State License #: a2 gS6 (off-7369 Contact: Phone #: 6,41 - �Sy- 0 5d,0 Scott L;fitIeFielcl Building Permit Info: Bld ❑ Elect Plumb Mech Residential N] Commercial ❑ Job Description: n "V 1G ck S-0 50'"0' G0.S Strapped �] On Platform ❑ Bonded FYf New Location ❑ Replacement Valuation: 1 a 00 Green Building Check must be completed and attached to this application. • Green Building Points achieved: �. Community Development i Cupertino pertino CA 95014 " Telephone(408)777-3228 CITY OF Fax(408)777-3333 *UPERTINO Building De artment JOB ADDRESS: PERMIT # OWNER'S NAME: Vc, PHONE 4 qok GENERAL CONTRACTOR' FAX # I am not using any subcontractors: & 0}� 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 e Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile • ( / Owner/Contractor Signature Date