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01030007 (2) CITY OF CUPERTINO BUILDING DIVISION PERMIT CONTRACTOR INFORMATION: BUILDING ADURISS: - PERMIT NO, 19964 WHEATON DR JUST WATER HEATERS INC 01030007 OWNER'S It AI'1'LICAI'ION SUI]ONE Ii THOMPSON .JONATHAN AND FELICIA 1764' NATIONAL AVE 03/01 /2001 Pl IONIC: SANITARY NO. CONTROL NO. (510) 293-9901 0 AHCHITIiCf/ENGINIiEH: BUILDING PICRMIT INFO �u— BLDG ELECT PLUMB MIiCH y J LICENMiD CON'1'RAC IOR'S DECLARATION z l hereby aa and I lana hm-M tenor,poosI m of C11,11,9(ea,mt Im,ms Job Description nim Fa.,tw with Section 7000)x1 Division Sof the Bminessvnd Rnfcsial.Gale,and my license pxsis mfull force and effect. REPLACE 50 GALLON GAS WATER HEATER nseho... s C 2 LiceCLic.N aq5 O i O Dole Cnnlmctor n+3 a'e ARC]111 HILT S DECLARATION t= g 1 understand in,plans shall be used es public record, 5 ae p O I,iecnce,l Prn(essinnul c c that I.,a 1carom,iH DECLARATION IKu 1 hereby ufhmn on I Int exempt tram the Cnnvns Coo Limuse for the t 2 Q fellow re rcasam ritual In 703 1...Business andimprove, ver eerie..Code:Any city m scuts Eo which,egobesvpm,ou,camtmcl,after.impmae,dem olish,ata-i,anyercumum a.3 ']. r t I' I pylic h 1 rise .'g d.t t nem Ihatl licensed'unwind n the n vise un ofthe Business and 1 on pter9 Sy. Ft. Floor Area Valuation Ittthat hi mg wnh Section rm,and Division o thea❑asides mp ProRsny vi Gdd or that he erupt Ihcmftnm and thr nasis for the alleged exemption.Any violation 1687 at See eI.tISby a nydurdduatforapamnit smjlcd Ibc vpplicam mIcivil prtndty Of run mom oma,Bee 1ta„arm dallnr.(550m). APN Number Occupancy Type 01.re ow ser orthe property.or my employee,with wages as their snle compensation. 00 will do the work,and the structure is not intended or offered for sale(Sec.7D4, Btu,irri Intl Profe,,;mn,Code:'I he C factor.Liernw Law dnex mal apply ,,im Required Inspections sof Propury Who build,or Improves thereon,and who does such work himself - caro, his own employers.provided that such improvements am not intended of 502 — FINAL PLUMBING ENERGY affected for pule.If,howevcq the building or impmvemcnt is sold within one year of °,n,plwion,thr swam buildcr will have the be,dcn afproving to t he did as build m 506 — GAS TEST ,pro.0im, a,rafxtar.). 507 — FINAL PLUMBING 01.a%owner of the pri f exclusively contracting with licensed commuters to instruct the project(Sec.16W.Ousinr,.and Profession,Cade:)The Contractor's Lactim..1,w does not apply to;in ow net of property who her Ids or Itnpruva dutrum. and who contracts fur such pn,jcics with a u ntructons)licensed pursuant to the if ais License law. 01 ass 1 e.annpl under Src. .B k P C for this reason / Owner Panic W(1RK13R'S COMPENSATION DECIAHAB'IsIN 0 I hereby anion tinder penalty of prjmy one of the following declaration.: Q/ 0 1 have send will n aiamia a Certificate of Content I, wlLlncarc for Wader's Compensation, as provided for by Section 37110 of the 1aM,r Cada fin the perfor ii if the work for which this pe,,air is issued 01 Noc and will Inflation W'orker's Compenmtion Insurance,as acquired by Section 3700 of the Labor Cade,for the Icrform nce of the work for which this permit is sued.My Wnrkcis Compensation Insurance earner and Policy number arc: Cartier', Lilley No.: CER'DPICATION OF E%EMI"I'ION FROM WORKHRS' COMPENSATION INSURANCE frhls section nacd not he om lural If the ry'nnit is for one hundmd dollars ($100)nr I”) 1 certify that in the performance of the work for which this permit i.issued.I ,hall run said,airy ler,na in amy manner wI is ,,hecome.rtIhjfct in tar Wnrke,s' Compcam;i lon Laws if Calif moria.Date Applicant NOTICF,'lo APPLICANT:If,atter making this Cenilleme of Exianmtion,you should become subject mthe Workds Cnmlrenwtiomp wixiorw of the Labor Code.youmust Q tinthwidI nnnply with wan faro......,,ser mi, ,air shall be daetncd revoked. Z f" CONS them iCfIONLENDING AGENCY ' I Leahy anima that there is s eau d!(S icn lending agency for the perfonnance W of the work Gn which Ihix Iwrntit is nsmal(Scc.301 Civ.C.) S Q Land ,brute z lands,crl Address V rO 1 crall y aha I have mad thi,uppfiraaon and¢am that the above affirmation is E. �+. turfed.I,gree m,anoply with Ill city land canary anlinance,send xenc Iry relating OU u,wilding construction.and hereby umhoHre epm,rntutives of ih6 city ,I enter upon iy the shows...emfoaed property far inspection pimpi rFi d (We)agree h,save.mdeamifYand keep harmless the Ciyof Cupertino figmiet U) habdhies, unSmad......le:md rxpen.e,which may in any way latus againw,aid U z City in con..........I the grunting of flu,perm,. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NONd'01N' Issued by: Date SOURCE REGULATIONS. y' Signlummol Appliciva/Cmara,... Item Re-roofs I HAZARDOUS MNIERIAI S DISCLOSURE Will thcapplicant orfuture Wilding occupant state orhandle Naturalist,material Type of Roof a,defined by the Cu,samo Municipal Code.Chapter 9.12,and the Health and Safety _ Cn]I,Section 25532001 O Yes 0N All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove rail bwardous air ramramimnm..as all by the Buy Area Air Quality Management Dixrierl all new materials for inspection. Applicant understands and will comply with OYe, 0N all non-point source regulations. 1 h:eve read the harardnus materials requirencris under Chapter 6J5 of the Callfn...a Health MS,ddy Coda Sections 2.1505,25533 and 25534.1 unll it that if the building does nm cursntly have a mato,,that it i.c ry c,pnnodality m unlit,the - rant of the requirement m which must be et prim In issuance of a CrrtlfiCme of nupccepanry. Signature of Applicant Date Ownmar authorized Igen, Dale All roof coverings to be Class "B" or better OFFICE