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08060026 (2) CITY OF CUPERTINO BUILDING DIVISION PERMIT CONTRACTnR INFORMATION BG1L�1 VYTEIQ�HEATON DR FAST WATER HEATER PER0598%0026 OWNER'S NAME: PERMIT ISSUE DATE DING SU 12601 132 AVE NE 06/04/2008 NE: SANITARY NO. CONTROL NO. ARCHITECTIENGINEER: RMV/RPLC GAS WATER HEATER BLDG BUILDING PERPLUINFO MB MECH 000 LICENSED CONTRACTOR'S DECLARATION U00 �a u ffirm Nde 1 homey aat I am licensed unr Provisions of Chapter 9(commrreJob Description - .. p . `ZW with SCCYOn?OM)of Division 3 of ft Business and Professions;Cade.and my license is a<� in full fame and effect Cl. Lic.g =mac Dam Conlrxmr iflARCHITECTS DECLARATION I undersand my plans Nail W used as public records g0� Liccved Mlfeaional 3 OWNER-BUTUER DECLARATION .� q I Wroby alarm that 1 am exempt from the Contractors License Law for the E p o following reason.(Section 701.5,Business and Profession Code:Any city or county K$ which recruit.a la'mtil to construct,alar.hnpmve,demolish,err repair any suuctum a priorais issuance.A..roximmstheapplicam formch permit to Eleasignednaamem < thuhcisliccmNpurscenttoNcproviswtuofthe,Contrxwr'sLicensetaw(Chapter9 Sq.Ft. Floor Area Valuation Y�s (commencing with Section 7W0)of Division Sof the Business and Professiaru Code)or Nat las is exempt therefrom and dm,eazu for the alleged exemption.My violation of Section 1031.5 by any applicant fru a Permit subjects the applicant to a civil penalty of ane APN Number Occas not mom than Rn hundred dolWs(S500). -occupancy Type 1,As Ownerof the property,army employers with wages As their solecompemation, will do the work.and t essoyttum is no,intended or offered formic(Sec.1044.Business and Professions Cade:The Contractor,U.Law closet,tat apply to An..of Required Inspections property who builds or i m pmva thetmn,and w M does such work Mosel f w tf uougb his own cmplayees,provided thatsuch improvements are not intended oroffeAed for ale.If, however.the building or Improvement U mid within ow year of completion,the owner- builder will law the WNen of proving that in,did rot build or improve for purpose of sale.). ❑1,As ownsr of the Property,am euluxircly convening wits llcemed eontrman in comtroct tee project(Sec.7W.Business and Professions Code:)The Conuacues Li, come law does not apply as an owner of propeny who Wilds or improves thereon.and who contracts fru sued pmjcm with a convvcter(s)Iiwmnd purman to do Damnation License law. ❑Iomexemptundm See ,BRPCfwthixreamn ver Date WORKER'S COMPENSATION DECLARATION 1 Wrathy efface un er penalty of perjury arc of die following declarations: l bare and will maintain a CerdOam,ofComent to relf-iisurt far Warker'sCompon- anion,As provided for by Section 3100 of the Labor Code,for rhe peffoonn a of the work rue which this permit is issued. , ❑1 haw tad will maintain Worker,Compensation Inman¢,u Am,had by Section 3100 of the labor Code,far the pca(armmer of the work forwhiN Nix Permit is Issued. ' My Worlmea Cma sucatian Insurntt cards,and Policy number are: Cartier. Policy No.: CERTIFICATE OF UEMPITON FROM WORKERS' COMPENSATION INSURANCE (Thux.t.need not W completed if the Permit uforane hundred dollar(SIMM or hers.) I artily that in the Performance of the work for which this Permit is Amid.l Nall not employanyperxninanyman rmuubecomembjwtaNe WorkmYCompensation Laws of California.Data Applicant NOTICE TO APPLICANT.If,After making this Ccnifiate of Exemption,you Mould become subject ou the Workers Compensation previsions of the Ichor Cade.you mus .,O foMwith comply with sueh provisions or this permit Nall W deemed revoked. z y CONSTRUCTION LENDING AGENCY [—� Ihorthy affirm that Vert u a manamem.heading agency,for to pefornance,of Ci the work far which this permit is issued(Sec.3099,Civ.C) 0.0 LCnders Name 7 z lender.Add. U O 1 artiry,Nat I haw read this application and seam,this the above marmots.is Iia c urcct.I agree in comply with all city and county ordinances and scale laws miming to 0U Wilding construction,tad botchy Nonm ae miential of this city to Anter upon an, LU above-mentionedpreeny.Q.,mm fa, An,Aspirins,purposes (We)agree to ave,indemnify and keep hnmless tie City of Cupeniao against h in co ser,judgmfdiccatuaadofpriueewhich may thray weyamue agaiasl aid City Uz inconsquencc of the greeting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date a SOURCE REGULATIONS. Re-roofs Signature of Applicn AZARDmr Date MATEIUAU nel-Part Type of Roof Will the applicant or forum Wilding acupnt awe wMatra..Matra..W material az dcBnN DY the Cupertino Municipal Code.Chapter 9.13.and and th nae Health and Safety code,swdoa 83324`'.? All roofs shall be inspected prior to any roofing material being installed. Cl Y. ONO 40 wd the,Applicant or future buildin Ota If a roof is installed without first obtainingan inspection,I agree to remove PP g Pant sax equipment or Mann which eml,havaNnus air contaminants u defined by the Bay Arca Air Quality Management all new materials for inspection. ' Disuin? ❑Yes CjNo I have mad the baaadau mam,nials mquin ments under Chapter 6.95 or the Cshfor, nix Health@ Salty Coda,Swtiom25505.25533 and 23534.1 understand tha,ifte Wilding dor rot currendy ban a ren.Nat it it my reapaanibility is notify the ottupare of the mwimmcna which mW,W met prior he ismawe Or.cervfeaw Of Occupwey. Signature of Applicant Date Owner Or auhom<d agent Dam, All roof coverings to be Class'%g."or better CITY OF CUPERTINO • 4 ITEMS OF 8 PERMIT RECEIP.TOPERATOR: pdtg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31623083 . 00 DATE ISSUED: . . . . . . : 06/04/2008 RECEIPT # . . . . . . . . . : BS000004996 REFERENCE ID # . . . : 08060026 SITE ADDRESS . . . . . : 20094 WHEATON DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : JING SU ADDRESS . . . . . . . . . . : 20094 WHEATON DR CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2340 RECEIVED FROM . . . . : JEFF JORDAN CONTRACTOR . . . . . . . : JEFF JORDAN LIC # 29100 COMPANY . . . . . . . . . . : FAST WATER HEATER ADDRESS . . . . . . . . . . : ' 12601 132 AVE NE CITY/STATE/ZIP . . . : KIRKLAND, WA 98034 TELEPHONE . . . . . . . . : (800) 454-8955 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- IBSEISMICR VALUATION 449 . 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 Permit No:6)'P6 (0() _(040581 05819 (office use only) City Of Cupertino Building Permit Application • E-Mail: Building-Permits ccDcupertino.org (Address is case sensitive). Jobsite Address:20094 WHEATON DR Date: 6/4/08 Assessor's Parcel Number: (0a3o83,00 Owners Name: SU, JING Phone No: (408)865-1664 Project Valuation: 449.00 Building Permit Info: Bldg Elect Plumb x Mech Job Description Remove/Replace Gas Water Heater Contractor Information Company Name: FAST WATER HEATER COMPANY Phone No: • Contact Name: Carol Randall Fax No: 800454-8955 Address: 12601 132ND AVE NE E-mail: caroir@fastwaterheater.com City, State & zip code: KIRKLAND, WA 98034 State Contractor's Lic. No: 877489 Expiration Date: 5/31/10 Worker's Comp No: 1761660 Expiration Date: 12/1/08 Carrier: California State Fund City of Cupertino Business License No: 29100 Credit Card Information Credit Card No: 4417123041349530 Expiration Date: 11/10 Name on Card: Jeff Jordan Visa © MasterCard ❑ American Express ❑ • The Building permit application and a completed & signed contractorlsubcontractor form need to be submitted with each permit. '+ - - Community Development 10300 Ton-c Avenue ° Cup -fto CA 95014 Telephone(408)777-3228 CI OF Fax(408)777-3333 �UPEIZTINO Building Department JOB ADDRESS: 20094 WHEATON DR PERMIT# D00,2. r!v OWNER'S NAME: SU, JING PHONE# (408)865-1664 GENERAL CONTRACTOR:FAST WATER HEATEE�R COMPA FAX# 425-814-9516 I am not using any subcontractors:_ �'`af! ` ' 6/4/08 Signature Date Please check applicable subcontractors and co m Tete 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 Roofing Septic Tank Sheet Metal Sheet Rock Tile • Owner/Contractor Signature Date