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06100018 CITY OF CUPERTINO iiUILDING DIVISION PERMIT ONTGq� 1� iRMAZ`�ON' BUILDING ADDRESS: PLUMB IN TIME INC PERMIT NO- 06100018 7883 CREEKLINE DR PERMIT ISSUE DATE OWNER'S NAME: 10/0 Z2006 CHING WU 360 MEMORIAL DR ST 140 SANITARY NO. CONTROL NO. ONE: (866) 293-3031 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH !00 LICENSED CONTRACTOR'S DECLARATION Job Description V P I hereby affirm that I am licensed under provisions of Chapter 9(commencing zw with Section 7000)of inion3ofthe Business and Pr ssions Code an4 in seis REPLACE HOT WATER HEATER 50 GALLON !'=0 y in full force and effec ?n? License C1atsLi•� F kk"— Dates/ - Contractorfilt ARCHITECTS DECLARATION I understand my plans shall be used as public records �yU y Licensed Professional h OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractors License Law for the 00 following reason.(Section 7031.5,Business and Professions Code:Any city or county $500 V which requires a permit to construct.alter•improve•demolish,or repair any structure z y prior it)its issuance,also requires the applicant for such permit to file a signed statement Valuation that he is licensed pursuant to the provisions of the Contractor's Liccnsc Law(Chapter 9 Sq.Ft.Floor Area 2 EO I- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or i that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of r Occupancy Type not more than five hundred dollars(5500). ❑1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If. however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did riot build or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon,and. who contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law. 0 I am exempt under Sec. B&P C for this reason Owner Dale WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑I have and will maintain a Certificate of Consent to self-insurc for Workers Compcn- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is My Wor is Compe11"1nsation ins u ce carrier and Polity num Carrie CATE OFEMPTION O WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I ccn;fy that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If.after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code•you must ,J O forthwith comply with such provisions or this permit shall be deemed revoked. z R CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of �. > the work for which this permit is issued(Sec.3097,Civ.C.) W A Lender's Name Lender's Address U 0 I certify that I have read this application and state that the above information is CL correct.I agree to comply with all city and county ordinances and state laws relating to 0 U building construction,and hereby authorise representatives of this city to enter upon the Wabove-mentioned property for inspection purposes. a (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and expenses which may in any way accrue against said City ;,,)'-Z in consequence of the granting of this permit. Date A LIC UNDERSTANDS WILL COMPLY WI ALL NON-POINT Issued by: So U ATIO . -7 d Re-roofs hgnat re pplicanUContractor Date HAZARDOUS MATERIA CLOSURE Type of Roof I the applicant or future building Occup store or handle hazardous material as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Cade,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes �Ne A* Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Hcallh&Safcty Codc,Sections 25505.25533 and 25534.1 understand that if the building acs not currently have a tenant. ' is my responsibility to notify the occupant of the en which must be me rio to issuance of a Certificate cup y Signature of Applicant Date _v All roof coverings to be Class"B"or better Ow er ihorired agent Date Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 r,UPEkTINO Building Department JOB ADDRESS: --7 86 3 a,eto- r�e— Dr PERMIT # O(0) OM)� OWNER'S NAME: t n U PHONE #40Q- 25*-;--1 OZO GENERAL CONTRACTOR: YY) -l ill- l I ryl e- FAX # am not using any subcontractors• /-=�Uj��Ao Signature Date Please check applicable subcontractors and complete the followmi Y' rmation: 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 CITY OF CUPERTINO 3m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36217052 . 00 DATE ISSUED. . . . . . . : 10/03/2006 RECEIPT # . . . . . . . . . : 36290 REFERENCE ID # . . . : 06100018 SITE ADDRESS . . : 7883 CREEKLINE DR SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . . CHING WU ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : PLUMB IN TIME CONTRACTOR . . . . . . . : PAUL HENDRIXSON LIC # 27607 COMPANY . . . . . . . . . . : PLUMB IN TIME INC ADDRESS . . . . . . . . . . : 360 MEMORIAL DR STE 140 CITY/STATE/ZIP . . . : CRYSTAL LAKE, IL 60014 TELEPHONE . . . . . . . . : (866) 293-3031 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL - ---- ---- - --- ----- ----- ---------- ---- ------ ---------- ---------- ---------- BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00 BPWHEATER PER HEATER 1 . 00 10 . 79 0 . 00 10 . 79 0 . 00 PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 ---------- ---------- - --------- ---------- TOTAL PERMIT 84 . 02 0 . 00 84 . 02 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER - - ---- ---------- - ------------ --- - -------------- CHECK 84 . 02 877 TOTAL RECEIPT 84 . 02 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- -------- ---------------------------- -------- ---------------------------- 502 FINAL PLUMBING ENERGY 506 GAS TEST 507 FINAL PLUMBING 35yy6 3. 663 C10 rv1 , v. WAT ER HEATER PERAIR! A, 3fa - ►-7 - o s a 3ii diM-n�- {- °I I as h L -7 E �a�rnireYc,zSe�: WZ NameCuQe rPhont SwaLsk a. a, ----- �03� _ Licenserr i cc'1$av t: h Cupertino Business License g: a B"°`! ci; Permit i�lfo� I - j uec� urn b v( I § Job Des n: Mach RS CAe nad Y i — ' C�JST Gfa=P rrc;eC$: ' Bcmdc, LocationReplacement (�YJ if ^_ppficabic Fee ID 2PWff EAT—E Z i 'e� escripracri r�eeirnl p ent iCe _mew BENT � �' � b SSve r � �cj-t t �"JLU-MB INC, BUILD G BUs?-4-Ss ,2eel�se CA I i i stork -. 00 I ;