07100190 CITY OF CUPERTINO ` ' '
BU[LDING DIVISION PERNIIT ���� ��� ����`������ °
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BUILDI G RES : PERMIT NO.
�14�� � STELLING RD JUST WAPER HEATERS INC 07100190 .
PERMIT ISSUE DATE
�ER'S NAME:
R.AMRATAN, JOANNE 3400 INVESTMENT BLVD � 10/29/2007
SANITARY NO. CONTROL NO.
PHONE:
(510)293-9901
BUILDING PERMIT INFO
ARCHI'I'ECT/ENGINEER:
BLDG ELEGT PLUMH MECFt
0 0 0 0
i p Q LICENSED COKI'RAC'I'OR DecuannoN Job Description
: V� I hcreby aCfirm tha� I am licensed unekr provisions o( Chaptcr 9(camroc�rcieE
; z� wi�h Scction 7000) of Div'e.cion 3 of the Bttsiness and Profcssions Cade and my �ianQ is RE PLAC E WATER HEATER
?� y in full Corce and cftec�
� � ? Licensc Clazs �• �
: E , r p Da�c Contractor
?j ARCHITECi"S DECLARAT[ON
i a Q I undcrstand my plans shall bc used u puAlic reconis
)aU
' u. F' Licensed Pcufcssianal
� y � OWNER-BUILDER DECLARATION
} 1 hcrcby atGrm �nt 1 am cxcmQt from ihc Conuactors Liccnsc Law fa �he
j p o Collowing mason. (Secuon 7(131.5, Business and Profcssio� Calc: Any eity or eaunty
�,°, � which rcquires a permit a canswct, allcr, improvc, dcmolish, ar repair any swcture
� z y y, prior to i�s issuancc, alsa rcquires thc applicam Cor such permit �o GIc a signcd stalrmcnt <' , Ft. Floor Area Valuation
y � ihat Nc is liccnscd pursuant to thc provisions o[ thc Conu�ctor s L"nxnsc Law (�aq� 9 �' q � 8 7 5
� t- �(commencing wi�h Section 7000) of Division 3 oC Ihe Businesc and Profcuio� Cade) ur
��.. ihat he is eaempt thecctrom and the bazu Cor the allegcd eumption. Any violuiun of
Sectian 7031.5 by arry applicant for a pertnit subjecu the apptiant to a civil pwlty of p R� Number Oeeupaney Type
not more than fivc hundred dollars (5500). 3 6 6 2 4 � � 1. L�V
❑ I. u ownu of the property. or my employces with wages u thc'v solc compmvtioo.
willduthewark.andihesuuctureisnocintendcdoraffece6forsslc(Sec.70A4.Businesa Required Inspections
and ProCessions Cade: The Conuacwr's License !aw does not spplY to an ow�ec uf
property who builds or improves �hercon, and who does sucA wort himselta Wrau6h his
own cmployccs, provided that such improvemen�s are na[ in�ended or o[kced Ca sale. If,
however, the building or improvement is sald within one year of completion. ihe ovner-
builder will have the burden of proving LL�at he did no� 6uild or improvc for po�pose of
sa1eJ.
❑ I, as owner oC the property, am exctusively conuacting with Iicensed co�vaaors m
consvuct the pmject (Sec. 7044. Business and Pro[usions CadeJ The Connaao�s Li-
ccnse Law docs not apply to an owner af propeny who builds or impmves �hnean. and .
who convacts for such projects with a conlractor(s) Ganted pursuant to the Oontraaofs
t.icense [aw.
' am exempt undu Sec. . B� P C far this �euan
...vner � _ .
WORKER'S COMPENSATION �ECLARATION
I hereby �rm under penalty of perjury one o( the following declaruianz
❑ I hsre and will main�ain a Cenif pm of Consent to self-insure for Worlr�s Compcn-
satian, as providcd for by Secdon 3700 of the Labor Code, for the perPorman�x of ttrc
work for whie4 this pertnit is issued.
❑ I havc and will maintain Workcr's CompensaUan Insun�e, u �cquired by Seaiao ,
3700 of Urc Labor Code. Car Nc perfartnance of the work far w6ich �his permit is issued
My Worke�s Compensation Insucance cacricr and Policy number are_
Cartier. Poliey No.:
CERTIFlCATE OF EXEMPT[ON FROM WORKERS'
COMPENSATION INSURANCE
(fhis section nccd not bc completcd if the permit is far anc hundrW do0ars (S I0�
or IcssJ
I ceniCy ihxt in thc performance of ihe work for which �his permit is issucd. l s6a11 not
employ any person in any manncr so as to bccomc subject to �he Workcrs' Comprnsation
Laws of Califomia. Datc
Applicant
NOTICE 7'O APPC.ICANT: If, aftcr making this CcniGcaic of F�cemption, yau shouW
bccome subjcct to thc Workcr's Compcnsation pmvisions o[ thc Labor Codc, you muu
� O faMwith comply with such provisians or this permil shall6c dcerticd revotcd.
z "" CONSCRUCf10N[.ENDINGAGENCY
[. ►�-. I hercAy alTirm that thcre is a consuuctinn Icnding agcncy fw �he perCarmucc uf .
�(, � �hc work fur which �his pertnit is issucd (Scc. 3097, Civ. C.1
W� Q Lendcr's Namc �
a z Lcnder's Address
U � ( certifY ihat [ have rcad this applieation and sute ihat the above infamauao �s
w � corrcct. ] agree to comply wi�h all city and county ordina�xes and sutc laws �eluiny w
rJ U building conswction, and hcrcby au�hori�e reprcscntativcs of �his city to cmcr upon Ihc
� W ahove-mcntioncd property (or inspccuon pur�wses.
(We) agrce to save, indcmnify and kecp hartnless �he City o[ Cupertino against
�� liabilitiu, judgmcn�s, casLS and expcnscs which may in any way acccuc agai�taid Gry
(� ,'� ia consequencc aC thc granting of �his permi4 Date
�'+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POIM Issued by:
SOURCE REGULATIONS.
Re-roofs
Signaturc of Applican�Contractor � T of R�of
HAZARDOUS MATERIALS D[SCLOSURE YPe
Will thc applicant or futwc building accupant stom or handle Iwrardoos maoQia�
lcfined by thc Cupenino Municipal Codc. Chapter 9.12. and the HcilW aad SafMy
_�� Scction 25532(a)? All roofs :;hall be inspected prior to any roofing material being installed.
� y�,q ❑ No
�II thc applicant or futurc building accupant usc equi�xneot or d�wi�xs which
If a roof i:; installed without first obtaining an inspection, I agree to remove •
emit harardous air comaminants az dcfincd hy �he Bay Area Air Qualiry A�aoa�ement all new m aterials for inspec�ion.
Dis�rict?
�y� ❑Nu
I havc rcad the hvardcws matcrials rcquircmcnts undcrChap�cr6.95 o(Urc GliCor-
nia Hc�lth & Satcry Codc. Sccuont 25505, 25533 and 25534. t undcrstand tiut iCthc hm'1�nB
docs no� curtcntly havc a tcnant, Ihat il is my respansi6ility �o noufy thc am�pan of �he
rcyuircmcnts which musi bc met prior to issuancc of a Ccnificaie of Occupu�.y. Signature of Applicant Date
�� . All roof coverings to be Class "B" or better
Owncr or authori�cd agcn� —
� �� I c� i 1�
Cit of Cu ertino Buildin Permit A lication
E-Mai I
Jobsite Address: 1458 Stelling Rd. Date: October 18, 2007
Owner's Name:-- Joanne Ramratan
Phone No (408)386-6701------
APN#: 366-24-001------------ Project Valuation S 875. 00
Building Permit Info: Bldg�__��— Elect____��_ Plumb__��_�_ Mech�___�
�ob Descri tion
Replace 40 gallon gas w<<ter heater.
Contractoi� Information
Company: Just Water Heaters Inc. I'hone: (510)293-2012
Contact Name: Fax: (510)293-2022
Address: 3400 Investment Blve. E-mail: permitsC�justwaterheaters.net
City, State and Zip: Hayward, CA. 94545
State Contractor's License # 591329 I:xp. Date: 3/31 /08
Worker'sComp#: OIDKRM11001070 Cariier: Nelos Exp.Date: 4/1/08
Credit Carc� Information
Credit Card #: ����
Name on Card: �ust Water Heaters Inc.
Expiration Date: 6/08
Visa � Ma�terCard �
Corriments
CITY OF CUPERTINO
3 ITEMS OF 3 PERMI7' RECEIPT OPERATOR: bethe
COPY # : 1
Sec : Twp : Rng : Sub : Bl}�:: Lot :
APN ........: 36E�24001.00
DATE ISSUED.......: 10�29/2007
RECEIPT #......•..: BSC�00003096
REFERENCE ID # •••: 07700190
SITE ADDRESS .....: 14��8 S STELLING RD
SUBDIVISION .......
CITY .............. CUF'ERTINO
IMPACT AREA .......
OWNER ............. RAI�[RATAN, JOANNE
ADDRESS ..........: 14�8 STELLING RD
CITY/STATE/ZIP ...: CUF'ERTINO, CA 95014
RECEIVED FROM ....: JU�;T WATER HEATERS
CONTRACTOR .......: GII�ROY, JOHN LIC # 15128
COMPANY ..........: JUf;T WATER HEATERS INC
ADDRESS ..........: 34C0 INVESTMENT BLVD
CITY/STATE/ZIP ...: HA5'WARD, CA 94545
TELEPHONE ........: (5]0)293-9901
FEE ID UNIT QUANTITY �,MOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
PPERMITFEE FLAT RATE 1.00 40.79 0.00 40.79 0.00
PRWHEATR LTNITS 1.00 24.48 0.00 24.48 0.00
TRAVDOC FLAT RATE 1.00 40.79 0.00 40.79 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT : 106.06 0.00 106.06 0.00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 106.06 MASTERCARD
---------------
TOTAL RECEIPT : 106.06
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
502 FINAL PLUMBING ENERGY 506 GAS TEST
507 FINAL PLUMBING
-" Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
CITY Of Fa�c (408) 777-3333
CUPE(�TINO _
Build�in De artment
JOB ADDRESS: PERMIT #
1458 Stellin Rd.
OWNER'S NAME: Joanne Ramratan PHONE # 408-386-6701
GENERAL CONTRACTOR: JustWater Heaters FAX # 510-783-6360
I am not using any subcontractors: ��`�- � G'`�-�� 10/18/07
Signature Date
Please check a licable subcontractors and con� lete the followin information:
SUBCONTRACTOR BUSI IvESS 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 Just Watex Heaters 591329
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
�-'`� 4-� o-,�-�`�n�--) 10,' 18 07
Owner/Contractor Signature �ate
10/28/03