B-2017-1842 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1842
7576 SHADOWHILL LN CUPERTINO,CA 95014-5052(362 24 030) STREET PLUMBING
AND ROOTER
SAN JOSE,CA 95128
OWNER'S NAME: SREEHARI NARASIMHAIAH AND SUKANYA DATE ISSUED: 10/27/2017
OWNER'S PHONE:408-529-3250 PHONE NO:(408)496-1155
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: •
License Class C_36 Lic.#582217
Contractor STREET PLUMBING AND ROOTER Date 12/31/2017 x BLDG _ELECT X PLUMB
MECH x RESIDENTIAL_COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
REPLACE 50 GAL WATER HEATER-SAME LOCATION
I hereby affirm under penalty of perjury one of the following two declarations:
1. I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
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GENERAL PERMIT APPLICATION
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• ___ - COMMUNITY DEVELOPMENT DEPARTMENT.*BUILDING DIVISION
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10300TORREAVENUE-•CUPERTINO,CA 950143255 .
CUPERTINO-
(408)777-3228-FAX(4OB)777-3333•buildinoacuoerti _no.ord .
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. - PLUMBING OMECHAIGCAL DELECTRICAL EIMISOSLIANEOUS .
PRO. JECT ADDRESS - •rile c.5)im.p Ow H i L L. LM APPH#
°Witia. NAME- PA-MS/MO IA0 SI e•G-04Alk, 1 PPR) S--M 32S1) EAR.
STREETADDRESS 3.53_6 swkei ow h di Li) cnzeZth.-?Nip-cA 9.10 I Li 1
CONTACT NAME flock sTrar,r. .
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- - -Is—4 •' 4%'- II Ealifred pcwrbiekop t -
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STREET. ADDRESS 022 q3 Vaintet cravy.„.Avt 01X,STATE,7:11?Safi j 0,§c... cA ggii EAT I.0 g.416._/I s-s-
El'mama 0 onmatatom, 0 ovamt.homir 1Xecomucio1lL OcaramcroLiona . El ARciirrEcr_.0 mama El =mum. El maw-
CONTRACTOR.NAME mi-€x 61/Ai-VI - LICENSENumBER5z2 17 : ,pCBGETYIS Ca 4 =Arc! .40,0763
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COMPANY NAME
STAterr PLI4M131kla 112007742. gks-ir kioi,drillie ji.:1,)fa. ' ifi)471.-G3 -
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STREET ADDRESS:2:213 wo„1 6,,,,,A. 6roje,Alt, CTIY.STATUE, "3
ier.. ..Jc..4.1.5728 •:i I 1 HA
AainEcromatNAME V =MENOMINEE TIMMS
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CCiivIPANY NAME ....E-MAIL . ' . . FAX V
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STREETADDRESS Cilir,STATE,22 • PHONE
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• lissoF -KSF'D or Duplex 0 Multi-Family PRE32.1 WII.DIAIlli - V
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smtucrtma- ClOathmexcial - URBAN AREAAIERFACE El -Yes ' 0 No FLOOD ZONE 0 Yes 0 No -
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DESCRIPTION:OFWORX 50 tole‘tt1cr--- 6-4 .1-er. p-efte-ce_fv-A4,4t- e. &drAii-t_ -
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TOTAL VALUATION: /50v
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- • MEPMisapp 2011.doc revised 03/16111