Loading...
B-2018-0986 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-0986 20771 SHELLY DR CUPERTINO,CA 95014-2971(359 11 030) WATER QUALITY PLUMBING INC SAN JOSE,CA 95125 OWNER'S NAME:WATERS CHARLES S AND CONNIE C TRUSTEE DATE ISSUED:06/11/2018 OWNER'S PHONE: PHONE NO:(408)267-9330 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-36 Lie.#295018 Contractor WATER QUALITY PLUMBING INC Date 02/29/2020 X BLDG ELECT x PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing —MECH x RESIDENTIAL—COMMERCIAL. with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: (N)50 GAL WATER HEATER-SAME LOCATION;RE-PIPE SFD I hereby affirm under penalty of perjury one of the following two declarations: (COPPER)-FULL 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 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$8400,00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 359 11 030 representatives of this city to enter upon the above mentioned property for Inspection purposes. (We)agree to save Indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations perth c�rtlno Municipal de,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signatuk' - Date 06/11/2018 Issued by:Jasmine Archbold Date:06/11/2018 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. I,as owner of the property,or my employees with wages as their sole installed without fust obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sce.7044,Business&Professions Code) z. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to constroct the project(Sec,7044,Business&Professions Code), Date:06/11/2018 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER r. 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 performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE z. I have and will maintain Worker's Compensation insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of[he Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534.I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the a. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material.Additionally,should I use equipment or devices which emit hazardous air contaminants as deflued by the Bay Area Air Quality Management District I Worker's Compensation laws of California.If,after making this certificate of will maintain compliance with the Cupertino Mon cipa�Cod"C 1p. .12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 2550 5 ,an Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agIn1•APPLICANT CERTIFICATION Date;06/11/2I certify that I have read this application and state that the above Information Is CONSTRUCTION LENDrnG AGENCYcorrect.I agree to comply with all city and county ordinances and state laws I hereby affirm that there Is a construction lendinggcyfor trmance relating to building construction,and hereby authorize representatives of this city of work's for which this permit Is Issued(Sec.3097,Civ C.) to enter upon the above mentioned property for Inspection purposes.(We)agree Lender's Name to save Indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City In Lender's Address consequence of the granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S nM ARATION Code,Section 9.18. 1 understand my plans shall be used as public records. . Licensed Signature Date 06/11/2018 Professional