01060171i�
CITY OF DIVIiS
BUILDING IONFO✓RMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
PERMIT N0,
11632 BRIDGE PARK CT
HOT WATER INC
01060171
OWNER'S NAME:
APPLICATION SUB DATE
HUI MARVIN M WAI AND SAU L
2531 GRACELAND AVE
06/29/2001
PHONE: .., - -
SANITARY NO. CONTROL NO.
(650)298-8494
_
O ARCHITECDENGINEER:
BUILDING PERMIT INFO
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BLDG ELECT' PLUMB MECH
LJ 1=
IP
LICENSED CONTRACTORS DECLARATION
1 herby affirm that l am licensed under provisions of Chapter 9 (commencing
Job DCSCrIpIIOn
O
with Section PJW)of Division 3 of the Bsminess and Pmfessions Cale. and my license
REPLACE WATER HEATER.
is in full force amt effect.
ULiccn.se Claes Llc.n
Date Contractor
ARCHITECTS DECLARATION
1 understand my plans shall be used as public records
u.
'
Lv:cnud Prrfes.ional
u. OWNER -BUILDER RATION
11 1 hereby affirm that 1 .m exempt in the
the Contractor's License law for the
, an
a fminwmg rtaw,n (Section Tons. Bneinese alio Prrresarnn Code: Any city or manly
e
C which rtquim a permit m comma, ahec improve demolish. or npaireny nmmae
$500
y. priamin isuancc, almrcyuirc,IMapplicam lucsuch µnnnmlilea siencd autancnt.
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-.. _ _..Valuation -
Ota he el' I1, 01 Jm po .b: rd c t 't r L L '(Lh plc 9
(ea gwnh Se¢' 7p1NB fD'is a ftheB. IP [_,o. CWe)
r rQF�pd , t_ .r %y
es
or that he is exempt therefrom and the basis for the alleged exemption. Any violation
-3 6(J5t
of Section9m L5 by any applicant for a permit subjects the applicant to a civil penalty
of notmomthanAmhundreddrnars(SJW).
502ApNVTRWL PLUMBING
ENERGY Occupancy Type
Of as owner eithe property, or my employees with wages as their tele compensation.
506 - GAS TEST
will an the work, and the structure is not intended or ofcmd'far sale "(Sec. 7014,
507 - FINAL PLR.;9(c9T14bspeetions' '
'Busirm,,'and Pmrestioat Code The Contractors License Law does not apply m an
owner of property Who builds or improves thereon, and who does such work himself
Ro n..employees, 'Jed lh' p ecs tended r
o.'Ic. If however.thell lofP me js,.Id withinone y of
comp) 0< owner builder ll have the landed fp g that h did
not build or
:
inuadve for purpose f wi
co 1 -a
of IM p pent' exel torcii erxdwon, th licamoal scommebas t
consumer Project ($ 7W4,N nne . pPnf ons Cud ) Th Can t nor s
License Lad not apply to An of who Id. p thereon.
ho <outracts f m.
- -
..lid ch prof ts w
_. ,cot trs) licensed am m me
Cot t License Law.
°1 pt IdersB&PCfor this mason
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w
O n Dte
- WORKER'S COMPENSATION DECLARATION
I hereby affirm at pmahy of perjury date of the following declarations:
O I have'vW will commain n Cenilicale of Coiner, to self -inure in, Worker',
_ Compensation, as provided for by Senior 37W of the "be, Cadc for the
performance of the work for which this permit is issued
° 1 nava aM'will eminuia Worker z Compentaiiun lonandee, as oc aind by So tion
37W of In< Land, Code. for the performance of the work for which this permit is
issued . My Workers Compensation him. caner and Policy number arc:
Cern r t' .• t Policy No. �
. ...._._... _- ._..___.
.. s ,• ,. - ,- .. - _... -...
' . CERTIFICATION OF EXEMPnON FROM.WORKERS
COMPENSATION INSURANCE I. . '-"
•'"' (Thisseciinn need Ana be'mmplcieJ il'thc permit is for ane M1undrcd dnllan
-� i'"• I- .11.• --- -^-
($ I W)lir ICs,.)
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... Itt;fY In t'n h MK lice fm'kf t hth p .,
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!ball t ply ny pe b ny mann s m hcmmc DJ t m the Workers
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Concretion. Laws of C I'fom .Dam
NOTICE TOAPo fi gth.Cenf t fE pf you ,hauls,
subjecuot the WoTII
ns m sent
dime Me, oecMd
ftthmc aation Ionalola
it xman1
� fonhwim comply with such provisions or this permis shall be doe cited oinked.
re int,
ONSION LENDING AGENCY
..
I hereby art! rmnthat Vs a
[here ii a <onsiruaion lending agency for the performance
. •
Lf tnc wmrwnicn Nis pcemit is it,ucd (see 3097. civ. C.1
..
'Lends,,x Name ... •'r`.:. ... __ _.-:_".: ..: ._.:a .. _...
._ __ _.. ._. .. .. ... ..
Lender',AJJrczs
. I certify that 1 have read this application and State that the above information is
1
context I agrte to comply with all city and county ordinances and state lass mlafing
-
mbuildingconmruction. and hereby umh ndc, representmives of this city to enter upon
the abcormendored ape t) to - pati n p opo'
(we) pre tindemnifypm,ed ph min an City . v pen iry
It J dem t. cost, d pontes may in any in.0
n
ech aid
y g said
C
Cut' :q 'acofT g i or this perms
' \p N'. COMPLY WITH ALL \ON POIpT
(� /f')
RE ULATIONS+ I , -
$OLRCE REGULATIO\S •�
SOURAPPLICE I
Issued by: . � / (/� Date
Stgtmmm of AppbcaNConuncmr 1. '-" . " ' Dam ' -
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Re -roofs
HAZARDOUS MATERIALS DISCLOSURE
i, Will the applicant or future buildingcomprin store or handle haravlou. materialType�of
defined
Roof
an bY.me Cupertino Municipal Code, Chapter 9.1'_, and the Health and Safety
CJJ S a 25532(.)
°r ` - ° IN.
.' - • ,.. ., ,
All.roofs be inspected
1
`� i n, ,rte t ',,,are Wilding g e A irAi t d mens
emith dr'. uinm 'tions, as defined by th Buy AimA 'Quality Alanagemrnt
. shall prior.to.any,Toofing material. being. installed.__..
if a roof is installed without first obtaining an "inspection, Cagree to remove
e
Dia oY., , I
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all new materials for inspection. Applicant understands and will comply with
all non -point source regulations.
I have read she Injoaddrals materialsq Munder Chapter 695 of the
CaliforniaHealth& Safety Code. Sections 25505. 3533 and 25341 understand that
ifthe buddtngdoes not came have avasa, her it is to, responsibility in notify the
- - '" """' "' '•`- +-^
rmntpam of the rcynirtments which mast be mel prior m innuancc of a CeniOcate rl
. Occupancy.
'
Signature of Applicant Date
All roof coverings to be Class "B" or bettei
Owner or aallorrsedng m It Date
'OFFICE