03070062CITY OF CUPERTINO
BUILDING DIVISION PERMIT
CONTRACTOR�INFORMATION
r 4 •.'kms . rM.- 3}.., .n:+:v6:�fi
BUILDING ADDRESS:
JUST WATER HEATERS INC
"""'03070062
OWNER'S NAME:
1764 NATIONAL AVE
PERMITLSSUEDATE
NE:
(510)293-9901
SANITARY N0. CONTROL N0.
,
ARCHITEC (ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
G7 0 0
LICENSED CONTRACTOR'S DECLARATION
Job Description
1 hereby alarm than 1 am under provision of Chapter 9l
ribeud
Stenon ndlef of Division Scribe the Business and Profcuinm Code. end my limnse it
my
in fu
License Class fares effectLim.M
REPLACE WATER HEATER
Data Gunmen,ammr
ARCHITECTS DECLARATION
(50.GALLON GAS) FINAL
- Ir\ice �®
I understand my plans shall w used a public records
CCP "2003 Q2003
SEP
Licensed Professional
OWNER-BUILDER ON
Ce
�`� lIJ
Contractors
I hereby .(Sero exempt from Ne Connno(t License Law fol the
m
I from
ade.i., moron. fecNun 91171.3. shot, and Pmfcssiom Code: Any tiny at county
on t.
which or repair any structure
which requires a permit re Construct, aimg improve,
BUILPM750'
h Permits
tufts issuance, also myuires the isionsnlfor achramum. LBicssignedstammem
ras,t
that pursuant mane Lew (Chapterock)9
oftheeBusinssand
Sq. Ft. Floor Area
Professions
rag with Sermon 7 Division 7 of the Business and Pmfcssiom Calc) or
(commencingwit of Division
(cat
,
Net he I. li and the burs for one Any violation of
and the
h emmpt any
cd camant
3'ABAIM6*crO0
Occupancy'T e
YP
Scmion7011.3hy onyapplicanafor epnmit aubjecu Nc applicant to.Civil Penalty of
io applicant subjects to
net mom Nan Ove hundred dollar (S500).
❑ I, as owner of the pmpcny. or my employees with wages is their in Compensation,
wi 11 do to work, and the slruaum is not intended or offered for sale (Sec. 70,14, Business
elions
{�
and Profession Coda: The Contractor's License law does not apply m an owner of
PPf�UMB Ins
property who builds or improves ldemon, and who does such wmk himself or through his
502 - FINAL Y
own employees, provided that such improvements are not intended or offered for axis. It.
506 — GAS TEST
however. the building or improvement is told within am year of completion, dm owner.
builder will have the burden of proving Net he did at wild ar harrows far purpose of
507 — F I NAL PLUMBING
tale.).
I, as Owner of Ne progeny, am exclusively contracting wild licensed contractors to
contract On pmmC% (Sec. 70,14, Business and Pmfasions Code:) The Comment's Li.
cense Law docs not apply to an owner of propeny who wilds or improves Ihemon, and,
who contacts for such projects with a eamrumr(s) licensed Pursuant the Contractor's
,
License law.
l em exempt under Sec. . B & P C for this«uon
owner Date
- WORKER'S COMPENSATION DECLARATION
I hereby drum under penalty of perjury one of the following declamation:
1 hate and will maintain a Cenfilloe of Continuo ulfdnnm for Worker's Comr n.
tion. a providea fa by Section 3700 of the laver Code, (a the performance of the
work for which this permit it issued.
01 have sad will maintain Worker's Compensation Imuance, as mquimd by Section
3710 of the Lever Cade, for the performance of Ne work for which this permit is issued,
My Worker's Compensation Insurance carrier and Policy numwr art:
Cartier. Policy Na.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not becomplemd if the permit Is for one hundred dollars (S1EB)
.,
leas.)
1 cenify Net in the performance of Ne walk for which this permit is issued, l dull not
employ any person in any manor so as m Imemoo mace, to the Workeri Compensation
Laws of C.1ifamia. Dam
Applican
NOTICE TO APPLICANT; IL after making this iof Exemption,you should
becomethe Worker's Compensationvisits alNer Cash. You most
d,
forthwith comply wild such provisions or Permit hall waccruedinvoked.
V
CONSTRUCTION LENDING AGENCY
1 hereby affirm Nat than, its Comwnion lending agency far be "Formal of
the work fur which this permit is issued (Be,. 3097, Cr, C.)
Lender's Name
Underi Address
1 cenify Nal I have read this application and slam that the shout information is
correct. I agree m comply with all city and county ordinances and sum laws mating in
building convection, and hereby euldorim mptmentativu of this city to enter upon the
above-mans ivacd property for impection purposes.
(We) agree to ave, indemnify and keep harmless the City of Cupenino agdnl
liabilities, judgments. costs and expenses which may in any way &acme against aid City
in consequence of she granting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT
Issued by:34��ko Date
SOURCE REGULATIONS.
Re-roofs
Type of Roof
Signature rd'Applicant,Condanclor DataHAZAR
HAZARDOUS MATERIALS DISCLOSURE
WIII the applicant or forum building apt Hort or handle hazardous material
a defined by ftCupertino Municipal Code. e. Chapter 9. 12. and the Health and Safety
-
Coda, scmfon2ss7z(e)7
All roofs shall be inspected to any roofing material being installed.
❑Yes ❑Nu
prior
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or future building occupant use equipment or devian which
B bmardous air contaminant as Jcfimd by the Bay Area Air Quality Menagcm.at
all new materials for inspection.
matin?
❑Yes 7N
I have read the haandnus materials requirements under Chapter 6.95 of the Califon
tie Health & Sorely Code, Sections 25505, 25,177 and 255]4.1 understand NazifNc willing
`
docs not Currently ham a renal Out It It my mapanihil ity to nod I she occupant of anc
requirements which most be met poor m issuance of a CeNBcam of Occupancy.
Signature of Applicant Date
All roof coverings to be Class "B" or better
Owner
oraathoHndAgent Dam
Ll
C
E -Mail
of Cupertino Buildinq Permit
jobsite Address: 10211 Stern Ave.
Owner's Name: --- Fuh BIII
Phone No.(408)255-4836
APN#: 375-11-068
Building Permit Info: Bldg ---- ----_
Date: 7-8-03
Project Valuation: S 750.00
,Job Description
Replace 50 gallon gas water heater.
Contractor Information
Company: just Water Heaters Inc.
Contact Name: Dulce
Address: 1 764 National Ave.
City, State and Zip: Hayward, CA. 94545
D�n2aabZ
lication
Phone: (510)293-2012
Fax: (510)293-2022
E-mail: permits@justwaterheaters.net
State Contractor's
License # 591329
Exp. Date: 3/31/04
Worker's Comp#:
1626288-03 Carrier:
State Compensation Insurance Fund
Exp. Date:
4/1/04
Credit Card Information
Credit Card #: 5474-6390-0026-5679 ��((
Name on Card: just Water Heaters Inc. fl Z
Expiration Date: 9/05 �# /� G
Visa ❑ MasterCard ® b
Comments
CITY OF CUPERTINO
BUILDING DIVISION PERMIT
CONTRACTOR INFORMATION '..
- dada at5??v'n'3�>4`«.xds.
BUILDLNGADDRISS:
ABOVE ALL ROOFING
PERMTr NO.
10400 STERN AVENUE
01010192
OWNER'S NAME:
700 NORTHRUP ST
APPLICATION SUR DATE
ROBERT NELSON
01/28/2003
ONE
(408)292-4188
SANITARY NO. CONTROL NO.
RCBiTECTIENOINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
lob Description
j F
1 hereby allirm that I nm licensed under provisions of Chapter Y (commencing
e
Z
with Sectiondm Businma and fundis is Code, and my license is
in lull Tome Mnar
License les I \ � `
RE-ROOF
'
a
Dam Cnmranor Cut I k 0 t
FONALE®
-
ARCH]TEC'S DECLARATION
yes
I understand my phos shall he used a public records
J U L 2 4 2003
Limned Profcaulonul
OWNER-BUILDER DECLARATION
e0
1 hereby affirm Iran cacmPt from Nc Cnmrns Law fur the
: Any
p0
on Co
folWichngrammr.(ermitt]03 c
t,ainessmpmw,dand emoliC,orrepirayorcounty
BUILDING
BUILDING
�,l
��
[0prior
onstr repair any svumurc
which it%isss a permit be canshe alter, i t for su demolish, file
tieits issuance, also rcgnidis the applicant for suchpctor's fIessigned sommem
he (Chapter
the Comsinessnd
Sq. Ft. Floor Area
4-Vey
$ W 1100
pursuaoanthe.1
3 �
mmeslicensed
ProeLaw
Dwionsof
Code)Y
(coor
(commencingmittSection and rl Division) the
the Business artaon. Any emotion
Net he is exempt Ncmfrum end to basis for Nc ellcgeJ exemption. Any virialinn of
be
Occupancy Type
Section 7071.5 by any applicant for a permit subjects tta applicant o a civil Penalty of
not more than Uw hundred dullars (SWL
❑ 1, u owner of Ne pmpcny. army employees with wages as their wk compensation,
3 0 5 —
Inspections
will drthework.aadlhe strucmmisnmimendedmoffered for sale (Stt.]Md, Business
and Professions Code: The Convent's License Law arcs not apply In an owner of
Property who buildelfs or improves the rcon, and who does such work himsordtrough his
307 - INSUA'PfWd
L
ownemployecs, provideddensuchimprowasomsare not intended orortercd fmcsle. If,
601 — ROOF TEAR OFF
hrwewr, the building or improwment is sold within one year of completion, Ne nwmr-
602 ROOF PLYWOOD
builMr will base Use burden of porving that he did not Wild or improve far purpose of
- NAIL
sale"
603 - ROOF BATTENS
r] 1. as owner of the popery, an actatiwly common, with licensed Chntncmrs n
604 - ROOF IN-PROGRESS
emistmet one project (See. 7W, Burls. and Prnfessloas Code:) The Cumfaelms Li-
cense Law does not apply to an owner of property who builds or importer Blamed , and,
who contracts for such projects with a contractor(a) licensed pursuant o the Comnmor's
License Law.
❑ 1 an exempt under Sea , B A, P C far Nis rtaon
Owner Da
WORKER'S COMPENSATION DECLARATION
I hereby affirm under Penalty of Perjury one of the following amlarations:
1 have and will maintain a CeroBerik Of Cement o selFinand, for Workers Compem
nn, a provided for by Section 3/01) of the "We Cole, for the performance of the
m fnr which this permit is issued.
❑ I haw and will maintain Worker's Compensation Insurance, as required by Section
TAXI of the labor Code, for the Performance of the work for which this pis issued.
�mit
MWolker'WQs�nlls7ceearts Policy
�sy 7 13
Carriero
CERTIFICATE OF EXEMPTION MOM WORKERS'
COMPENSATION INSURANCE
(Th6 section need not k completed if the permit is forone hundred dollars ($100)
less.)
1 ccnify that in the performance of the work or which his permit is issued, 1 shall not
employ any person in any manner to as to hernme,object to the Workers' Compensation
Laws of California. Date
Applicant
NOTICE TO APPLICANT: If, efnr making this Ccnificate of Exemption, you should
become subject to the Worker's Compensation powisioa of the Labor Cade, you must
forthwith comply with such pnitiocas mdor permit shalldeclined
he revoked.
O
tiCONSTRUCTION
LENDING AGENCY
1 hereby allirm that them is a ennswetion lending agency tor the performance of
7
the work for which Nis permit is issued (Sec. NPP. Civ, C.)
QLender's
Name
Isndcr's Address
z
0
1 ccnify that I have mad this application and sole that the anew information is
(~
coact 1 agree be comply with all city and county ordinances and nate laws dilating to
U
building convection, and hereby allOOTiM repecunmlws of this city to enter upon the
above-mentioned properly for inspection putiwses.
(We) agme n save, indemnify and keep harmless the City of Cupertino against
V)
Ii abilities. judgments, cross and expenses which may in any way aceme against said City
Z
in consequence of dee granting of this Permit.
�-s
APPLICANT NDERS'rANDS AND WILL COMPLY WITH ALL NON-POINT
Issued by:94s, Date
$OURCP ULATIONS , / f/U
Z
Re-roofs
signature of Appli .:UComramor Dam
HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Will the applicant or future building rccupam store or handle Im ardous material
ao defined by the CuPertitnicipal Code, Chapter 9.I3, and the Ilcahh and Safety
Code, Section zss:+zpj'r
All roofs shall be inspected to an roofing material beim Installed.
❑Yes No
s
prior
P P Y g E
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or future budding meopam me, equipment nr devices which
'mit hmardous air nmmmimalk a dcOned by the Bay Arca Ail Quility Management
all new materials for inspection.
ndny
❑Yes NN.
I have mad the bmaNnos andedslarcquircmcrus underChapler695of Ne Califor-,\
ni ea W dr. Saf1) Crede. SeNnn J and Z55Jd.1 taeilding
��/
ci the it is my
ices nm curt ly bow a moan, Nat it is my me amiCOO'e notify the mcuPant of IAC
w notifnt e occupied
~
icip hmoobe mpnrmni¢aancanracenireakafWevpany.
�rT�� y / , s/j
Signature of Applicant Date
All roof coverings to be Class "B" or better
Owner Or wahnrined agent Date
Building Division
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3228
Fs:c (408)777-3333
wilding Depaent
Subject: Reroofing policy for the City of Cupertino.
1. Prior to permit issuance, you must agree to comply with 1997 UBC Standards
and manufactures specifications on reroofing.
2. New roof coverings shall not be applied without first obtaining all inspection
'-and written approval from the building inspector. A final inspection and
approval shall be obtained from the building inspector when the reroofing is
completed.
3. All roofs shall be inspected prior to any roofing installation.
4.To receive a final sign off from the City the following steps are required.
1) Preinspection and/or tear off approval.
2) In progress inspection approval-
3)
pproval3) Final inspection approval
a) Spark arrester installation.
5. If plywood is installed, a plywood nail inspection is required.
6. Any roofing which is applied without first obtaining an inspection, will
require the removal of all new material down to the sheathing so that the
proper City inspection can be performed.
IMPORTANT:
1. Flat roofs musthave a minimum of %" per foot slope and demonstrate that
there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time ofinspection.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name: i�X ]!� P �'�)
Address:
ReroofmgCompany Name: �f.% boye M\ cebZS VI,Q Sol04nl'I-R- LT
Applicants Signature: '/'G//�-- ��{��/liu-� Date: h 2 O
fJoe Antonucci
(Chief Building Official)
6/25/01