00080094 crBUILDING
Uo'N DIVISION
lPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
OWNER'S NAME: APPLICATION SUB DATE
2.0730 GREENLEAF DRIVE JUST WATER HEATERS INC 00080094
HONE: SANITARY NO. CONTROL NO.
J. C. DEACHA 1764 NATIONAL AVE 08/14/2000
O�O ZQARCIII'1'F 1/1iNGINELR: BUILDING PERMIT INFO
u (510) 293-9901 Luc F.LF.0 PLUMB CH
LICENSED CONTRACIOR'S DECLARATION
z n• I bercbv ammt Ilial I am Bernard unser 9bommerefn Job Description
rro,hann� fchst a n er g
F,HF-yt with5egion](k1H)of Di:cin Jof the Budnessand l'mressi...Code,aadmy lire...
a I, is in full force and a t, r
aeaTass I.iccnse Cl71%dj}— S DELI 1M
D{j'Iy4}T1vrV _ Contracts - -
F re ` ARCHITECTS t a,Pu A
"g deml:mdtnyplar,snnBb Isedasplimiarecords REPLACE 40 GALLON WATER HEATER
GrG
es o Licensed Prarmsinntl
a Py s OW NI:12-BUuipt DECLARATION
1 hereby a(Orm on 1 um eBusine s an the Contractor's License Low for IM
C5 a liillnwing renaon.(Semon]OJIS,Business and I'mfasloro Code,Any city or enunly
N tF C which requires a permit to constm n.alar.improve,demolish,ar repair any unanchor
r,3= prin miuiauana,alsorequire,the applies..launch pemtirm file.signedaa¢ment
that he is licensed pu¢wnl..thepreb,mo,of,he Comment,License LawlChapter 9 S Ft. Floor Area Valuation
Icmnme..agwith Section7ddsBnf Division 3.[,he Business and Pmfeaal Code),
q'
or that he is exempt Nerefmm and the basic for the alleged exemption.Any violation
of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty
of not room than firchundred dollars lSS«B. . APN Number Occupancy Type
❑1,as owner of the property,or my employees with wages as their sole compensation, $887
will do the work,and the struma..B not intended or offered for sale(Sec"7ID4,
Baume,,and rrafasiam Gale:The Gomm,....'.License Lw due,tot apply In air Required Inspections
owner or
,act,who builds or'mtpmves 1h,c o r cod who does such work noweir X633042. 00 -
,rfourthhi cke,ce, ilal iht h' p ver t t' teadmlo 32
ullenal Ro sale.If,however, l I d bng or hapimserierni is sold within(me year of - -- •..
corilifiction,the owner father ill basell 1 f prorvan,math fd ,rhld ,r ,
"p f purpose
"` a' I ) 502 — FINAL. PLUMBING ENERGY
01.as owner of the pro,may,an excsu>ivay contracting with licensed contractor,in 506 — GAS TEST
cons mm the project(Sec.]BW,Business and I'mossion.c Cade:)The Contractor's
Llcerve law does act appy'to a a nvivaof Pmpcny who bobbin improv.>Ihcrenr. 507 FINAL PLUMBING
and who contracts for such projects with a c antra s)licensed pursuant it the -
Contracmis License Law.
❑Ium exctnPl under Stt. ,B&PCfee this..all `
Owner Date
WORKER'S COh1PEN5A'1'ION DECLARATION
h I hereby atria under perahy or perjury one of the following deelamcmns: (� )
❑ I have and will maintain it Ccnilicme of Cni,,ent m roll'-insure for Workul'y - 6
C.... ser,alivar m provided fnr by Suction 1700 .I'the Labor Gxlc'far the /
pear ounau'c of the work for which ihis permil is ixared,
❑I have and will maintain Worker k Cn up.....am Insam.ce,as required by Section a /o
3]1X1 at the Labor Code,for the performance of the work for which this pemtil is
issue).My Waded Compensation Insumnc.,artier and Poplicyl!n��umber,v((,,e(�:
Caboaa n� Policy��03 0— 1 /)
CERTIFICATION OP EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
Tfu,sermon need not be completed if the permit is for one hundred dollar
IS 100).r raxf '
,unify Ihit In the"Rome ance III like wrnk fnr which Ibis Perm,,is issued,I
Ahall ran cop,any person in any inuaocr s..as 4.o become,object ,, he Workers' '.
r peltxnlii a Laws of California.Dam
pplicant
NOTICE:TOAPPLICANT:if, ],a,making:hiss Criifcatc of Excaptinn,you should
become subject to the W'orker's Compenection provisions of the Labor Code,you most
Q 0 Grthwair comply with such provisions or this permit shall de deemed revoked.
z ^
F" CONSTRUCTION LENDING anit,a Y
a4. 7 I hereby which Nat there iss anted(See. lending vgency(or the performance
of the work for which this permit is issue)Istt.J(MJ],Civ,C.)
L Lender's No.
� z Lender:Address
C.7 1 certify that 1 have read this application t.d state that the above information is
W [.. correct.I agree Ip comply with all city and entry ordinances and state laws rehaing
0 C.1 m building eomvvcuan,and hcmhyaull r,,.m,csconams aphis city..enmrup,an -
'n, G,] the a r ve-a entimted properly fnr impccda.pnrpu,va. -
E. Qat fWe)agree las ,indemnify and keep houric,a the City of Cupertino against
15 liuhililic,judgments,costs and expenses w nth may In any way accrue tgaina said
V z City in......rence of the granting of this permit.
^ APP ICANTUNDERSTAND. NDWILLCOMPLYWITHAL NPOI Issued T I
RCEREGULATI S. d b y' Date
gnmurern Date Re-roofs
RDOUS MATFRI S DISCLOSURE
x511 the applicant m fmure building acopam store or handle horallom mus eri:d Type of Roof
it,defined by the Cupvrtino Municipal Code,Chapter 9.12,and the Health and Safety
code,Section 25512(a)?
0Ye9 ' J''"" All roofs shall be inspected prior to any rooting material being installed.
Will he appri.ant or rutlire Inklingneanpnal use equipment ar device.whish If a roof is installed without first obtaining an inspection, I agree to remove
emit ha,mdous nor Onamniums a,de Grad by the Pray Arca Air Quality M,mm
ageont
liotrix:? all new materials for inspection. Applicant understands and will comply with
°Yaw ElNo, all non-point source regulations.
- I have read the resurrects..aerials requirements under Chapter 6.95 of the
California Health&Safety Cade,Sections 25505,25533 and 25534.1 undemmnd Ther
iflhebuildiagdcesnotcunentlyltave tetmn thatitis my Asprntsibiliy to notify the
occupant of the require s which n sl be i el prim to issuance rat Certifies..of
/Decnpmmy. Signature of Applicant Date
allran m esagen Date All roof coverings to be Class `B" or better