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'CITY, OF CUPERTINO
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CONTRACTOR INFORMATION:
PERMIT
PERMIT NO,
74igAAC WY
11 1 1
JUST WATER HEATERS INC
�6Nps�iSKIRK
1764 NATIONAL AVE
APPLICykTIQNYB?7J 002
y//
PHONE:
(510)293-9901
SANITARY NO. CONTROL NO,
ARCHIrECT/ENGINEER: , y
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
II bbDD Criptlon
- Ihereby o0irmthat Iamlicensed under Provisions o(Chapter9(commencing
REPLACE WATER HRR
with Section ]BBD) of Division 3 of the Business and Professions Code, and my license
is m fun force and even...
,
(5 0 GALLON GAS)
License Class Lic. g
:Date Contractor
ARCHITECT'S DECLARATION
understand my plans shall be used as public records
'
'Licensed Professional'
"'. ' OWNER -BUILDER DECLARATION
I hanky avmn that 1 mu exempt from the Contractor's License Law for the
'fallowing reason, (Section 7031.5. Business and Profusions Code: Any city or county
which requires a permit to construct. slag improve, demolish, or mpair any strout..
___ ____ _.. _
115
:pnortow usuma, Iso requires theappinanr for such pemrit ro fileasgnodsuxmea
. Nat illice pa ' i to the pm'vrsiom of the Cotarrcmfs License law (Chapter
'(<omrye'-gphhSmrq 70g0�of DinsionJaf the Buhmess arW Prafeuiom Code)
/ . F,[., F'loorArea- � a g. g
tiJhi-? i � q'i + t'+'ij it A"v'cy.
, Valuation
or Nat he H exempt near in and the basis for the alleged exemption. Any violation
5 9 0 6 0 0 3 . 0 0
-of Secdan]031.5 by any st icniv far a permit subjects the applicant to a civil pantry
lof not More that Bat hundred dollars(5500).
APN Number
,. al' Occupancy Type
OLas'ownerofhe progeny. or my employees with wages as their sole compensation,
502 - FINAL PLUMBIN
ENERGY
506 - GAS TEST -
RequirNGInsp'ections"
"will do'Nework;'and the structure 14 hot intended Of offered for sale (See: 7144,
Bminess'and'Punressiom Code: The Contractor's Licenx Law does not apply to an
owner of property Who builds or improves thereat, and who does such work himself
507 - FINAL PLtUJMMBB
or through his own employees, provided that such improvemcma arc not intended or
-' _--- - - " -- - - --- — -- -� - -
:offered for sale. If. however, Ne buddy g rnpruverrim is sold wthm one'year of
-- �—
0,4, •, ,
sampler the owner boulder will have the burden o(prov ng that he did ria budd or
improve for puryou of saleJ.
for
of she papeny, am contracting with as to
yy`.y
cimmarowncr
commit Cods:)x o Con
(Sec, 7040. Business and Professions Code:) The Comacmr's
Business
Litems Lam doe, not apply m in owner of property who build,
avedoes n improves thereon,
-
_ond.whomo we
eonvoctapj.licensed,pur,uant.m the.
...__..____..__.. __ ..__.._-.-__.._..____..._.___.._ ...... ........_.__._.__ .�._......_. __.___.. ..____..,..__ ._
Li,amfocauch.pmjec,r.with.e
❑ I exempt coderSee: ' "'- ' a&PCfor this reason
I'; :i„�'.. I'ln;ll:rt
„
1 li...t
f 1WORKER'SA^
r { Due
Town
COMPENSATION DECLARATION
'
I hereby ffimr- d Penalty of perJry one fNefollowingdclaratione
O I hove ail will mo stem a C n fleme f C nsem to If for Workds
'�Csmpenaauon, as, pmvideo for by -Section 37M of the labor Code, for the
,'performance of the work for which this permit is issued., .._.
O 1 ha a and will mu np W6rker's C pe ton Insuana, ox required Ay Stttioh
'37M of the Labor Codc, for the performance of the wmklfm which this permp'is
is. dad My Workers Comps do Ins m' ''co e d Policy number art:...
'Comer'_ 1. irtl'{..f?.411Po1¢Y No: ..
4`•; •q o`5.}'.fdlsp K.ll,nl
t P.- �a. r -L 3
..J
cit .,,;;ICER {t—' EI�ATIONOF EXEMPTION FROM WORK2R5'� "'-
- .- . • • ' a ,- rt
,'_ _, COhIPEN5AT10N INSURANCE
" a Mix semis ncednnon be'coimletcd of the permit is for one hundred dollars
'131001 ar less.)
I
' I c nify that m the performance of the work for which this perms a n ed I
shall not employ any person n you er i t s become subject to the Workers'
rT--y.*f az 11 a r M
t
Compensation Laws of California. Dam
' NOTICE TO APPLICANT If after making this Certificate of Exemption, you should
bttome subject to the otters C mpensau n proof theInbor Ca u, you most
forth nh amply wnh such pro 'ons o rh s perm t shall be domed re ked
r '
_
�
CT._
CONSTRU ION LENDING AGENCY
1.:, -
1 h reby df 1. Nat there is a connowt on lending o6 ncy f theperformance'
oaf
Ne work for which thi, permit is issued (Sec. 3091. Civ. C:)
-
-Lc df -Name._ _.— _. __ ._ ..
... .... ..._.__._..___ _._. .. .� ._____..__. ....____... ._
lander s Ad .11 ..
- 1 c n fy than I by ad this apple n and Not Ne aboveinfomutmn 1,
r' //(/IIS/J.
counter. 1gc toc ply with ajcountyordiwrcaand state laws ng
bcity
eru
and herebyapedion iwwf.,'etive.ofthiscity ro corer upon
fobuildingcontioned
propend for inspersion p
r
the abojWa)
ritioned
houu},,,-
(We)dgmetosave, keepharmless the Cityofcrue Agaiagainst
liabilities, judgments, cons end eapenxs which may in any way accrue against said
and expenses
:City'.in consequence of th2'B� Sting of this permit.,
'APPLICANT UNDER5f�s5NOS AND WILL COMliLY WIYH ALL NDN -POINT
Issuedb ;&L� Date
Y
BOURCEREGULATIQW." ^ -
' •Data
.SiBwtuWiil
RO-IOOfS
.p ISCLGSURE
the alic'H^ZARDOrcbuldm auSDISC
pP g P store or handle morwous MW64
Type. of Roof _ . , ., ......, ,.... _ _ .. ., ,....... ,...._ _..__
-mdefncdby,the Cupenln'Mumcipal Cade Choput Al3and Ne HmidimdSafe{Y
Cbde Section 5,�
ave :� : i'ON., :: 'r' +
.11t
_All roofs shall be_inspected.prior.to any..roofmg material -being installed.____-.,.,
-..,
- Will the opphcant r future building ac pat use equipment d vices nigh
If a roof is installed' without first obtaining an inspection, I'agree�td remove
em t haxaNuus rev contaminants as defined by the Bay Area Air Qualily Management
District?,
all new materials for inspection. Applicant understands, and will comply with .._ -
oYea n ,.o No
all non -point source re ulauons,,... Ivry II fii•;'f�: n_
p g
t'
1 hwe teed {he haaardous materials nquiremems under Chapar fi 95 of the
.,.
California Heainh & Safety Cade, Section, 25505; 25313 and 25534. Loadersmno that
_
1fthpan ids Y
it is my repbmibility to notify theocc
hoveam mthnirior
,.
eregntcumm
anrafhere vemumn whhaveich rhe'mh to n.n ane of a CeniTatof
Oce lra r
Applicant Dale
.. ..
_Signature_of _ , . , - ,.
All roof coverings to be Class `rB+' or better '+
o ern ayNar:cosec Dare
.OFFICE.... ... _-