02090135 CITY,OF CUPERTINO
<Butcn7NG DIVISION, :PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO,
7996 SUNDERLAND DR JUST WATER HEATERS INC 02090135
APPLICATION SUB D E
MTMIE RAHUL 1764 NATIONAL AVE 09/ 192002
PHONE: (510) 293-9901 SANITARY NO, CONTROL NO.
O O 'ARCHITECT/ENGINEER: to _ BUILDING PERMIT INFO
I- BLDG' ELECT PLUMB MECH
a zu�
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N E LICENSED CONTRACTOR'S DECLARATION Job De�scnpuon
pinto ction7' )ofDois that lam Maenad underpnd PransoionsCor and mmeorig cense REPLACE WATER HEATER
P,_Ero with Section]008)af Divisionlof the Business and ProfessionsCd<.and myliccnu
_xs�.5 iainfmlrnrceandefrecl. (50 GALLON GAS)[�ONA/ A,�®
rc ,a ••license Class, Lica
K'O pc.0 Data - C.morkmr
w3.tit' ARCHITECT'S DECLARATION g,� ' q q
l understand my plans shall be used as Public ski
NOV O ZOO2
�Y
m'S 2 O 'Limmed Professional -
c o. OWNER-BUILDER DECLARATION
vl �y I hereby affirm that 1 am exempt from the Commcror's License Low for the
BUILDING
,following Mrs .(Section 7011.5.Business and Profcasions Cdc:A,city or county
f€o 'which requires apormit to mmoruct,olmq improve,demolish,or repair any swctum
c. pn t t ' iow"d p,alsoreq p epp of forsuch Concr rmr issigned.umment - -- -_ .7.SO.. at
1Falhen lttnudpursition 7I pro fstonaof the the BusinesanenseW (Chapter 9Cod) S Ft. a,, E, tea ,n, Valuation
(comment i tit dee ]1X111) fDivulmor he stilled
dP fie ns Code) t, ty`I,'i s D1 4 9•a f Yast s } Iy,rl,Et i 1,70>'ti
or Shat hen 31.5 b ran,a and me baso for me ms me smyuon Any striation �3 6 2110 3 3 .0 0 '
-.f genion e than by any applicant for a pemrit suM1jecn the applicam to a civil penalty
,or not moremamfive hundred aoyars(g51gI1. APN Number Occupancy Type
61.as owns,of the property,or of cmployms with wages as thehsole compensator, 502 - FINAL PLUMBIN ENERGY
will do the work;and the suucmm is no,intended-m'offmod for sale(Sec:70,kI 5 O 6 - GAS TEST lox'
Business and Prorcasksm Coda:The Conttactn.s License law does ant apply m r Required Inspections 1L is t"%;
owner of property Who builds or improves thereon,and who does.inch work hi mself 507 - FINAL PLUMBING
or through his own employees.pro%cled that such improvements art nw intended or __."_-____.. . .. _.._............
.—
completion,the:If,however,the building or Improvemem n:old within not Wild of .,' f•,i' \' ..:,i,r
'completion,the owner-builder will have the burden of proving dill he did not di1J or
imprm'c for Purpose of sale.).
1
3y Oraownw oPthe p(SmnYorun Business and mrocimgns CWenude Contractor's L11.P ❑f .
ocense theow does
(app.]1114,Business and Professions ildc:)The Contedcmr's
.- --I m -Litems law does not apply m mj owner tit property who builds or improves l.so,t n,
:and wool's mmense La such Pmlens with.a.aontracmrtsl.lacrised punueat.m.Ne. __
r
--
Contractor's License law..
4a -Oram eumpl under Scc." I � "-.'B&PCfw dlis reason Itin c�'/"C' fkt
Owner. .. Date .. L,,.
�.i'',Ir',t I, WORKER'S COMPENSATION DECLARATION.r,
' I hereby atlinn under paint,of perjury ane aflthc following declarations:
jl ❑l havetI nd'iwill rocautain S Cki licate'of Conseni Ito self-insure for Worker'.%
.,Compensation. az,provided for by Section ,17W-of the Labor Code, for the
•Pcrfon arkmc'afdovwrkfor which this permit is issued,; ,
111 h d 'll ma r W rk' i Compensation linctiourse.as rtqu red by Section
17W of the Tai Coati the,performance of the wits for which this Permit's
issued.MyWorkers;C p .cton Insurance tamer andPolicy number am: _
..0 ctfIy0lill: !'r .oL aPolicyNn ., .. n - fn �- .s f 'rNti r1, A;
y. .' .1 l f t.�f
`•,!' t-CERTIFICATION OF EXEMPTION FROM WORKERSi - s f Cr Pli/), u ° r
COMPENSATION INSURANCE'`""'
.. _. ._.. _ .._...-_..... I—.._ .-..-__,_ . _..._. _ _ ._,_ .. .�. ..
I
''•r - (Ih�s sen lin new not bic i;o lkuid if the permit is for one hundred dollars ,'s Ai �•.'PC6l7,.I't.'� 't,
(SI00)nr lcss.l
1"rt rylthni n 1h pe f I' ca f tM1 k 1which this permit's issued,1 i`.„11
sit II 1 employ any perwn n ny ma m in become subject Iothe Workcrx'
Corn pe i n Laws fC I D to
.NApt"'ant. -.. . .. _... ._._.._.. . ."_. ._ . ...... . _ .. .. _.._._ _.. ._ ".
ICE TO APPLICANT,If.after making this CemGcate of Esempuon you should •
Q Obecome subjoin to,rc Wo lti is Cn trxii noon provisions or the Labor Code,you must
forthwith comply with iuch prorisiors or this permit shall be deemed revoked
F:!fn CONSTRUCTION LENDINGAGENCY- P ILI
,'- I hereby foo R thatM nn tin i n I d g . .) fed 1h pert Ira .'f t ."
r'�n .bf tH kfa whd tit pc II d(S ipN] C;C), y .,,ii_1
Ca: "Lender' Nme,._. , .. ... ... s .-... ...- .. .. .V_' -i _ .__.._. ... .. .. .. .. ..
? IQJ
z Crnderi Address` ._. el '1.'a'I;L•i1.:1:
V-Q . .e ,. I.;.
1 cNfy It 1 hi a read this application a1 d sure that N d information is
'fsi°Fir comm.I agree to comply with all city and cotisty indraccos and state laws offering
to building mmlfunron:und herebyy aolhorm representatives w(ihis city to enter upon
t the above-mentioned,property for inspection purposes.„ „
(r,y .(Wc)o'yrce tomve:indemnify and keep hint she City of Cu'Pcnin't inst
FI"M liabilitictjudgmmts,mvs and expenses which may in any way accroc against said
V:Z Croy - sequence offhe g tng of this Pr is,'
- ••APFIIGA\T UNDERSTANDS
AND WILL CONPUWITH ALL NON:POINT issued by; Date
SOURCE REGUCATIONS.
Squouture ofAPI!Iicam/Contmmor - ""� Dare Re-roofs
Code Scn m12
HAZARDOUS MATERIALS DISCLOSURE
sa<defnwb titppl s f t Wildng me pit care or handle haramdus material __ Type
wnti
y e Cupensro Municipal Cd Chapter9.11 and the Health and Safety
5513(), .. sj 5 i. � t l a..
❑Y ' - SI ❑no ` Via. 3 ! All.roofs"shall be inspected prior_to.any.roofing material being installed..
wR
he_applicanto future buildg u v t use equipment devices which If a roof is installed without first obtaining an inspection;I agree'.Id remove
e ca
t h w u. it contimincumv as derined by the IffiArm Air Quality Management
D 1 t 1 all new materials for inspection.,Applicant understands and will comply with
.. r - ..
IT OYs 19 No
all non-point source regulations,,,I , x r r,
"1 .. ..
I haven red rbc Safety
Code, materials requirements a under Chapter.1morsu of he
that
Jf the uil ing cad
Bc of cur Cody,Sections 35505.t it ie and 35514.I Lid holif tthe
iRhe building does rtcurrcntlyhave n tcnamilhm itizmY W Y Y
nsiofit tonocf the
focupar.of the requirements which muipbe inn prior 10 issuvlcc of a Certificate of
Sig natu;e o _ .ppf A Lean. t _-.. ._ .__ . . ._ ..Date
All .l roof
coverings amhbnzeil agent. - 1 Dau _..._. .. . . _ .. ._..
r. f coves to be Class `B" or'Better
O
OFFICE