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08010006 (2) CITY OF CUPERTINO .�x';tgt '�.SoT1l=swleM iIUILDINCr'D5vIs1ON PERMITCU NTRAMOROFORMAZTION BUILDING ADDRESS: PERMIT NO. 10395 FARALLONE DR BETTER WATER HEATERS 08010006 OWNER'S NAME: PERMR ISSUE DATE ILANGO GANGA & VIJI ILANGO 351 FALCATO DR 01/02/2008 ONgnimmnon SANITARY NO. CONTROL NO. (408) 250-6672 ARCH17EC rENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 10oLICENSED CONTRACTOR'S DECLARATION IOhDeBCrI Description 1 hereby affirm Nor 1 un Iimued m under provisions of Chapter 9(or rmodn{ p n wlthSection7000)atDivision 3oftheBusiness and professions Code.redmyticenmis RMV & REPLACE WATER HEATR, 50 GAL INSIDE CLOSET H in full font and effect 5 Z Llcenm Class Lic.N Dam Contractor ARClur ECTS DECLARATION eU 1 understood my piano"I be used at public ncards Licensed pruressianal 5 OWNER-BUILDER DECLARATION 0 1 hereby alarm that 1exempt ad,Confrom Ne Contractor License Law for the Off following moon.(Sentian 7113 1.L5,ci,Must.and Professions Cork:Any em as county $Pi which nequlnea a Pcemit m ennmvct,altos.Improve,demnluh.or repair any urawm prior to its issuance,also nequims Ne applicant forsuch permit to Ole ulgned statement pp o that heaslicensed pursuant toNs,Provision ofNeCom on'License Law(Chapter 9 Sq.Ft. Floor Area 1 Valuation Y 6 (commencing with Section 7000)of Division 3 of the B usimea and Professions Cods)Or $ 000 — that he is exempt rhunfrom and the basis for the alleged exemption.Any violation of Secdon 7031.5 by tory applicant for a pamB subjects this applicant to a civil pointy ofNumber Occupancy Type set mom Nan five hundred dallua(g ). 36931020 .'°f p y yP 0 1,u owner or this,property,a my employees with wages u theh man compensation, will do the was.and Na swmure is not intended or affered for sale(See.7044,Business Required Inspections and Profns esstoCade:The Contractors License law does not apply to an owner of q p property who builds or Im proves thereon,and who dots such work h immlf or through has awn employess,provided that such Improvements art notimmoded incurrence formic.If. however,Ne building or Improvement Is mid within oa year of completion,the owner- .... builder will have des burden of proHng and Is,did ret build or impmw nor purpose of tole 1.u own of de prmpeny,am exclusively contmin{with accrual cont¢ton to censnmct Out Project(Sec.7014,Business and Professions Code:)The Coutichnes Li- . canoe Law does oat apply to in owner of property who builds or improves themmn,and. who contacts for such projects with a emntauart0 licensed pursuant to the Contractor License law. 0 l cm ammtuNin,Seo. B k P C for this m�onn - Owner Dam Z / KER'S C 1PP,NSATI�ATION 1 hereby.111he ander penahy of perjury one or the following declmations: 1 haw and will maintain a Canidesto of Cannot to self-boort for Workers Compen- .on,u Provided for by Section 3700 of the labor Code,fm the performasece of the work for which this permit u issued. 0 1 have and will maintain Workers Compensation hundamee,u sequined by Section 3700 of the labor Code,for one performance of the work for which this permit is Issued. ' My Workers Compensation Inwnme nmier end Policy number are: Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Deas medm need set 4 ocmplemd if tie permit Is format hundred dollen($100) or less) I unify that in the perfarmaat aj, c war fo which Nis pe mit is i=ts .l shell nm employmyperom titin mann m rob cam neje 'orkeea'Compe ti Laws of Califomia.Dam_ APPliunt NOTICE TO APPUCANT.Iflddr meting this cur iRcem 4f FacmPti n,you shauhl Immune subject 0 the Worker Compensation provisions of Ne labor Castle.you mut ,J O forthwith comply with such provisions or Nu Permit shall be doomed ovulate. 'Zr CONSTRUCTION LENDING AGENCY r {+ hereby which nn that dart uscor(SO':. .Cis. a{cnry for NepMormamt Of ai 7 the wort for which Nu permit u orad(Sec.7097,Civ.C) Landers Name � z Leaders Atla—•. .. 1�Q 1 canary that I haw read that sppl'eation and sum that are above information is ' carrtn.l agra to comply with W city and county oNlnenms and most level relating to Q SV^ building construction,and hemby mthorine mpnxnuim of Nis city in trim upon the � show-mentioned Property far Wpemton purpmes." y (We)agree to tow,indemnify and keep Wooden the City of Cupertino against r/) liabilities,judgments.cosi and espouses which may In any way amus,against mid City V Z in consequence of the{rantint of Out permit. APPLICANT UNC ANDS AND L COMPLY WITH ALL NObN-P 1 Issued by: Date SOURCE REGUL 0 ^\I y 1( YP D Date Si{nuurt or Appli Re-roofs RDOUS MATERIALS DISCLOSURE I Type of Roof ' Will the applicant or future Wilding occul a utuom or handle hazardous motorial u defined by the Cupertino Municipal Code.Chapter 9.13.and the Health and Safety Coda,Section Z533(a)? �/ All roofs shall be inspected prior to any roofing material being installed. 0Yns �Ne Will that applicant or fuwm building accupanl om equipment in denim which If a roof is installed without first obtaining an inspection,I agree to remove 't hoodoo air contaminants u dermal by the Bay Arta Air Onslity Management all new materials for inspection. t7 ❑m f�Na 1 haw mad use,hnarNeamaeriaisroquimmmuonder Chspmr6.95 aide Califor. ria Hul"SafetyCode,Sections 25505,25533 am125534.1 ordnntantl thuif Ns,building dm not currently hew•anent.and it is my responsMlity to n odry the oceupant of the mcfaremc 'hen leem�pyr♦rmimaanceofaccnintamorma 0 Signature of Applicant Date owner ter seri stns `W Da All roof coverings to be Class"B"or better Deo 1 000 (0 CITY OF CUPERTINO p�' WATER HEATER •CUPERTINO PERMIT APPLICATION FORM APN # Date: © j 00°1 /01 coo g Building Address: /0 3 9-C" 0f1q-aZAL1,oi✓E -ode, C' ci/9EeT/ N o, C A -9Sply Owner's Name: Phone #: 5 -Ani 4 u G fbY 4 A ✓2 ✓'I 2LAnf G o, �oevSTE&S 579 Contractor: Phone #: 46-72 Fax #: Cupertino Business License #: 6.1'I F,1 to Contractor State License #: I Li Contact: Lry 4 O a ff61/4,4 Phone #: /100 _, S5--S707 Ask Fax #: Building Permit Info: Bldg ❑ Elect ❑ Plumb Mech ❑ Residential ® Commercial ❑ Job Description: a 4i? W q Tz;--/z H E r4 TFrz ^ S7b C,aQ - al mor" Strapped ] On Platform ❑ Bonded ] New Location ❑ Replacement Valuation: /000 000 ` Green Building Check must be completed and attached to this application. Green Building Points achieved: CITY OF CUPERTINO WATER HEATER CUPEkTINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Permit Type Group 1PCWHEATR Commercial Water B PCWHEATR HeaterNent 1BSEISMICOM Seismic Commercial B 1PRWHEATR Residential Water B PRWHEATR HeaterNent 1BSEISMICRE Seismic Residential B 1PPERMITFEE Plumbing Permit P 1TRAVDOC Travel & B Documentation 1 BUSLIC Business License B CITY OF CUPERTINO • 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36931020 . 00 DATE ISSUED. . . . . .. : 01/.02/2008 RECEIPT # . . . . . . . . . : BS000003596 REFERENCE ID # . . . : 08010006 -. SITE ADDRESS . . . . . : 10395 FARALLONE DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ILANGO GANGA & VIJI ILANGO TRU ADDRESS . . . . . . . . . . : 10395 FARALLONE DR CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-3104 RECEIVED FROM . . . . : ILANGO S GANGA CONTRACTOR . . . . . . . : FRANS CARTWRIGHT LIC # 26514 COMPANY . . . . . . . . . . : BETTER WATER HEATERS ADDRESS . . . . . . . . . . : 351 FALCATO DR CITY/STATE/ZIP . . . : MILIPITAS, CA 95035 TELEPHONE . . . . . . . . : (408) 250-6672 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- --------- ---------- 1BSEISMICR VALUATION 1, 000 . 00 0.50 0. 00 0. 50 0. 00 1PPERMITFE FLAT RATE 1. 00 40.79 0 . 00 40.79 0. 00 IPRWHEATR UNITS 1. 00 ' 24 .48 0. 00 24 .48 0. 00 ITRAVDOC FLAT RATE 1. 00 , 40:79. 0. 00 40.79 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 106 . 56 0. 00 106 .56 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 106 . 56 #1083 --------------- TOTAL RECEIPT 106 . 56 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 518 WATER HEATER • Community Development SM 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 �UPEI�TINO Building Department JOB ADDRESS: 10_31S- /�f}/C AL L on,E' J)a PERMIT # C.vpER 0 -A G7 �Dl 000 (0 OWNER'S NAME: .T L 4N4 o /}N A PHONE # 4 R C-7o GENERAL CONTRACTOR: — f # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood • Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile o l o� 2�8 Owner/Ge�r Signature Date