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0706010500 iUF :ZU 1Z)H ,nZ IFS Ja )aU U. .Qy 1H.] joo -Z6 BUILDING DIVISION PERMIT VISTA DR OWNER'S NAME: BARBARA BEYDA NE: ARCHITEC (ENGINEER: WATER HEkTERS ONLY 970 E MAIN ST (800)835-5946 I hereby affirm that I am licensed under provisions of Chapter 9 (commencing REPLACE WATER HEATER ;vith Section 7000) of Division 3 of the Business and Professions Code, and my license is n full force and effect. t Q '57-1 �.� License Cass _ 3 O Lic• ff - Date �" Contractor ARCHITECTS DECLARATION I understand my plans shall be used as public records Licensed Professional OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractors License Law for the following reason. (Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to rile a signed statement that he is licensed pursuant to the provisions of the Contractor's License law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis 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 more than five hundred dollars (5500). 0 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law docs not apply to sn owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sal. If, however, the building or improvement is sold within one year of completion, the owner - builder will have the burden of proving that he did not build or improve for purpose of sale.). 0 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code:) lite Contractor's U - cense Law does not apply to an owner of property who builds or improves thereon. and. who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License law. 0 I am exempt under Sec B & P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain a Certificate of Consent to self -insure for Workees Compen- sation, as provided for by Section 3700 of the labor Code. for the performance of the `worrkk for which this permit is issued. pl[( have and will maintain Worker's Compensation Insurance, as required by Section �'7� of .hc Labor Code, for the performance of the work for which this permit is issued. My Workees Com ensation Insurance carrier and Polity n berar •3, Carrier: Polity No.: — CERTI CATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued,) shall not employ any pc n in any ma ncr s to e c subject to the Workers' Compensation Laws of Cali[ Date Applicant i NOTICE TO APPLICANT. If, after making this Cendicatc of Exemption, you shook] become subject to the Worker's Compensation provisions of the Labor Codc. you must ,J O forthwith comply with such provisions or this permit shall be dcerthed revoked. ZCONSTRUCTION LENDING AGENCY , 1 hereby affirm that there is a construction lending agency for the performance of (Y > the work for which this permit is issued (Sec. 3097, Civ. C.) W QLender's Name 0 � Lender's Address U 0 1 certify that I have read this application and state that the above information is t>. F correct. I agree to comply with all city and county ordinances and state laws relating to U building construction, and hereby authorize representatives of this city to enter upon the above-mentioned properly for inspection purposes. >" a f Cupertino against (We) agree to save, indemnify and keep harmless the Ciagainst t] liabilities, judgments, costs and expenses which may in any way accrue againstsaid City U Z in consequence of the granting of this permit. ►� APPLICA UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT SOURC LATIONS. Signature of li C or Date S MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety Codc, Section 25532(a)? 0 Yes 0 No Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defhncd by the Bay Area Air Quality Mauagcmeni District? Cl Yes 0 No I have read the hazardous materials requirements under Chapter 6.95 of the Califor nia Health & Safety Cade, Sections 25505, 25533 and 25534.1 understand that if the buildinl docs notyyaarrtr��nd have a tenant, that it is my responsibility to notify the occupant of tht reouirer%ntaCwhich must be Inet prior toNuancc of a Certificate of Occupancy. Date Owner or authorized cnt " 35602052 Issued by Re -roofs Type of Roof q. Ft. Floor Area 070��105 PERMIT ISSUE DATE 06/13/2007 SANITARY NO. CONTROL NO. BUILDING PERMIT INFO BLDG ELECT PLUMB Job Description LM1 Required Inspections Valuation Type All roofs shall be inspected prior to any roofing material being installed. If a roof : s installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant Date All roof coverings o be Class "B" or better 3 ITEMS OF 3 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN 35602052.00 DATE ISSUED.......: 06/13/2007 RECEIPT #.......... BS000001644 REFERENCE ID # ...: 07060105 SITE ADDRESS .....: 10883 CANYON VISTA DR SUBDIVISION ....... CITY CUFERTINO IMPACT AREA ....... OPERATOR: Patg COPY # : 1 OWNER BAFBARA BEYDA ADDRESS CITY/STATE/ZIP CUPERTINO CA, 95014-3908 RECEIVED FROM ....: EDIVARD A GREGORY CONTRACTOR .......: MCCEE, PAT LIC # 18986 COMPANY ..........: WATER HEATERS ONLY ADDRESS ..........: 97(l E MAIN ST CITY/STATE/ZIP ...: GRI,SS VALLEY, CA 95945 TELEPHONE ........: (8(10)835-5946 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT ---------- THIS REC NEW BAL BENERGY PERMIT FEE 1.00 ------- 34.86 0.00 34.86 0.00 0.00 BPWHEATER PER HEATER 1.00 10.79 0.00 0.00 10.79 38_ 37 0_00 PPERMITFEE FLAT RATE 1.00 38.37 ---- ------ 84.02 0.00 84.02 0.00 TOTAL PERMIT METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT ' --------------- 84.02 --------------- 84.02 VOICE ID DESCRIPTION -------- -------------------------- 502 FINAL PLUMBING ENERGY 507 FINAL PLUMBING REFERENCE NUMBER -------------------- MC VOICE ID DESCRIPTION -------- -------------------------- 7- 506 GAS TEST 4 CUPEkTINO 0-7 �1� o I �� CITY OF �CUPERTINO WATER HEATER PERMIT APPLICATION FORM APN # _ Water Heater / Vent PlumbingPermit Issuance EnergyBUILDING Business License Date: 64,13-0,7 Building Address: I /0333 � Cl �� (7 � U l s T� r Owner' Name: �� Phone #: _ v` 7—Jrv03 u r q J"q Contractor: / aer }��'��ers �� Phone: �3c�- Z , 3v0 / License #: 3 75457 Contact: Edward Gre ory am Phone: S�� - �/ l - 6 � �f Cupert}'�?o Business License #: ! �6 9 Building Permit Info: Bldg ❑ Elect ❑ Plumb Mech ❑ Job Description: W 4 W Wq-4,e /. /\ � e, L 7 e ✓'- Residential Commercial ❑ Cost of Project: U00 Strapped On Platform Bonde j ❑ New Location Replacement Qty. if FPP T)Pcrrintinn Fee Group Applicable rec u -J BP HEATER ppERMITFEE BENERGY BUSLIC Water Heater / Vent PlumbingPermit Issuance EnergyBUILDING Business License BUILDING PLUMBING BUILDING CITY OF ''UPEkTIN0 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: PERMIT # /0 V, -5 )r Y OWNER'S NAME: Ta,- Q,,ic-` cl4 PHONE # VO 5 00-3 X GENERAL CONTRACTOR P r ti ty FAX # PYI am not using any subcontractors: Signature Date nle��o �l,o.,lr �r,r,li-�hla clvnn+ra-tnrc and rnmrilPtp the fn11c-,wine, information_ Owner/Contra o Si ature Date 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 s 7 (z 3 7�1 S7 Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contra o Si ature Date