BLD-2021-1081BUILDING PERMIT
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 20135 CEDAR TREE LN CUPERTINO APN: 316 34 007 PERMIT NO: BLD-2021-1081
OWNER'S NAME: OWNER'S PHONE: Not Provided
CONTRACTOR: AIR & PLUMBING SYSTEMS INC, 14107 CAPRI DR LOS GATOS CONTRACTOR PHONE:
DATE ISSUED 6/8/2021 10:21:50 AM ISSUED BY:VALUATION: $8300
JOB DESCRIPTION
1) Upgrade Electric panel upgrade from 100A to 200A to support heat pump water heater installation 2) Add 40Amps 220V electric outlet to support electric charging in the
garage 3) Replace current 50 Gal Gas water heater with 50 Gal Heat pump water heater in the garage. Model # Model #XE50T10H45U0
LICENSED CONTRACTOR INFORMATION
CONTRACTOR: AIR & PLUMBING SYSTEMS INC
LICENSED CLASS: C20 WARM-AIR HEATING%2C VENTILATING AND AIR-CONDITIONING, C36 PLUMBING, B GENERAL BUILDING CONTRACTOR
LICENSED NO: 901246
EXP DATE: 07/31/2021
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
force and effect.
I hereby affirm under penatly of perjury one of the following three declarations:
1 I have and will maintain a certificate of consent to self-insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
2 I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
3 I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, l must forthwith
comply with such provisions or this permit shall be deemed revoked.
I understand and agree that I am electronically signing and filing this application and that checking the box below has the same legal effect as manual signature. I also
understand that I have the option of filing a paper copy of this application with a manual signature but have chosen instead to file this application electronically.