01010021 " CITY OF CUPERTINO „ ,.• A • '
E tl`
BUILDING DIVISION PERMIT.. `CONTRACTOR INFORMATIONwC
A BUILDING ADDRESS: ' 'r. "t • PERMIT N(1.
149E ASTER CT. : -JUST WATER HEATERS INC 01010021
OWNER'S NAME.: APPLICATION SUR DA'IR
FREDIANI VICTOR J 3 AND' LINDA 1764 NATIONAL AVE 01/04/2001 '
PHONE sod SANITARYNO. oCONTROLNO.
. . (510)?93-9901,'•.:_.„
O'O ARCHITECTIENGINEER: t BUILDING PERM]TINPD
ra BLDG' ELECT .PLUMB, MECH
m D LICENSED CONI RACfOR S DECLARATION - J - '
Z y 1 h by ff'm th t I licensed J p fChapter 9( ane g - - Job Description - -
OX�-c ItS 1 7000)dDivision 3oftheBu dl f: -.Cade-and f,li : -
Sm�; nrnf atrretl REPLACE .50 GALLON GAS WATER HEATER
z rA-c Lic n.lCor. I M 1' ”
a O Dote - Contract°' "
ARCHU HCl'S DECLARATION
C O 1 d :r d y 11 : hall
-he o,ad :p thh ec'ords
Licensed P I: nnulOWNER-BUILDER DECLARAI ION
- - '• t ,
'
Q= I hereby chiral that I nm exempt Four to C°,irmu License,Low for the -
C ¢ doll 6 (S t 70315 Billions,.,ad Prf C I A y'ny.1 county '
❑
which q p n construct,elle improve,clararrish,Or aphil'ally sh hature
_ oProt is Ile Infinite, applicant f ' I in aligned rmem
that he ]focused polnuh,utao
pwooi rm Contractors Lis L (Chapter -A
Sq. FL Floor
- Area .•
Valuation(tri ng ,an nron),ro . 3 nn Be dl r. ,n'Codo)
ort'Ih seatth, f and'he
basis to, 1 ats'd , pl Any"Anlafion $11.74
rSet 70any affilicanfnp t:ni cf,OcapPl is itculd rally
of airt,nrrmanfive n J aaua.'ase,u
APNNumber - Occupancy Type .
0 L lu'owncr°fnhe property,or my employees with wages ex their sole coniparation,;
n.
will I theL J[lieis tintended f d f (S 7094 r �,4, +.v „•
Bus f d Professions C d The Central(,,,',License' Lion deal fact apply to an - „ Required Inspections
�w f property Whofunds mp :Ih d- d h k h nself -
r through his own on pl y en provided that such mprwtn t are One infendel or 502 —' F I NAL •PLUMBING ENERGY _.
offered for sale If,howavan the building or i,npmvemeat is sold within Zine year of ,
e
°mpletion,the rwner_bmlder will have the burden of proving that head net hada or 506' — 'GAS TEST
Improve ke pmro
pc of hale). ' '. -
507 -FINAL PLUMBING
°I,o'..a,of the property,um eschl'i'lly enthralling with Needled confrachas to
construct tho portent(Sec.7044,Basincs and Professions Coda:) The Contractor's -
License Law docs nor apply to an owner of pr,two,who builds or infpmbes thereon,
sod who contracts for such projects with a contractor(s)licenced porlio nt fb the -
°1 arn ar.enript under See B&P 6 1o"hi'venson
Owner Dl . . .
WORKER S COMPENSATION Ilf CLARAI ION
Ih cachyafrm ruder.plaulty orPJ >'one a I the follow ydeclinations.,;
- , +
t a
I° Ih d II astin a Cfl Our..1 Consentt II bar Work,,', / ;
Cr, pe i asp ided f by Section 3700 f the ],an Code forthe
pert e of the work for which this puts f s issued. _ -
°(have and will mein lain'Workers COntpcnxatirn In'urmfce,as rwuired by Section
3710of f the Labor Code, nnthe perfort a ice of the work for,which this permit Is
�iswodMy Worker's Competnatlon Ireurance cnrrizr mW Polley oumher are
Cartier - Policy Nu.;. - ^ - _ �• t, ,
CERTIFICATION OF EXEMPT ION FROM WOR KERS'-
COMPENSATION INSURANCE t • ,
(TI-its sectmn deed not he completed if the perofh is rn-ohe likindwhi dollars
- (siold'rhs) , ..., s.
I certify thm in to performance of the work fur which Ihi,pcorun is Issued,1 .41
shall nm employ nny,prnnn In any manner so as to laconic'mbject to to Workerx' - - -
Cnmpareatiou Law ttf CaLmrnin,DOE, r -
Applicomt, ,
NOTICE'DO APPLICANT,if,nBe,making tl'Calibrate of Exemptio, you should
hesubject o the W k c pf't I W Of d Labor Cob e you must '
Q'O.
forthwithm ply with, 1 P 'ante fir this 't shall bed V -eked. - '
Z 2
F CONSTRUCTION LENDING AGENCY-
1
GENCY I haveh,affinno into B mroci o f to fd fl fbe p.
)for to rf moa e - -
011 work I..Much this n
por ', � seed(Sao 3097,Civ C) � - -
C4 A Lent .Nathe
a z Lent Address
.0 Q
I n'fY but ur ;allthifly
t and shdirauat th h e' f rum us
W. f••t icor t.1 g t plywill; 11 ry and county J dt t i...relatiog. 'r _
Q [�
enter
to bile mhx a i s .Ito,' p of es ftl 'lyh inn •, '
elinto
P y ffora p t p es p:
F,y Q,t
(We)agf save.h
indrionify andl herml the city or cupenno against a ,
itZ liabilities,) dg an,,. f nJ pn :which in
y n any a
ry c ega ut olid , -
C.7 City no rion.eyu.al,,of the furcuirl,of this pe tit - - -
APPLICANTUNDERSTANDSANDWILLCOMPLYWITHALLNON-POINT j• i•'
SOURCE REGULATIONS .?, r issued'by:.... 'Date,
.• Slgnewrciif AppliwnVGmOnnor ' Date. Re-roofs
• HAZARDOUS MATERIALS DISCLOSURE
Will the applicant Or there IF ria'fg Occupant.mre fir handle ba;,au+aj,,baaharal . 'Type of Roof' -.
' fd
as tl by the CYpm cri Mi nib p J Codes Chapter 9 12 tuaf Hefihh and S fry 1.
Cod Serf tt 25532(a)u •- - '
'- °No, All roofs shall be inspected prior to any,roofing material`being Installed.
Will m l tinro l ban,Inddinliotouparl cle•yuip rent a x ex.1rOl If a roof is installed without first obtaining an inspection,iI agree to"remove '
red J eon W d,Pned by the Bay Area Air Quufhy Manage nun
District' - " - ` all new materials:for inspection..Applicant understands and will comply with.
11°N° ' all non-point.source regulations.
- hilariousr
' h ad the 1 I:ray fn tinder Chap as fi 95 of the
Cnlif -' script&Safety Cade,Seeuons25505,25533 find 255341 under'wnd the, - ob -
t ifthelooking does in,firm my have a chain,that it isrt,N.p hifit,no twiny he • ' -
- are,at of the rcqulmnmntx which ,,a,,b lInorm'sa' ce or s Curfunly of -
Occupancy. ♦ -
• � 'Signature of Applicant ;.�-' ' • ° , - Date,' -
- owhe,rrattnd>w aeer,t •, . ,Duce All roof coverings to be Class.."B'L or better' c. "
OFFICE A