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08040063CITY OF CUPERTINO �("- BUILDING DIVISION PERT imom.♦n �a4K` ry -0To�N 1� ATIY& �-s.•.�y�+iv'.�er.. FAST WATER HEATER BUIL 1 G DRESS: ��p11 CRAFT DR APT A PERMIT ND. 08040063 OWNER'S NAME: PERMIT LSU) OATS ANDREW E YEE 12601 132 AVE NE 04/09/2008 ONE: SANITARY NO. CONTROL NO. RCHTTEC (ENGINEER: RMV/RPLC GAS WATR HEATER BUILDING PERMIT INFO BILOIG ELECT PO O (� O LICENSED CONTRACTOR'S DECLARATION Job DeSCfIpIIOn 1 motley sires Wt 1 we liaised cracker pmvisiu mof Chapter 9 (commencing with Section 7") of Division 3 of ft Business and Professions Code, and my Ikenm is in full fume aha effm,, License Clus Lk. N Dam Contcwmr ARCHITECTS DECLARATION I urkcnsand my plans shall k used u While rtamrds Licmned Peoficaiamsl OWNER-BUILDER DECLARATION I berehy affirm that I em exempt from the Commctor's License Law for the following reason. (Section 7031.5, Business and Profesaiuns Code: Any city or county which requires a permit to comLrocL alter, borrow, demolish, m repair any structure prior in its iuuancc. also requires the applieanl for such permit to file a signed smemcnt Nu he, W licensed pumtatu m the provisions of cm Contrxtofs Lucas Law (Chapter 9 Sq.Ft. Floor Area Valuation (commencing with Section 70001 of Divkton 3 of the Business and Professions Code) or deat he is exempt therefrom and the basis for the alleged exemption. My violation of APN Number Occupancy Type Section 7031.5 by any applicant for a pesmlt subjects the applicant to a civil penalty of not mart than five hundred dollars (11500). 0I,uownerofinepmpeM,wmyempmywwithwagesutheiroleca Mmdon, Required Inspections will do thework, and theawclum it notimmuded oralfeied for ilk (See. TOsa, Busircu and Professions Cada: The CoavacreM1 Lice-, law don est apply 0 an owou of proponY who bulks IX Impmvea thvmn, and who does tuelt wcolt himself e, thmagh his We employms, provided that such improvement, art not intandW oro@red fn, We S, bawewr, the Wilding or improvement is sold within one year of completion, the owner. Wilder will have the hordess of proving Nat k did not Wild or improve for purpaxe of sale.), 0 1, as awns of the propenY, am exclusively contracting MN licensed commlon m ca stroct the project (Sec 7W. Business aha ProleWans Code:) The Comemusec. Li- ane law dIXa mat apply to an owner of progeny who bull" or improves thereon. and. who conuacu for such Projects with a commuer(t) Executed persons, m the Contractor's License law. 0 lamexemptumdn Sec ,B&PCforthisreawn , OwnerDab WORK'S COMPENSATION DECLARATION ER I hereby aBhm corder partly of perjury, ars of the following decluadmre I have aha will maintain a CctiOesm of Consent m self-Worm For Worker's Compare n, u presided for by Stttian 3100 of the labor Cade, for the performance of the d for which this permit is Wood. 0 1 have and will maintain Worker's Compntudon Insurance, as required by Section 3700 ofthe Labor Code. for the performuct of the work for which this permit is issued ' My Warkees Compensation hwrsnee cmier cad Pol(ry numkr are: Cmmr. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (This seetlon need not be completed if tk permit W two= hundred dollars ($100 M Lem) 1 cestify deal In the performana of tis work for which this Permit W isamd, I shall mat . employ any Prison in saymaorcrsou in biome subjnt in the Work&Compenudm - Laws of California. Dam Applicant NOTICE TO APPLICANT: IL after making this Conitieam of Exemption. you should become subject in the Worker's Compensation provisions of the Labor Coda you most feMwith comply with such provisions or this permit M91 W doomed rewkctl. 1 CONSmis,ac ONLENDINGAGENCY money Waco(Sco. rmlending far Ne performurce of Ile, wort whautresthatdirt which tics permit W isared (Sec. 3t3S1, Civ, C) .) Na Name Undoes Lender's Add. 1 certify that 1 ban mW this application and sum that the show Information W correct. I agree in comply with all city cad county ontinuces and came laws relating to Wilding construction, and hereby authorize nepruentatiwa or this city to enter upon the above-mendmrcd progeny for inspection purposes. (We) agree to saw. indemnify and loop harmless the City of Cupertino against j liabilities, judgments, costs and experuo which may in any coy aecoe against mid City in of the of thin OLIC RSTANDS ANranting I NT UNDEanes APPWILL COMPLY WITH ALL NON-POINT D Issued by: Date SOURCE REGULATIONS. Re-roofs Type of Roof Signuurt of ApplicaDOU Dem HAZARDOUS HAZARDOUS MAigJUAIS DISCLOSURE Will thea, applicantmfutureipalbuilding handle u de, e. ChAp r9, 1m Health and by tis: Cupertino Municipal Cade. Chalnor 9.12. and the HUIN cad Satcly Sed Code, zss3z(.)? All roofs shall be inspected prior to any roofing material being installed. 0y. ❑Na ❑Yes If a roof is installed without first obtaining an inspection,agree to remove Will the applicant or future Wilding occupant use equipment or devices which .I It huaknes air comeminsnts as corned by the Bay Area Air Quality Management all new materials for inspection. ries? 0Yo [3 No I have mad the huaNaus materials requirements under Chapmr6.95 oftAe C,lifor. nW Health& SafelYCak, SeWons 25505,25533 and 25511.1 untlenund Nat if the Wilding dace rot cunentty hew a tenant, Nat it W my mapmuibility m nodly tin occupant of thc requim=nuwhkhmnstknmtpdorm Wm ofa Ccniricareuffkcupstry, Signature of Applicant Date All roof coverings to be Class'A:a' or better owner or uthIXota agent D,te' • 4 ITEMS OF 24 • CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 37502009.APTA DATE ISSUED.......: 04/09/2008 RECEIPT #.........: BS000004429 REFERENCE ID # ...: 08040063 SITE ADDRESS .....: 10121 CRAFT DR APT A SUBDIVISION ......: CITY CUPERTINO IMPACT AREA ....... OWNER ............: ANDREW E YEE ADDRESS ..........: 10121 CRAFT DR APT A CITY/STATE/ZIP ...: CUPERTINO, CA 95014 RECEIVED FROM ....: JEFF JORDAN OPERATOR: patg COPY # : 1 VOICE ID DESCRIPTION -------- ---------------------------- 518 WATER HEATER VOICE ID DESCRIPTION ------------------------------------ CONTRACTOR .......: JEFF JORDAN LIC # 29100 COMPANY ..........: FAST WATER HEATER ADDRESS ..........: 12601 132 AVE NE CITY/STATE/ZIP ...: KIRKLAND, WA 98034 TELEPHONE ........: (800) 454-8955 FEE ID ---------- UNIT QUANTITY ------------- AMOUNT PD -TO -DT THIS REC NEW BAL 1BSEISMICR ---------- VALUATION 449.00 ---------- ---------- 0.50 ---------- 0.00 0.50 ---------- 0.00 1PPERMITFE FLAT RATE 1.00 40.79 0.00 40.79 0.00 1PRWHEATR UNITS 1.00 24.48 0.00 24.48 0.00 1TRAVDOC FLAT RATE 1.00 40.79 0.00 40.79 0.00 TOTAL PERMIT ---------- ---------- 106.56 ---------- 0.00 106.56 ---------- 0.00 VOICE ID DESCRIPTION -------- ---------------------------- 518 WATER HEATER VOICE ID DESCRIPTION ------------------------------------ • 0 Permit No: O.6 D� oU / 399145 (office use only) City Of Cupertino Building Permit Application E -Mail: Building-Permits(d.)cupertino.org (Address is case sensitive). Jobsite Address: 10121 CRAFT DR #A Date: 3/31/08 Assessor's Parcel Number. Owners Name: YEE, ANDREW E Phone No: (408)253-5720 Project Valuation: 449.00 X Job Description Remove/Replace Gas Water Heater Contractor Information Company Name: FAST WATER HEATER COMPANY Contact Name: Carol Randall Address: 12601 132ND AVE NE City, State & zip code: KIRKLAND, WA 98.034 State Contractor's Lic. No: 877489 Worker's Comp No: 1761660 Carrier: California State Fund of Cupertino Business License No: 29100 Fax No: 800-454-8955 E-mail: carolr@fastwaterheater.com Expiration Date: 5/31/08 Expiration Date: 12/1708 Credit Card Information Credit Card No: 4417123041349530 Expiration Date: 11/10 Name on Card: Jeff Jordan Visa ® MasterCard ❑ American Express ❑ The Building permit application and a completed & signed contractor/subcontractor form need to be submitted with each permit. 0 • Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 buildingDepartment JOB ADDRESS: 10121 CRAFT DR #A PERMFT # D Que L OD (P3 whKAL (-:UN I-XAC1'UX: FAST WATER HEATER COMPANI FAX # 425-B14-9516 I I am not using any subcontractors: _ C'v_ -_ _ ! �`�° 3/31/08 Signature Date Please check applicable subcontractors and comrilete the following information - Owner/ Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Pencing Flooring. Carpeting Linoleum / Wood Glass / GIazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/ Contractor Signature Date