06060198 CITY OF CUPERTINO
BUILDING DIVISION PERMIT 'XON'T Q-Ty,0 R�INFORMATION. 'I , N","i
BUILDINGADDRESS: BETTER WATER HEATERS """06060198
7746 ORO GPAND
R PT,
OWNER'S NAME: PERMIT ISSUE DAM
LUM DARREL 351 FALCATO DR. Oe/221/2006
NE: SANITARY NO. CONTROL NO.
(408) 250-6672
ARCHMECTIENGINEER: BUILDING PERMITINFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
I berby In imi��u�rpm�emor� 9(mm�ing Job Description
with Section I=)o"fDivition 3 ofthe Broamas tod Professions Code.and my licenses
in full force and effect. REPLACE 40 GAL GAS .WATER HEATER
Licer.Class Lic.N
Dow—C.-inactual
ARCHITECTS DECLARATION
I understand my plans snail k used as public records
JyU
Licensed Prulluctional
OWNER BUILDER DECLARATION
O
I harcb, Mrst that I ron attempt from thic Contractor's Licenda,Law rat ft
O C Following husion.(section 7(n 1.5,Business and Pr
Chat:Any City err County
which ouptuas.permit 1.emcarect.Ater.improve demolish,Mr repair my stucture $649
prior art its issuance.also OcCuircy ft applictual for men Permit to file a signed statement
if that to is licensed purstrant to flue provisions of Ove camusetar's Liechas Law(chapter 9 Sq.Ft. Floor Area Valuation
C fetontreaturti,with Section 7M01 of Division 3.1'tho Bissirtest and Prolicsim.Code)or
Nat he is exempt therefrom and the basis for the alleged exemption.Any violation of Occupancy Type
Section 7031.5 by any applicant for a permit subjects the OPPIii 1.a Civil Penalty Of
had...than five hundred call.(S500).
C]I.um=ofNepmp ny.mmy=ploy=with mrzutheir mlcmmpamdon.
will do diewort and die structure d not intended or.ffmd boards(SCC.70th.Buctmead
and Pinfesto..Cod.The Cartractors License Law does son apply an an owner of Required Inspections
property who builds or improves thersorrand who does suchwarichinselfor through his
Own employees.provided instances improvements art On intended aroffens!forsale.If.
however.the Wilding or improvement u;said within note year of completion.has cwhou,
Wilder will have 0,burden of moving too he did not Wild.,improve for hophrise,of
01.as own"of the property.ma exclusively conaraccurig with licensed canvazters to
.Momet the project(Se..7014.Business add Professions chat:)The Conditions.U.
cents Law does no,apply in an Owner of property who Wilds or imposes thchum,and,
who Contracts for such projects with a contractor(s)limned pursuant to and cafturacior's
License Law.
C]I and attempt under Sce B&P C for this
A/ /101 4g-;u76l,�
WO ER
COMPENSATION DECLARATION
I hereby affirm under Penalty of perjuryand of the following c1cclaustimue FINALpr%
I as m and will maintain a Ceniflesess of Counter to scif-insum for Wool Compen-
sation,as provided for by section 3700 of the Labor Code,for the performance of the
wort for which this Forest is issued.
C]I haw and will maintain Wordur's Compensation limitations,aa required by Section U
37W of he Labor Codo,for the perform.idtha,work for which this Permit is burned.
My Woulan's Compactudion Insurance Carrier and Policy number an:
CERTTRCATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCECarrier.—Policy No.:
(The;second need Out be completed if the Permit is future,hundred dollars(SIM)
M-las.)
I cered(y that to the pvformance of the wari,for which Ons permit a W.d.I aludi.1
employ any person in any anchor ad u to areadon
Laws of calif I Dir ; Z!�-mr—=_
NOTICE TO APPLICANT.If,after andtinu;this Certificate of Exemption,you should
become subject an the Workou't;Compensation provision of the Labor Coce,you most
z forthwith comply with such provisioner or this Permit shall the commul reneflacal.
z 0
W) CONSTRUCTION LENDING AGENCY
I heraby.M.thad there is.commuCtion lerulitilitseric,or Ou,M(tormamcactf
CL > ths work for which this Permit is issued(Sit.3099.Civ.C.)
1-mcfer's Name
z Lenders Add.
U 0 1 Cattily that I have read this applicaunn and muc bar the above ittrinnom.m is
Ly F toren.I agree to comply with all city and county onfidance,st and state laws relining to
0 building construction,and hereby authorin:murcycousfives of this city to enter upon the
wU above-mentioned property for inspection purposet
>�
(we)agree to save indeease and mnify and oxp humorless the City of Cupertino pinn dsnt,,.1
ch mase in
U Z I.c-cocchourse of do,tranoti.g of this paurnit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOUR E REGULATIO
14 / ( 91 a, -C7
ft�L 4�-;?,2 24:� Re-roofs
Sigurd..of Applicam/C.mravet., Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will has applicant or for=Wilding occupant accure or handle hamnlow;material
as&read by the Cupertino Municipal Code.Chmm,9.12. oil the Health and Safety
Cook.Section V5324)? All roofs shall be inspected prior to any roofing material being installed.
0y. P14/
If a roof is installed without
Will the applicant or future building Occupant use Cqui men,or devices,which first obtaininan ins spection,I agree to remove
I up
Craft but,anknut air chountiourns as defined by he Bay A.Air Quality Manal all new materials for inspection.
District?
0Yes b4.,
I have road the hvallous materials requirements under Chapter 6.95 ofthe Califor-
his Health&Sad.tyCed,.&.d.25505.25533 and 25534.1um1entmld thad if the Wilding
does net currently have R tenant,that it U MY hespOrsibility 0 Madly time 0CcaPaM of the
Occur I Pon of a Cereficau,of Occupancy.
Ll�]i�
7 Signature of Applicant Date
Owner or authorized agent All roof coverings to be Class"B"or better
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY Of Fax(408)777-3333
SCUPE(�TINO
Bu.ilding Department
JOB ADDRESS: PERMIT # (50 Gb/
OWNER'S NAME: ,4RC L 1,U #t PHONE # �3T
GENERAL CONTRACTOR: 94�t1z:tv-- (�,< I JA t. #
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
Owner/Contractor Signature Date
CITY OF CUPERTINO
�m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36218023 . 00
DATE ISSUED. . . . . . . : 06/22/2006
RECEIPT # . . . . . . . . . : 34989
REFERENCE ID # . . . 06060198
SITE ADDRESS . . . . . : 7746 OROGRANDE PL
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : LUM DARREL
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
RECEIVED FROM . . . . : CHERRYL LUM
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
- --------- ------------- ---------- ---- ----- - - --- ---- -- -------- - - ----------
BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00
BPWHEATER PER HEATER 1 . 00 10 . 79 0 . 00 10 . 79 0 . 00
PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
---------- ---------- ---------- ---- ------
TOTAL PERMIT 84 . 02 0 . 00 84 . 02 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ----------- - ------------------
OTHER 84 . 02 VISDA
TOTAL RECEIPT 84 . 02
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
502 FINAL PLUMBING ENERGY 506 GAS TEST
507 FINAL PLUMBING
•
CITY OF CUPERTINO
WATER HEATER
COF
• CUPERTINO PERMIT APPLICATION FORM
EAPN # Date.
ress: /ten ., I�
Owner's ame: P one
Cop�a(c � Phone: 'License#:8a. g /G�
was T�
Contact: Phone: Cupertino Business License#:
Gv.vz- �
Building Permit Info: flr-- 1-1M'6 y0 i,,1 4- &9--f WArZ - k7�CA7�k—
Bldg ❑ Elect Plumb Mech
Job Description:
Residential Commercial ❑
Cost of Project:
Strapped On Platform Bonded Er
New Location ❑ Re lacement
Qty. if
Applicable Fee ID Fee Description Fee Group
BPWHEATER Water Heater/ Vent BUILDING
PPERN=E Plumbing Permit Issuance PLUMBING
BENERGY Energy BUILDING
BUSLIC Business License BUILDING
•