01040058 (2) CITY OF CUPERTINO '• .. -
BUILDING DtvtSION. pERMITCONTRACTORINFORIVIATION:f. -
BUILDINGADDRLSS - - PERMIT NO. 1
10490 DAVISONW., ' _' HOT.' WATER- INC . 01040058
OWNER'S NAME: APPLICAT[ON'SUB DATE
HOPING SINH„ET AL '' 2531-1,GRACELRNA AVE 04/1.2/2001
PHONE: _ - - • .t•. SANITARY NO. CONTROL NO. '
(650) 598-8494.
n 0 0 ARCH]TECT/ENCINHEk; - - BUILDING PERMITINPO' • y. ,
BLDG. - -'ELECT PLUMB MECH
,Zn
z S N LICENSED CUNT RACTOk S Ill CLARATION - - - lob Description
0 z vo I hcroby aIT. J I I h .eJ d pr ” I Chi 9( ' g p
p 4t-w wlh Scmion]apU)�fD -c ot3 nrthefl s.n111 ro!� n C°dc,aWn)leenee Y -
��,�a Lein hr and effect. REPLACE WATER HERTER.
060 D I' #
w O¢ ARCHITFC'I'S DECLARATION
tytyy a nJ r W yllun. ,hall be used as public records
, a
5p0 L ed poacy,ional- -4
OWNER IIUILDER er he ARATIUN
Ihereby'IS 'In-'I a.. Ili l I t L I' for in
v..aY
Q fall ge (Seed ]Inti p -ee JP f h,o A) 'll rcoumy
Stow whichttl prmn t- t he p 'Jmll repair ally 1 (J
3_ p 1 t yT,,h pPl Ir hp all ,"' Immmem -
that no licensed p f In n p nh c , t L 1 dd apnre
(ci on Sq Ft: Floor Area .V uation -
ngwfh SLe(in7WU)nf De 3 rlh�RrcCnde)
o lh'the is di,dered B d he basis for In alleged iscal,ion Any violation ; - , ' d
of Section 7031.5 b any applicant t rotor subjects Ilio p pl l'ant to a civil penally a
of I m 1 y hundred d n,r (asap) - APN Number • . Occupancy Type '
❑Iowner,
e Ilhep p 7y rlry pl frc with
did t. t intended
ffevtl lf tSip n7f14
^
will do II k ?
Business I Profession'C s Th Contractor's L 1 J , ,ply, ' Required
Inspections'"
w f property Who builds 'I , tJ d h workh' . Ir
throughor his n mpI r .1 d thor suchpr d d
nr 502 u: ..FINAL'PLUMB,I NG, ENERGY ',
lr red Inr sateIr,however,at the hu Nina p lwoure n s sold vitro°e,yc.or
otnpledod.we°wer-builds, ill have linebaNenofprovingl hat he did nothuuder
o 506 —- ERS !TEST - -
imprtru'oforpurposeors.dw).
' 507 .— ' FINAL PLU
MBING
- .
Ell.aownerofthe p(Seeny,ant iscla Ru',ruieelyd'Proleisecies hrensedenmrncmtst° ' '
LicensIllishoe
et the oe)at(See. in
niter el and'Pm Ill,,
Code,)The Contractor's • -
- Llcetuh Law does four
apply m an owner of it coney who builds sed porsou t or the '
and who commits dor ,, projects with u c„mnmmr(q fken.ed pursuant In the` • - - ''
Contractors License
D 1 coulditerelutdcr Sec, Il&PCI'nr thikeetain
Owner Dom o 'v -
W'ORKER'S COMPENSATION DECI-ARATION
_ Ibloody.tnlm l uhYorpebuy lone or ne tiaow'ta do clinical
�1
E:l I lot,,i l II '' Iv C IIec f3 Ll Irl . efor odeWorker's
- • '
p I E' provided lied whir by S cion-394 of Ilio Ldhor Code, for the
performanea nr me work ror winch this hemdt is issued
- 5'• - ,, - a _ -
C 1 have and will nouretioneWorkers Conipsinsatiou Insurance required by Svefon
]]IlfI nil the Labor Code,for h licit vu ue of the walk for which this pen t I ie "
m cd.My Worker's Cm Te...non Gu ranee u R cr red P°bcy number am: - ` '
Currier: Policy No.: t
CERTIFICATION OF EXEMPTION FROM WORKERS' rCOMPENSATION INSURANCE
Th'acctmnk - -
f cul n°f he minpinnJ It Ibe permit in ror nnc hnnJrnJ dollars -
($IINI)orlccaJ - - '
I reIPIk that in the'pe in only ret it the work for which this I e issued,I ' n
perni
shall t f pI ry any p . t m Y to bemntc subject to the Workers . . -
Ci n p :t Lawv c f Carfum'n.buten
Applicant . . ♦, .
NGIICLTOAPPLICANT.If,rionerairell,hi,Cnlcat,of Exentint You should
z he ,brief In the WorkersCnmpeuf p .of the fatbar Code yen mint -
'f°rthwlhunfitly wid .u1fp sic llspertnl shall'b°dvrdddxvokcd.
z ..
FCONSTRUCTION LENDING AGENCY
a1
hl IT trial theren.tmer ding ug n Y it,,the puthel In ve "
W
-,oftlle Work bit vluhtl prour to issued(S F3097,Civ.C)
9z Tecon"s Secure
L.6W,Acid,cis
C+ W • I tfy(full 1 food eli
IPI'sn
111 Into[lie ab n
f�mtat
is Fl rroll.I alive to cu npY with all cit loin carry oNamat le los clminK
Vto hbe a eion hereby nulherrrre msenttivoxof thisntYto cntcnitan
he above-meationd property for ncpcation rP�eev.r
_ ,
. .
-
w
_
wop
,� W (We)uglee to.vavok'a n ex,viend youth alay ic,ra City ar Ca AtIol agniaid
Cit, f I dg 1. cook'and ,e.re I-f y',Amy waY scene ugu rd said
V City ANTUnwofthcsm(AND this - -
SOURAPPLICEREGUL TIONS.DS AND WILL COMPLY WITH ALL NON-POINT - +d
SOURCE REGULATIONS ... Issued by: k•in i 4 Date's------------- ,
Sts t I Ap,l VL t t Dole Re-roofs - .
HAZARDOUS MAI I RIALS DISCLOSURE
Will
ppr' I 'alone
"'ile t, ivt t n n tr d f a r recruit' Type of Roof -
"uslf irkedbyt Cup to Municipal CJ Chapter 9.I2 din II Ithand Saint
,
CM S t 255320 t d-
°Y °N All roofs shallebe inspected prior to any roofing material being uistalled.
wd
- ae applicant t future b riding ov tuse=a it t, 1 i �wIt nM1 If-a roof is installed without first obtaining an inspection, I agree to remove -
ent,rotund. nusu renal nuav JcJnW by the Holy Arca Air Qtdty Mnfagemunt _
Dienicf7 i. „ all new materials for inspection.,;Applicant understands and will comply with
d Yu3.• 0 N I' all non-point source regulations.
1 Irive necd,the h J-un,loolonall loloolinivell under Chnptcr 6.95 1 the „ r California Health&Safety Code Section,25505 25533 and 25594 1 understood Ihn,
• . if the building I not currently have a noneol,duaaI Y p hl,yt ffyth
"cupan of the reym
tttenunrest
fs solicitb psur eo Certificate nut 'or to of e of ,
-. Signature„of Applicant, Dale -
Taro,oraumnraenagent - Datc k - 'Alb'folcoverings torbe Class "B”or better
or or
OFFICE , „