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08020002 (2) CITY OF PERTINO BuiLosioN - PERMIT C,U,N,"CRACURgI .1VT'URMA�TMION`t�`'". PERMITNO. SHANG CT FAST W!.TER HEATER 08020002 40 NER'S NAME: PERMIT LSSUE DATE YEN, TSUHONG 12601 132 AVE NE 02/01/2008 PHONE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEERt BUILDING PERMIT INFO REMV/REPLC GAS WTR HTR BLDG ELECT O O u00 LICENSED CONnRd underSDECons of CON JOb Descri on 1 hereby aRinn tiYA 1 am Ikrenscd under provisions of Chaeta 9(enmmcaing P aim Sunman 101)0 ofDMidon 3 ofthe BusiasaaM ity license i, ^ H m full race endis DMA Licensa Lic [F tote Co ARCHITECTS DECLA ATI / 1 undersand my plans shall be mind u public record, S9� Licensed Professional N OWNER-BUILDER DECLARATION �9 1 berehy Affirm that i am exempt from to Contri License Law for the i.a o following teason.(Station]031.5.Business and Profecdow Code:Any city at county $las which mquires a permit to eonstra6 alter.impsaw,demolish.Or repair any=more z> prior to its issuawe,also requires the applicant for web permit to file a signed Sudamen, g Lung In,islicensed pursuant to an,pmvisinmorthe ConucloYsLicense Law(Chapter 9Sq.F FFloorArea Valuation (commencing with Swoon 1000)of Division 3 of Alo Business and Proressiow Caleior Nn he I.auimpt Newfmm and Ne basis for Na alleged exemption.Any violaJon of Section 1611 .5 by airy Applicator fair a permit subject,the applkwt to a civil Penalty of APN Number Occupancy Type not more Nan Roo hundred dollars(ML (3 I,as Owner of tie property,or my employees with wages As thelrsob compensation, will do Ne work and tie man.4 notiiti oranerad Waste(Sai TUN,Business Required Inspections and Professional Code:The Contractor's Lieem,Law dura sol apply to e ns an Owner of q P property who Wilda or imPsaw thereon,And who trap sols work his if a through his Owns emplayeas,provided thawch lmpmwmeau..at intended aolremd for We.If. however,me building or impmmnem is said within ow year of completion.the owner. builds wit]law the bathes of moving that An did wt build or improve for purpose of ale.). t ..... ❑1,at names of m,property.am eaclunwly conmaAing with licensed aanuaron in co mini me Pmkct(Sea.101,4.Business And Profnulom Code:)The Cmusator'.U. curse Law does mot apply to an owns of property also builds or improvea tartan,art , acus contacts far such pmjeeu with a an,ractoNp)licensed pursuant to the Cmnuaaor, License Law, ❑Ism excmm under see .B&PCfa Nismswn Data WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury ane of to fallowing dalaatiom: ❑I haw and will maintain aCerlicete of Consent to self-image faWadiesCommon- amin,As provided for by Section 3700 mf Ne I.Wr Cade.for th,performance mf the work for which ads permit is issued. ❑1 haw and will maintain Workers Gmpensnlon Instnna,u required by Semon 370()of th bar Code,for Ne pedortnwa of to worts far which this permit is issued. My Wo ons wati An carrier And y No.:nudlPyete;. _ GArier. Policy FROM � RKERS'//J/��]� C RTIFl TEOF COMPENSATION FROM WORKERS' COMPENSATION INSURANCE (Thisseaiw mad Ant uncompleted if Ne Permit is farms,hundred darer($100) or lass) 1 ceniry,that in the performance of the wart fm which this permit is issued,I Nall not employ any person in any matter so as in baoma subject to the Wmrkerat Compensation Laws of California.Data NOTICE yet NOTICE TO APPLICANT-.the Wor s'after making this CeeEtae of Exemption,you u mus baane subject to is Worker's Competition Permit itiom of the Isom Coda you must wJ O forthwith comply with much provisions or Ni,pemnit,cuall be darned revoked. z CONSTRUCrION LENDING AGENCY y t^ I thereby Linins that Nem is a conswNmn lendingageay for the performanee of CYi> the work for which m4 permit is issued(Sec.3091,Civ.C.) tiW Q Lando,Name =z Lenders Address , U Q I anify that 1 Mw rad this application and sun that ass Won information is - .... U,E contract.I agree to comply with all city and county ordinanms and sun laws rtlming to ' .Q building construction,and hereby wNwise represenutws of this city a anter upon the [i] ahmve-mcntimad property far inspection purposes 6. (We)agree to aro,indemnify And kap harmleas the City or Cupertino against a.w Vl IiabllNesJudgment,casts and expenses which may in soy way ansa gainst Amid City U Z in consequence of We grudng Of this North. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL Q N N-POINT Issued by: Date SOU E TIONS. GRe-roofs _. Sigmaure Of6micauggConammol t, Da HAZAReARIDS MATERIALS DISCLOSURE Type of Roof Will thoapplieutarrutumbulldingacupwtromoibabdiehuy o"matorid - de0ted by the Cupenina Musdcipal Code.Chapter 9.12.sed to Health and Safety .Section 25532(0l ,3J All roofs shall be inspected prior to any roofing material being installed. ❑Yes yNa will the applicant or fuare building maupant use equipment or dcvieea which If a roof is installed without first obtaining an inspection,I agree to remove emit ha>ydnus air eonumiwnu a defined by the Bay Arcs Air Qualhy MAnag,m,nl all new materials for inspection. DiwfnT �ss�f�N ❑Ye, - 1 haw sad the hmudau ma CdAb requirement,underChapwrii.95 artieCairns. nis Halm&Safe,yCodm,Sectau 23505,15533 aW23534.I avJersund Nuif tit,building docs not currently haw a enrol mu it U my mapomihili,y m teufy de aeumnt f tie ,gni hmtlawwamr.catrwaar� C/ Signature of Applicant Date Owner alio rixed.gen, DAR/ All roof coverings to be Class"B"or better From: 01/23/2008 14:14 #398 P.005/010 CITY OF CUPERTWO 391366 WATER HEATER Cur iN0 PERNM APPLICATION FORM APN# �� o a Date: 1/23/08 Building Address: 828 HOOSHANG CT Owner's Name: Phone#:(408)517-0409 YEN,TSUHONG Contractor: Phone#: 800-454-8955 FAST WATER HEATER COMPANY Fax#: 425.814-9516 Cupertino Business License P. Contractor State License#: 29100 877489 Contact: Phone#: 800.454-8955 Carol Randall Fax A 425-814-9516 wilding Permit Info: Bldg Elect Plumb 0 . Mech Residential ❑x Commeroial ❑ Job Description: Remove/Replace Gas Water Heater Strapped ❑–'On Platform 6— Bonded ET New Location ❑ Replacement Valuation: 449.00 Green Building Check mast be completed and attached to this application. Green Building Polnts achieved: B)� From: 01/23/2008 14:14 11388 P.o08/010 391388 CITY OF CUPERTINO • WATER HEATER CUPe�riNO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Permit Type Group IPCW IPATR Commercial Water B PCWHEATR Heat=(Vent BSElSMlC0M Seismic Commercial B 1 1 PRWHEATR Residential Watar B PRWHEATR HeaterNent BSEISWCRE Seismic Residential B PPERMITFBE Plumbing Permit P I TRAVDOC Travel & B Documentation BUSLIC Business License H • • CITY OF CUPERTINO 4 ITEMS OF 8 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35902008 . 00 DATE ISSUED. . . . . . . : 02/01/2008 RECEIPT #. . . . . . . . . : BS000003827 REFERENCE ID # . . . : 08020002 SITE ADDRESS . . . . . : 828 HOOSHANG CT SUBDIVISION . . . . . . . - CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : YEN, TSUHONG ADDRESS . . . . . . . . . . : 828 HOOSHANG CT CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4218 RECEIVED FROM . . . . : FAST WATER HEATER 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 'VOICE ID DESCRIPTION ---- ---------------------------- -------- ---------------------------- 518 WATER HEATER • INVOICE INVOICE INVOICE INVOICE INVOICE. INVOICE INVOICE INVOICE INVOICE • CITY OF CUPERTINO PERMIT INVOICE OPERATOR: patg Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35902008.00 INVOICE DATE. . . . . . : 02/01/2008 REFERENCE ID # . . . : 08020002 SITE ADDRESS . . . . . : 828 HOOSHANG CT SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : YEN, TSUHONG ADDRESS . . . . . . . . . . : 828 HOOSHANG CT CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4218 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 DESCRIPTION----------- DUE FOR AMOUNT DUE -- -PAID BALANCE ---------- ---------------- ------ --- ---------- SEISMIC RESIDENTIAL PRINTING PERMIT 0 .50 0. 00 0. 50 PLUMBNG PERMIT ISSUE PRINTING PERMIT 40 .79 0. 00 40.79 RESIDENTIAL WATER HEATER/VE PRINTING PERMIT 24 .48 0. 00 24 .48 TRAVEL & DOCUMENTATION FEE PRINTING PERMIT 40.79 0. 00 40.79 ---------- ---------- ---------- 0. 00 106 .56 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- --------------------------- 518 WATER HEATER Community Development 10300 Torre Avenue WPc Cupertino CA 95014 Telephone(408) 777-3228 Fax(408)777-3333 0 Building De artment JOB An S : PTPERMIT # D F0 2-a OWNER'S N PHONE # GENERAL CONTRA R: FAX # I am not using any subcontractors: =Siggna Da Xe Please check applicable subcontractors and complete the following ' 0 tion: 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 G OI rr/�or Signature Date