02060199 CITY OF CUPERTINO - ', '" � - - ` - 1.
BUILDING DIVISION PERMIT CONTRACTOR EWORMATION '
82°bRh'jTDPP6DRIGUES # 71 WALDRON CONSTRUCTION COMP Rh41T002060199
iWAIKTASILTMORE APARTMENTS P O BOX 598 APPuc01V78,y12002
PHONE: (408) 377-8186 SANITARY NO. CONTROL NO.
seZ ARCHITECT/ENGINEER, BUILDING PERMIT INFO
PoPat,O BLDG ELECT PLUMB MECH
y i
m i LICENSED CONTRACTOR'S DI CLARATION '
;i_� Iherel,yalfr;ahit In.lransedunaerp,oAkinarofChapter 9(commeacmg INTER.RENOVATIOZ 'ID�L1ED KITCHEN AND BA
=tw
is in full force and efffect.sinslldonslam, n3anheBaamtsaaarnfersmnsenae.anamr°""s` NEW WASHER/DRYER, NEW WALL A/C, NEW FLOOR
Y j psr
1.0u
O0u L...ew Class Lf,p
i 3 y Dote - em,oaclnr
ARCHITECT'S DECLARATION
"°g 1 nnder,land a,y plans shall be aced as palsic recalls
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1E
a O Licensed Proc,sionvl
OWNER-BUILDER DECLARATION
Is
411,, 1 hereby of inn;has 1 am exempt from the Cammem,'s License Law for the
I—Z a following ' . 7031.5.Businessd Profession,Code:1 y any r county
3whPwhouln :, tae p demolish, memo,
$34660
a - po it.. wgrcsm pprcit IP 'n nios atatement
........._...... ._._ __- _- _ _
min dp ant-p p nn t I r L C Sq.FL.F1 our Area a ,.f Valuation
(commencing besex asci moo)ofDivision3 nn lBusiness,yaProfessions eae) r 369-03008 :'00. .V. �r... ,._s '
or that he,v 31.5 b therefrom and she hasis far the elldthe iemyt on.Any v stenos
of antlnn]031:5iv anyapplicollfar apermit subjens ih<npplicam toacivil pen;eiy
nr antennae moa rue nanarea donors(Ssno). APN Number Occupancy Type
101 - FOUNDATION
❑1,d owner of the progeny,ra hi mI,hot intended
wages a theiredf axle compensation,
'Bc,,iao the work,and the Cod,
The Coal.intended ore Law for sole apply 1.an —
PIERS
own,,ss and property
Who
ids The Coal theo's License Law dcee not apply m an 103 - UFER Required Inspections -
own,,of property Who hands or tomatoes t ;hereon,and who encs wen work himself
or through I'. aemployees,provided that such m,prmeme is are I leided)ear or 104 - REBAR.._ __. - .. . . . .. . _. ._._ _. _. ..._. .. ... ..offered for sale.o rte weveq the building or improvement's sola welt n nae build of ,_ s , „
•improv0on,meowne,"ifle.trwiunaa•<massa<anrprn.ingthatnedidnotbuuao, 105 - ANCHOR BOLTS . . .
improve for purpose fevleJ.
.,.106 .-- .SEWER &...WATER. _.
nn n par m1 a iacmrsln 202 - UNDERFLOOR PLUMBING
attainment thel J Ct(s 7041 Business a P f.. as Code:)TheC baerors
License
r t L LI tensnot
L pply to an owner ofproperty who improves thereon. 203 UNDERFLOOR MECHANICAL
-.ad,wh.contracts
f n P Jects w th. om,amors)licensed P oma bathe
C
_.
204 - UNDERFLOOR, FRAME .
❑1 pt nd s cmrfish,aran 205 - UNDERFLOOR INSUli.ATION
r
Own
\ RKER S COh1PENSATION DECLARATION��y 301 - ROUGH PLUMBING
-I het<by afrrm ander penalty nr perjury one of the foilnwing aedumtions: 302 — TUB & OR SHOWER
0 1 have and will c;ammam a Cenifcate or coastal in self-insure for Workers 303 - ROUGH MECHANICAL
N,za Compensation, as provided lar by section 370 of the Labor Cade, for the 304 - ROUGH ELECTRICAL
permrmaa<e sant ware mr wmen mil p<m,it is t wed"
305 - FRAME
01 nave and will mulmliffm Worker',Comp,nizelich brilliance, - a ' dnys<lon 306 - HOLDOWNS
3700 of she Labor Code,for the lbarbormaricc of the rk for which this permit in
issued My Workers Co g C 1 bur c me a J P 1 cy x e: 307 - INSULATION
Carol
43wiaanevN :. 3.08, SHEETROC&.
CE RTIFICATIONOFEXEMPTIONFROMWORKERS i .� ) s 1,
COMPENSATION INSURANCE ' 309 " EXTERIOR LATH _
310 INTERIOR LATH , a
mrs c tlun need not be completed f the permit is for one hundred dollars -
csioojpn<ss.) _ 311 - SCRATCH COAT
1 al lel r m Per aa& rm<wakr •n nmtsp<nniria{�ata,l 313 - ROOF NAIL.
'i1 II n t mpl y any pe n any manse 'o vs to become wb;en io the Workers' 5 01 - FINAL ELECTRICAL ENERGY
C pe mtoni.aws 1 California.Date •
.A'Plicnar
NOTICE TO APPLICANT lrener ink gays cemfcare rEx<anran.yaa amara `502 - FINAL PLUMBING- ENERGY
Z ntenmesabjetunmtWorkerscon,ptnaatanponisiom
asoftheLahorCode.yhausl 503 - FINAL MECHANICAL ENERGY
O forthwith coli wiffstrall i.ocres or ths permit sold be occurred ok,d.
Z . -,.
504 - FINAL BUILDING ENERGY
aAGENCYsa505 - FINAL ELECTRICAL
V] L 'e add t CONSTRUCTION LENDING Ih p f,rmantt'
i h by nfrrm m uh on wn led '
name rkf tick th pe,ml sl su date 3091 Ci¢C7Y
yp L ar N _,. ,. 506 - GAS .TEST.. ...
v:z507 - FINAL PLUMBING -
J «rrmtln am ppb t d mt muss emm,mlronis 508 - FINAL MECHANICAL
C`U to m 1gc t Pb beall authorize
my d nesand Sate laws elating
O;:U the building n.audb al binspection
nspec representatives nM1 -tymemrupon 509 - FINAL GRADE
the h e)agree
reeIdpmpenyf instar eprp,e - 510 - FINAL PLANNING
(We) g e to rue, tl emnify and keep hmml.s the C n f i n tli,io against
fn:V1 liab,l t judgments.f t and expenses ib ch may in any any ace me,egoist said 514 - F NAL P WORKS
V; Cty 'c 9 nh "ou'U h p s - T i
APPLICANTU ER SAND WILL COMPLY WITH ALL YONPOINT'` I
SOURCE Rccn 7 Issued by: Date
s g.,; rapplmanucnnva<mr .: - '. Das Re-roofs
Chili,S ct n 25532(a)?,AZARDOUS MATERIALS UISCLOSURL and Safety
Type of ROOF - r :.•r _
a 8 oc gam i re or h ndl h e
DYpe Cd Chapter 9,12,aache He
. : odea dlbyhhe Cupertino Municipal PP .,,
_ ft' ..ti . t. _
r .a1.' ., to, -.-..,
1 Al]roofs shall be inspected prior[o any,roofing,material being installed
wpm pplc to r en lag p i' .q p ma at-'tea nrn If a roof is installedwithout first obtaining an`inspectiorliI agree'to-remove
chair hd s main S�sns/Jf d by the ByA - Al Quality Management
Diet c? I Y"'�` all new materials for inspection. Applicant understands and will comply with
YY all non-point source regulations.
1 have rend the hazardoes�nraternals Teiliircraznta under.Chapter 6.95 of mhe
California Health'&Safely Code;Sections 25505,25533 and 25531.1 understand mat
ififfelamidin apes o�curte,tl M1 m that i a,mresponsibility� the Signature of Applicant Date
O c act/yq� Wursnissuance/ J"
Date, g
oc p nt f l u ar ss h mot be met p ,oyf'a enifcaie of
o , Al] roof coverings to be Class B or better -
vwhnrzeds
c..a`, r.., : OFFICE._, .. .. .. .. , .. ..... __ .-_-. .. .. ..-