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03010083 CITY OF CUPERTINO BUILDING DIVISION PERMIT ;CONTRACTOR INFORMATION`" BUILDING ADDRESS: WALDRON CONSTRUCTION COMPM ILRMITNO, 20060 RODRIGUES AVE # 12F 03010083 NER'S NAME: P O BOX 598 APPLICATION SUB DATE LAKE BILTMORE APARTMENTS 01/15/2003 PHONE: (408) 377-8186 SANITARY NO. CONTROL NO. ARCHITEC(ENGINEER: BUILDING PERMIT INFO RLDG ELECT PLUMB MF.CII 1=1 0 0 0 '0,O LICENSE DCO NTRACTOR'SDECLARATION ce U F 1 hereby affirm(hal I am licensed under provisions of Chapter 9(commencing Job Description yza� wim$et9inn]IMMB of Division lnf NC BuninoiypnJ PrnfcuionsGxle.end mylicenmis in fall rumqan}1 effect /— INTERIOR RENOVATION oigc Date ClY cnNn REMODEL KITCHEN/BATHRMS/NEW WASHEFff A1&=0 ARCH]'rECI'SDECLARATIONglass Vaasa �44y Withstand used as public mods WALL A/C, FL COVERING apWD LLa. LicensedPmlexxionxl MAR 2 5 2003 S OWNER.BUILDER DECLARATION ce <2 1 hereby affirm Thal I am exempt from the Contractors License law for the p�^ wKOO following reason (Section 7131.5,Business andPruessionsCalc:Any city orcounty BUILDING .K 2 K which requires a ferret at consmact,alter,improve,demolish,or repair any structure prior to its issuance,also mquirea me applicant for such permit to file a signed statement Nal he is licemad pursuant to the provisions of the Contractor's Liecause,Law(Chapict 9 Sq. Ft. Floor Area Valuation �Tj 0 (commencing with Section 7000)of Division 3of the Business and Professions Code)or i $ that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant o a civil penalty of APN NumberC not more than Few hundred dollars($501). y Type 0 I,az owner of the property.or my employees with wages v their sole compensation, will do Ne work,end the structure is not intended or offered for sale(Sec.7044,Business 36983808 . 08 and Professions Code:The Contracmrs License Law does not apply to an owner of Required Inspections pmpeny who builds or improver thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If. 101 — FOUNDATION however,the building or improvement is sold within one year of completion,the owner. lO2 — PIERS builder will have the burden of proving dust he did not build or improve purpose for of sat L 103 — UFER I,as owner of the property,am exclusively contracting with licensed contractors Int co wc,the Project(Sce.7044,Business and Professions CmICJ The Conuactmr'a Lt 104 — REBAR cense Law does not apply to an owner of property who Milds or improves Ihemon,and 105 — ANCHOR BOLTS who cmmi to fursucl rojects with a contractor(s)licensed pursuant to the Contractor's' License Lew. 106 — SEWER & WATER ❑lam exempa Sec. B&PC1 r1hi5 an" 202 — UNDERFLOOR PLUMBING net D31C 203 — UNDERFLOOR MECHANICAL WORREJUTCOMP0SATION DECLARATION 204 — UNDERFLOOR FRAME I hereby anirm under penalty of perjury one of the following declarations: 2 0 — UNDERFLOOR INSULATION I have and will maintain a Cenificate of Conserv to self-moum for Worker'sCompere union,as provided for by Section 3700 of the labor Code,for the performance of me 3 01 — ROUGH PLUMBING work for which thisperni`isissued. 302 — TUB & OR SHOWER 1 have and will maintain Workers Compensation Insurance,as required by Seninn 303 — ROUGH MECHANICAL 3700 of Or LaMr Code,for the performance of the work for which Ibis permit is issued. My Workers Compensation Insurance carrier and Pulicvmber am: 304 — ROUGH ELECTRICAL CamcU. ,Z Pill icy No.: 305 — FRAME CERTIPICATE OF EXEMPTION FRM COMPEN.SATON INS RANCC•ORRERS' 306 — HOLDOWNS CThisxncliun amdow hcalmplcted iflM permit isforone hundreddellars(glg) 307 — INSULATION irless) 308 — SHEETROCK 1 anify that in the perform ce of I c work a which this permit is issued,1 shall not 309 — EXTERIOR LATH employ any person In niter suhjecuothe Wnrkers'Cnmpensminn Laws dreafirprnia. I 310 — INTERIOR LATH Applicant NOTICE TO APL' A :If after making this 'Ecxte of Excmption,you shnulJ 311 - SCRATCH COAT he am suatheworker's Comps rtsalimn Pm vont of Be Lahr Calc,you mon 313 — ROOF NAIL Z roMwim comply with such provisions or this permit shall be deemed mvnkcd. ? o CONSTRUCTION LENDING AGENCY 501 — FINAL ELECTRICAL ENERGY [— Ihereby am.mat there is a commuclion lending agency lm the perkxmanccof 502 — FINAL PLUMBING ENERGY he dlUl which pCm111151IIYed(SCC.31N],CIV.C.) Under 503 — FINAL MECHANICAL ENERGY W Q Le 'a s Name 7 z Under'sAddmxS 504 — FINAL BUILDING ENERGY UO 1witifydeal Ihaw read this application and smmthat the above information is 505 — FINAL ELECTRICAL W F correct.l agree to comply with all city and county ordinances and scale laws totaling I. S GAS TEST Q building construction,and hereby cultures,representatives of Nm pa is city enter art the 0. construction,a how mentioned preperty for inspection purposes. O7 FIN $I G I (We)agree to save,indemnify and keep harmless the City of Cupenioo against 11/ rh liabilities.judgments,costs and expenses which may in any way accmc against said City ,55 N CAL U z maln.5equencc fire raining of this Permit. '--' APPLICANT D STAND);AND WILL COMPLY WITH ALL NO INT Issued by50 Date SO ERF. U N�. //W//If� 2A 11-2 Re roofs 514 — NAL PUBLIC WORKS HAZARDOUS Sig`naturc of ApplicaDare HAZARDOUS MATE RIALS DISCLOSURE Type of Roof Will the applicant or future building occupant marcor handle Health sd Safety az defined io the Cupertino Municipal Code,Chapter 9.12,and the Ilcallh and Safety e,setae,25532lan ❑res All roofs shall be inspected prior to any roofing material being installed. Will the applicant of(inure be dlmg eccupml ow cquipment nr devices which If a roof is installed without first obtaining an inspection, [agree to remove emit haaardnas air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. District! ❑Ycs o 1 have maJ the haeardoex materials requirements under Chapter 6.95 of me Cullfor, Iia Health&Safety Code,Sections25505,2.5513 and 25534.1 understood mol 11 me Mi lding fres mol cu 0 ave a tenant,mal it is my rexlxmobilily IU nattily III acupa to on ryuimme s muss cap' of issuwcc nleCcnlacatcnl 714 �&&� = /�53 Signature of Applicant Date Owneem out t argent a'—Deort All roof coverings to be Class "B" or better AMIL CPPY OF CUPERTINO . BUILDING DIVISION PERF CONTRACTOR iNFORMA.r. N BUILDING ADDRESS: WALDRON CONSTRUCTION COMP YRMITNO. 20060 RODRIGUES AVE # 12F 03010083 OWNER'S NAME: P O BOX 598 APPLICATION SUB DATE LAKE BILTMORE APARTMENTS O1 15/2003 . PHONE: (408) 377-8186 SANITARY NO, CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 o t� �oo LICENSED CONTRACnderp DECLARATION Job Description V I ionhereby70 affirm that I em licensed under provisions of Chapter 9(commencing wish Section](g111)of DiviaionJof Ne Busi nJ Prmfessiom Codc,enJ my license is in fullforeea effect. INTERIOR RENOVATION of- DatensCli REMODEL KITCHEN/BATHRMS/NEW WASHER/DRYER & — ARCHITEECCS D LARATIO ondersaJFL sea d nyplans shall neused sspublic records WALL A/C, FL COVERING 6 w0 Licensed Professional OWNER-BUILDER DECLARATION -e f I hereby affirm Nat 1 am exempt from ale Casions o License c Law for the e,-w_p0 which following motionUIMSa (Schon]onstr Business and Professions Code:Any city or county $� whim 2quircs a permit ac amilmn,alter.improve,dtmmitt a repair any SLTUCIUM Fly pdorwitsissuedpursu acquires;tohethevisiosofa,each Comencit miens Lmdsutement o Nathe mencccnud pursuant Mahe of Divisionf the Conuumrand Professions Code)or Sq.F[. Floor Area Valuation (cat he is(commencing Section and the Division r metes Business end on,Any Cnde)or i $ Nat he Is 31.5 b therefrom and the hula for the alleged exemption.Any violation of Sad on am 1.5 by anyreddwrs n!50 rmitsubjects the applicant macivil penalty of APN Number cy'Type nos mom Nen five hundred dollars(5500). 0 1,u owner of the property,or my employees with wags u their sole compensation, will do the work,and Ne sysowm is not intended or offered for sale(See.7066,Business 36983088 . 88 . and Professlmus Code:That Contractors License Law does not apply ban owner of Required Inspections Property who builds or improvs hereon,and who doessoch work himselfor through his own employees,provided than such improvements are not intended oroRered forsale.If, 101 — FOUNDATION however,the building or improvement is said within one year of completion,Ne owner- lO2 — PIERS t builder will have she burden of proving that he did not build or improve for purpose of at )' 103 - UFER 1,as owner of the properly,em exclusively contacting with licensed convscon Ia 104 - REBAR co at ) the project(Sec.]066,Business and Professions Code:)The Convectors Lo cense law does not apply to an owner of property who Wilds or improvss thereon,and 105 - ANCHOR BOLTS who contracts for sue mjecu with a comractudds)licensed pursuant to the Convenor's License law 106 - SEWER & WATER ❑1ardammitu Sep ,B&PCIrws ason 202 - UNDERFLOOR PLUMBING Ow"" Date 203 - UNDERFLOOR MECHANICAL WO ER' COMPENSATONDECLARATION 204 - UNDERFLOOR FRAME Ihcmby elBmt unxrpenalty of perjury one of sae followingxalansions: 205 — UNDERFLOOR INSULATION 0 E]Ihava and will fort ine Cion 37 te of ConaemmCrate.for of m codons provided roemisectionl]00of lM labor Cox,for the pertomnantt of IM 301 — ROUGH PLUMBING work for wham thisPermitissued, orker 302 - TUB & OR SHOWER ❑1 have end will maintain Workers Compensation refer whi h inquired by Section 303 - ROUGH MECHANICAL J]00 mf be labor cox,for the pertmrmanm of Ina wort for which this permit is issued. My Worker's Compensation Insurance camlerano monopole �ankram: 304 — ROUGH ELECTRICAL Carrier: Poluty; 305 - FRAME CER TIFICATE OFCOMPENSATIONEM I ,FROM INS INSURANCEWORKERS' 306 — HOLDOWNS (This section need not W completed if the permit is format hundred dollars 0 IGy 307 - INSULATION I cmir) 308 - SHEETROCK 1 certify any in the psr(orm acs oft work or which Ibis perinea is issucd.l shall not 309 - EXTERIOR LATH Laws employ Calibrate. in nncr subject to the Worken'Compemation Laws of Califmmia. a A310 - INTERIOR LATH Dpiicem NOTICE TO APPLI A :It,after making thisiricam of Exemption,you should 311 — SCRATCH COAT Wcome subject Int the Worker's Cmd onxmion pro Bions of the Labor Calc,you most 313 - ROOF NAIL zforthwith comply with such provisions or Nis pn:rmil shall be deemed revoked. Z� CONSTRUCTION LENDING AGENCY 501 - FINAL ELECTRICAL ENERGY Ihereby aThr.Nal there is a construction lending agency for the performance of 502 - FINAL PLUMBING ENERGY IQ 'he work for which this Permit isissued(See.Hatt,Civ.C)lenders theme IT] 503 - FINAL MECHANICAL ENERGY A az Lenders Address 504 - FINAL BUILDING ENERGY U O 1 cenify than I have mad this application and suis that the above information is 505 - FINAL ELECTRICAL IS. Pcorrect I agree to comply with all city and county ordinances and sate laws relating to U building construction,and hereby authorize representatives of his city to cam,upon she 5 GAS TEST yabove-(We) are to property for inspection an little es. 0 7 FIN B I G / (We)egmeto cove,indemnifyandkith harmless wCityas Cupcnstsagainst (/ y liabilitiex,ju�AN rosy and expenses which may in any way accrcc against said City tj N CAL ^•a U z in eonuque ? '^ APPLICAL COMPLY WITH ALL ON-POINT Issued bye O Date SOURCE R /�° fs Signature of Applu nl/Comractor Date Re-roc 514 - NAL PUBLIC WORKS HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future Wilding occupant tore or handle namNous material M defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Code.Section2531](¢)1 ❑Yess el� All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove emit hazardous air cmnumirsi u as defined by the Bay Area Air Quality Management all new materials for inspection. Din n1 ' ❑Ys I have mad the nectarines materials requirements under Chapter&95 ofthc Calder- me Hcallh&Safay Crede,Sa ons25N15,35533uu125536.iundcrsundthuif Nc Wilding does not to it ave a¢nano thna it is my rcsponsihility m nouly a Occup t of the r qulrcmcaM1s/v s/a,/�apnor to iMuanae oracenirtmt u1 ens Signature of Applicant Date Owner of/�/ramaWr�P/t l7�'d,jial Da —) a, All roof coverings to be Class "B" or better 0 0 CITY OF CUPERTINO I• 2 of 5 PERMIT RECEIPT OPERATOR: conniew COPY # 3 Sec : Twp : Rng: Sub: Elk: Lot : APN . . . . . . . . : 36903008 . 00 DATE ISSUED. . . . . . . : 01/16/2003 RECEIPT # . . . . . . . . . : 20864 REFERENCE ID # . . . : 03010083 SITE ADDRESS . . . . . : 20060 RODRIGUES AVE # 12F SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : LAKE BILTMORE APARTMENTS ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : SAN MATEO CA, CA 94403 RECEIVED FROM . . . . : LAKE BILTMORE APARTM CONTRACTOR . . . . . . . : WALDRON, ROBERT LIC # 21547 COMPANY . . . . . . . . . . : WALDRON CONSTRUCTION COMPANY ADDRESS . . . . . . . . . . : P 0 BOX 598 CITY/STATE/ZIP . . . : CAMPBELL, CA 95009-0598 TELEPHONE (408) 377-8186 E ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BENERGYADD PLAN SETS 1 . 00 22 . 20 0 . 00 22 . 20 0 . 00 BPERMFEE VALUATION 34 , 660 . 00 380 . 00 0 . 00 380 . 00 0 . 00 BPFIXTURE UNITS 2 . 00 16 . 66 0 . 00 16 . 66 0 . 00 BPLANCKADD PLAN SETS 1 . 00 22 . 20 0 . 00 22 . 20 0 . 00 BPREPIPE NO OF FIXTURE 2 . 00 16 . 66 0 . 00 16 . 66 0 . 00 BPSEWAGE UNITS 1 . 00 62 . 16 0 . 00 62 . 16 0 . 00 BPSEWER SEWER SYSTEM 1 . 00 19 . 98 0 . 00 19 . 98 0 . 00 BPTRAP NO OF TRAPS 1 . 00 8 . 33 0 . 00 8 . 33 0 . 00 BELEC200 METERS 1 . 00 22 . 20 0 . 00 22 . 20 0 . 00 BPVENT UNITS 1 . 00 8 . 33 0 . 00 8 . 33 0 . 00 PPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00 BPWATER UNIT 1 . 00 8 . 33 0 . 00 8 . 33 0 . 00 BREMAIRHAN NO.UNITS 1 . 00 8 . 33 0 . 00 8 . 33 0 . 00 BREMFIXT NO. FIXTURES 8 . 00 8 . 88 0 . 00 8 . 88 0 . 00 BREMINHOOD NO UNITS 1 . 00 8 . 33 0 . 00 8 . 33 0 . 00 BREMRECEPT NO. OUTLETS 8 . 00 8 . 88 0 . 00 8 . 88 0 . 00 BREMVENFAN NO UNITS 1 . 00 41 . 63 0 . 00 41 . 63 0 . 00 BSEISMICRE VALUATION 34 , 660 . 00 3 . 50 0 . 00 3 . 50 0 . 00 EPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00 MPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00 ---------- -------- -- ---------- --------- - TOTAL PERMIT 773 . 16 0 . 00 773 . 16 0 . 00 • V 0 •ITY OF CUPERTINO • 030/ 0 0 �3 NO PERMIT APPLICATION FORM rCYN# Date: Building Address: Owner's Name: Phone #: Uv-e BILTMbk� APhETM>?�r15 (off rJglo-5300 Contractor: License#: R.W anrJ &1jS-rI'gMoA ING. 71X137 Contact: Phone #: Ja5 wgmf5k ReoSC2--r MAuA6j5?- -5308 Applicant/Contractor: Fax #: LACE L oR& APAOTMEW-5 (psb �t6- 537 $uil. ing Permit Info: Bld Elect PlumbMech Job Description: N c2 R07""71&j -t Residential: MULrI- 4Mi�� ieazeaderin,G Commercial: r Sq.Ft. Floor Area: S/Sq.Ft.: I D00 SF. Architect/Engineer: Valuation: RAYMuuDo �T4uP 2 S,NCta,e RSS �� b6o Type of Construction: Occupancy Group: lZ l QuantityFee ID Fee Description Fee Group BAPPLOTHER Other Appliances -MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXB Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V <=200A ELECTRICAL BENERGY Ener BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi-Family Res MECHANICAL BNEWMULTI New Multi-family Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL • BNUCObfMIvi New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING * ZG 1 of 3 am-, CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM . CUPEkTINO Quantity Fee ID Fee Description Fee Group BNUMULTI New Multi-family Res PLUMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING I _ I BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE PbIg Fixture PLUMBING i BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING 7 BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinklerBackflo PLUMBING BPSTORM Stonn/Rain Water PLUMBING I BPTRAP Kitchen Trap PLUMBING E BPVENT Alt of Drain &Vent PLUMBING • BPWATER Install/Alter Water Pie PLUMBING BPWHEATER WaterHeater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units<= 10,000 din MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL 8 BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL • BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Li ting Fix ELECTRICAL 2 of 3 ; C '- CITY OF CUPERTINO CITYOF PERMIT APPLICATION FORM • CUPEkTINO uantit- Fee ID Fee Description FeeGrou BREMVENFAN Vent Fan Single Duct MECHANICAL 4REMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSF&2FAM Single & 2 Family BUILDING BSFNA Single Family New Add BUILDING BSPECIAL Special Insection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL I EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING • PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> IM to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75 M Btu MECHANICAL • 3 of 3