00080031 CITY mt owe PERTINO ' CONTRACTOR INFORMATION: PERMr No.
DIVISION PERMIT
BUILDINGADDRESSr - -
SAN]'1'A BY NO. APPLICATION SUBMITTAL DATE
OWNER'S NAME. 20080 - WALDRON 'CONSTRUE ION COMF'AI IYO0080031
NIC CONTROL#
PHONE: LAKE BILTMORE APARTMENTS 73 HERBERT LANE ." 08Y04/2000
ARCHITF.CTIENGINEER RULIIING PERMIT INFO
00 (408) 377,-81.86
(6^ LICENSED CONTRACTOR'S DECLARATION
-O C I hereby affirm met 1 nm licenced under provisions of Chapter 9(commencing Job Description
Fmtw with Seclum 7000)m'Divrxron 3 attire Business and ProRuiova CWa aM my license is
axy.'ai mfullforoentdefT t. yr
cenuCau tat, INTERIOR REMODEL'
a 3 u y Dau _ Coro mor - - ,
O.a - ARCNTPECTS DECLARATION
I understand my plank shall be used as public records
S O O Lanced Pmessimul
BUILDER DECLARATION
z G 1 hereby affirm that 1 am exempt from th e w
'Oo following..n.(Section 7031.5,Business andP C oy or only --gyp
which moires a permit m comwm,slur.improv, marline,or y r wet
fls� Pit.nen.ice.a,na:.lwm9airexroe.pphc.nlrar aEle kt a S" F&1 TAT Valuationqs,a.
But hex licensed pun ¢ N pts i»ans ofthe Cyan m tuw(C
f<ommcncingwM sanon 7000) fOl iaion3of req Buuneuond e- a .)ar ppNr Number Occu anepp'�::����rrs.,,aa
Met he ix eumpt lhcmf m d N Buis for me alleged excmpi .Anyt�a1 ,}n of p y CZ3t7121O
Secd.n 7031.5 by any applicant for•permtr sub)au 1M iwliCanyll,o eI IvrLbe y of L..":.._- — 3 ''
nes vwre Nen live hundred dollars(3500).
01.sa awpeiafau prsal an my employees with wages as Heir sole compenuunn. J$ (�tai['g�j Inspections
willdadrework,aname smemmisnainimd oroffc Wfm Wc(Sec.7W,ausineu 369031Q YM I11Q1•.
and Pmfe.iam Cade:The ConnnetohLt...Lew data am apply m an owner of
p la ft,who builds or improves Monaco.and who does such work himself or mmogh I '
hie we tropbyee"provided mat each imptowasonn are not Intended or aBtrtd for . 101 — _ FOUNDATION
sale lL hmvever.the building an impravemant is sold widdn ane yevaftmeml.m.,the
tw ildnwillhawMeburdenofprovingMethedidnotbuildorimprowforWr- i 102 - PIERS ,
w afcld.L w LIFER
I rmthepropcny exclusi"Plateau..Code:)The
nntt.snn to 1 104 — -
ons tthe peojen lSee 7016 Business aM Prafesnons CWe071u Conuecrora V- 1tZf4 REPRR•e
ems Ice dose mita lye nor of snot who builds or improv.thereon,and _
what contracts rs th.canvactodolcensedpiumat.1h;Coommod" - ----- -- 105''— ANCHOR BOLTS
License law -
❑lamex tta1 '- BBPp�a 106 SEWER & WATER ' .
Owner D.ta d 202 - -UNDERFLOOR PLUMBING-
WORKER'SCOMPENSATIONDECI-ARATION 203 — UNDERFLOOR MECHANICAL
Thereby affirm orderpenallyteperjuryoneofthefollowing adimiam: — a ..
❑ahave and winm.net.n.U.37 ofComent Complan. 204 UNDERFLOOR ' FRAME
talion,ex provlCN for by Sauon 3700 of me labor Code,for the perfomuuce of airs r
walk for which this pemdtisomW, 205 .— UNDERFLOOR INSULATION '
0 1 have aW will maintain Warkttt Compensation Insurance.as nquirtd by Sation
37M ofthe labor Coat,for me performanse ofthe work for which this perrat la issued. 'a 301 ROUGH' PLUMBING
Ca Workers Campenwtion Inxurantt emntt end PoI Icy number nrc: .
Certitt: PolicyNo.: 302 '—; TUB R• OR "5HbbIER'
•
CERTIFICATE OF"EMPfIONFROM WORKERN 303' — ROUGH MECHANICAL
COMPENSATION INSURANCE
frussomen need nota completed iftlt Pemit is farrow hundred dollars(SIM) 304 — ROUGH ELECTRICAL
or leas.) �r .
Iwolfy that In the perfmmene,.fmtweak forwhich mi.permit is issued.I mall 305 FRAME - -
not employ myPerson inany manner aoastobecome.bjec.oMeWorkers'Compcn- '06 — HOL•DOWNS
.lion Laws of California.Data 3e 1
Applicant rT
NOTICE TO APPLICANT.If,after nuking this Carificau of Exemption,you should 307 — INSULATION,,
became subjectto Bit Workers Compensation provisions of Me labor Code,ymu must 308' ' 'SHEETROCK -
fmlhwithcomplywithsuchProvi'ams or this permit mull be deamW ftwI
coNSTRucr10N LENDING AGENCY 309 — EXTERIOR LATH - -
O Q IMae byafrmMet Mo.i.ac...rucameIrmingagencyfoods PcHomt.oeof - 31.0• 'INTERIOR LATH '
" y me work for which this permit isissued(Sec.3U97.Civ,C.)Lancers Name 311 —' SCRATCH COAT
_
a > `dr`Add " 313 — ROOF NAZI_
fs7 ^E I certify that 1 have stall this application and stere mat Me above information is
�i. awnleft.,.to comply with all city mad Worry ordinances and xluelaws ulalingto 501 - FINAL ELECTRICAL ENERGY
Q z "boildini...macaon,and heroby authorize relmo...nivee of this city to enur upon the
UOabase-mennonodprope#Y for inspection purposes 502 FINAL PLUMBING ENERGY
:aV (We)ag . itw
reetove, emrrifyandkeephatmleastheCityofCupertinoalumna — ,
O Iiebilitin.jWg u.casu end.pens which may in my way aca50' FINAL .MEL'HRNTCAL ENERGY
ve against said City v
W
local hegmndngathis permit. 504 — FINAL BUILDING ENERGY.
pa API'I. :A f dUIiHSTANDS NU WILL COMPLY WITH At NON-'DINT
U z sou C lit T1 s./ b 505 — FINAL ELECTRICAL
Sigrulurt of Applicmt/Cantr.ctor O Dart506 — GAS TEST .
HAZARDOUS MATERIALS DISCLOSURE r307 — FIPIf)L "`ZL{dMta7NG'
Will meepplicanior future building ackm,ml Imre or handle hauNaux nrodoml Re-roofs- 108 — FINAL MECHANICAL- as defined by the Cupertino Municipal Code.Chapter 9.12,and me Heath and Safety
Cosh,,Section 25532(07 Type of Roof 509 — FINAL GRADE
Ye. ❑No
Will the eppllcaot or future Wilding occap.nt use equipment or devices which All roofs shall be•Vds�eeteKll�tiiir't&Ice WR'm material being
emit harardoox air mntamirunu as definW by the Bay Arca Air Quality Menagemem installed. If a roo€S4nsta1hMwtithD ob4a tog an inspection
• °"a"° I agree to remove all new materials for inspection. Applicant
❑Yes ❑No d
411�=16;haiadwnmateddaregaimmemsan&,Chapter695oftheCm- un erstands and will comply with all non point source regulations.
ramiCode,Sacuans 25505.2553)and 25536.1 understand mat if the'd �rrtmly vvvppQaunem,muit ismYres ,1p bittyJJpnn nifYetreoccupantn¢�yrp�cugrcy./SgL / �/ Iy/UU Signal re of Applicant Date
Own or a..,-"—ag nl Data _
All roof coverings to be Class"B"or better
OFFICE
i
County of Santa Clara C, U[V
Environmental Resources Agency F, T
County Government Center, Easl Wing Q.
70 west Hedding Street, 1 I th Floor
Son.Inge. California 951 I0 A
(408)0299-4132 FAX 295-9786
October 24, 2001
Cal Aqua Pools
Attention: Greg Purrey
PO Box 361353
Milpitas CA 95036
PROJECT NUMBER: SR0805865 & SR085866
PROJECT NAME: LAKE BILTMORE APTS.
PROJECT LOCATION: 10159 S BLANEY AV, CUPERTINO
The renovation plans for the above project have been reviewed by this department and
have been approved.
At least two (2) inspections are necessary in order to complete the swimming pool/spa
construction approval process. Inspections for pre-plaster and final construction will
be required. Contact the Plan Review and Construction Unit forty-eight (48) hours in
advance of the required inspections.
The pool contractor must notify this department upon completion of the pool(s)/spa(s).
Pool(s)/spa(s) must not be placed in use until the owner or agent has received an
inspection report, in writing, from this department signifying the pool/spa and ,it's
appurtenances have been constructed and equipped in accordance with the approved
plans.
We also request that a key to both the enclosure and equipment room be provided so
that our staff can conduct unannounced inspections throughout the swim season.
If there are any questions regarding this letter, please call this office at (408) 299-6060,
between the hours of 8:00 a.m. and 9:30 a.m., Monday through Friday.
ERNEST WONG, REHS
SENIOR ENVIRONMENTAL HEALTH SPECIALIST
PLAN REVIEW AND CONSTRUCTION UNIT
DEPARTMENT OF ENVIRONMENTAL HEALTH ,,,a ,
cc:: City of Cupertino Building Department
Board of Supervisors: Donald F. Gage, Blanca Alvarado, Pete McHugh, James T. Beall Jr.. Liz Kniss
County HXCCnllve: Richard wittenberg .o: