01060112 CITY OF CUPERTINO
BUILDING DIVISION pERMIT CONTRACTMINFORMATION,:'
BUILDING ADDRESS: PERMIT NO.
.20080 RODRIGUES # 10K WALDRON CONSTRUCTION COM ANY01060112
k .
OWNER'S NAME: APPLICATION SUB DATE
LAKE BILTMORE APARTMENTS 73 HERBERT LANE 06/19/2001
• PHONE: j SANITARY NO. CONTROL NO.
(408) 377-8186
O+O
ARCHITECT/ENGINEER: I BUILDING PERMIT INFO
�,q I BLDG ELECT .PLUMB MECH
z 8 h z, LICENSED CONTRACTOR'S DECLARATION i Job Description '
o t hereby affirm that I am licensed under provisiens of Chvpmr 9(commencing
°-y[�-j. with Sectio.10007 of Division3of the Business and Professions Cale,and my license INTER.RENOVATION/REMODELED KITCHEN AND BA
a 2- ism rml force an y I
���< uadseCla Lia.It 2I�4f 7 NEW WASHER/DRYER, NEW WALL A/C, NEW FLOOR
ad
m 3 y Date Cnmrvc
RCHITECT'S DECLARATION
O%j I andasmnd my plans shall be used as public accords
i d p0 Licensed Professional
o .. OWNER-BUILDER DECLARATION
1 hereby affirm that I am exempt from the Conoacmr's License Law for the
C?< following reason:(Scene.70315.Business and Professions Code:Ao,any m al many
o
limichne'laira,liaerrair to c-mwe,alter.improve.demolish, r repair any structure
. ........... . .
Far,la,d,I nIP .tLmlptf lm,k f na,Contractors Lian c, (CMI -I Sq. FtF1oorAtel
¢ ! q�^ a]Uat10❑
( nBw,h6 „ 70tg1 of D1 s-n9ol,hc Bust {{ aqd Professmns Code) b`�(y'R1 :1 l R, '- s { '{„?_ ',4ey
or,ha,he s exemp„hemfrnm`anJ,he bas s for,rte alleged d,'mption.Any v nlatmn "
-of Section 703 E5 by any applicant for a permit subjects the applicant Io a civil penal
!efao,mme,nan'fivehundreddoums($5o0). ry Aft uTu er ;I'ea,;.--', Occupancy Type
❑1,as owner of the property,or my employees with wages as their sole c-n,,dection,
,Bnsrma'1hdV P fi as ndoms eCoder The
Carroll
License Law does snot aMly
.ltoou
an
102_---P I ER
S Required Ins_pe,ct.ions"."
owner of property Whobuilds o p esthreoe whodoes such work himself 103 UFER° t1brh h' employees,
empl ye s.provided m t improvements ,intended
enegIra teb'Wn prut la ',n deyear r 04REBRcoplt' to b Id Ilk the burden ofprovingthat he did ,build oI ,.
imp r p tp- fi l l
'
105___ ANCHOR BOLTS _
_ ¢ the t(sec 71w1 B °rtsl licensed cto,ehe 2 Q4 - UNDERFLOOR''.."FRAME ._ _.._
_ %tru t p cc, such e m with ,r Professions
[C da: d tet to 1Q6 - SEWERlie WATER
❑1 m unse LS c rte fpursuant nt c,o s
Coal. L f the p pe ty n ly c.vac a
L s Ll d y m t o mese ad P re cede m The c improves to 202 - UNDERFLOOR PLUMBING
p Pen n n Id
' 203 -= UNDERFLOOR MECHANICAL
s not apply
B&P f hi ,I .(,.
o <r; ; v - ''"Dam ' "" a� r' 205 - UNDERFLOOR INSULATION
ORK. COMWAT
IONDECLARATI
In by rr d Pen¢ nre nn f I g < ,ioa 301 ROUGH PLUMBING
1.
302 - TUB & OR. SHOWER
.. � Ih -a' Iil ma nm 'a court rC asentaalf f wk',', 303 - ROUGH MECHANICAL
\
Compensation, as provided for by Section 3700ofthe.Labor Code, for the
p rr c'erine yx,r nkn,tniap, 'ys island..,. ,I 304 - ROUGH ELECTRICAL
r ❑I h a d III'm t in Worker's'Co p s t Ynshm c i required by,Section 305 - FRAME _
37W f the'Labor'C Je far,he Performanceh
f,e work tar which this p i Is
i 3 0 6 - HOEDOWNS
d My Wo kers Co p i Ins carrier y r and Policy bar m.
., ..u _ .... .._.. T,...v.
307 —INSULATION'
I 7 s P M v ..
r 1 CERTIFICATION OF EXEMPTION FROM WORKERS: ' )r-
,r + 5 308"- S'HLi ETROC'K'?x"t.1 UI. _
.. CC)MPENSATION,INSURANCB , - -309 EXTERIOR LATH
'I . ...... _.
(Th'sect'-.need no,be'complemd f me perm¢ for one M1unJreJ d Ilars -
t rs1003 I i
310 INTERIOR LATH '
Pr' vx vin ab3aat,-m ..- _ •31,1..._--'SCRATCH'CC1AT -:.,, _. .._..__:
{ yyl n fy.th t di pc f rmantt f,he o k f- h h th pe m t sued I
sh 11 -, to n n an a n s m beco e W kern' 313 - ROOF NAIL ! 'i" ` h
C P s t n Wd "Cal f- 'Dat . . ._'
....'Appleam '� .... .., . .._.__._501_- _FINAL-ELECTRICAL ENERGY._.,,
out
CeRfri fE mP, n'yo h IJ ---
O z f nn m mply a chp Pen ' p ns°1'n L a Code:y ,t 502 - FINAL PLUMBING ENERGY
NOTICE TO APPLICANT If fl
iq
b c° bl a th Worker Cn
m p r int shall be deem d ked
,Oin, .... .._ 503 ._-._...FINAL._MECHANICAL ..ENERGY...
E CONSTRUCTIDNLENDING AGENCY' 504' - FINAL BUILDING ENERGY .' ',
I neacb nffi that there - , tion lending ag cy f- the perfo nee
ai-17. I rm mkforwnmhm pe i' Iu a(s e 3a�7 c,.cl _; 'T_ .e 505 FINAL ELECTRICAL
-Londe shame s • _ _ _. ......
tae FAdd 506 - GAS TEST
D Z r f
507 - FINAL PLUMBING
'V'Qr , Ircn,fythmlhavareedmsapphcauonanesammm,heabmenlb�m�t-�'Ia.
w,F" <i:"agree,�mmplyw,htllcry dc,myoNinancevands,amlawsrelarn,l 508 - FINAL MECHANICAL
O;r, no bu ld ngc nt 't dh by ,h uacpacsemat fm ryt, , pen
nb b ryf- p t p rp 509 - FINAL GRADE
(r Or' O g t e n d mnify and kap h le m C fy f C p rte ag nm
w l alt
U' y ey
unit Id 510 - FINAL. PLANNING
Z
514 F A U WORKS / O
50L 1C R ND LNSNDS AND WIfLCOhIPLY WITji AI NON-�INT'�'� Issuedby:
S gn t 'PApplle n Contnmmrl- : (� .,Date',,,'," Re-roofs
Type of Roof
❑Y t t N y IEv, s t I T . ...
a Will mea Icat ft bldn Salary,'
C tl S pen 255321 I M Pam tore orb dl h b t "
I f a by m CupcN M od Cn p, 9.12 d m H Lh d
r r , Q oofing material being installed _
11 roofs shall be inspected rior.to.any.r
="T ppl c t r t r b ed ucc e t y eq p nt d xe n cn If a roof is installed'without firs obtaining an inspectiori'I'agree to remove
e , du. rc tin t db th Ba AreaA It AFng t'i
t t O
n 8 all new materials for inspection Applicant understands and will comply with
I 'rNnal]rior -int source regulation
I . I ,I a read'he 1 z4rdous mem I q acimn s d r Chapmc fi 95.of me
Calf P ealh&Safety Cd seiti .25505.25533 d25534-1laderstiamdao _
',:ifthdnl ngJ-es not eurrcn0ykvea¢nein mht i,isgry responsibilitymnotify the
au,hnrize 1 h h'm s,rte met p or In ence of,C nit t of,
i0c n q " '�����,�_ Signature of Applicant _ Date _
oc rc
o d ,t Date All roof coverings to be Class B ' or better
:x, .., .. t
r
a t , r OFFICE .. . .