01100125 CITY,OF CUPERTINO I . -. - - '
BUILDING DIVISION- PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10139 S BLANEY AVE # 2C WALDRON CONSTRUCTION COM ANY 01100125
OWNER'S NAMEAPPLIC TIONS BDAM
LAKE BILTMORE APARTMENTS P 0 BOX 598 10,23/2001
1 PHONE: (408) 377-8186 SANITARY NO.- CONTROL NO.
0'"E ARCHITECT/ENGINEER: BUILDING PERMIT INFO
C00
BLDG ELECT PLUMB MECH
m 2 LICENSED CONTRACTOR'S DECLARATION
lob Description
i z_0 1 hereby octan that I am licensed under pmvislons m
of Chapter 9(commencing
wtce et
ithSection]nm0)ofDiv
ision3oftheBusines
,raceProlessionsCode,and mylicense INTERIOR RENOVATION.
zo4a:cnalcia=`anaetfe°' LeX (REMODELED KITCHEN & BATH, NEW WASHER/DRY
a. Data Date Corinna., WALL A/C, FLOOR COVERING. )
ARCHITECT'S DECLARATION
-'= I understand my plans shall be used as public records
:gyp,
4 w p O Licensed Professional
OWNER-BUILDER DECLARATION
w— I hereby affirm that 1 am exempt from the Common's License Law for the
y
I,Z< following' ❑m - (Section 7031.5,BuDas and Profusions Code Any city or county
which requires a permit N concloact,.11c,,mpove eemborrepah,any sw re
—'rimm itsissuance, Io ouPire,rhe pplmam protector omBe.sigetl stat o
(till/ I n'dp 7of the ractrsenseLaw9
a inawi05etionA"mof Division3ofthe Business
and
Professions Code)
-
-{;; i�T R _...
_,._,.,. ..$3...4..6._�_._.._at_io.n
or that is exempt Syead thbasis fm,ha. ezcmni.An,violation
orSectionany
applicntfor apermit subjects
t@eapplianttoacivil penaby
ofnotnoethanBvenanareaaalars(ssmm).
369VMt9nb®10 it'a;.,.r . . Occupancy pe
es owner of the property;or my employees with wages as their sole compensation,
will do the work,and the structure is not intended oroBered'for-sale(See.7014, 01 FOUNDT '
' Ars nes,s J Profs :Cod The Contractor's 1 - A
s L cense Law does not apply to an Mi 4bired Inspections
owner ofproperty Whbuilds p thermon,and who does such workn If 102 PIERS
Intrough his own aniployces.-provided that suchimprovements are nt intended or
Q56nedf 1 If,however,the building
,la g p . t is sold within one y
f 103 UFER
co pit th b Id will hue thebrd provingfthth cid otb Id or
inp forprp of 104 REBAR
[ s owner of the property, contracting withlicensed contractors t
...r /
_
ronTun the protect(sec 7044 Business and Podfikaimas Colic)no C ntra(or s 106 SEWER & WATER
u n La a c. of apply roan Der f a tom y hob le mpr c omrcms 2 0'2--- UNDERFLOOR- PLUMBING- ---
Corona
ad who vont ons for such pati=ds with.a contractor(%)licensed pursuant to the. - ..
lra«Lacxv
&PCT tnlsauemt 203 - UNDERFLOOR''�!MECHANICAL
o �D G�D� 204 - UNDERFLOOR FRAME
w RXLRscoMPENSAno D cu AnoN 205 - UNDERFLOOR INSULATION
I hereby alrrm urger Penalty or Ped�ry pde or,tne following declarations:' 301 - ROUGH PLUMBING
El1 hive'and'wlll rountam a cerificaie'of`Consent ro'eel6insum far Workers 3 02 - TUB & OR SHOWER
Compensation, as provided for by Section-3]W of the'Isbor Code, for the
_ pert f to w k f h h this pe t ed., ,
303 - ROUGH MECHANICAL
304 - ROUGH ELECTRICAL
ElI have and will' ' m W k C at n l a cc are red by Section
TIM'd the L bun C d f i the pirlimmunce of Ne"i Rk f r which this perani s 305 - FRAME
issued My Wn ke m
Worker's Copon ensat insurance Sect a Pol cy b a - e 3 0 6 HOLDOWNS
c a".� d I i'-,; 1 s.,`d e's{polcytNo..
..,
I 3OJ-b 1INSILATI GN ry A V1:
SC RTIFCADOOFEXEMPTION ROM WORKERS'q
COMPENSATION INSURANCE .. .l
'
_3.0.8-.; SH'EETROCK,__._
'.' oh hou cednotberompidafth pound isf one hundred dollars 309 - 'EXTERIOR LATH'
.._.,.._.,__310 .._....INTERIOR-,.,LATH .. M _.__,..._ .:.., . ..
i, i ten fy th t Person
rata c f r rk f e co h to s ct ., t .
.hallea plopws ofaDate o as to become subject workers 311 - SCRATCH 'COAT 1 •'tief s_,
C ntpe sat -Laws of California.'Dete' - "" '
APN cant : .....; . i.,.. .., _.... ...3.13..=.ROOF. NAIL. ,.
NOTICE TO APPLICANT If.aftt making thcrtfirme re rapt nyou should 501 - FINAL ELECTRI CAL``ENERGY
O '7th ee be Coca,y must
h such previsions or this pandithall be
PLUMB
Y a t r rCTIONLENDIeGAGEC me km. ,502-„_ FINAL, MECHANICAL
bs bl t t tM1 W do rs Compensation nt n pr t ns
` 503 FINAL MECHANICAL ENEGYi `
forth th nilly t CONSTRUCfION LENDING AGENCY -
I hereby which
that a cur me pef nn 504 - FINAL BUILDING ENERGY
(z7e bf lh kfor ti h@sPermum slued(Sec 3(19] Cv.C) r ,-
:z
Tender',Na a .__. -
1 Q ' 505 ="FINAli ELECTRICAL' -
Le a r Aad - t - -
V 0 1 rectify that 1 h d thisapplication d tate that theabove t' formaon is
506 - GAS. TEST
rect 1 agree to comply nh ali city and county ordinances end state laws rel ting 5 0 7 - FINAL PLUMBING
NG
co
to building consmuctirm'and thereby lialbortie repostimativis,of this city to enter upon 508 - FINAL MECHANICA
,fi,�nn ry tb abr t tl p p rty f pectin purposes. ,
L>0.. .. a o ❑ fy and k ph "1teCty fC pri'no-gains( 509 - FINAL GRA
ffrr V1 liab 11 s all
_,a t d pe se h h y any y Gam t sate
f, C ty m e se once of th g rug of Sir pe t _ "
^ APPLI ANT N 'RST AND WILL COMPLY WIT N N P INT br Issued l 0 r_ N Date
SOU ER . 19 `�.1',
aignm fAppl nVConttenor .t x ,D t Re roofs
HAZARDOUS MATERIALS DISCLOSURE I1
a - t W II the pphc t d f Nre W Icing ps tstoreof ha ale ha1ard is matenal - Type Of Roof, — ^^ -
s deRn a by the Cupert o M pal Cod Ch pt 9 12 and the Health d Safety -
c ac s a nn zss3z e> -Al roofsshall be itis earednor.to.�
ti
❑Ys is uta Q�p'� t tahly A a Sm t.- 2 g4f
p p any,roofing.material-being installed .M. „_ ....
win m appii t faro b 'Idmg G pact u e eq pate t ae
an which If a roof is ilistalledvithout first obtaining an inspectioa;Tlagree.to'remove
gem t hazard us a cot a t aeK dby N H y Arca A Q I ty Managence t
matenels¢u rcments o der cna ter e:9s br rte all non- omt"ials for inspection.^Appheant understands and,will comply wnh
D t m❑h ve ead,ine naxara , a .._all new pater,_ ._ .__...
source regulatrons .,;1 . .
c n
9 P ^
oc a t le., is h ch must b t ort is.an f C ri
land that
C I r m a H alth&Sffety C de Sccuons 23303 23333 a tl 23334 1 de
p p fi ate of "
0 c pan
r - � ��� 1� Signature,ofApplicant,_ Date
o e ra ten ca g nt r , r 1 Data 1, All roof coverings to be Class B or better t
OFFICE
I f ' _ ,