01060110 CITY OF CUPERTINO -
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:,
BUILDING ADDRESS: PERMIT NO.
20020 RODRIGUES AVE # 6A WALDRON CONSTRUCTION COM ANY01060110
OWNER'S NAME: APPLICATION SUB DATE
LAKE BILTMORE APARTMENTS 73 HERBERT LANE 06/19/2001
PHONE: (408) 377-8186 SANITARY NO., CONTROL NO.
❑z Z ARCHITECT(ENGUMER: BUILDING PERMIT INFO
Bi lu U BLDG ELECT PLUMB MECH
Z up
LICENSED CONTRACTOR'S DECLARATION
z 5 y a Job Description
I heresy a%irm that 1 am licensed under provisions.f Chaprer9(commencing
,y2� is In falliorcebadnfDivision3oftheBusinessanJProfcssionsCode myb=hose INTERIOR RENOVATION INCLUDING REMODELED K
a is C°reeana` �j AND BATH' S . NEW WASHER/DRYER, WALL A/C,
z w 6 Licrose Class �/ Lic.# ✓1 t
y Date Contractor �- COVERING.
ITECT'S DECLARATION
I understand my plans shall be al as public records
ip Licensed Professional OWNER y
o BUILDER DECLARATION
I hereby.(firm that I am exempt from the Contractor's
oComms License Law for the
fllowngreams.(Semon 70315,BEmissions ColeAnyctyo
which q Acinit m conswd after, demolish o,p,or my Im,lam
ou3w ,. 'iuo
totnd -fed MIry.tna run Cout I 1 Chaplet S Ft.Floor:Art,aa a r 1 ualion
..mat ne :��mh y�nererra Be�dmieasts rarme aRE�s�Je sa�J o,rnn scd� k_`A:�".• i`�.$_:c9' r.l.. ,.•r' e,
d' % y violation /� TjtyyAAryf�� qq
of Section 7031.5 by any applicant for a permit subjects the applicant to acivil penal, 3 6 9U V 6. V
III tat mare than five hundred dollars(5500), r l PI.',.:, ,. Occupancy Type
❑1,as owner of the property,or my employees with wages as their sole compensation.
'will do thework:and Thet ure
in 's t"intended- ' offered for ale(Sar.-7044," -- - --
�Bu reds aniffirlyfiessions Cia&The Ccutoremar a License Law does not apply to an 101 - FOUNDATIWuired,Inspections 3 --'
owner of property Who builds or ina,mves thereon,and who does sath work himmlf
arThrough n employees.provided mt n improvements not intended r 102 PIERS _______
._W -eT al�:If,n tM1 bila- . . _..__.._.. _.._.__ .._.... .__.. __. ._..__ _n -:- _
Ig "p in t m 'inndneye or 103 UFER
ampler on,the owner budder will have the human of proving that he did not build or
nt vafor par Toseofame')' 104 - REBAR �
I s er.r thet Any, -exclusively contracting mod licensed ' u' '1O 10 6 SEWER & WATER I
I05` - ANCHOR'BOLTS h
construct the project t(S 7044.Busies d e Professions Cud )Th Contractor's Yy
License Law Jces not apply m an owner of property who builds or improves thereon — '
such is w th.a cot hods)I'ccnsed. s t
p tt me. --..._ 202-._...UNDERFLOOR--PLUMBI-NG-- .. ... ._...;_.__ .._....,.,,._
.and who t cm for p ) Lion
Cot t I Li en La
ohne v = ";` '""')B&PConnls 203 - UNDERFLOOR'oMECHANICAL
ower DoleaD' 7' 204 - UNDERFLOOR FRAME
�wQRKEI coMPENSAnoN DECLARATI 205 - UNDERFLOOR INSULATION
I hereby affirm and pealtyofp luy ofth rollowngde=mar°e:- 301 — ROUGH PLUMBING
• ❑ I h and will' t a Ccmf1a !a fConood rc sed nsurc for Warkery 302 - TUB & OR SHOWER
Co penafon,-arp dad f by Section 3700 of the Labor Code, for the
perfnrma e'artheworkfor n' gtnixpertnd 3issued._. 303 - ROUGH MECHANICAL -
❑In And will'ma t Wrker'ACompe r fsurvticeasrequire�bySuitoui 304 - ROUGH ELECTRICAL
3700 ofihe'Labm'Co for the performance of the wink for which This parfait is
-C pesi nim me and Poly a lam 305 — FRAME
(CERTIFICATION _ 3 0.6' '- HOLDOWNS __.._......
ss
,,..:it t: ,..i
Carte IFICATION OF EXEMPTION FROM,WORKERS — 1307. 4_/rINSULATICONR
r COMPENSATIONINSURANCE p"
`` IgTn �o�n a of be ci,mdleted fN.perm tis( ane basad aonars 309 — EXTERIOR LATH oll;..Ilt
($ or ) v t5
31'0' INTERIOR- LATH
t, iMYlrf croon"fht nthp= any
sm kpan, 'mi'thcissued,
in t qmp! r r,pe n n v man, to ne�am bl t, tisl
m me;wmkers 311' - SCRATCH
II COAT l :r I I .L
Comppiation Laws ofClf Date
'ApPlc nt
O Z ( ._..... ---3.13 - ROOF.-NAIL—....
" __
NOTICE TO APPLICANT If, h kt gth C of i fE e , y should 501 FINAL ELECTRICAL ENERGY " I.0
becomesubjectt diewoeker' Compensation p sdfm Lan Code, t
'rts m ply ..n inch o tux pt nmlxd d aO . .
502_.._-_FINAL._PLUMBING_ENERGY _ _
E,,,°� "•. h `.'CONSTRUCTION LENDING AGENCY 503 — FINAL MECHANICAL ,ENERGY-."` `I"
>, armwad,
fwhichm p t .ed(s 3u97c se)Yf°rtn perr',m <_ __ __ 5,0.4 - -II BUILDING ENERGY i1
r' Ih by frmthnh rko clonl d
L Q -'Led Nme :... - .._ . ._... .-...._.. - .._._._
505
P Z :Lea Aad : 506 GASATESTECTRICAL ,
UO r _ ,
I nfy th tlh aim ppl, t nd m¢@ash m f m
W p`". 'corretl gees . mply maltc ty' I rry J ' Ott I seltrg 507 — FINAL PLUMBING
Q r..) ;rob Id gc -t--1 dh ny th p r"- Fm tytater upon,
y am= b n t p,p p tyr np t p p 508 - FINAL MECHANICAL
) g ' t Itlern fyad Ae pl ole bsheCry fCdpef "gstf
m Ilablu login„15 t a pie nnnyrpy y gayrt said 509 - FINAL GRADE
V z APYLI UN iRSTANDSAhDfWILLCOMPLYy�ITFALLN N pDINT ' .
IssuedDate
ISiBmt (Appu� tfc t t i„�, Dm=,'.,'; Re-roofs -
AZARUOUS MATERIALS DISCLOSURE
W II to ppl'c toff b IJ B c Pa t t 'h ale by da rustarral Type of Roof-
asdfcJhymCpen M tp1 Ch Pt 912 dmeH Ith t
fyt
cba sat 25532 d?” - All roofs shall-beIs t .inspected.
t
: a .- rT� nJt . .. 1 .
inspected prior.tOr any,roofing.material.being installed.
'n Wtll theapplicant future bull g c p nt u eq pm m a a n n' If a roof is installed without first obtaining an inspectionjagree to,nmove
d
of inn t dcfnpd bym BYA aA Q ItyM h;
�(/ all new materials for inspection. Applicant understands and will comply with
ave -,,., t ”-`all non point source regulations,. - - -
' 1con read'the Iamufloard,ares I rcqu re ems u d r ChITAte 6 95' f tl e
'Cahloon He ldi&SofetyC d Senors 25505 25531 and 25534 I ond r Land that
f the bu ng it tc- - nam th'tin
-a Aon tbIt,y to not fy th -
n P sante f C r icor (
_Q °" 1Cp1 n nmustb t rtal; Signature_of Applicant Dae -_
pa ( r
e .owner m°rlaep_ag , r ( n .. All roof coverings to be Class B ortbetter '
2 _.. OFFICEIf . _.. .. _ ._. ..._.._. ... ...
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