02070163 'e CITY;OF CUPERTINO
,',:BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: . PERMIT NO.
200,70 RODRIGUES AVE # 13C WALDRON CONSTRUCTION COMPANY 02070163
IWNER'S NAME: APPLICATION SUB DATE
LAKE BILTMORE APARTMENTS P O BOX 598 07/25/2002
HONE: SANITARY NO. CONTROL NO.
(408) 377-8186
O
pz Z ARCHITEC (ENGINEER: BUILDING PERMIT INTO
WO
8� BLDG ELECT PLUMB MECH
'ran
Z i LICENSED CONTRACTOR'S DECLARATION lob Description
4
O Z- 1 hereby affirm that I ion of
B under provisions of nsChapterCash and(commencing INTERIOR RENOVAVAT I ON
with Section e'"d e f Division 3 of the Business and Professions Code,and my license
gixi ismruurnraanaerr"` KITCHEN/BATHS REMODEL, NEW WASHER/DRYER &
aea a License Class - Lic.is
;LL� ,Date ARCHITECT'S DECo.CLARATION WALL A/C/FLOOR
L 01 undentnnd my plane shall be used as publir rtcordf
�Y
w6 p p Lic<sued Professional
g e O4,1 am BUILDER DECLARATION
t:n"'ew` 1 1 hereby.(Sero that 1 1. exempt from the C Professions
o :Any c Law for the
(=Z_ whit (Sato 70315 Buinnsand Prof Code p. an orcounty ,
F O
whichrequires_ permit t n t n alta p e demolish,or rtpv,any strvcmm
3 .poo a rs er else 9 tan ilio tf uen pumntofkaeLaw(Chement
LLL ... ... .
mat ltelslr<rtsea wrs ant to the pro to rine tractohLcense Law S Ft. Floor Area- ff ,, uation
(commending with Scratch'7(m)ofDvidon 3 of me Business and Professions Caste) a Evir 1 „_ya9 �;};w s sis;�•,I,yt-•
or that he to exempt th atfram"bM the basis for the allegal emappou i,Any violation 1
-of Section 7031.5 by any applicant for a permit subjects the applicant o a civil perralty f�tpt
.nf
ma,omore man five hundred dorsa MOD). 369Q�"Utrgm�F6 _ 1,I%B Occupancy Type
O I,as ownei of the propeny,or my employees with wages us their sole cmngneatio i.
..Baeihess'ama Professions Code The Contractor.,License Law does not apply to an 101 FOUNDATI uired
will do-the'work:and'the structure is not intended'or oRertd for We(See.70 .- ---
@Iq Inspections r•a .,l
or drr it i his ow Who Willi or impedes thereon,and who am,such work Mmwlf
or through his own employees.Provided that such impr ra is sol oro not intended or 102 - PIERS ____ -_- _ -
'dRcrw'for sale. Noweveq the Wildin-or im ivJcmenfis sold within-oie eafo( �---''-'""--"----'--"" s, ,
8 le r UFER - .ror:ai r,..
completion,the ownerxilJcr will have the Wnknof proving that he did not Wild or
m rovermpupn of le.). 104 - REBAR
Laaas''owner ofthe pm pe
am acwsmdrrontrandne with bansee rnntracroam 105 — ANCHOR BOLTS.. b't,�•:.__. dC:i':�
a wet the project(Sec.7044.Business and Proreamons Code,)The Contractor a 106 - SEWER & WATER.
License law does not apply to an owner of propany who Wilds or impmva thereon,
> and,who contracts for such.po cani.widt a com ucar(m.Bcialmd pursuant to the .. .._..--2 02 — UNDERFLOOR--"PLUMBI .
'NG-------
*°= Conbacire's License law,
= ❑Iamexempt role,See ' �a•r bs 'f"' 'B`&PC for rots reason 203 - UNDERFLOOR''MECHANICAL
ow,-mer': Dare't - - 'Vlri 204 - UNDERFLOOR FRAME
Cour, G1f6Y6WN5AT10NDECLARATION 205 - UNDERFLOOR INSULATION
l' issurdfily
I hembyaffirm ander pgoaltyoff peiiaoi one nfmq fnnnwing aalarations:- 301 - ROUGH PLUMBING
❑ 1 have'end'ivill'meimiain'i c:nifichle ofC"m to.elf.iaeure for workar•e 302 — TUB & OR SHOWER
;WCompensation, as provided for by Section 37W of the Labor Cade, for the
fpraaedftheworkforwhichthispemitisissues.,. 303 — ROUGH -MECHANICAL
❑I save ins wilriniin1m.Wdrkcr'.,Compeamion l.,nme;e,as required by Schoen 304 — ROUGH ELECTRICAL
37M of theLanor Coe.fo:me perfginrence of the work for which this permit is 305 - FRAME
WorktairCiianiversation lainimace carrier ct d Policy mbe em
306 '--- HOLDOWNS,
C+amer . - 1.,Lafd Folt yN' t
"^I l t.'.CERTIIICATIONOF EXEMPTION FROM WORKERS '� `A, ' SO.7 ^ INSULATION',` s
'COMPENSATION INSURANCE t
... . .
new not he rmmplam if permit is bar onehundred dollars309 - • EXTERIOR LATH
CIWI ..
s
in
-_. - 310- INTERIOR,;LAT
tehhad alt nPl th`y � e 313- - ROOF-TCA 'COAT
per,
OTIC TOAm I Worker's Com menu rovimbrte of Lector Calc,y hors
c f mepw�ork four wyhr�cM1 this permit s issued,
/ o/i
Aipl sots - ---- NAIL
NOTICE TOcttoth Alf li
..kid, pi you should 501 — FINAL ELECTRICAL"ENERGY
x - - pens p o Liu
Zmon m<o plrwhniarhv o did,permit shallxer d newked. 502..--,...FINAL -PLUMBING_ENERGY_
-.rn CONSTRUCTONLENDING AGENCY 503 - FINAL MECHANICAL ENERGY' l ` L
F' 1 h by than that them' con woo I d 8'ag Hcy f the Performance
r
�.� oflhe link far which this permit is tiuw(Sec 309,Cio.cl,. I'. _ __ _504 _—_ FINAL BUILDING ENERGY _
Lchdew Name.: . ...-._� . .-......,.' ..., - -_ _...___..
Uhaer',Addda' 505 — FINAL ELECTRICAL.,
V'0 1I cePirr'iM1at'i nave read this epplicminn dna ewtem�bthe above lnfur onion le
506 - GAS TEST '
writs l agree to comply;vim an city and<qunty ordinances and state laws relating 507 — FINAL PLUMBING
? OsO mWildingconstmetion:andherebyauthorizerepresentativesofthiicitytoenterupon 508 - FINAL MECHANICAL
'the W i rd Idiif speer prpose
F-Gi (W 7 g io d m ft'dna kttph I theCity ofCupsnno nuts,
fin liabilities.judgments costs and expenses which,may.n any way accon,against said 509 p— FINAL RA
V ,Z C ty n cosequence of the gtani ng of tM1 pc t �j
APPQCANT UNDERSTANDS AND W1 L COMPLY WITH °i Issued xALL NON POINT `iss
8O0tCE REOl.IL1T ONS:i AND :1 O I'' A "G Date
Signature of APPlidanrrCattmctor DateRe-roofs /
HAZARDOUS MATERIALS DISCLOSURE, `
W111h pph tpanne ming occupant tooro dlhartallomaterial -. .-Type of.Roof
as drr w by the Cupstfirvi Municipal Cade Chapter 9,12.arta the Health and Safety , 1,,,;s, , ,
CM,Section 2553(1 Ifists tee) i . 1 ',..• 51
, All roofs shall-be.tnspec[ed poor to.any.roofing..matenal being installed._.,-
Wllthaappl, tmiut p,1v ld g upmnuseeq ipmentordeviceswhich If a roof is installed without first obtaining an inspeetioriAlagree'to remove
+ ❑Y fi ed by Inc Bay Arc A r Q elty M.nagcmrnt
t W w; tram tam nimsaaao all new materials for inspection;-Applicant understands and will comply with- _
t n -- _ _
all non-point source regulations.
;1 s.. s .
1 had recta the briiniuus mater I egmrcmem under,Chaper(595'of the
Cal1 iromia Hea dei&'Sarcty Cada Sections 25505,25533 and 25534.,1 undemand that
8 Y hunt,that it is my texponsibiliry to notify the
f the building doe t currently have a¢
ace p l t the req m h h'inu t b mer p tm t i Crnircate of
OCC
w r -02 Signature of Applicant . -_. . ._ „- _ .-.- __ Date -.
gwmerm authnd:ea agent t :,Dade All roof coverings to be Class"B" or.better
CrrVOF CUPERTINO -
,Buu.D,INGDIVIStoN .. ,pE• T ��CONTRACTOR•INFO- ' �IONi�''
BUILDING ADDRESS: t c•• •' - PERMIT NO.
200,70. RODRIGUES AVE # 13C WALDRON CONSTRUCTION COMPANY 02070163
OWNER'S NAME: APPLICATION S1.111 DATE
LAKE BILTMORE APARTMENTS P O BOX 598 07/25/2002
PHONE: SANITARY NO. CONTROL NO.
qqq (408) 377-8186
O O '"CHITECDENGINEER: BUB.DING PERMIT INFO
Z _ ILDO ELECT PLUMB MECH
. '. LICENSED CONTRACTOR'S DECLARATION
0 z m' '1 tl: 1 hereby Off.Mar I em licensed under provisions or Chapter 9(commencing Job Description
so with Section7")ofDivision3ofsheBusinessendProfessionsCode,andmylicense INTERIOR RENOVAVATION
.U I.in full force end effect.
sc .u .Licenu Class
Lica KITCHEN/BATHS REMODEL, NEW WASHER/DRYER &
p�3 a ;Dge... Conrrecmr WALJy,._Jy
t=°.g i uneemvna my ARCHITECTS
n:nalb�.n:e P bB� rrves 11"`Il�
s?R LRevsed P,ofeunond_ .`y. r
OILDER DECLARATION SEPI 6 2002 Crp f�a n
1 herebgaflimthat
I am
t em es<mpf from the Conoacsor's License Law for Ne
t?< ,following rano.(Section]0]13,Business and profession,Code:My city or county tr V da'�tl�tai
:,which requires a permit m'smnswet.Offer,improve,demollth,or repair any swcmrt
it- .,,pdoi mire iesuorce,usomquirta the applicant Fw suchpemdam Gk a sigoedatmement _
this lie is linq»sed pOrsujmco m`ept'Dilsnsof fhecnnvactaf,Lidips law(Chepter9 ,I•. S Ft.,
(mm�eticivg qiN SrKon,70�0)of Divi,ion]of the Bwineu end NofW=Codel 'M- .,e ,�,! v- (? ?y n
ve that he A eaemPf rhercfrom'and lie basis for she alleged exemption.Any violation '" . '" '" e"` s 1 i t'
.of Section 7071.5 by any applicant for a pe.itsubjeon he applicanao a civil penalty- p{�f�j�t}� I -
i,°f mn.,e than five hundred ddlars(S500). 3 6 9 V S U U'Om�fb �'"," ENim Type
01,u owneiof she property,or my e:mployeas with wages u Nair role compensation,
..will na'do'shb work:end she 4wCNR Isnot InaMm'or ORe d for sale(SCC.1040. - _.. .. .. ... ......... _ _ ___
'owner of pro arty Who
Code:The Contractor's License law d«,not apply to an 101 - FOUNDAT IUQuired Inspections i'
owner property Who builds or imided t Merton,and ve doe roto wank himself 102 - PIERS
or funoffered
t, his own efuldOlhowes.cet.r.the Wilding
that such improvements arc ms installed of
inReiidfon�le:wner- ildewilhave g&Impnooemcmuuld wit hid one wear of -__ ..___ _ . ..._.. _. _. ....._ ._..____.-_...... ._....._._.__-__..__
'co pl ro she owner bre Iden will have the burden of proving dui he tied not wild or
10 3
ire frpsryfa- ofe). 104 - REBAR
Iunw - tree .....__ _._._ ... ...__ . .-_ . .. ._ .._..105. . .
_q p pmpeny.am<xcwsnvd confmcu" .ANCHORBOLTS __. ... ...... .
co wet the project(Sm.7044 Busmen end Pmfeunom Chia:)T1s Con°uecror s - F-' `- •"
_
License law don am apply to an Must.of pmperty who builds ce improve Merest, 1 O 6 - SEWER & WATER. '"`' Z.
mtl,who comaeea focsuch pmjec(.wish a communist licensed pursuant m the.
»1 �ContracmelLicense Lo - 202 - UNDERFLOOR'-PLUMBING ._. . __.--_--
❑lam emptund"Sec r (' 'B&PCfor Nis rtaun 'MECHANICAL
203 - UNDERFLOOR'r
owner. �,l „K, °aa ' �L 204 - UNDERFLOOR FRAME
aoRswnory DEClwRwnory 205 - UNDERFLOOR INSULATION
_ - _ hereby d 0 m under p wry of p rjmy one°f req(°Bewing dedmationa:' 301 - ROUGH PLUMBING
•0 1 hse and bio'maimef.:Certificate ofCensent fo self-insre far Wether•, 3 O2 - TUB & OR SHOWER
.C"mpensfionr,n provided for by Section 37W of the Labor Code, for the
P fempneenr dwnrfor,which mma ._
apittis,u ,. 303 - ROUGH -MECHANICAL
01 have and it]round.Worker's Compenimion Insumn:e.:i required by Section 304 - ROUGH ELECTRICAL
rro0'ofthe Labor CoEe;for the performance of the work Fear which this permit is
iniad:My Workel:Comparcu on Iniu once carrier and Policy number art: 3 0 5 - FRAME
306 - HOLD,OWNS
sv -CERTffICAT10NOFEXEMPr10NFROM'.W(}RKERS - f 3Q']' �INSULATION•'1
- ' CO MPENSATIONINSURANCE -
_ .. 308 SHEETROCK--- - -
(this union riced not be completed if the permit is for one hundred dollars
(slGo)orleu.) 309 - EXTERIOR LATH
310 --,-INTERIOR LATH
i I c NfY shat in Ne peHormerce Of she ark for wbmh N pcmut is iuved 1 -- -
ih II n t e ploy anY y mann syglo t¢yoCaybksf to Ne w rkeR 311 - SCRATCH 'CdAT + " r�
Compea m Iawe o liP / ate' V C/
Appl a t f" 9T�i91�5 313 ROOK- NAIL.-
.rvoncE'roAPoth corBwrmak gmsCniflemofExempuo You should 501 - FINAL ELECTRICAL ENERGY
tact m sublcet m tit Workers Ci Motion provisions of the Labs Code,you must
O C
to with comply i such pros sons or rite pems t shall be dee ed masked. 502 _ FINAL _PLUMBING-.ENERGY.--
E
corvseRucnoNLENDING AGENCY 503 - FINAL MECHANICAL ENERGY_
a "
I hereby (firm shin N u a constructionlending ejency forthe perfomunce
W.., or the work for which titsOm,itr,issued(Sec.'3W7:Ci._c.2., �'_ 504 - FINAL BUILDING ENERGY '
y:C1 Leede Name- . ._... ._..
..D
:Z (lade Address 505 . .FINAL ELECTRICALt
U'.O •, 1 certify that 1 have rtatl this application and sate that the above infomutivn ie 1506 - GAS TEST
W torten.1.8 M complY.wiN all city and county ordipawep and mese lewd relating 507 - FINAL PLUMBING
mbuildingconswetionfond hereby Authorize hapR,entadves of Ni:city reenter upon
y-W, haewve.mmind, In, rtyfor insperdnnpurpwa._ 508 - FINAL MECHANICAL
0. . fWe)agree to save,indemnify and keep hmmlcu fhe'Cty of Cupertino egunst
.. U;0' liabilitie,pull, esu.Coss and expenses which meyiv ony way accme against said 509 9 - FINAL
U'� City in'conuqua ce of Ne gaming of this permit.' - 1 ^
k�
APPLICANT U, ERSfANDS'A,D WILL COMPLY WITH'ALL NON-PONT 1.0 F A G U
r SOUACEREGt'LATIONS. r:' Issued $ Date
Ssgnmurp of Appheam/Contractor } ... ^;• :r •Dam' Re-roofs
HAZARDOUS MATERIALS DISCLOSURE ,'{
Wll the:pplic t9r future budding occupants.ter,handle bhunlow mdefu Type.of Roof_ _... ... -
u defined by the Cupen no Mumc pal Code Chepm 9 13.aM Ne H um and Safety "" "'
Code Section 753J1(e7 - „• . .
aYe All roofs shall be mspected.pnor.to.any.roofing material.being installed.
.c• Will theepplimnt rfuture building Occupant use equipment ordevices which If a roof is installed without first obtaining an ins eetiori;:11agree'toremove
contaminants at defined by the Bey Man Au Quality Management g p
all new materials for inspection Applicant understands and will comply with
lei roll IhdVe read
° .-.• _.
District?
❑Yes
all non-point source regulations: -
Ne hued s m:urius rtgwrcmema antler Chalet,understand
of the
Cal fomsa HwIN s Safety Codecurrently
Seniors ent.dust
it
and 75534.1 undersand Nat
if the budding don not curtenw have a tensor tem it is my responsibilitysuancoaer notify die - -
ocs:upaot y.the rtqui menu which must be prior a issuance of a Certificate of '
... 0.'cupencY./.n/
l' W
�oZ Signature of Applicant _ _ _ Date
I Owner oramhon;ed agent
Data All roof coverings to be Class "B"or better
OFFICE _ .. . . .. . ._:._ ... .. _.
CITY OF CUPERTINO.
BUILDING PERMIT APPLICATION FORM
Building Address: 20070 a �3
svner's Name: Phon No:
LAKE ItTMoRE APn2Tnn - GSD S`i6- 53o0
Contractor: License No:
R. WA'Limm Coari2l rcTlorj , fr-jc,
Contact• Phone No:
S WEAvt�rt PRDJFCr a!, G 5`16-5308
Architect/Engineer License No:
RN u4po, 9TAUSM �NCU►rk K55
Applicant/Contractor:
o¢B A~Me IMS
Building Permit Info: (circle one)
Bldg Ele Plumb Mech
Description: Ihrm4a grwvA�nom IN R&r000eLZ-0 W
NEW WA0mfpeve+eNew Weu-ala NEW Roe¢ C^i AJG
Residential: MULV-FAmM Commercial:
Sq. Ft. Floor Area: S/Sq. Ft.:
f00 SF
APN # (Must provide): Valuation
3r�1-o3-00 � 3'F G6o
Type of Construction: Occupancy Group: R I
. if Fee ID Fee Description Fee Group
Applicable
BTEMPPERM Temporary Bldg Permit BUILDING
BCONSTAX Construction Tax BUILDING
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BOVERTIME Inspection Overtime BUILDING
BPERMFEE Bldg Permit Fees BUILDING
BMITIGAT Housing Mitigation Fee BUILDING
BPLANCHK Plan Check Fee BUILDING
I BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plan Check Repeat Fee BUILDING
BREINSPECT Reinspection Fee BUILDING
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Inspection BUILDING
BSWIM Swimming Pool BUILDING
ZADDCHG Address Change BUILDING
r 773. �G