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03010084 CITY OF CUPERTINO BUILDING DIVISION PERMIT CONTRACTORINFORMATION:• i BUILDING A DDRESS: WALDRON CONSTRUCTION COM Ppb YRMIT NO. iI - 20100 RODRIGUES AVE # 913 03010084 NER'S NAME: T) 0 BOX 5598 APPLICATION SUR DATE LAKE BILTMORE APARTMENTS 01/15/2003 7AI1CIIITECr1ENGINIBBt' NE: (408) 377-8186 SANITARY NO. CONTROLNO. BUILDING PERMIT INFO BLDG ELECT PLUMB MICH 0�0LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licenced under provisions of Chapter 9(commencing Job Description with'aaakn]IXX))nf Division Jof Bm BFax and Professions Codamd my Been.is infnnforce anit Hes INTERIOR RENOVATION zOYaz Lirensc'Cim L .N 0zFp Date Couramnt REMODEL KITCHEN/BATHRMS/NIFa Fe R & ARCHITECTS D .ARATION f ps eersundmyplansmaBltcased PPubrccard, WALL A/C, FL COVERING d`tuV MAR 2 5 2003 1—�o� 1.lcunmdPntl'ussinnal OWNER m BUILDER DECLARATION 00 I heathy affifm that 1 L cacmpr from the Contractor's Co :Any c Law for the b p0whichingrcaesa (Saint]1171.5.Business and ve,deolih.orAnycityoscoumy BUILDING $ which requires ti perm're construct,alter,improve,h parmsh,or repair any suvamm poorusits iensed passnntto the prevision of for such permit m file ssigned statemem (that he emannislicenwit pursuant to provisions of the eBnedrnr's License Wous Coda) ad Sq. Ft. Floor Area Valuation a�p (commencing with Semoon]fl(I()nf Division Jnfthe Busincu onJ Professions Cnde)nr y $ that he is attempt therefrom and the hasis for the alleged exemption.Any violation of Section 7071.5 by any applicant for a pannissubjecus the applicant to a civil penalty of APN NumberC I e not more than five hundred dollars(M). Y 'mJ P 0 I,as owner of the property,or my employees with wages u their sale compensation, will do Ne work,and the structure is not intended or offered for sale(Sec.704,1,Business 36903 008 . 00 and Professions Code:The Contractor's License Law does not apply to an owner of Required Inspections pmNmy who builds or improves thereon,and who dsessuch work himself or Brough his own employees,provided Nat such improvements sm not intended or offered for mile.If. 101 — FOUNDA'T'ION however,Ne building or improvement is sold within one year of completion,Be owner buil der will have the burden of pmvi ng But he did not build it,improve for puepose of 102 - PIERS mi .. 103 - UFER 1,as owner of the property,am exclusively contracting with licensed contractors to 104 — REBAR consumer the project(Sec.7(M,1,Business and Professions Code;)The Commetorb U. Ceram Law docs not apply to an owner of property who builds or improves themon,and, 105 — ANCHOR BOLTS whocon�Wufmsu projects with a contracror(p pursuant licensed pursuano the Contractor'sLicense 106 - SEWER & WATER 0lam exam IScc. .BA,PC 'this eman 202 - UNDERFLOOR PLUMBING nrr Dale / 03 203 - UNDERFLOOR MECHANICAL WORKER'S COMPENSATION DECLARATION 204 UNDERFLOOR FRAME I hereby acorn under penalty of perjury one of the following declarations: 205 — UNDERFLOOR INSULATION ❑ .have and will for bynectioCertificate7N)of fir, ammCode,f rwurkcrs Compere 301 — ROUGH PLUMBING satinn,u provided for by Section 77p1 of the labor Code,foe Nc performance of Nc work for which this permit is issued. 302 — TUB & OR SHOWER 0 1 have and will maintain Worker's Compensation Insurance,as required by Section 303 - ROUGH MECHANICAL 3700 of Ne LaMv Code,for the performance of the work for which this permit is issued. My Warke/s(;omMnmtion Insurance carrier and Policy num her am: 304 — ROUGH ELECTRICAL ,Casper: P°I' n.: 305 - FRAME J^('/ CERTIPICA'TE OF GXEMPf10 OMWORKERS' COMPENSATION I SURANCE 306 - HOLDOWNS (This section need Ins be completed ROB,Permit is for one hundred dollars IRI) 307 - INSULATION lamf 308 - SHEETROCK 1 certify Nat in the performance of a wm nr which Nis permit is iuuc .I shall not 309 - EXTERIOR LATH employanypermn'nany Wdhrw as esuhjenmme Wir, rope scion Lowsca CaliRRni 0� 310 - INTERIOR LATH Applicata NOTICE TO APPLICANT:It.after making this Cerilicale of E notion.you should 311 - SCRATCH COAT become subject to the Worker's Compensation previsions of the labor Code,you must 313 - ROOF NAIL OO forthwith comply with such provisionsn this permitshall M deemed revoked. z CONSTRUCTION LENDING AGENCY 501 - FINAL ELECTRICAL ENERGY t-, 4 1hereby alRsmOat man,isa construction lending agency lot the Performance if 502 - FINAL PLUMBING ENERGY LK > the work far which this Permit isissued(gcc.71XR,Civ.C) 503 - FINAL MECHANICAL ENERGY W Q Lender's Name z Le der'sAddmss 504 - FINAL BUILDING ENERGY U O 1 certify Nat 1 have read Nis application and state that But argon information is 505 - FINAL ELECTRICAL B,, P: correct l agree to comply with all city and county ordinances and swe laws relating to O building conswction,and hercbyUniforimrepraventarivcsofthis city toenter upon the 5 GAS TEST POW. abort-mentinncdproperty for inspection purposes. 07 FIN sF^' (We)agree to save,indemm fy and keep harmless the City of Cupertino against to liabilities,judgments,costs and eapenms which may in any way accme against mid City tj N CAL T,) zin cnnscyucnce of the gr ting of this permit 5 '—' APPLICANT U or AND WILL COMPLY WITH ALL N POINT Issued by 50 - Date ' SOU3CE RC:Gy�A I .. / ✓c 1 ' / 3 Re-roofs 514 - NAL PUBLIC WORKS mgnamrc al A,PT[caHApircomorefor Date ARDOUS MATERIALS DISCLOSURE T,pe of Roof Will the applicant or future building occupant slam or handle hamNous material �7 US defined by the Cupertino Municipal Code.Chapter 9.12.and the health and Safety de,Section 255720or, All roofs shall be inspected nor to an roofing material being❑Yea P P Y g g installed. Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove coot haraNuUs air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? � / ❑Yes ��"{\No 1 have read the haiardous materials requirements under Chapter 6.95 of Ne Califon rain Health A,Safety Cmxle Sections 2591.5,25577 and 25534.1 Understand that if the building dm4tt notenurcntly_ha u tenant. mi Nlity to nnG1y IM Pant nl Nc n v\ire/menuwLLLLLLd/t met usissmncenfaCertifmala.A, -2 � Signature of Applicant Date O cr.rauthorizedagent LaA T Data All roof coverings to be Class "B" or better All \ CITY OF CUPERTINO a uxa >ti,:, ' Bun-ulNCBrvfsloryPERN4I �CQNTRACTOR'INF_ORMAT BUILDING ADDRESS: WALDRON CONSTRUCTION COMPAbYRMITNO. 20100 RODRIGUES AVE 913 OWNER'S NAME: P 0 BOX 598 APPLICATION SUB DATE LAKE BILTMORE APARTMENTS 01/15/2003 Ilolve: (408) 377-8186 SANITARY NO. CONTROL NO. ARCHITECrIENGINEER: BUILDING PERMIT'INFO BLDG ELECT PLUMB MECH o 0 0 foo LICENSED CONnsedunderpDECLARA7WN Job Description 1 ion? affnm that I am Licensed under provision of Chapter 9(commencing with Section]")of Division 3 of Ne Busi nand Profession,Code,and my license is t-M„ inrenfnreeindirect. INTERIOR RENOVATION I o 1 Z LicenseCl L .N OzFn Dale Convector REMODEL KITCHEN/BATHRMS/NEW WASHER/DRYER & F—f'J' ARCHITECTS D�f.ARATION � WALL A/(.' owe lameratma my pl.na shall be used uric record, , FL COVERING u�3o°. Licensed Professional x OWNER-BUILDER DECLARATION efr ot i f 1 hereby on that 1 am eacmpc from the Contractor's License Lew for she i oO rot'owing reason.(Section 7031.5.Business and Professions Code:Any city or county u$E wllah requires a permit it construct,alter,improve•demolish,or repair any swcturc Fly prior in its issuance,also mquiru the applicantforsuch permit o rile asigned statement ££ < that he is licensed pummant to the piryboom or the Contractor's License Law lChapter 9 Sq. Ft. Floor Area Valuation C€� (commencing with Section 7008 Of Division 3 of the Businessand Professions Cole)or 3$ shat he is exempt therefrom end the breis for the alleged exemption.Any violation of Section 7031.5 byanyapplicuofora pennitsubjecuthe applicant toacivilpcnalty of APN Number yT,p not more Nan five hundred dollars(!50(EL c 0 0 L As 9wner Of the pmpcny,or my employers with wag.As their sole compensation, will do the work,and Ne structure is not intended or offered for sale(Sec.7060,Business 36903 008 . 00 and Profusions Code:The Contracmri License Law dura not Apply m an owner of Required Inspections property who builds or improv.Nemon,and whodeas such work himself or through his - ownemploye.,provided Nat such improvements are not intended uroffered for vie.If, 101 — FOUNDATION however.On building or improvement is sold within one you of enmpletion,the owna- builderwillhavetheburdenofposingOathedidnotWildorimprove for purpose of 102 - PIERS ;(1. l,.owner of the 103 - UFER property,BsinssAnd conmains with licensed io 104 - REBAR construct Law the project(Sec.]066,wner or and property whobuilds Code:)The Contractor's rid ccnuommucusnot apply PMjeCUan ownerofp mr(ywhobuildu"uantr9v.thennoord 105 - ANCHOR BOLTS weense Lace for su projects witheconuumKs)0ttnmd pursnansmthe Contractor', 106 — SEWER & WATER Lkersu taw. ❑lama.. ISec. B&PC ,this mom 202 - UNDERFLOOR PLUMBING owner �L�/�A Data 4Q=%93 203 - UNDERFLOOR MECHANICAL WORKER'S COMPENSATION DECLARATION 204 - UNDERFLOOR FRAME hereby. m9ndrpnaltynfp�nyme°fnemunwinga«la,,;ons: 205 - UNDERFLOOR INSULATION C]1 have end will mainuin a Cenif¢ete of Corium so self-insnm for WorkcfACompum .tion,As provided for by Section 370(1 of the labor Code,for the performance of the 301 - ROUGH PLUMBING work for whim this Permit is issued. 302 - TUB & OR SHOWER Performance 1 have and will maintain Worker's Compensation Lrequired by section 3 0 3 - ROUGH MECHANICAL 37W of the Ichor Code,for the perfnrmenof Nforwhich e work for whichh this permit is issued. My Worker's compcreation Insurance carrier and Policy number art: 304 — ROUGH ELECTRICAL TE OF EXTIO> 305 - FRAME CERTIFICCAOMPPENSATION INSURANCE ORKERS' 306 — HOLDOWNS (ThB section need not be completed ifthe permil is Room,hundred dollars(11100) 307 - INSULATION orless.) 308 - SHEETROCK 1 certify that in she performance of a woo which this permit is maac ,1 ahall not emvinyany lersom'nanyummer Ol esuhjectt.lh Worker' rope s tion 309 - EXTERIOR LATH Laws mrc.lirnmi Applicant310 - INTERIOR LATH NOTCETOAPPLICANT:If,after making this CeriricauofEcmption,ynushould 311 - SCRATCH COAT became subject to the Worker's Compenselion provisions or the Labor Code,you must 313 - ROOF NAIL O z forthwith comply with mcA provisions nr the permit shall MJeemed revoked. z CONSTRUCTION LENDING AGENCY 501 - FINAL ELECTRICAL ENERGY I hereby affirm that there is a conslmcdon lending agency lot the terformanceor 502 — FINAL PLUMBING ENERGY C, > the worknder's urwhichthis permit isiuucd(Scc.309],CieCJ Name 503 - FINAL MECHANICAL ENERGY W Lender',forty Ikr Landeri Address Add a Z 504 - FINAL BUILDING ENERGY U O 1 certify mall have mad all iapplication and sem chat the above w,tmaciun a 505 — FINAL ELECTRICAL 0 F building 1 agree to comply with all city and county ordinances and aa¢!awe relating to QU building eotionedoo"tytortbyection' repreumalivrsofthiscity locnmrupon the 5 GAS TEST W alcove-mem;orcdpropertyforinspeaionpurpous. O7 FIN I gy (We)agree to save,indemnify And keep Write.duo City of Cupcnino against VI liabilides,judgments,costs and expenses which may in any way aceme against mid City' S N CAL. U 7 �in cousequenc°°f the gr tering of this permit.PPLICANT Uff��HH�� TANDS AND WILL COMPLY WITH ALL NggqNNN PO NT Issued by5 ODae)UU CE RED A'('I / gy am. fA,�'p— .CmuW,lnf ,"`�� •�/I Dow Re-roofs 514 - NAL PUBLIC WORKS HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will me applicant or furore building Occupant store or handle hawdous material .defined by the Cupertino Municipal Cone,Chapter 9.12,and the Health and Safety ' Code,Section 25532(x)? All roofs shall be inspected prior to an roofing material beim ❑Yea � p p ' y g g installed. Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit ham,dnus air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District' ❑yes 1 have read the hzaallows materials requirements under Chapterri.95 of the Califpry is Hemdc&Safety Code sections 25515.25533 and 25534.1 undersand thatifine Wilding does not em mml ha ,nem,Nat it is my responsibility m molly t . pmt or the reynim.ntswc t met owisseanccofl Ccniric,,,�fu e. Signature of Applicant Date O�crofauthmimd egcnc Date All roof coverings to be Class "B" or better CITY OF CUPERTINO I* 3 of 6 PERMIT RECEIPT OPERATOR: conniew COPY # 3 Sec : Twp : Rng : Sub : Blk: Lot : APN . . . . . . . . : 36903008 . 00 DATE ISSUED. . . . . . . : 01/16/2003 RECEIPT # . . . . . . . . . : 20864 REFERENCE ID # . . . : 03010084 SITE ADDRESS . . . . . : 20100 RODRIGUES AVE # 9B SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : LAKE BILTMORE APARTMENTS ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : SAN MATEO CA, CA 94403 RECEIVED FROM . . . . : LAKE BILTMORE APARTM CONTRACTOR . . . . . . . : WALDRON, ROBERT LIC # 21547 COMPANY . . . . . . . . . . : WALDRON CONSTRUCTION COMPANY ADDRESS . . . . . . . . . . : P 0 BOX 598 CITY/STATE/ZIP . . . : CAMPBELL, CA 95009-0598 TELEPHONE . . . . . . . . : (408) 377-8186 OE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW SAL ---------- -- ----------- ---------- ---------- - --------- ---------- ---------- BENERGYADD PLAN SETS 1 . 00 22 . 20 0 . 00 22 . 20 0 . 00 BPERMFEE VALUATION 34 , 660 . 00 380 . 00 0 . 00 380 . 00 0 . 00 BPFIXTURE UNITS 2 . 00 16 . 66 0 . 00 16 . 66 0 . 00 BPLANCKADD PLAN SETS 1 . 00 22 . 20 0 . 00 22 . 20 0 . 00 BPREPIPE NO OF FIXTURE 2 . 00 16 . 66 0 . 00 16 . 66 0 . 00 BPSEWAGE UNITS 1 . 00 62 . 16 0 . 00 62 . 16 0 . 00 BPSEWER SEWER SYSTEM 1 . 00 19 . 98 0 . 00 19 . 98 0 . 00 BPTRAP NO OF TRAPS 1 . 00 8 . 33 0 . 00 8 . 33 0 . 00 BELEC200 METERS 1 . 00 22 . 20 0 . 00 22 . 20 0 . 00 BPVENT UNITS 1 . 00 8 . 33 0 . 00 8 . 33 0 . 00 PPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00 BPWATER UNIT 1 . 00 8 . 33 0 . 00 8 . 33 0 . 00 13REMAIRHAN NO.UNITS 1 . 00 8 . 33 0 . 00 8 . 33 0 . 00 BREMFIXT NO. FIXTURES 8 . 00 8 . 88 0 . 00 8 . 88 0 . 00 BREMINHOOD NO UNITS 1 . 00 8 . 33 0 . 00 8 . 33 0 . 00 BREMRECEPT NO. OUTLETS 8 . 00 8 . 88 0 . 00 8 . 88 0 . 00 BREMVENFAN NO UNITS 1 . 00 41 . 63 0 . 00 41 . 63 0 . 00 BSEISMICRE VALUATION 34 , 660 . 00 3 . 50 0 . 00 3 . 50 0 . 00 EPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00 MPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00 ---------- - --------- ---------- ------- --- TOTAL PERMIT 773 . 16 0 . 00 773 . 16 0 . 00 `ITY OF CUPERTINO• p o o PERMIT APPLICATION FORM v3 CITY OF CUPEIZTINO • AP # Date: Building Address:, Owner's Name: Phone#: I-al(e BICfMDIP� �rpAeTM2►rf5 G� 5q/o-5300 Contractor: License#: 9.WAWP-D4 &jjSrz4Mo,J 1AX '774q37.Contact: Phone #: UR45 W azq� MA;JAtee, sa �i� -5308 Applicant/Contractor: Fax #: LMCE L o2c h ormnrrS (p5b) S16- 53-7¢ Buil ing Permit Info:, Bld Elect Plumb Mech Job Description: N ,6 R6uaJ�� IW-WlDt v OMIC-p wrWV-FJ ,e�Dgje � uew UASi t AI Residential: lVAu�T i- FL1M1L Commercial: . Sq.Ft. Floor Area: $/Sq.Ft.: 1000 SF. Architect/Engineer: Valuation: �Y.UQ), STAAW�k SNCtAne Q55 • Type of Construction: Occupancy Group: uanti Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/COmm/ uasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax —Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V <=200A ELECTRICAL BENERGY Energy BUILDING I BENERGYADD Energy Add Multi BUILDING 13INVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi,-Family Res MECHANICAL BNEWMULTI New Multi-family Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL • BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING I of3 r ��3. !6 ;ml- CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPE TINO Quantity Fee ID Fee Description Fee Group BNUMULTI New Multi-family Res PLUMBING BOVERTIME Inspection Overtime. BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING I BPERMFEE Bldg Permit Fees BUILDING _ BPFIXTURE -Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinkler/Backflo PLUMBING BPSTORM Stonn/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING f BPVENT Alt of Drain &Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfrn MECHANICAL BREMAIRHAN A/C Units<= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL 8 BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL BREMSIGNAD Rmdl Si s Add Branch ELECTRICAL BREMSIGNSRemodel Si az s, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL 2 of 3 ;e�- CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM • CUPERTINO ua0ff Fee ID Fee Description Fee'Group BRENdVENFAN Vent Fan Single Duct MECHANICAL BR''5.IVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING If BSEISMICRE Seismic Fee Res BUILDING BSF&2FAM Single & 2 Family BUILDING BSFNA Single Family New Add BUILDING BSPECIAL Special Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL I EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERNIITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75 M Btu MECHANICAL 3 of 3