01100124 CITY^OF CUPERTINO
BUILDING DIVISION PERMIT -CONTRACTORINFORMATION:
BUILDING ADDRESS: PERMIT NO.
10099 S BLANEY AVE # lA WALDRON CONSTRUCTION COM ANY 01100124
OWNER'S NAME: APPLICATIONS BDATE
LAKE BILTMORE APARTMENTS P 0 BOX 598 10/ 23/2001
PHONE: SANITARY NO. CONTROL NO.
(408) 377-8186
q O Q ARCHITECDENGINEER: BUILDING PERMIT INFO
kL"pl BLDG ELECT PLUMB MECII
8NN
gI Z LICENSED CONTRACTOR'S DECLARATION Job DOSCrIpUOn
jz„p - Gunny ) mat I sin3ofthelicensed unamprodsion,of Chapter 9 sionsCde,annmmweing
nse INTERIOR RENOVATION.
mCm with Section700B)o[Divisi°nJmf the Baslnessond Profession,Cnde,and my license
fz�a is infullciseandeffect. » (REMODELED KITCHEN & BATH, NEW WASHER/DRY
Licenss
Date Contracmr WALL A/C FLOOR COVERING. )
3 0 4 ARCHITECT'S DECLARATION
" _ 1 mbderstund my plans moll be ante as public records
on
1 at 8'
nib p O Licensed Professional
u C Z Q OWNER-BUILDERDECLARATION
w I greasy affirm 1exempt from 0r,Contractor's
ie Law the
following (Section Business and Profession,CcxWc An, it, county
zzD
Four1 q e t(consumer, Iter mfor'sudemol h file. i any alstmt - --_,-- ---_- _--_
p t t I q theppl Gem for cath pe.ito flam.'gned.mrm t -�- -- � - --��-���
tbath§dd adp deanl td thb�r°lions of the Cunwcm L' L (Ch pt 9 a sS 'pt FIOOr.lIBd 4 atlon
(c gwins t t]0I1f1) fD'Division 3 order,Bh,msP and Professon Cd) (. .i� 3 t1, atq'ra /lu t llJJizxt-�.'.:l°�'`y. $346��P
o that he rs exempt therefrom and the hosts for the allegeh efemd000 Any violation i
of Section 703115 by any applicant for a permit subject,the applicant m a civil penalty'
tof not more[]ran five hundred dollars($500). 369P�bpcp Occupancy Type
,IJI f the properly:or my employees with wages as their le compensation,
*•" wll do the.work,and the structure is not'intended or offered for sale(Sec.7044; e
Bus nessmna Prrifesvons Code.The Contractor's License Law does not apply to an 101 - FOUNDAT Tired lnspectlons '
owner of property Who builds or improves thereon,and who does such work himself _ 102 - PIERS
11
o moonlit his own employees provided that such improvements t intended or
oR red fo s le If,h e the budding t m r en tu is s Id w within one year f
'cs pit to n ki lln th barren are , hot n did n, la 103 UFER
imp fir rp m se fsai t. 104 - REBAR
pll sownerofth property,ame al s elY t lung-wthl nsce convact rsm. -- .1'0.5__.- S _
wit t ....
Lie
t t th p o3 t(S c 7044 Businessa d P fess c n Code)The Contractors _ :,
L L does n apply t ownerf p pen,who bunds or improves th reon, -
106 SEWER & WATER '
-an s such projects with a commmorts).bcensed porsuam to the _._... .,.2.02 ._. -UNDERFLOOR- PLUMBING'
d h tact
C t t Law
❑1 m p e sc ' �f&Pc rm rga,nn 203 UNDERFLOOR MECHANICAL /
o G 30 0� 204 UNDERFLOOR FRAME
ORKE SCOMPENSATIONDECLARATION 205 - UNDERFLOOR INSULATION
Thereby affirm under renal ofplry eofihef 11 gd elamhn,:- 301 — ROUGH PLUMBING
❑ I ha a and°will'ntantao a'•Cmin t f"C ordI.selfmwr°for Worker's 302 — TUB & OR SHOWER
Co.pe t 'as;p e d f r by Section 37M of the Labor Code, for the
Perfnm,anae'nnhe work forwhich,tnia,�rl is r,syea.fhl_ 303 — ROUGH MECHANICAL
❑Ihouse and will na to w kr,rsCn ce t Insnuam quredbyS Imn 304 - ROUGH ELECTRICAL
3700 r deb Labor Code,f dee peau r he wmk r inch this Permit is 305 — FRAME
ie dMvWkiCmp t I ' eadPly be
ca e 7f , r tr'Ad �ole,Nn . /306; r HOLDOWNS _.
31t CERTIFICATION OFExEMPTIGN FROM WORI(ER$t � f ° ` rs307�! F�INStIliATION:If"� l
COMPENSATION INSURANCE ... - ..... - G ...
308 SHEETROCK-
"" ('fhlssaionn it not be completed ith permit is for one hundred aonms 309" — EXTERIOR LATH
-�
31.0... _—INTERIOR -LATH
l o defy tom in M1 performance of,he work for which this ' tit is suet,l f
p 311 - SCRATCH '^COAT'
'it IIP 1 em I a _ 1C 1 rWorkers' ••';
s p y ny p rs n )' ginner a t become s b act to the
Appl c niton La .of Calf ma Da _ -„313 - .ROOD, NAIL,- ,--,.,.,
NOTICE TO APPLICANT If,after makingthis Certificate fExemption,you should 501 FINAL ELECTRICAL`s'ENERGY `
ti b) ,1. b W k Compensation p ens of the Lab Cod 'yo must
O forlM1 th Iplywith hp nun m pemtsnanxe a km 502 _FINAL PLUMBING ENERG
ta > sl ss ' CONSTRUCTION LENDINGAGENCY - 503 — FINAL MECHANICAL ENE GY'1
504 FINAL BUILDING ENERGY
aa.:H ono Ihk fby n hilhatth saso construction( lending
] Civ.e) r the Performance
gar, y p
q Lcar,same' - -- ' 505-'- FINAli- ELECTRICAL' _.. __ . . .. -
L ndet's Add is ,h
O� +< t , .i,. 506 - GAS. TEST r.l '.
U ,dy I erlfythat Ih a dthis appl t d sten that the alae informationis
t a agree m comply with all city and county oNinan s and store laws relating 507 - FINAL PLUMBING
01U ID 'building t cin sehereby aumrepresentativesfm—cityyt enter upon 508 — FINAL MECHANICAL
y w tu b e t eaproperty r ,Peat too purposes. 509 — FINAL GRA E
1 W) g m save d fy.and k gip h the City f C p Dino gamut
fry liab hit 1uJ encs c t d pense h h m y n any y gainm said
C.
Uv�4 Gty o r, heeofthcg I ofth p t
A CA N $T BSANDWILLCOMPLYWITHI/qL/tJ, p,{�,{P INT' Issuedly30 N
90 C
eo Re-roofs
stiilr Aplicamh7 runon-
HAZARDOUS MATERIALS DISCLOSURE
cant i peOf:R
OOe:iWIIN aPPli nt *
esdefinedbytM1 C p n M l l d Ch p9 12 dh H lth dSf ty _swtwllCode 5 coo 25532f
sit l r x e1i _ionto. t 4
❑Yea '. , All roofs shall be inspected prior.[o.any,roofing matenal.bemg installed. .._._—.
f W 11 th apple t . f t re b Ila g occupant equipment a les man If a roof Is installed without first obtaining an inspection l lagree t0 i&emove
amts tl otii
.,Pont,as fi dby th ByA A Q ItyM ' gment
all new materials for inspection ,Applicant understands and will coin ly,wlth
all non-point source regulations;,.
` 1 hev rcod.th ezmd mnien 1 comments code,Chapmr 695mLthe
Cal for a Hee &' fety Code Sections 255115:25533 and 25534.1 understand that
'Ifihe ball in
s is anti/ha eet tNauusmy resp nslbilitym notiry.the
l oc p t of he' m'is whit 'mu t be met p nroins a of a eriifirote of
-n m .. .
°ocapeand / `Q Signature of Applicant .. Date
o r, au sd fie get at All roof coverings to be Class B” orbetter
.-OFFICE .. ._. . _.... .- . ... ,
..s_:.r s _ ,