02030091 CITY OF CUPERTINO ' -'
BUILDING DIVISION PERMIT �CONTRACTOR-INFORMATION:,
BUILDING ADDRESS: PERMIT NO.
10099 A BLANEY AVE # 1C WALDRON CONSTRUCTION COMPANY 02030091
- 'OWNER'S NAME: APPLICATION SUB DATE
'LAKE BILTMORE APARTMENTS P 0 BOX 598 03/19/2002
ONE:. SANITARY NO. CONTROL NO.
(408) 377-8186
.. u _ BUILDING PERMIT INFO
ad— ARCHITECT/ENGINEER: - BLDG ELECT PLUMB MECH
<� C77
LICENSED CONTRACTOR'S DECLARATION Job Description
I hereby afrrre that 1 am licensed under previsions of Chapter 9(commencing r
INTER. RENOV. INCL : KTCHN REMODL BATH (2)
whn secnof 7ofq)or Divismn3onbe easiness afa rrornaamns coon.dna my Rceae
xz�a License Clan< isc'fullgxceanaaffect
. NEW WASHER/DRYER, NEW WALL A/C, NEW FLOOR
Licp
GadV Dole - Cirtmemr FBI1B6� LE® _ -
3 a ARCHITECT'S DECLARATION Y II D9 F'"R.
i u ON� :' 1 understand my plans shall be used as public records
s o nLicensed P fes ions MAY 14 2002
"X,`?�y OWNLR-BUILDER DECLARATION
', 1.1wareby affirm that I am exempt from the C L' e e Law for the
FL
ZPoll g - (Se<fo 7031.5,ficonan,, ad P .f C de Any city or many
Q ' -
z commennn I c n.t t Ile pr demolish, repair any sl a rc
63m .p q q N PPl uam for oath permu fl us6 eJ It t ". }.BLIIIh ...__.. _ ._..._..... .. . .
w sat tFill
n, t t o < Is
atn u . ap rs t, mapro.f mnsormecomtmctor'a Ln ccn pt s r . S Ft Floor-Area ,,.,x Valuation
( gwih Se ion 7000)of Divison3eRhe Baine..ad Profess...Code) _ (',iv
9'It r.. ,.,E - it,!,. '
or time he is exempt mcior nix and the basis for the alleged exemptimi.Any violation 'arcininrlp nn
of Section 703 1.5 by any applicant for a pumil subjects the applicant to a civil Penally-,
of ol mere than live hrmdrea dollars(s500). APN Number .,., Occupancy Type
❑I,nsowner of he prepeny,m ony employees with wales as their sole compemation, i ni FOUNDATION
—
will do h'work:and thesloeture is not intended or Waited fat,Sac,7044,
'Bus fess end'Piofessions Code.The Comrocmr's License Law does out apply to as 102 - PIERS Required Inspections - '-
owner of property Who builds or improves thereon,and who dues such work himulf 103 - UFER
.1 through has do.employees provided that unit ame,curnern, I dui or _ .._.._ .. .._.
off cr fo s le if ho c lh n la'ng
m1privenear i Id w lift.one Y' of --_. -.. 104 _ REBA..._ ._.._._. _,.,. ,._.._..__
R
6irld,liam h u e b r
Id will have the Horden ff proving that he did net broad or i
map r rorpnrposeofame) 105 - ANCHOR BOLTS
as owaerof m� _ __._.._ .. . _._ — _. -.._ ...___._
= property,tyame Inn ly ..amfe i Ihl' n ac ivouca to ...106 — SEWER &- WATER
nswct me project tsec '/n4a,Business and Proreaa ons cone)Tse centracmrs 2 0 2 — UNDERFLOOR PLUMBING
iccnse Law docs nm apply to an net of pmpcny who builds or improves thereon,
and who eo tracts for such projects wim a contractor(s)licensed.pursuant.to.me. .......___......'2 03'-- "UNDERFLOOR--.MECHANICAL-
Committees . ---,.—.
-131ronLcense Le
olame< lafaerse "' B&Per mid s 204 - UNDERFLOORS FRAME''
205 - UNDERFLOOR INSULATION
WORKER'S COMPENSATION DECLARATION 301 - ROUGH PLUMBING
In ebyarrmn d p<�>,nrorp ) lir" onnerml ,mgaevmratmna:- 302 — TUB & OR SHOWER
A ❑ I h and will ri cenlee r coiaseu,m selnnsare for Workers 303 - ROUGH MECHANICAL .Compensation, prod d bIit 3700 or.,he Labor Code, for the
Performance
erfo manceofthe work forwhich,thisp IsssueA 304 - ROUGH ELECTRICAL—
.-.._-
'
-
❑1 have d ill aneirmi.Worker's Coinpe asat en Inforrancears required by Section 305 — FRAME
3700 of the Latour Code for the perfoirnanceof the work'for which this a mit is 306 - HOLDOWNS
issued My Worker's C top n at Insurance e and Polls n m,bc
307' INSULATION=
Carte f '� It) Policy NI. - .- f 1 -
(This section FICATIONOFEXEMPTION FROM-WORKER6i 7 308SHEETRO&- # r k
CCRTI
"I COMPENSATION INSURANCE 309, EXTERIOR LATH ,
need no,meompin d'fine permit is for one hundred dollars 310 — INTERIOR LATH `
1SI00)or le s.)
31,1. .._:--SCRATCH;COAT _..
O .: n fy m`('eoWrco TklerB Cea'npaetqnks,at sin p cnr sonf_thfEL bopfCad y,p,yao n laI
.. IL313 - ROOF NA1 Sri Ib ,employ an
Laws ELECTRICAL
RICA�L. ."il
ENER
GY-Appm 501- --- FINALENERGYNbTCETOAPfcomplyT_, 502 — FINAL PLUMBING
Obet m bm
forts m
_.
_FINAL._.MECHANICAL_ ENERGY. _ _. .-....
Z nd(So Send CVCc ._.- . -
F 504 FINAL BUILDING ENERGYI `,'
W,q -ceemlahereby Name.WccoNheRusccoN`LENDINGdAGgagCcyf the m e 505 - FINAL ELECTRICAL`
t.y 'fm kf h hlh petmua
g em with ally aiu d county ordinances d t state laws rcl Pis - — -
O F" To buLender'silding grat.com anwhercb mor¢euntymfviceand city laws rat on 506 GAS TEST
-p 507 FINAL PLUMBING
to
roe " Torrb<Ilacfymtlhpyr dm Ypl al r state maid m r t s 508 - FINAL MECHANICAL
U
the b o coned pend f inspectionn purposes. .
509 - FINAL GRADE
es,jg t s demn fy and keep har ices the Cny rime'against
liabilities,judgments. sts and experwas,which mary'n any way.,a.e against said
510 - FINAL PL ING
ulzCtyy ria sq flhegoup goClh pe , 514 N y,JpRKS.._ .. 0 2—
�APPLICANT D T DS AND WILL COMPLY WITH ALL NO'a POINT ` S^ fro `
SbtIREE REi nif.� Issued by: Date
S,gnal eof ApplicardCon,racmrt, :.:. "' ;Date, )' Re-roofs
W I � PP HAZARDOUS MATERIALS DISCLOSURE
he a r r m building occupant store or ha me nav,rd a mat Ty
1 .. pe of Roof..
pen o Municipal Code.Chapter 9,12,and the Health and Safety; `
Corr defined Coy
-Cad S t (255320 a N 1, fi Q 7 P r Y4 v. �, '•.
Dyes ( ' All to shall be mspected-prior to any roofing material.being installed _
-
use
.srt or
❑Yes irPeon,` future
def db the Bay AeaAr alt Mang hob' .. . .`.PP g p ` 'Agree to remove
tactl ha a tl'the ha¢ dou len 1. requ remetni Quality Management
all non point source d wdl comply with
If a roof is instal a wit out first o tainm an ms ecnon
it
y - regulations - _.
c 1 rh xe6hn azSafety Code s'�hon assns 25533 and Chapter 695 of she all new materials for inspection. A beast understands an
nd 255341 undersand that
if the ReY doe tc tlh off h -' -
Illi( . . 1e
building Va/�li�U lilt- Y p Y .. ..
p d p m� t f l Signature of Applicant
roof coverings to be Class"B"Io,'better `
oc nt fIM1 rem 4 l h utb et lei en faCnd
g PP..
.,an,
r, g
_..OFFICE