01070143 CITYOF cure \u
BUILDING
CONTRACTOR INFORMATIOBUILDINGBUILDINGc DIVISION PERMIT
BLILDING ADDRESS: PERMIT NO.
10109 S BLANEY AVE # 17A WALDRON CONSTRUCTION COM ANY01070143
OWNER'S NAME APPLICAfTION UB DATE
LAKE BILTMORE APARTMENTS 73 HERBERT LANE 07/27/2001
PHONE. (408) 377-8186 SANITARY NO. CONTROL NO.
O z Z ARCHITECTIENGINF.ER:
O O BUILDING PERMIT INFO
u V BLDG ELECT PLUMS .. MECH
`y a E L/ L-'r' IJ
IS5 = LICENSED CONTRACTOR'S DECLARATION Job Description
Z'='❑ I hereby affirm that 1 an,licensed under provisions of Chapter 9(commencing
F_t� wits soari°a7w0)ar°i.;,mn3armean.mes:,nd pmre.doa,n.le,aw my uaea,e INTERIOR RENOVATION.
2 s< LscenseClaform,radelreaL (REMODELED KITCHEN & BATH, NEW WASHER/DRY
d z w¢ License Class Li<.N
=`J °at` c°"" °` WALL A/C FLOOR COVERING. )
3 u-L-,. ARCHITTCl Ii DECLARATION
F g C I undersand m
y plans shall W used a public mcoNs
oO L,ccnsed 1'mfesmnul ��
n is OWNER-BUILDER DECLARATION
1 nmaso affirm that 1 a.1. exempt sad the Cmrans C s Licence Law fur Inc /
!-'a following mason.aram,17onstr t.ale, andve.didons Code:Anyairy orcurry. `
D which aus require,a permit 1°cunstruct,ober,improve demolish,or mpae any am<mrt j
E3= prionoi¢iszuance,alsom,indtheapoicau(orsaah amindamtileasiII-dramarrm
tow he is Inenmd In...;,in Ise the pro,morl of Inc Cammcmr'.s License Law rchaper9 S Ft. Floor Area
(connnnmingwilt,Section 7000)or Oilman 3 of lire liminess and Prom,ama,Code, q. C3 ��Uat10❑
or Iha,he is exempt henchman and the basis for,he rlige'd exemption.Any vinlmion Y
of Saation]031:5 by any applicant for a pmm mem,it subjects the applican,,n a civil penally
or on' oan five hundred dollar.(kmol. B!8n3�0 Occupancy Type
❑1,as owner of Inc pmpany,Or'try employees an wage,as Meir role compeasmiae,
will da the work,and the leucon is nm intended or offered for sale(Sec:7014,
'BLaaess rad P'nfesdoas Code:The Conuacmr's License Law Joe.lar apply m an 101 - FOUNDATIIQII6)•uired Inspections -
ofpropenyWhoWildsorimprovezmemon,andwhod«s such work himself 102 - PIERS_____
owner
or through his own employees,provided that such imptovcmems am not intended ar
-offcm l for salt:If,ImOner,the Wildin C "-- - '-- -------
g or un en Offorc n sold wi,nid one year of ----- - ---- - ---- -- -- ---
nnipladan,me owner-n,dmer will Laza me bride„lar provng IWa be did and mildor 103 - UFER
i app vefar purpomorsr`'), 104 - REBAR
N[71,a wneroftnepmanX-Mme;clddvelrcontra7ungwitniirmauadcontnciorsto _ 105- —ANCHOR- BOLTS__. . __-- .-,- -- - --- --
- LieenseLaw`aesant " r�6aw�erofpraertywhoWildsO:)'m,ecorraemr, 106 - SEWER & WATER i. .
apply property Wildsimprovestmi
-.and woo cont,a, Tor such-pro3m,win t avua6sl J p it,to the
Ga h„ i c,.el,,w ---202 --UNDERFLOOR ' PLUMBING -- ----- ---. ... -- -. --.
❑taro ndersl R&Pcfrte'areasan 203 - UNDERFLOOR)'MECHAN'ICAL
"GmC �I-���� 204 - UNDERFLOOR FRAME
WORKER'S COMPC:NSATION DECLARATION 205 - UNDERFLOOR INSULATION
- � Inamnr„rfir,a rnner pu„a4r ser Flemyane l”
and 301 _ ROUGH PLUMBING
❑ I have and mill maintain m certificate or Cousin, sel& wre for worker. 3 02 TUB & OR SHOWER
Compensation, ax provided for by Salton 3700 of the UW . lar the
, Code
- cermr'a:ncennh work for inthis p mil is issued
303 - ROUGH MECHANICAL
_ ❑ Lose O;dwill mAnam,WnrgeraCmapan.a,MnI....aa,ac,a:r,HnindbySeri a„ 304 - ROUGH ELECTRICAL
- 3701 of ma Ldaa Cale,for Iha Illimnance at the wars for which this perms is 3 05 - FRAME
=. _ issued.My Workerh Compeasalinn In-drove eartier nnJ Policy-number arc:
306 HOLDOWNS
- < - _
Carrier: Policy No.( Lt
.t 1, 11 4CATIONOFEIGNI10NPROhIWORKF.NS' 307 - INSULATION
_a Sa,. COMPPNSAI'ION IN4I�RANCE ' -
308 SHEETROCK --
va n ('Th `[tion need not W clam Ie,N'f the s for one hundred Jnllm
IS!rgt les., 309 - � EXTERIOR LATH -
I rrlyahmin,h forimm ceuflh rkr Hahn pc 1-. `.uM,l 310 - INTERIOR LATH , - -
cal^ r ^ILaµ,""`. la 'y ,a.I,ne.ane. n)eatlamewarkerk 311 - SCRATCH 'CCdAT
pea calirmm:Dale " 313 - ROOF NAIL -
NOTICE TOAPo the ANker's ahcmakugmis Cisdans of the
LaWr ode,)owhmulst 501 - FINAL ELECTRICAL ENERGY
bemire wM1jer m,ire Kbikers Compensation Orovi,nm bf Ise W Wr Code,you,nu.a
Q Q fonhwim comply with such provisions or'his farad,0.11 ire deemed revoked.
.. -- - ... _._ 502 -- _FINAL- PLUMBING ENERGY
a'' "CONSTRUMONLENDING ACENCY 503 - FINAL MECHANICAL ENERGY
hercny arm,that there is a conslruc,ion Icnding agency for the perfam,arm
ofthe work Tor ahichthisrmmpeit is owed 3097,Civ.C.) 504 - _FINAL BUILDING ENERGY
i` c liner':Name- - 1 - 505 - FINAL ELECTRICAL
U-� Iuernrrti,allm,varca,d,bi.applieanaaanasi:aematma.anaaenmrmanan;, 506 - GAS TEST '
OE. 5artke,.I date Io comply ran a11,cay tare eoua,r°minaoeer and state laws relwiag 507 - FINAL PLUMBING
.V lob building t Iia rm byauthorize p iw, (tti. lyt ntcr upon
E. a. me W r rip pent Tacdepaha,.e, 508 - FINAL MECHANICAL
Fr O] larb I Iii )agreet su da n fy I keep h ml.to the C'ry f C pen na ago lav
Ing m.cu I pe 's hch y ,lay y. ,:d"'a, 509 - FINAL GRADE
V::z City y .nl ! 18 Ilhf ry. t,
APPLICANTIJNDERS'TANDS AND WILLCOMPLYW'ITHALL NON-POINT •7 �U_
- NA ING
sOORCE REGuia'noas: _ Issued�$: Date U/
Sigmtme Of AppEcant/Comorcupr - Due Re-roofs
HAZARDOUS MATERIALS DISCLOSURE ''
- "
Will`Iba'af`,phcwa dr from Wt dfny rcchpma nam a.noodle maritiara material Type of Roof-
as defired by the C,pen Mu c p Cmlo,Chafer 9 12 and theII Iih and Safety -
Cod Strom 25532(a).” a'
. . yes- All roofs shall be inspected prior to-any roofing.material being installed.
Emiu II mapplicantnf lure n Id1 dosefaro,sa. p d which If a roof is installed without first obtaining an inspection, I agree'to remove
r 1 ' r aLa rM1,,a,tl slny lFe Hay ArcaArQu:r,y Alunugemen,
DNai"o}, all new materials for inspection. Applicant understands and will comply with
all non-point source regulations:
"I have mad the harardom nrarands requirements under Chapter 6.95 or the '
Califomin flat h&Su1'cry Cade S-
I
,
aal 25505,25533 and 25534.1 undertrnslard _
ifthebu,ldar t"nal cun'cmly hus'e nundal,,hal i,is my mliam"Hily m marylire - - - -
Oc ape,c 1 gqui.a
at ss hlch mull be,net prior In issuance of a Cenifmm ser
It
�Jl
Signature of Applicant Date
owner ser seamanme.agept Dale All roof coverings to be Class "B" or better
_ OFFICE--