02050029 CITY OF CUPERTINO -
BUILDING DIVISIONPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS:
10109 .S BLANEY PERMIT No.
# 17D WALDRON CONSTRUCTION CO PANY 02050029
IT WNER'S NAME: APPLIC71ON S tB DATE
LAKE BILTMORE APARTMENTS P 0 BOX 598 05/ 07 {/2002
PHONE: (408) 377-8186 SANITARY NO, CONTROL NO.
e -- '
O z Z ARCHITECT/ NGINEER: '
z 0 I I. BUILDING PERMIT INFO
566 � . , . . BLDG ELECT PLUMB MECH
S i LICENSED CONTRACTOR'S DECLARATION I Job DBSCTI hon
„C° withSecrnn]00(pofDivsion3MtM1e`Businessand�ProfessnnsCodeo�dm>"u«�t� INTERIOR RENOVAVATION
'Y is in full force and effect.
.'oda License ease Li, 0 KITCHEN/BATHS REM NEW NEW WASHER/DRYER &
30 n°t` SDECL°r WALL A/C/FLOOR t4/ dh
_ - ARCHITECT'S DECLARATION 44 fr
�� 1 understand my plans shall healed us public remMs
I..p Licensed Prefess,onal
C
w o - OWNERBUILDERDECLARATION U A xaooW �
thereby affirm that 1 am exempt from the Connector's License Law for the Y
t�Z a following reason(Section 7031.5,Business and Professions Code Any city or county
v which requires a Permit to construct,alter,improve,demonsh,or repository structure
..Po T t I y tl .Fd tf p 'II fl Signed Statement, V
that he licensed lt m p a nn Contractor'.I-cento,La (Chapter9 S Ft;.Floor Area All—
(commencing 'mIThenoma'a (if Division.. fm1 s dPr Coder ' ��N rNs.aQ': ts n.{..Ife t'..( }; • , 461,§ yatdon
orS the s exempt th f om and The bell,forth,alleged ekempfon Any normally - ^
of Section]0715 by any applicant for a pemTit subjects the applicant m e civil penahy
of not men than five hundred d°nara($500). 3 6 9VYVIIBIb90 Occupancy Type
f]1,as owner nr die property,°r ter en,ployeea won wawa a u,etr som compen..ran. '
will do the work,and me.s mnuu is Outintendedor offered for sale(Sec.]0u,
Business and Prafcss;°ns Coda The Carl'...",License Law does not apply'.an 101 - FOUNDAT R04iiredInspections-
ownc
r of prupeny Wh°huilds or improves thereon,and who tloes such work himself
or mrougM1 his cow-employees.provided met such improvements arc not intended or 102 - PIERS
°Berea for ante.If..however:the building nr improvement is sold within one year of - 103- - -UFER
completion,The owtmr-builder will have the burden of proving that he did not build or
imp f p rpo of sale.). 104 - REBAR
p:P ,y wavay,mtmrngwdlicensed° tmctanTo 105 ' = ANCHOR-BOLTS
dote,t'Ie project(Sec.7044 Business and Professions Cod,)The Comracmh -'
_ License Law'does nm apply To armi of property who builds or improves thercnn, 106 - SEWER & WATER
" and who,contracts for smh projccls contractor(s)licensed
i Contractor's License Law. W111a °°""°""°`"` - 202 --UNDERFLOOR -PLUMBING -
❑lame.=' funder B&P C formis reason 203 - UNDERFLOOR MECHANICAL
ownc: " ' pr(f{L .Dote 5- -0� 204 - UNDERFLOOR FRAME
WIC6W,6WVENSNrION DECLARATION 205 - UNDERFLOOR INSULATION
I herehy.rrpn ones family of perjury he-fill'f.11"Mng deelararnns: 301 - ROUGH PLUMBING
{��r•';�`:�� ❑ I have,and will maipllon a Cemftcme of Consent 16 self-inure for WorkersCroorpe3 02 - TUB. & OR SHOWER
.! x' Pinfornmtlon, he provided I'or by Section 3x..ad. me Lannr cone, f°r me 303 - ROUGH MECHANICAL
perhnmance of me work for which,his gmon is ixsuN.
❑1 have'and will ma'main Walker',Curn,anomum Intimi nce,us required by Section 304 - ROUGH ELECTRICAL
3](10 of,he L der r Cade,for the performance of the work for which obis issued:Myy wk 's Compensation 1 pemm is 305 - FRAME
- [as ca and Poli y number are:
C 'CERTIFICATION Pulicy No.' -. 306 ...� HOLDOWNS. -' . . .•,..•..... :.:.•.' _. -. __
C%EMPI'ION FROM WORKERg' S.. ..a Ifr307"'-307
COMPENSATION ''
ATION INSURANCE
-`p perntitiarn - . ..... ... ..__ . 3.0.8 ';;e....SHEETROCK...._... -
_.
' (Thun n need hall be completed if m one hundred dollars
'° 309 EXTERIOR LATH
1clemifymt parrrnapnl_na.kIn, or�h`n)ei`m°mewsued,1 - 310 . _ INTERIORLATH .-, _ -.-.. ._•. . ... ... ,
Shelf `employ any Person in any manner erK 311 - SCRATCH' COAT
Comp °tion Caws ofC 1 f fin .Dote'
Applicant _
NOTICETOAPPLICANT.If,after making This Cenrftcce ofE 511 OFNAIL.
• ne�nme.antet t°mew°rkera con, 'r x
emproq You do, FINAL ELECTRICAL 'ENERGY
Z' 1 ns provisions robe Lan Ana yen mos, -
O O mrtn me mplyw;tnsuch p m Permit shall Ile heated!invoice, 502 - FINAL PLUMBING ENERGY
z
'CONSTRUCTION LENDING AGENCY -' - -
IherenydffrtnThai m re communion leading x 503 - FINAL MECHANICAL ENERGY"
a > gagmcyr me °""... 504 - FINAL BUILDING ENERGY
of Ill. k r nteh m pemrt aaaea(s Jog]ev.c.) t
t4a Lent Na
z „ ..
V-Ol-end :pde' - 505 - FINAL ELECTRICAL -'
1 greemcOm dm ppf t a tt Ordinances n laws dialing
506 - GAS, TEST a
eL F e":re I s t u 'Ty d county a nee. e T aremrng 507 FINAL PLUMBING
yOT W mteubd g m1-pPopertyf binspectionprppu "°rob �ryt "`upon 508 ' FINAL MECHANICAL
L;96 (We)agree to save,indemnify and keep harmleisthe City-of Cupenrno again$
L A liabilh;es.judgments.costs and expenses,hien may in my way accrue edema mid 509 - FINAL GRAPE
U AiryfnconsegUNDE°f/I}}..TANDSA of AND WILL
'- 510 - N NG jSL
APPLICA[J�SUN�R'TpNpS gtND WILL COMPLY WITH ALL NON-POINT
souRCE'r 'uI 1 5_9 1 Issued b3'l Date
Srgn:num°f ApPhemuCtionum pate Re-roofs
HAZARDOUS MATERIALS DISCLOSURE
..
Will the oldlificat ftmwild;n,clead am sore or handle huadmu material , Type Of.ROOF.
as defined by.theC pent M n c r I Code ClipT 912 and'hHealth d Safety Safe - - - -
Code 255130? �. S, .. ...
roofs shall be inspected lyra to any roofing,material being Installed.
wan applicant 1 bolded occ p mnseequ Pn No aevtoes whim If a roof is installed without first obtaining an ins ectiori, I agree to remove
�mn huardou 1 ronmm nv t def d by ,,am
Bay Area Ah Quality Management g p
all new materials for inspection._Applicant understands and will comply with
Yes
all non-point source regulations,
i a Health ,he h rdo s mals requnentents under Chapter 6.95 of the
California Halm&Safety Code,Sections 25505 25577 and 25534.1 understand that
if the building does-at c°rrently have.lactam.that it is heye.fordiddlity mnmify,he - -
occupant of the enime ments which must be me,prior, issuance of a Certificate or
o«npmcy. ..
Signature of Applicant _ 'Date _
Dobe All roof coverings to be Class "B"or better'
I
�. + .w .. ..OFFICE