00100174 CITY OF CUPERTINo
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUI LDING ADDRESS: , PERMIT NO.
1.011.9 S BLANEY 15F WALDRON' CONSTRUCTION COMPANYOOIOO174
OWNEIVS NASIH. - APPLICATION SUR MATO
RE APARTMENTS 73 HERBERT LANE 10125/2000 ,
PHONE: _ SANITARY NO. CONTROL NO.
' 140&) 377-13186 ..
C ZZZ ARC111'rEC(ENGINEER: - BUILDING PERMIT INFO
cut .BLDG ELECT PLUME MECH
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S H j LICENSIiD CONTRACTOR'S DECI.ARATION Job Description
ZO y_ hereby N'Onn mal 1 um licanwe unser pamvisinns of Chtminv 9la...... Icing ' .
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with S I' 7001dof D'vsn,3,1'1 he B, : 1profession,Code,all ny!leen%c f -
YfJ sinfall'force and effect y'
Lic ,' Cr. x INTER.,RENOVA:TIN/REMODEL KITCHEN AND •BAT DateI
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AItCHIT1iCIARA'rioN
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Ianeer%t:..,dn,yFlnn,.n,Bnenreen.PnnremnN% ' e APD WALT_ A/C, ADD
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i0 0 Lmcnval I'ndes'stnn'al _ r
OWNER-BUILDER DER Ill CLARA ION . .• '
Wos , urn.S that , rl r N Carmichael L' 1 for me
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!Illi b .(S t )070 11511 .' IP (. rs' C I ,AY ty <mmy
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ou Ilito or is 111-allor,Ill.,M1 I 1 I ,ye i lm PPI' ,I h pe 'ti f l g J aa,nen `
n n d provisions ofn c t r.License I-, ,cit r,er9 S Ft. Floor Area a in
tribal h pal the I , ell -m I II Ube PI AY" Ia,In Y '
of sm m 7031 5 M1y any,papahcant lie a R I. bJecu Ise(PPI anus u r vil penul,y "
nrnm lm,m,wn e.e natmrea aoBa,%lasool' APN,Number _ O cuP3Rcgpe_
71 I, nl property, v N r 'n p, i nt ,toe ocill , • .
Ill tirek PuInseam ,' t eJ R IfI (Se 71W
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Business and Pt. -
Cst That Connote. License Lot,dusts nor apply to an ' 3 uired Inspections I
W t,hhis ty Who n e m .........,att,rem, a,d ver does a w..rk n ,.yell 6903008. L�9
oerelf t n his awn employers.th Pnwmcd mut fuck lememcis sol Bre nm intended of ", •,>•• - , `
offeml l I If,h x the budding pa -c ni it. la 'Inn me Year n(
completion,thh,'II 'Inttleth n J ,pa wingth�h eienmbuildor 1.01. FOUNDATION .
pan p p'. . f-I.1. . . _
302 — PIERS
o fleet eenyan Lela els t , i mli e)Th m a t —
ul Project is 7wa B Ill 1:. c lTn c t t , 10 ,—. LIFER.
Lce 1 IUP,I,, al ly mild: - - _, .
coma I ^Mr1A ori t. ',n , e, lilicensed pr0a m• 704 - REBAR -
❑Ia 1��A n.r<Iff 1 n' re's..0' 105 '— ANCHOR BOLTS"
°w�41/�� n'e I�/��- 106 — SEWER R• WATER
KORRI!R3COMP f p,,j. DNDECLlidla,ON , `20.- — UNDERFLOOR PLUMBING,
Ithereby' fr ad pal oy fp•rI r rd loll ` ga rmtmns: 203 UNDERFLOOR NIECHANICAL
❑ 1 bele and will ma n''n a Ccn fi mm ofConsent to self for Worker'% '
Compensation. a% Pnwnlee fn, by Set 3700 oI all Lahor CeI , for m 204 — 'UNDER-FLOOR•-. FRAME tc
111 lis l 1 205 — LINDERFLOOR INSULATION -
P to rey I by Se,nn _
❑1 d- e II Worker r .301 - 'ROUGH±, PLUMBING
3700 r n ],;,I -( ,e r II pa Inl k r a n d''pa n,l is
Carrie.My Noah%en Pen:ion lnPolw careier a„e Policy nnmxr are' 30?_ — TUB $� OR SHOWER .
Carrier: - XEM IIO '
cERnFIC COMPENSATION
OMPEP ATIONINS PROWwoI<Rults' - 30A3-- R,f0t0C0H'c MECHANICAL
COnIPEN5AT10NINSURANCF, 304 — ROUGH ELECTRICAL ^ '”
(This aero....ais,.I nlMmnnPlnal it don Is,ualrr far rent hamild Jnnare • >%/ ,,.
a❑knnr leaf.) '305•'— FRAME' . .
1 rectifythat inIce performance of ihm walkl 'life nm':�e t nal ' 30E' HOL,DOWNS • - '�'
.Ban 11 y't y 1,11,11, ,v ,anal : 'a R I,.,ne a hico m the wmkir, - .. 307 INSULATION
Camp , r Luu'sofclo ' .Dale r
"pap°` 308 — ShIEETROGN
Not ICE AIII(CAN1 If,allr kIg1 Lcrfr f CxemIsiai youshould' '
Z neon h ll'I w k c o'schatiali i ho'kalmelnbnrCallayl,n it,(
' AmlociIoly with such Prso ,.tlyl li, hall tedeeedo309 EXTERIOR L9T- "zO . .
-
F �' CONSTRUCTION LENDING ACENCY 310 — INTERIOR LATH
,C Ihereby amrmthat them ifaconstruction croulgagencyfmme,trtnm,ancn i f ?,,j;1 5CBATCH."COAT '• '.'
Liz oIbe work for x hich his permit is issued IS.,3197.Civ.C.) '
L'O Lender's Nanie r - 3113. — ROOF NA T L -
Z Lender's Ardor, - •.
(_) c 'fill o e eon. pRlcat and late moor n 501 - FINAL ELECTRICAL ENERGY
OF nnrec,.I b eI ProWm all city ad my r . I III II c 502 FINAL PLLIMBiNG ENERGY
V „blin'ur g ,a%I-(fon:, n 'ly o„ra ..pae%e..Irn�.�,rn hi,riIy,ar,lerlP...' 503.'`_ FINAL MECHANICAL' ENERGY
�. 4. 'Ihc aM m I' o s e, lde f Pe f P q -
[.. 6. (We) g I sale,indemnify fY d keep h .IhcCity f C loco g'n%t -
.. vl booth dbm a pawn:: lthmar g, try callallh','n, 504 FINAL BIIJI-DING ENERGY
V � City it lyl,uc of lh ! nab of Ibis paw li 1. '
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT 505 — L ELECTRICAL . / � /,
SOURCE REGULATIONS. - Issued by: _ Date l'^� 'V U
S gtwl %Appal r D 16 Re-roofs: -
HAZARDOUS MATEDISCLOSURE 507' — FINAL NLUMBING
wnm ppaue t, fIren Ili..g.npe11'a laturocii,houndle n Nn:cm,iemd, Type of Roof X08 Fl:WAL fYIECL11=1id7:C li...,,
%al'daor o �by'fion 593P t M "I-ICd Chula JI I pal HaIII ;,,at Sfny ,
50.9 — FINAL, GRAD
°1e' °N - ,Ali roofs shall'be n S ect d. iorTq r �n -
1, P y ntaterlaFbeing installed.
WII II "Arcur Il' b I" I I 'P, -I -wh'1h (� t�l r\tI. � l�t1111
'lit rd ,..tan ,n„a,aameanyll B>nrelAnp I ynta ugamen, j if a roof is ins[ lle�3 with u I oblm I x1110004 eU1on`I agree to remove
all new materiaWfIr ins iFAAfigLA Rli t E A §
orv.. P Plll bide ndwill complywith
all no point source regulations.
I have read the tiaz,Nnus mallard"'reyuirenien,x under Chop,er G.95 of the `
C hforao Health&S f ry C of s uo 550.9 25531 d 15534.p J t and that
_ %thee IJ 1 I ' dytrBill y p 'ti l'IYI ca dl
I h p I bch nunbn ,pai d,us%aan f C 'renin if '
oe I
Signature of Applican Dale'
D e raamoreeJage„ w — "— - - All roof coverings to be Class `B"or better'
OFFICE