00060108 CITYOF CUPERTINO -
BUILDING DIVISION PERM_ IT CONTRACTOR INFORMATION:
HUH.DINCADI3R6SS.'F' '•I .•, - PERMIT NO. -
OWNaRsrvrl0129 'S BLANEY/16C WALDRON "CONSTRUCTION 4"Y716f4"IM"VM`0F 01.08 -
PHONE
LAKE BIILTMORE APARTMENTS 73- HERBERT LANE IINITARrO6/16/`c��i1`LINO' -
0 0 AItCIiITIiCI/IiNUI NEER: i - ¢ (408)377-81 B6'
d - •uuII.OINc PERMI'II IN[f) '
uY 'BLDG I'IJiCI' 'PLUMB h1LCi1,
� IBJ I=1 LJ
0z I2E, Ihcreby aRinvhut Inor DCOcncdunder�OR'pSckutmi Nf Chew 9 feommencing, ' ' lob Description '
rr v;tw with Seci on 700Xp of Division i of the Bu d Proheions Code,and my license -
6y�j J< dpi flat
III mA effect.
Is�3 a UN pat - c o
Ftuo ARCHIL CI'SDICIARAfION INTERI RMDL OF BAT S K H NEW WALL
Nag 1 t,Jenta ul In,plans shall be used s public records
w� NEW T KING-WASHER A R
s
a a licensed Professional
Oat I am exempt from the RATION
I hereby affirm that l exempt the Courai License Law for the
C O
folicu,mg7Ui15 Business andP :Code A,icilyu,orrk,
whichkiller,orprose.dicusilish,or excur,oly,laut'c
� � Pr, t t L y II l,l ,I hpermit t II aspeed. Nncn
Ihath ' II t Ih p , of Contractors,L L fCla ler)
m - Sq. Ft. Floor 8 d al n 10❑
a. 'feo enLwih Section 70001 or DiZimi 3 of it,Broke,and Profess Dns'Coded -
or Inc,he is exempt,herefrotn and the til for the alleged exemption.Any Imlaion
.fire,
dS t- 703156y y (ml tf subjects
n , re to r n dol d Il :(55003 I nnI I to a civilpexialty AP wnkletcxchpancy Type -
°I I tl p P tY v 11 y m i"k ff
w'II 1 II 'k I the.o I o merited(it(rood to r:"I fS 7M1
Bis I Porkissick,Code Der , . License Law doesare apply, Required inspections'. -
r of i he,ow employee,Ids or provided
at such ncl uho docs such work F moll y, '
or through hi.own employees.provided that such ilork is
am ldo'm imender or - 36903008. 00
offered for sale.If,howeverbebuilding or impn of pro,n sold within noe year of
36903008. 06 -
completion,the owner-builder willhave the M1uNen of proving that he did urn bnilJ or
w nhcpr p ,y end.. Iy ' , ,Ilg"If r n. d ,turn", r.,n 101 FOUNDATION, •,- -
LiconLie( l project IS u 7044,Bd P r :c i TheC nm l 102 — PIERS
,
Lwd,es un pply,o an nw ter nrpmper,y who hold. impm es the o "
Una wan contracts for such p ) r with a contractors) d p sunm t the
1 Q3 — LIFER '
'ISCor yral.eenxel. _104 REBAR
a xe pt unJcr `/It R /C for anis rc
w J ( �� 105 — ANCHOR BOLTS
i NOR6LR S C)MI IiNSAT10N L I. It f J u '
106 — .SEWER .& WATER
n,ereny.nn, "leap 'Ip pi re I.0 isa r r -
202 — UNDERFLOOR PLUMBING
° 1 have and wall m morin a Cby feat or Consent ft . L msurc for Norkcr s
rn,npe.,nsatinn, ne no tried for by Section non of e6s LanorcoJe:(or u,e 203 -`UNDERFLOOR MECHANICAL
perr ae ttn .,k for h this occon ed 2204 - UNDERFLOOR FRAME
° ave Jmaintain Worker's ia _ on lirequired f the b to rf ce of[Iework ar which is `205 UNDERFLOOR INSULATION
,,mdnlyw x .c p -r : cJpolicy ,
onho,me 301, ROUGH PLUMBING
Came,
CIRTIFICATION OFI%IIA1FfION FROM WORKERS' 302 — TUB x OR -SHOWER
CnsfPHNSAnoNINSURANCE; (( 303 — ROUGH MECHANICAL
rTh also need not be completed if thepe r.
't is Lamc hundred dull.r� > " -
'304� — ROUGH ELECTRICRI_
305 — 'F.RAME
'I n Il d l e p r d -k r l e d p I " d I 306' — HOLDOWNS
shall ply v p ) m us t hcuime un)eu,d the Nnden ,y
Aicntcompensation Luxs nr California.Late ,\\//V'I
NOTIC"' 307 — INSULATION
Z NcomesoOAI'PLICAYTIfafte king❑ Cnra mtheLabrCode,of Beemption, uu should ., 308 — SHEETROCF. '
become ubp.au theta h Cmp s:n p - n:'if
o dnevokeou mus r
zQ hemostat' c mplywm such �nr 11 prm,.h'11 he Jeented revoked -
309 '— EXTERIOR -LATH '
CONS RUCII ON LEN UINn AD hNCY
04I he cry affirk,I I'll(mntneion leadngagunc r the ped, na 31.0 — 'INTERIOR LATH`
of the work for o cis this Penna os txwmd(See.3097,Ctv.C.1 •s
y S Lcnde,sName 311 — SCRATCH COAT
U Z Leadi Address -
r'U O I ntylea Ih "din ppl t and ,are the, lie ninformationo.. 31.3 — ROOF NAIL .
w H enrreyr
cover' t ply to II city' d ,,only r � into I,: Iing 501 ,-- FINAL ELECTRICAL ENERGY
O U mcar lli,g" smllo, dhereby oafhar eprcietrl'sys nl lh stir a cool. pr .
Ihean,n t Ipropertyf p tit ...... 502•'— FINAL PLUMBING 'ENERGY,
' raid gianlf(W))&1'
I'. dJen Ik Ill n i"..tu,erctyyrcpn�mnss.oni - ',503 FINAL MECHANICAL' ENERGY'n t g d than pe t ADy!{{D,WIILCOMPLY WITT LHON tO 504 FINAL• BUILDING EhI�RGY.Issued by: Une
slgnatumarnpprea,t)L - Dale Re-roofs 506' GAS':TEST r
J IIAIARDOIIS MA I'LRIALS DISCI OS6R - '
whthn�pphctJ it nips occupant too, h dlba'.anl etttater:J Type ofRoot FINAL PLUMBING .
as Jef,led hY lite Ct pen no Mame pal Code,Chapter 9.12,and theH ahh.md Safely -
Code,Sechop25572tar' ' 1ri 8. —' FINAL 'MECHAiNICAl1
°Yei °No All roofs sha ('`��ns e r t m ma erial bein, installed.
Will the applicant or future building cecupam use equlpmem or devices which g,IC w I� � g, ,
r r Quality Nick col [f n roof-is in';. d wit o I o a aurins ection,.l a rree to remove _
moil hnmrdauv air enn,omlnnnK as definet11 Oa Ba Area Air p �.
DI-rni=," : - all new mateAlS or nsp�Rr r, I TIp[Fars6nds and will'comply 'With
°Yen °N" all iron-pointSdulice'•regGlithEAL PUBLIC WORKS
I have read the hasardoue materials requirements under Chapter.6.95 of the s
Cif IT H hh.9 S5 pyGwle,Seeunns 25505,255Ji and 255W.1 J mnJ that - ^
of mcoverb 'hf g 1 m Qu ntly hmxalnnam ma ntstay resp nfpt mify the
s,ccup t of
n uh¢h m a M met prior to es a Ce Ocum of s '
p Y � G�w�
Signature�ofApplicant.. Date ,
Owner nr anmollaed ogan,• - - - Date _ All roof coverings to be"Class "B" orbetter. .f•
CITY OF CUPERTINO
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BUILDING PERMIT APPLICATION FORM Building Address:
lD/df L51M-a) AV15 . "T 16G
Owner'sa Phone No:
e �T�Vto✓le znctc-n�IS !-5 -S
Contractor: License No:
Contact: */0 Phone -1-7
�-1-7 _ F/9/,
Architect/E gCX SS6� Licepse rJb: �9�3
ApplicanVContractor: 11
/
G arm
Building Permit Info: (circle one)
Bldg Elect lu ech
escription: IN OFiGP AiHs e Kazoi6aiI Aj t Bul�r>rken�
wh8M6e. De"11
Residential: i/ Commercial:
Sq. Ft. Floor Area: �b $/Sq. Ft.:
APN # (Must provide): 63'O�� Valuation ZS
Type of Construction: Occupancy Group:
•
Qty. if Fee ID Fee Description Fee Group,
Applicable
BTEMPPERM Temporary Bldg Permit BUILDING
BCONSTAX Construction Tax BUILDING
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BOVERTIME Inspection Overtime BUILDING
BPERMFEE Bldg Permit Fees BUILDING
BMITIGAT Housing Mitigation Fee BUILDING
BPLANCHK Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plan Check Repeat Fee BUILDING
BREINSPECT Reinspection Fee BUILDING
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Inspection BUILDING
BSWIM Swimming Pool BUILDING
ZADDCHG Address Change BUILDING
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EPERMITFEE Elec Permit Issuance ELECTRICAL •
BELEC1000 Elec 600V <=1000A ELECTRICAL
BELEC1001 Elec 600V >1000A ELECTRICAL
BELEC200 Elect Svcs 600V <=200A ELECTRICAL
BNEWMULTI Multifamily Res . ELECTRICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT. Lighting Fixtures ELECTRICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power Device/Apparatus ' ELECTRICAL
BREMRECEPT Rcptl, Switch &Outlets ELECTRICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Marquee ELECTRICAL
BREMTHEATR Theatrical Lghtng Fix ELECTRICAL
BSF&2FAM Single & 2 Family ELECTRICAL
BTEMP Temporary Power ELECTRICAL
BTEMPSVCS Temp Dist Svcs ELECTRICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
BAPPLOTHER Other Appliances MECHANICAL
BBOILER1 Boiler <= 100,000 Btu MECHANICAL
BBOILER2 Boiler >100Kto500K Btu MECHANICAL
BBOILER3 Boiler >500K To 1M Btu MECHANICAL
BBOILER4 Boiler>1M To 1.75M Btu MECHANICAL
BBOILER5 Boiler > 1.75M Btu MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMVENFAN Vent Fan Single Duct MECHANICAL
BMNEWMULTI New Multi-Family Res MECHANICAL
BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL
BREMACOVER Ac Unit >10000Cfm MECHANICAL
BREMAIRHAN A/C Units <= 10,OOOCfm MECHANICAL
BREMFURN Relocation Of Furnace MECHANICAL
BREMFURNOV Relo Furnace > 10K Btu MECHANICAL
BREMINHOOD Installation Of Hood MECHANICAL
BREMRELOCA Relocation Of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMVENSYS Ventilation Systems MECHANICAL
i
PPERMITFEE Plumbng Permit Issue PLUMBING
• BNUMULTI New Mulifamily Res PLUMBING
BNUSFD New Singlefamily Res PLUMBING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPFIXTURE Pblg Fixture PLUMBING
BPGAS Gas Piping System Fee PLUMBING
BPINTERCEP Ind Waste Interceptor PLUMBING
BPREPIPE Repipe Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn Sprinkler/Backflo PLUMBING
BPSTORM Storm/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt Of Drain & Vent PLUMBING
BPWATER Install/Alter Waterpip PLUMBING
BPWHEATER Water HeaterNent PLUMBING
BPWSVCS Main Water Service PLUMBING
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