02030093 - 'CITY OE CUPERTINO
BUILDING DIVISION PERMIT ,CONTRACTOR,1.NFORMATION:
BUILDING ADDRESS:
PERMIT NO.
10129 S BLANEY # 16L WALDRON CONSTRUCTION COM ANY 02030093
OWNER'S NAME:
APPLIC99TION 5 B DATE
LAKE BILTMORE APARTMENTS P 0 BOX 598 03/ 19y2002
'HONE:,'
f? r 408) 377-8186 SANITARY N0. CONTROL NO,
POP❑ ARC.H1,rEC/ENGINEERbe ; BUILDING PERMIT INFO
<u[4 BLDG ELECT PLUMB MECH
Fz
O N'_ -! LICENSED CONTRACTOR'S DECLARATION Job Description
5z,-o l ahembYon7000)ofmasIs.3'iecn,Imi...prnd1,01eim°fChapter aft.anamm=neise REMODEL—KITCHEN, BATHS,WALL A/C UNIT, FLOOR
m.tWW with fall Section ofDivision3'If 111,Business end Prolessions Craft.and my license
f x g] is in full force and ellen.
' �3a8denseClah Lice AND WASHER/DRYER.
Date " Contractor
ARCHITECT'S DECLARATION
..1 understand my plans shall be uuJ as public rtcards
3a Lmemed rale„conal MAY 1 4 20021
s6 Ce OWNER BUILDER DECLARATION
1 hereby affirm mm 1 am attempt from the Comr"aor's License Law for,he
ofollowing reason.ISec,i°n 7031.5.Bushes and Pmfesvons Code:Any city or cony ,
which requires a pm
permit to construe,,altar,improve,demolish,or repair any slrucm
6 3$ -Pa,hprovisions
of
for Commodities
omm rmes License
Law
(htamc, -
,hmh sI irs itperin,1700 Pn nsofthe the Bmt°YsL cans,Law(Chapter 9 - ”"-"-"_ "-------
(m , g, ll Sem ]0001 of Division basis
o 'heaBuanassynd PmfAn onsC J) f t1., '� Sq Ft Floor Area 'g y, �;••r Y _ Valuation
or that he ns exemptlM1erefrnm'enJ the basis for IM1e aIle d c{em "- t' `a 4.. : .. a_4 -'l r 4. s 1...C.
of Smmn 7031.5 b an the
Pimm Any violmmn
Y y applicant fora permit rvgmu,he appli<am m a civil petmltynn
-
sof nm.maa man rive hundred dollar,(s500> APN Number Occupancy Type
01.os net of the pwrardy.or My employees wire wages as their sole cumparmitian, 101 _
FOUNDATION
-will Jo the work,-and the stmcmu is-no,'intended or offered Far.]a(Sec.7(phl,
Basinaa.'mr!'Pmressi°m Cad=:The Contranara License Law does nm apply to an 102 - PIERS Required Inspections
owner of propany who builds or improves flamer.and who does such work himself 10 3 - UFER
&
or through his own empl y pro ided that men improvements a t tended or
'ored for sale if,-ho er ih building or mpmvemem ns sold thin o year'of -
104 — REBAR — ' —--
nnplmon the owner hu Iter will have thehumanvepentis thathehold or ��'• ..n
impmvefarparposeaf:ale.). 105 — ANCHOR BOLTS I`,
1 a a of m pmpcny con c lusivcly contracting with licensed comractors m _ --" ,-
swi - 106 — SEWER-&"WATER _ -- — ,f, , -- -------
a
t the p jcn(S 404a B .'ero d P Ics. ms Code)Th<improves
2 02 — UNDERFLOOR PLUMBING
License law Joe t apply owner of property h Wilds proves thereon, t 1
..Lind trense 4sachp Jects.wim .core nor(s),Ic dp rsaan4o he --203---' -UNDERFLOOR'-'MECHAN'I CAL'
ContractorsL ce Lie Ln -
❑1 t mpu er Sec I l ' ';p&PCI ,his mason
I l4204 — UNDERFLOORk' FRAME":I
°I °,+e 3—l"—trL a 205 — UNDERFLOOR INSULATION
L•, WORKF,RSCOh/PENSATIONDECLARATION 301 — ROUGH PLUMBING
`�'•' Ihertby a0irm under penalty of perjury ori,of the following dealamtimu: 302 - TUB & OR SHOWER
aridismand as- rave edfo, :y Sedum,37 deo, to Land, Code. 303 - ROUGH MECHANICAL ,
compenaa,mn, aa.praviaed ear by�sanian 3]00 or me �bor ewe, ror me
Peaarmance Ofthaw°M for which this paemit.ts issued. , 304 — ROUGH ELECTRICAL
❑1 have d w It maimunim.Wcake,la Co.pe ,'9 0Im. ce s q- d by Section 3 05 — FRAME
3700 f,h labor Coda, r m
f e pert our c of me work f r" n'h shim permit is 306 - HOEDOWNS
uedM Woke,s Co p MoTb=ra
carne r ' pen ata l{Pd Policy N, <ra dP 307 ,--•;,INSULATION rr
`.. ,.. -.
CERTIFICATION OF EXEMPTION FRQM WORKERS - f3O'8 `'-`•SHEETROCK-Ir •r ' `�
L,
COMPENSATION INSURANCE
_.. __ 309 EXTERTOR'—LATH —
(3100"h a n,plelea nnepermnt:for nnahundred aonn,a 310 • INTERIOR LATHI
) less.) ... - -`. •.
r.,, 1 codify it I in the pet rmo f m work f h ah m Pear 1 :rssuw 1 .. . ..'... ..•3 1-1.":'_' .'S SCRATCH COAT - „.....
hall t reply by pe m any ner t become subject t to the Workers 313 — ROOF NAIL "
Compemmion Laws of Cabfomna D.'a•
8 50.1. _:n_-FINAL—ELECTRICAL.-ENERGY.... .
O NcomesuOALIeANTIfaR k, m Grtfgl neElabop'Cwyynmla 502 FINAL PLUMBING ENERGY
nccome hereby aiRmi'CONSTRUCT]
jhON hcrtUCT`ONLENDING JAGENCYde wr< ka 5.03.. ..-.. .FINAL ,MECHANICAL _ENERGY,
Z JCompensationp n ft
forthwith complym s such provisions
504 — FINAL BUILDING ENERGY"r
a,'> B a8 nay for me perfohnnn -.
W grin work for wAchm prmd : :y<q(s Civ 505 — FINAL .ELECTRICAL �t "
y)G Lend rsNme ._.._-. -. .. -. . .
p.z Lena aAaare_ ._.. � - 506 — GAS TEST , � ...._...- —00'00 . ._. _._..---... . . _
U 507 — FINAL PLUMBING ai
I can fy the,l have rend,h s applicm un and stun ihm me above nforma,on is
�a,F cOmod 1 agree to comply with all city and county ordinances and state laws relating 508 — FINAL MECHANICAL
t.7 to building est cion: ndh 6y mba pre- ,ties of,hsCity, mer upon
tt" ,he mvI-ommicined propcny for con purposes. 509 — FINAL GRADE
G6( (we)tigno,t sat indemnify and lase,I arml m the City f Cupenl 'against
r p liabilities.J agree , costs and penus w h ch may any way cco gins,said d 510 — FINAL P I NG
V Z City enc q fth gmm g of this parr.
rut pcut •`
AcPPLICANT E N lV1hLCOMP1YWr1'HALLNON'POINTs' 514 N WORKS
souaGL Rr LLtr `r�J �.�4)"l— Issued by: Date
Stgwt rcof Applmant/C ntmn r •,-
Data
HAZARDOUS MATERIALS DISCLOSURE - "' - Re-roofs
r;p
Wll the applcam rmmbuilding'o¢upam stem or handle hazmadus m,d;l
as endbibC n Type o£Roof. .
,no Municipal Code.Chapter 9 12 d me Heahh end Safety
Cade t 5 n
Dyes,
oi
All-roofs shall be ms ec[ec] prior[o-ant roofin
wn me ppl -, future bu la c t :< devices - p -P Y g.material being installed..
g« la q pm t n n If a roof is installed without first obtaining an ms ectim I-agree.to remove
,h .b a c im m def dbyIIheByAu Air Quality M.anagm t g p
"' all new materials for inspection Applicant understands and w core 1 with
-oyes - all non-point source regulations ' ' P y' -
LCadf4lfla
read the hill nrdous come Is req nremema under Chapt r 695 of the •'t '
lln&'Safety Cwe,Sec,ons 25505,25533 and 25534 1 understand that
oes not curmndyhevea,enamfmat i,is my rspbnsibilitY,o nbtify theuirem t In h of be me,p , haman ofaccmfieme of
'� r :'�' Signature of Applicant Dateedagant t Dme,,. All roof coverings to be Class"B"or better
o..
.OFFICE