01020081 CITY oFBUILDING
U
SINo
DIVISION ' CONTRACTOR INFORMATION:
PERMIT '
I '
BUILDING ADDIiliS£ II
, - _ . I'I!It MI'I'NO.
10159 S BLANEY WALDRON CONSTRUCTION COMOANY01020081
OWNER'S NAME: APPLICATION SUR DATE"
LAKE BIL-TMORE.,APARTMEN S. 73 HERBERT LANE , 02/14/'2001
• PHONE: - - - SANITARY NO. CONTROL NO.'
(408)377-8186
00 ARCIII'1'I!CLA!NGINEER: - - BUILDING PERMI r INFO
❑❑ Ii 1.DG, ELECTPLUMB MCCII
Z
•av' LICENSED CONTRACTOR'S DUCLARAT'ION` Job DCSCrIplIOIt
I Imreb ffnn mat 1 xm licensed under p g
p�'^c Y+ Provisions nl Chapter-91wmvtmncin
Fit; with Section IDall)of Division 3 of the Rmine,sand P...N er,Ciabo.rdnp,license -
n full Ince and thee,.
0.�ir � Lieetno C"hts, Lw.N1. INTERIOR RENOVATION ,RNI) REMODELING ,KI
a u vo Dwe ARCHITECT"S DUCI"ARA'I]ON -
u' 1 understand m lin,shall be used ROMA .�p „
i }5 Y P as punka ecartd,
LED '
w�p0
Lwsa,adP f -I -
n J o
which
' '(W,NFBUILDER DECLARAI
II I) ffl liIto x pll ,he Cannitla I.' 1 fill the
Lb ony ,y nunlY
- MAYO 20
01
wh b y a pernI it)
construct.alter, aipra%,J.mnli,h aeps r
-
any swcwrc
1.
e. that h licensed i i m-p )isl hl t I r f License fe d(Chapter) Sq. Ft. FI( Area - L���/'� Valuation
(at d anS , 7IXN,a f e 3 of the R :' niProfession,C on NG $3435QI
orS , put I I o n ,M1 Il Il l u A y violation '
nrS ].1315 nY' Y IPI tf ,Ix ,mn7,.slltvt PPl cawn ei Jl pc tally
t tmtnna r,en ,rated dona,a lsslgn. � 'DPN Number -' -.Occupancy Type
donne Properly..,ntycoldoyee,void wages as,cit-olc e.ao,ansainr 3690312108, 00
01,"o
thk nd ) 't . n t , l d rr d f r 1 IS .byN.IP r.: L d Tn c , r . .. 1 I : , I I,toat
Required Inspections 'Ta l art,Nl hunk p tl ,. kl'rnclf
�,,N t I hisowa etpltyer, p,,AaLdo such hl6lmvrtt isaren not intended or 101 — FOUNDATION - -
offered be,sale.If howcvur,the nailaing or iob,awrmeta i,sold within one yew of
completion.the nnner-hmmedwill have(he burden ofproving that heaidnotbuild or 102 — PIERS.
improve for purpose at wle.)• _ _ -
- I tnnemp t) I �vlr I t s 'dra I . I .Iu,n, 103 - UFER
tnp )et(s Gwyn : IP f. :Cd )The rttetW., 1.L.4 — REBAR - -
I
Lrov does at o ly to a.curator p pity who ba ld. p Ifincoctin. ,
and ohn,curfews for such projects,vim a co trac,oes)been ea p n„n,o me 105' — ANCHOR -BOLTS
Content an',License Law: - • .
t01 nor1 pr Scc. ,B&P r}ndtk a 1.06 — SEWER d� WATER” -
owo,-r n:,.a - ��� /]///y�n/ w 202 UNDERFLOOR.•PLUMBING,. '
- _ "/IDiJJ'lLIY Mflb �f� ARAf10N' � •. '
/ut (/LV)1/ 203 — UNDERFLOORS MECHANICAL
. IherebyalrrinntmerPenaltyofperjuryunaofdicfollowmgdealarations: - .204 ` UNDERFLOOR FRAME _ -
° 1 have and will tnatatain a Cenmaam of Consent to sell-i�snre for Workers 'e:05 UNDERFLOOR INSIJI_RTI ON
colnl>`•osryop, c.pod,In for by Racmnt .inxt ,d dte Lanae code, ror me 301 — ROUGH PLUMBING
Cvoraorso'aumcu al Ne work Lor wblch tbia peon:.Is iesunt. -
°Ina.eantiwill t»ainlaia Worker scorn,nsadoiInsurance.o required by Section 302 — TUB &• OR SHOWER
3700 of the Labor Code,fur rhe perfomrance of the work far which his pmmit i, ,
i,sned.MYwnrkdsC...a,cnsadunmscrane eadtitr adrorcynotahn,No: , 303 ROUGH MECHANICAL
Carrie: PolieyNo 304 ROUGH"ELECT RICAL 1
CERTIFICATION OF E%I!MPT ION FROM WORKERS' s
305 —, FRAME
COMPENSATION INSURANCE
(This aactioalle,dnol he contplemd if,he pennil is ror one harared dollars - 306 — HOLDOWNS '
rstnn I"idlT - - 30'7• ,— INSULATION '
"idly'butin,I I tf ner k I' �hio this object
,,line
x lss,cJ 1. -
C."" P!> r fC. Fav tt r. a. , [season, ni ,t .I wodkw, - 306"' SHEETROCK .
Compo t. d,ta lrw,nreald ia.Data II 309 '— EXTERIOR LATH
NOTApplicant
NOTICITOAPo ICAN the-WI B Bmaking.1 'C rlt tc baExemption,Lao. ,lc, onshould 31121 IhITERIOR� LATFI`
,,0z nee : 11 uo theta k C p 't , : INdo,anod...use n msr '
0 nm-.II "nor"l,win, rIt p w,,,,,l ,ped tr,alt II nr dee ileo rev teras �. � -
311 •— SCRATCH.•COAT
FRUCTION coinarENDINGAGI!NCY 313 — ROOF NAIL -
Fai 7 I berth,alTmt,his chem is a anud Si,v, Ieadlog agency for the perfurtnance ,r
t
of Leader's
work rre which his panni.is issued ISec.3tM7;Civ.CJ
Lan,IeC,Naraa 501 — FINAL ELECTRICAL ENERGY
Fj C 1<ndar,Addres'` 502 "- FINAL. PLUMBING .ENERGY
I eertil that 1 have orad this application and state that the above in orntariun
mn
F eudct.Iag,.a '
,naonaply ithaue and a„untyoahaturcesandcarelaw,reform, 503 FINAL MECHANICAL ENERGY
O U ton n g do by m presentative, nh' ',ytenticeuPon 504 FINAL BUILDING ENERGY
atheaM......connoted a ,ay far newslion
prat ,.cW 1 g I : d fya Ikeep ! s he Coy rc I Ii a,aam - 505 FINAL ELECTRICAL _
V] Ilnbltt J ly I: t ray t. y y' "gain, said _
V 'Z City , seyuetee or bs gremng or N's p,rah 506 = GAS TEST
APPLICANT UNDERSTANDS AND WILL COMPLY sl ALLNON-POINT Issuedb
SOURCE REGULATIONS, y: 1907 — FIND' Ill I IM,ta"INIPate
Sgnaaac or AppreaalICowmwor - Da,a Re-roofs 508 -• FINAL. MECHANICAL_ .
HAZARDOUS MATERIALS DISCLOSURE - -
wllmeappueam•nratwennuding,thenpatna,00rorhnndlebroadonamu"ial Type of Roof' 509' — FINAL, GRADE
ac defined by the Cupeninu Municipal Code;Clone,9.12,and the Ileuhh and Safety - -
Code,St'edon2ss321a)a 510 — FINAL_ PLANNING
0yc, ON.
- All roofs shall bei td P r n at installed."
- WiII thea Kanto or l mote budding nest P` �. y ��� ”"—""'�� -
'PC d damn,ca Air car it' mie=,wmeh U a roof is installer without first o Lamina an ms ectior l agree t'o remove
cutis huewdans ufr enmm�tinnnty LL,do filled by the Wty A,ca Air'Quali,y M:vutgencm � p 6
• umbar^ all new materials for inspection. Applicant understands and will comply with
°Yes ave °Nt' all not:-point Source regulations.
I bare read the
.yhatiankCoo,,eOi is 2 reyuimmwa,under Chapter h95 of the
Calif Ila Ith&S' ,y C d Se, .455111 25537 115514 t t y thot
he e
'fthe
l 'I d1 t ,lykI ntl , I : ) '.I lily lo (lythe
a 'ct t II -y ' t n,wh rb oust. tpr urn '„ 1 C, drum nl
Oc up
Q Signature of Applicant Date
Owns aahoar - Data •I All roof coverings lobe Class "B"or better '
'OFFICE - d