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03010085 Ask AOL CITY OF CUPERTINO •,A;;;«�, -,-- - BUILDING DIVISION PERMIT CONTRACTOR INFORMA N:` BUILDINOADDRESS: WALDRON CONSTRUCTION COMP If RMITNO. 10169 BLANEY AVE # 4E OWNER'S NAME: P 0 BOX 596 APPLICATION SUB DATE LAKE BILTMORE APARTMENTS 01/15/2003 r &e (408) 377-8186 SANITARY NO. CONTROL NO. ARCHITEC rENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH t� 0 �00 LICENSED CONIRACnderp DECLARATION Job Description raj I hereby affirm that 1 em licensed unser and Proons of Chapter 9 my license is p �� with Section 7000)ofDivision 7of the Business;and Professimm Code,and my licence is Gigmfunmleead (feel INTERIOR RENOVATION b Lkensc Clas� LIx i Bata conme R ODEL KITCHEN/BATHRMS/NEW WASHER/DRYER & F= �ARCHITECTg E��RATION �y-�� Iunderstsn0 my plans shall heusedaspuhlie records R BB�'7l 97C, FL COVERING c 3LL LICCIIECJ PNkHInnBI OWNER-BUILDER DECLARATION LLQ MAR gx 1 hereby affirm that 1 am exempt from the Contractor's License Lew far the �oo� F 0 o following reason.(Section 703 L3,Business and Profession Code:Any city or County a�$ which requires a Permit m construct,aline Improve,demolish,or mpzir any r F-Za prior M its issuance,also requires the applicant for permit to file.signed ££ thatheislimmdNmantmthepmvisiomoftheConvacwrsLinnaaw( cep r Sq.Ft.Floor Area Valuation K $ (commencingwilh Sention7")ofDivision7ofrhe Businessand Ponfeadons Coda)or — Net he Is exempt thmafrom and the basis for the alleged eamption.Any violation of Section 7071.5 by any applicant for a permit subjects the applicant a civil penalty of APN Nb nqt more Nan Number Sibd&ftfilive hundred letters(5501). cy Type ❑I.as owner of the property,or my employees with wages m their sole compensation, Will do the work,and the mumme isnot intended or offered for sale(see 7044,Bottom 3 6 9 , and ProfeWom code:The Contractors License Law does not apply u an owner of Required Inspections property who builds or improves thereon,and whodom such work himself orthonugh his own employees,convinced Natwch improvements are not intended oroReras("We.if, 101 — FOUNDATION however,the building or improvement is sold within one year of completion,the owner. Wilder will haw the burden Of Proving that ne did not wild or improve for purpose of 102 — PIERS a " 103 - UFER .u owner of rite property,.B exclusively contracting with:)licensed mmcamn m 10 4 - REBAR Cents the project(Sec.]044,Business and property who ore Codei The Contrao em. n cepaawdoes not cep lyccuwiowner of=wr(ywhowdpumantmfts non. and, lOS — ANCHOR BOLTS who contractsCor sue onjecu wiNaconvamrp)liartadpursumtmthe Conmmors 106 - SEWER & WATER Licence Law. � ❑lam am It n 4 �5g,�� .B&Pc rthte 'ren 202 - UNDERFLOOR PLUMBING 0wmar WORKER' MPENSATIONDECLARADa /A 203 - UNDERFLOOR MECHANICAL 41 1 204 - UNDERFLOOR FRAME handyaffirm, maintainaenalyof Riceofumenttothe fnsumingd«kersCo 205 - UNDERFLOOR INSULATION ❑]haw and will for by eCion 37 0 of Co Labor Code. for for Wohera Compere anon,as provided for by Section 7700 of 0e uhor Code.(or the performance of the 301 - ROUGH PLUMBING work for which this permit is issued. 302 — TUB & OR SHOWER ❑ 1 have and will maintain Worker's Compensation Inunnm,a required by Section 3 0 3 - ROUGH MECHANICAL 7700 of the Labor Code.for the performance of the work for which this priest is issued. My Workers Compensation insurance carrier and Pn rynumnarare: 304 - ROUGH ELECTRICAL c.mif Pq .: 305 - FRAME CERTIFICATE OF COMPENSATION INS FROM WORKERS' COMPENSATION INSURANCE 306 - HOEDOWNS (This selion need not he completed ifthe permit is income hundred dollars 307 - INSULATION orlcsa.) 308 - SHEETROCK I cenify that in the ,to nca of work f r which this permit is issurd.I shall nm 309 - EXTERIOR LATH employ any Persons y annero rbc object the otters Compemation Lewsota)roNia 310 - INTERIOR LATH Applicant_ NOTICETO APP ANT:IL e(mr making this Crani am of Escmption,you should 311 - SCRATCH COAT become subject to the Worker's Compensation previsi ns of the labor code,you mast 313 - ROOF NAIL 0 ,2 forthwith Comply with such previsions or this prrmil shall the diatoms evelmd. CONSTRUCTION LENDING AGENCY 501 - FINAL ELECTRICAL ENERGY [-+ kforw afErm that than isseed( eConstruction 09 ,Cing agency for the performance of 502 - FINAL PLUMBING ENERGY the work for which this permit Is issued(Sec.7097,Civ.C.) wq IandaraName,Addm 503 - FINAL MECHANICAL ENERGY �7Z LandaraAedn4s 504 - FINAL BUILDING ENERGY U p 1 cenify that I haw read this application and sum that the show information is 505 - FINAL ELECTRICAL correct.I agree to comply with all city and county ordinances and sure laws relating to pU Wildingconswction.andherebyauthor3arepreamativesofthiscitylocnurupnnthe 5 GAS TEST w ohove-mendnnedpropenyfor inspection purposes. 07 - FIN G (Wan)agree to save.indemnify and keep harmless the City of Cupertino agaimt h liabilities.judgments, and expenses which may in any way aceNragainst mid City 5j N CAL V 7 inconnquen of egaintingofthispermit. Issued by5O F7 APPLICA ER ST DS AND WILT,COMPLY WITH�LPQlrrr - Date SOU�CE E TIO /1�",., /G� he LG(F✓ Re-roofs 514 - NAL PUBLIC WORKS nnurt of Applican✓ConRDO Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will Iter applicant or future willing m,Chapter some or handle Iosalloes material m de.Sed Section the Cupertino Municipal Code,Chepkr 9.12,and roc Health annc Safety ceda.$reties 25532(e)a El Yes ?< All roofs shall be inspected prior to any roofing material being installed. 41 Will the applicant or future wilding Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit h randous air Conuminanei as dc0nad by the Bay Area Air Quality Management all new materials for inspection. District] ��\/// p El Yea [�Vu I have roans the hiresmaerials requirements under Chapter6.93 ofthan Celifor. malice gt Sefcry ,Sections]5505,23533 and 25534.Iundcrstand that lithe wilding does nm cu ly,saw a enan4 Nat it is my reipomihility m ratify r ottupanl or Ue trireme nmostthctljynor oissuance of.Ccnifcaceupanc� Signature of Applicant Date LL�/r/ti/ d�/�i Owner m authmiad agent — I� Date All roof coverings to be Class "B"or better •CITY OF CUPERTIN• p o o o (FS CITY OF CUPEkTINO PERMIT APPLICATION FORM A f�T APN# Date: 369- 03 -oog /-4-03 Building Address: Owner's Name: Phone#: LAICI; 8/LTMbR9 APAQ7A oAM Gr-d �1��c-S300 Contractor: License#: R.W ftA &jSTUMoAI tw_ 77037 F Phone#:C O W Ma# A6C-?_ sb Sgto -5309 t/Contractor: Fax#: LACE c o215- APq,0nr eMT5 Gsa 5.16- 5374- �uiW,i,ng Permit Info: Bld Elect Plumb Mech Job Description: ' c2 I vucna � l�p(G oMC-V 14n"IFAJ ) ueW WASWx/Cwej Residential: MULT -MI ' � Commercial: Sq.Ft. Floor Area: $/Sq.Ft.: 100 SF. Architect/Engineer: Valuation: �YMtW00 S7A+t SNC�ate RSS ("too Type of Construction: Occupancy Group: /, 1 uanti Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax-Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi-Family Res MECHANICAL BNEWMULTI New Multi-family Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb .{� PLUMBINGp- 2 Jo T 1 of ' -77 ?_ / CITY OF CUPERTINO '- BUILDING DIVISION PERMIT CONTRACTOR INFORMATION :•nay .'�"o ..., ,i,., •„ RUILDINGADDRESS: WALDRON CONSTRUCTION COMP YyRMITND. 10169 BLANEY AVE # 4E NERSNAMI!: P O BOX 5098 APPLICA]lON SUB DATii LAKE BILTMORE APARTMENTS 01 15 2003 PHONE: (408) 377-8186 SANITARY NO. CONTROL NO. ARCHI'I'ECP/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MD211 0 0 0 0 X00 Lm that iDCOMPund R'SDEdmorof hap Zf-- ON 1hereby arrm+Nat1am licensed Buinespmd.aonaofs Code,and Job Description with Sectinn]IXXp of Divixion3nf the Business and Professions CnJe,and mylicensees o Nmlllorce d•l fact. INTERIOR RENOVATION zo z Ltcersc clan I.i OZ-, a con me REMODEL KITCHEN/BATHRMS/NEW WASHER/DRYER & F= B �cr'sq R"T'onn N WALL A/C, FL COVERING �_ z 1 understand my plans shall be used as public records t�tl ^ g t� tai+ 36o6u �0tl AN. ISO u. Licensed Professional t"t=� OWNER-BUILDER DECLARATION <q I M1crchy.1h.'hat 1 am exempt from The Contractor's License Law far the oo following reason,Secant 7031.5.Business and PrefessionsCode:Any cityTocountyac MAR 2 5 2003 which requires a permit to construct,alter,improve,demolisq to repair any structure pour m its issuance.alsu requires the applicant for such permit w file a signed statement That The ia0anscd pursuant to provisions of contraem,a L�<aze Law(Chapter Sq. Ft. Floor Area 11 Valuation r�tzo (commencing with Section]IXXB of Division 3 of The Business and Professions Gale)or BUI y i that heisexempt therefrom and Ne hasis for the alleged exemption.Any violation of U Section 703 LS by any applicant for a peonit subjects the applicant to a civil penalty of ppN Number e '1�� e not more than five hundred dollars($500). y J p 1,as owner of the Property.or my employees with wages as Ncir to compensation, will do Nework,and The structure is not intended or offered for sale(Sec.70A 1,Business and Pmfcssions Code:The Contractors License Law does not apply to an owner of Required Inspections property who huilds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for mile.If. 101 — FOUNDATION however,the building or improvement is sold within one year ofcompletion.Neowner- builder will have the burden or proving Nat he die not mrild or improve for purpose of 102 - PIERS 103 - UFER L es owner of the propcny,em exclusively and convecting with licensed ouns lorI i- 104 — REBAR cnnstmn the protea(Sea]Ik4,Business and professions CnJe:)The Contractor's Li- censeLawdoesnotap Iytoanowner ofpfopenywho Wild,orimpoto.detena.and. 105 — ANCHOR BOLTS whoeommmurforsue rnjcnlwiNacontracmr(s)licensed pursuant oNcContactors License Law. 106 — SEWER & WATER ❑ P//� lam axe pt n «( .BatPc1h aasan 202 — UNDERFLOOR PLUMBING mer 6�f� Date �ar 203 — UNDERFLOOR MECHANICAL WORKER' MPENSATION DECLARATION 204 — UNDERFLOOR FRAME hereby idwilaffirm intain Cenahyate f uryoneoflh following declarations 205 — UNDERFLOOR INSULATION I have and will maintain action 37W of the Lab r Code,film for Worker's ce of the ration,as provided for by Section 3]W of the Labor Cade,for The performance of the 3 01 — ROUGH PLUMBING work for which this permit is issued. 302 — TUB & OR SHOWER ❑I have and will maintain Worker's Compensation Insurance,az required by Section 303 — ROUGH MECHANICAL 37(X)of The LSMr Coda for the performance of The work ror which his permit is issued My Worker's Cnmpensation Insurance carrier andel Policy num her are: 304 — ROUGH ELECTRICAL eyTlo.: Carie glt' 305 — FRAME CERTIFICATE OF EXEMPTION FROM WOR K ERS' COMPENSATION INSURANCE 306 — HOLDOWNS (Thisscctionaeedn llwcompletedifNcpernotisfarenchundrcddellars(511X) 307 — INSULATION or IC55.) 308 — SHEETROCK I cenify that in the perfon ace oft work f,which this permit is issued,1 shall not 3 09 — EXTERIOR LATH empI any pcT on i yry anncr n the ubjca o the Vnrkcri Cono,manim _ Lawaorcarfamm P 310 INTERIOR LATH Applicata NOTICE '0 APP ANT:If,after making this Ccnias am of Exemption,you should 311 - SCRATCH COAT become subject the Worker's Compensation provisir ttor the LaMn Code,you most 313 — ROOF NAIL OO forthwith comply with such provisions or this permit Nall he deemed revoked. z CONSI'RUCTIONLENDING AGENCY 501 — FINAL ELECTRICAL ENERGY o-5. IherebyncErna at them is aeonsbuctionlending agency[or the Performance of 502 — FINAL PLUMBING ENERGY rY ? the work fur which IN dFarmit isoxced(See 3097.Cm.C.) w p UnderName 503 — FINAL MECHANICAL ENERGY Z) Z nderaAaefeaa 504 - FINAL BUILDING ENERGY U O 1 cenify that 1 have read this application and state Not Ibe above information is 505 — FINAL ELECTRICAL coon.I agree R+amply with all city and county ordinances and state laws relating to O U building construction,and hereby authnrim rcpmscnmtivcs of Nis city to care Nc 5 GAS TEST Ice ahovc-ametioned propcny lot inspection purposes. 0 7 FIN (We)agree to save,indemnify and keep harmless the City of Cupenino against CL liabilities, costs and expenses which may in any way acerae against said city 5 N CAL: U z in on ed. of cgmntingufthi,minis. '—' APPLICA I RST DS AND WIL COMPLY WITH AL1.NON P INT Issued by5 0 - Date SOURCE E 'HON y ��CCGu 3 Re-roofs 514 — NAL PUBLIC WORKS HAZARDOUS Dam namrc of Applica IIAT.ARDOUS MATERIALS DISCLOSURE Type of Roof Will The applicant or future building Cg u,Chitin store or handle Health and az carload by Be Cupertino Municipal Cnde,Chapmr 9.12,and the Health and Safny e.section 25532W.1❑res T - All roofs shall be inspected prior to any roofing material being installed. Will the applicant nr future building occupant T.Trial or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants az defined by the Bay Area Air Quality Management all new materials for inspection. Distria5 \� ❑Yes /dS" 1 1 have read No hammous materlalsteriti uncons ander Chapmrt,95ol'NeCcIdor- niaHealN&Safely .Sections 255B5,25533 and 25534.1 understand that if The building does not on 11 term.Nat it is my mallorsibilitY m notify t r pmu of the creme rmg1Wignortoiaaaanaof.CeniBeateo epnew, Signature of Applicant Date `� � n All roof coverings to be Class "B" or better Owner or authorized agate Dam