01100126 j
CITYOF CUPERTINO t - -
BUILDING DIVISION PERMIT ',.CONTRACTOR INFORMATION:,
BUILDING ADDRESS: PERMIT NO.
20010 RODRIGUES AVE # 5B WALDRON CONSTRUCTION COMPANY 01100126
OWNER'S NAME: APPLICATION SUB DATE
LAKE BILTMORE APARTMENTS I P O BOX 598 10/23/2001
PHONE: ' SANITARY NO. CONTROL NO.
(408) 377-8186
i
O ° ARCHITECTRINGINEER: I BUILDING PERMIT INFO
Lk' i BLDG ELECT PLUMB MECH
ya Z 1' L- ___] I-
NaC
LICENSED CONTRACTORS DECLARATION
I h by arum Iha I am licensed under Prov sons of Chase,9lcomm n 'ng: ..Job Description
wA Section 7iwolnrrnva,Ca3nnheBusiness and Professions Code,and ntylicense) INTERIOR RENOVATION. '
cis elf and affect. (REMODELED KITCHEN & BATH, NEW WASHER/DRY '
S a a
o U -L¢enCla. L c kDI Cnmraetm i WALL S stp�; ARCHIECS DECLARATION
A/C FLOOR COVERING. )
O card,
Iunderstand ypla. hlib da Publr
22 adProfessional
1
OWNER BUILDER DECLARATION
L: , 1 h -by R Ih t I pI f II Contractor S L A a Law for the
county;
_ Y L
�.d which
following (Section 7031,5,Businessd Professions Caen y city orrccturaj U
a ° Wh ti ts e, n 1 t all p d Permit
orrepair anysl
m m .th t t 1 9 thef chpe mil micensele a gaw( hapterstatement
mornmen en eAput$t ntolhbPfD Division
Central and Isl<w(CM1(Chapter 9 Y,,S $ Ft Floor ea ati0
m mg da Saturn 70oar The- 3 nncepsipcsanadtihi.A mnaea)F e . .,.� I{{_,9"a tot„ ;..s! #?�`�,j..,'4' f�7 ) $346
or Nth 'empl,h'refrom ant the h for the alleged clement t Any l Penalty
{
oaf S n e than r any dreg dollar,
for a p rm I subjects IM1e applicant to a civil penalty`
Cr 1 man eve M1anarea annars easool 3 6 itljtgrtLjg>0 1'1:;.. Occupancy Type
f �D Ita a owner ofthe p p ny or my employees 'lI wages as 1M1 I compensation,
wll t thereintended ork;iand'the.vu t is n t .,offered fr .Is(Sec'7094"
'Bus Cess eud Profess o Code The Coir acro s License Law does not apply to and 101 - FOUNDAT I0pired Inspections
comer ofp pony Who 1,11cls or improvesthereon,and who does such work himself:
or throughn employees.p dater nimprovements 1 intended ; 102 - PIERS 1
r offedfrsale lfhowever,1l Buildingent is soldd-ithn one """"'- "' _ .._»___ ._- _ I
^;u.- tcorinkrion,me ownerboalder will have On burden of proving that he did not build ori 103 - UFERl'-_',1
P P f 1 104 - REBAR
_ . ...
1 ❑Aep m.7exclusively- ancontracting mr<e dna Corer sl i ...._105._ -. .ANCHOR...BOLTS
Insetowproject(sc 7toa B andertywh a codeITh c « e s' 106 - SEWER &. WATER
L cense Law tice,i not apply In an owner of properly who builds or,mprov<s thereon,�
and h mrzc to, h p )acts with a c0 1 aelat(s)I rend pursuant sl ...___. _. 2 02 UNDERFLOOR--PLUMBINGCracromme " - -
Dlam mp aprse ' "` Bj,&ec nn' rcason1 203 - UNDERFLOORsMECHANTCAL'
p
/3d Ul " - 204 - UNDERFLOOR FRAME
WOR CER'SC MPENSATION DECLAR,,((TION 205 - UNDERFLOOR INSULATION
Ihereby affirm underp<mallynrpeduty' mr,ngfollowing a«IarBCaa: 301 - ROUGH PLUMBING
D 1 hose end"will maintain e'Certifiaie' c,nsenl'n self-Insure for Worker'sl 302 - TUB & OR SHOWER
Compeasedor�.-previded-for ny�Soetion 37W of the Labor Costs, for the
potham,aneennneworkfor which this Permit isissued;,,1 , 303 - ROUGH MECHANICAL "
IDIIa d"diad badWrker"Co ge ", nlsuran asrcquireJCy;Saton; 304 - ROUGH ELECTRICAL
,3]00 of Ilia Labor C d f r the performance
(Ne work fo wh ch this pe 1 is 305 - FRAME
issued My Wo ke Co pc sai o 1 su ce
'Cartle+ „r!'.�Pol cy No 'Tan I<y t, : e .•_.: :306- '.HOLDOWNS — 1 -._ -..
CCRTI17CATION OF.EXEMPTION FROMIWORKER$ t.. 7'I'14INBULtATT ON.^'f!,"t't
j COMPENSATION INSURANCE . . _.-_.,._. - '
308, "SHEETROCK--
s` t (Th 1 d I b o pletcd f m pc l is f h dred doll
3.10----' TNT
ER
I > 309 EXTERIOR LATH
_.-.. ERIOR_.LATH
p I-I,
n fy th t III perf "S k f h h Ih pe t S is ad.1; •^, ,._.....
carrier
anon 1 pl Y Y l r iC be b,n t vM1elw rkem 311 SCRATCH
mpe at Lnws fCa,r -D le `
APp1 m -.' - --..-. .313.._-. ROOF.. NAIL..__
"NOTICE TO APPLICANTS after making thCenrcale of Exemption,yo Hold
become sail
e 16
.:h-.e,. Worker's Cu.mp-nvsshopPr provisions o
fineLabor Cod
b rCd you
u
mu's"t
501 --- FINAL ELECTRICAD',`,E,
NE_R..G,_Y
fonh Ihcomwith such provisions Ih p hebe deemed revoked. 52 FINAL, LUMBING0 -
ENERGY---Bi cr R " `CONSTRUGTIONENDINGAGENcY 503 - FINAL MECHANICAL ENERGY
I herebyfirm thatem 1;a S.dwousloamEndingag y fthepfi
fdr rkf thispermitissued(s 3097cv.c), 504 - FINAL BUILDING ENERGY
a,gQ r Lenders Na e
I< a Address '. 505_ FINAL -ELECTRICAL
VGAS• TESTO Iccmyihalh dins application nand state thin aliInformation is 506 .
"
_.. _
.,,
.
r W [r
co cti I agrce to comply, Ih. II city odd county ordinancesd state laws mining 507 - FINAL PLUMBING
O U to, leis const alimaadn byoum pnative on city to enter upon: SOH - FINAL MECHANICAL
W m b ve boned p ny f i Peru „pup
..
(We) g'e to mdmnif'pe an Pharmless the CdI of61ncommi against 509 - FINAL GRA
ar'tq liab I des j 1, ❑ pence which may;n any ay accrue against lead I
Uy cty,n<Cn no n11��eeg do fh t 510 N NG
S1"ANDB- LL COMPLYtVITN (3p''P INT,
S Re REG .Y 7 v. „i �. �f o_ r88lled III Dace
_gn w pplicanUCo 1 actor',. r, , •iN„Dat Re
LS
l -HAZARDOUS MATERIADISCLOSURE
..,,.t 'wn m PPI 1 rem b I 'ng c Pant store nal na>e,aoa:mahariallType of Roof.
as ear ed by th C pen n n , cod chem 9 12 d Ih H hh d Sof ry F ', s ..e m p t, t n !' '• .0 ':
.code o`Yon ssos3z(I Yl+ N'", r kn, a T} t, a. ,I l - y-t 1:5,L)',- .,,tdh.
All roofs.shall be inspected prior-to,any roofing material being installed
,{ wulme pPt<anl f t en lag < p 1 �9 p t a a n h If a roof is installed without first obtaining ata inspectI'
agt agree toseinove
all new cmth erd c Ins t d naby the BayA aA r0 alyM
,
urr q P nota materials_for,inspection Applicant understands and will comply with
all
DY s ad' hazardo s malcnals re mrements'under Che rer 6.9
-Point source regulations- '-
"' Ilheve 5
rstanddIh '
Cal fpH alth' f ry Cd S-lions 25505 253]3 end 25534 i undebut t 1
'fifth nu ld' d s"� io rtc tl hveate I ,h 11 ...
ns ally to Dol fy the. . ._..._..._....- .._. .. . ....... ._ . .. .I` .' . ._ ._ _.Il 1 f IM1' u rem m ch inusl be r p o'm is u Cie- f Cem, le
mf
V///V✓// / g. Applicant Date
signature of, _
o tnonae t ag t ,DareA11 roof coverings to be Class B a better `
in
-OFFICE ICE