01060113 c[ OF DPv SIONO
BUILDING SINPERMIT CONTRACTOR INFORMATION:
' BUILDING ADDRESS: PERMIT NO.
20020 RODRIGUES 6C WALDRON CONSTRUCTION COM ANY01060113
OWNER'S NAME: APPLICATION SUB DATE
LAKE BILTMORE APARTMENTS 73 HERBERT LANE 06/19/2001
PHONE: (408) 377-8186 SANITARY NO. CONTROL NO.
L_ 4 '
Cat ARCHITEMENGINEER: 1 BUILDING PERMIT INFO
U - BLDG ELECT PLUMB MECH
z 8 vNi i LICENSED CONTRACTOR'S DECLARATION + Job Description
o Z-,5 1 hereby vffmt mm 1 am licensed under provisions of Chapter 9(commencing p
p_1_ with Section7")ofDivision3oftheBusinessand RofeationsCWe ylicense INTERIOR RENNOVAITON INCL REMODELED KTCHN
�x � ismmnfnmeana a15�SYm BATH (S) , NEW WASHER/DRYER, NEW WALL A/C N
S rc0 i License Clnc Lic,p
3c. Date .Comrac or ti e-yrn CONVERING
ARCHITECT'S DECLARATION /
O 1 understand my plans shall be used az public records
t++ p O L¢enseJ Pnaessional
n OWNER-BUILDER DECLARATION \P/
I hereby alBrrn Shat 1 am exempt from the Contra 's License law for the
t?r following reason.(Section]0315.Business and Professions Code:Any city or county -
O which requires n permit to cummucl.alter,improve,demolish,or repair any structure
w P11111a Is s � .,.
Gale(commencing
with
iw toes Pvi the ame l e L St.Ft FlOor•Area
Ch,c. y I ' 43�Cuation
Ice n9 Sh Recto 911001 [Dv 3 rthe Open
nJPii.An CWe) ` �k? a = tj "J")'("i'•
or that he s exempt therefrom and the bass for IM subjects
the atemant to Any violation L r" 3 1'.. 1..\i 4i itl..-L,.a } s
of Section 7031.5 by any applicant for a Permit subjects She applicant m a civil penalty '
wf not mom than five hundred enHas 15501). 3 6 9 69H( TbeJ i T::f-,:r', Occupancy Type
❑has Owner of the pmpeny.or my employees with wages as d¢irsole compensation.
'-
will do'the work,and SM structure is nm-inteMed-or offered for sale(See:]044,- -
Business andTioressions Code:The Contractor's License Law does not apply to an 101 - FOUNDATIWuired Inspeetionsv,l,1-. :'Tf'
twix,of property Who builds or improves Them..,and who dues such work himself I
or through his ownemployees.provided that such improvements arc not intended or 102 - PIERS
.-dllcied'roi sale:If hbweveq The building -
or improvement is sola wimm a��Teta ar 10 3 - UFER r;s.L• , •rug s —" ---
•'ompletiomthe orpme ficithder will have She burden of proving that he did not build ar !"
( ire vc far puryau of aal=J.
104 - REBAR �
1 a.owner,of the Pnr luv Inle105' "ANCHOR"-BOliTS 1 contracting crnsdc t Sor m
on wet m
.__.
The
1 m (see yoand e coda 1 Th c acmr: 10 6 - SEWER & WATER
License La s anot uos ply t n owner f rh Will 1Ts th rton P.(.,:if
..,.
._,and.wh con cis.fors hp�acu.wN. .comcror(s1.Iccn
nsed.puuall,m.the .._.
- 202
Cmmac i r.1'en Law. UNDERFLOOR PLUMBING- - - - - _
01 am em u e e "' In' B&PCfor this rcnrnn 203 - UNDERFLOORG'MECH'ANICAL
Paber� 204 - UNDERFLOOR FRAME
f -WORK SCOMPENSATIO DECL RATION ` 205 - UNDERFLOOR INSULATION
Inreny riffiron underPenalty orpeparyon.offlue.following al nuns 301 - ROUGH PLUMBING
4 I hic and upt'm--i n a C r re te of Consent to sm1f.imam,for Worker's 3 02 - TUB & OR SHOWER
Compensation, as,provided for by Section 370O W-the Labor Code, for the
p an
n � ee'nrmbwork,rnr. nienmis it is s.gcd,.,, 303 - ROUGH MECHANICAL
❑1 hale ind'will maintain Worker's Cumpenistim In'adrance,as rcquimit by Swtiuo 30.4 - ROUGH ELECTRICAL
37W of ntn'Lannn'ends rd:inti perrnrmanee of The ad Policy gmrn mis''p m,is 305 - FRAME
"- issued.My Workers Compenidtwo haumme currier and Polies robe
Carrrtr CERTIFIICAlIONIOF( L , ... " Y rt
Policy No. 306 -'
;'HOLDOWNS" ;'
5,, EXEMPr10NFROM.WOH%ERS, „ { t,;n f 3O'7 '--' }INSULATION' •e fes`'
iv COMPENSATION INSURANCE-
- 309
308= iSHEETROCK
(Th d n'n W I be'
completed f n Perini[s E hundred JNWre
(RIBO)n le 1 I - EXTERIOR LATH I
-0.•Y ...__,-._ S P
comp at Law h =nm p t a a I `3.10 - 'INTERIOR' LATH _ -..
.chant t m Sh teed revoke)o k
311 - SCRATCH COAT
NOTICE TQAPPLICAN'T provfts ortgk s rmushallene dLmm to pshould -"- 313.--....ROOF---NAIL
y pe o the k for h
p Y Y Pe try w m bee The a t th W
PP �
Meme subecuo the Woke/s Co making p Y 501 - FINAL ELECTRICAL"ENERGY
,Z pcnmi provisions fihe labs Code you must
�O tenh m m I m _ _._FINAL .PLUMBING._ENERGY
O x
w rA ; the b 0: ICON5TRUCTIONLENDINGAGENCY 503 FINAL MECHANICAL ENERGY
a , Y Shat 1h iiu.a cS on I d rtes c ,
F nm permtsa ea(se3w] r c1 504 - FINAL BUILDING ENERGY
a _
505 FINAL ELECTRICAL
of nh k2 h
B gencYf the pert
Q L'e tlersNm
Z) Lent r Ale - '
v 0
e
w daa lrtry that I have teas this application dscam Sh tin aboveinformation
is506 - GAS TEST
�
b correct I agree to comply.with all c ty and county ordinances and state laws relating507 - F I NAL PLUMBING
Orr, 1, Id gc wcton dh by autha rep mJres f1h1s tKt n ter upon
w men edproperly f r tipatriot, 508 - FINAL MECHANICAL
d (We Ticeto save, nJmifyAnd keep ha Ie.snieCty fCpn1 nganso
cn liebilDes 1 gmeae,c n v d e )times which may any ay cane against said 509 - FINAL GRADE
UZ City con y ce of eg citing of his perms
ArPLI AN 11 +RS SAND\VILLCOMPLYWIJH LNO POINT 'j 510 - F AL L NG /' �-ZS I
souR c i" s _ ��5 Issuec4 ate
Signature Applicant ancestor' : rY -'; +d .Dam: ` _` Re-COOfS
HA RDOUS MATERIALS DISCLOSURE
wit me',ppl t rrt building pa store 'hall na:are usmase'iI Type of Roof .. _ .. ..
as definod by the Cupamru Municipal Chapter 9.12,audit Healthand S r fy' y '"'-""""- ^" ^^'- ----••
Cod S❑Yon 3553 fat { Y ., t ., F zs t. i i.i it, i vi'," {.ilY Y!}1,,
u ,. .
P. All.roofs—shall—be. inspected.prior to.any roofing.matenal being installed..
• IW lite ppl^tit future b B g co p i equipn t r .6which' If a root Is Installed without first obtaining an'inspecti6n' l aoree'to'remove
,itict?I t [�vs Jet Jbym By1 aA Qua]t M 1
'°i." .oytt P.
v', " gall new materials for inspection. Applicant understands and_w_ill comply with
I .•s : . �.�' � all-non-point*sourceregulatlons _ _
read t e h zardoua.m«rials req item is under Chspier 695'nf the
Cuhforn aHcahit she(YCele,Selina,2550525533 and 255141 understand thoi
pFihebuld gJot of Sly emnam chair rsmY rcspon lbll tyt notify the'
ocii.p C of or ,rt h h must be S pun i Tjua{e of. C 1Gcarc of
17 O<i'
t " p Yi t -. -.`r[C� .., ,.- Signature of Appbcln[_ Date
L
water rmpAori ater ' _. -_. ....._ . ... _. __ _..
. . ,agent _:
'Data All roof coverings to be Class-"B" o`r�better
....OFFICE'"---.. --