02070160 'r-Aas,'-4 _WL4 e x _ ,, 1 _ _ - .- :13;.'I,,, -_ -
1 CITY.OF CUPERTINO .•u•. '• "'^"�' -"
BUILDING DIVISION ;pE 'T •CONTRACTOR'INFO ON .
• BUILDING ADDRESS: PERMIT NO.
'. "2.0030 RODRIGUES AVE # ' 7L WALDRON CONSTRUCTION COMP Y 02070160
s OWNER'S NAME:,
APPLICATION SUB DATE
; ;LAKE .BILTMORE APARTMENTS P 0 BOX 598 07/25/2002
PHONE 4 - SANITARY NO. CONTROL NO.
(408) 377-8186
O O ;RCHITECf/ENGINEER: BUILDING PERMIT INFO
EE cps c + BLDG ELECT PLUMB MECH
ion' Il'�s;''`I'heteby eRnm NeeLICENsED lam lOittnxd under Siov uliui cn•1,:"er7(commencing Job Description
Fgts°y isviN S«tion Y000)ofDivisinn3of me Business�rrd Profnsmns Code.and mylicepe INTERIOR RENOVAVATION
7 •u iameCfall orce e;q ellen. / �m.s�-� AV r-� /
sg6iLaanaCpa• : ua.g KITCHEN BATHS R Jn�k HER' DRYER &
u53� IDY," . ECLar WALL A/C/FLOOR
:•• ARCHITECTSSDDECLARATION ,
,1 understwM mY Plans shall be used a public records SEP 2 6 2002
nea
,.
S22❑O '.Lcio sed ProfessionalI
^:'i,p!•" OWNER-BUILDER DECLARATION
w tri' 1 hereby eRrm that 1 em esemp[from,he Cone Bade,Liana Law for she BUILDING
tlG
I:z< s ollowing reason.(Section 7031.3,Business and Professions Code:Any city or county
f F O which requires a -it'a reareaca cher,improve,demolish,or reryu my mocom,
$.y prior in its issuure,shoo requires the applicant for such pemus in She a aignsel uncertain ..
- 'tf�'pa'ub«needpunaanN�u,<prey:iansdfthecanmxWalinanalaw(ch.pter9 : h„ . ,Sq. Ft,f'IooPArea,.h v'1ua[ion
+
(a- rest)Section.0[p).of Division 3 of die Braineµand Professions Code) �' 1 ; ,, ,s-, 2 }s:.x $3 4 6 tD O-
or tut hb la eAfmpt do,
nerroM and the basis for the alleged exempt...Any violation
. -of Section 7031.5 by any aPPlicten far(Permit subjects mevpplicant to.civil pewsy �t t�l�sm r;ryt'i + : Occupancy Type
;L(rot more ohm five hundred dollen shoo). 3 6 9 Ml6 5 TS. beS
.❑I.ai owner of the progeny,or my employees with wages a their sole compensation,
. "wi;do'Ne wok.and'the'asrae ea'a not Intended or'affected!'for We'(Sec:'106i: ... .. _. . _ _....... _._...._..._..__...___ _
'Bnsli in and professions Code:the Conuracmr's License law does not apply to an 101 - FOUNDAT IJ�Nuired Inspections �'''•
'Mimi of pm«fy Who build,m improves tharann,and who does such wok himself
or 102 - PIERS
tmouyyh his awn employees.provided Nim
at such pmm
evees eon not intended or
for We:If,hdwevcr;the building or impidvemeni fi sold within on'e'yeaf of .. _... ........-__. ...
n t Aploim the awner-builder will have Ne burden of Proing t
vut Its did nos build or 103 -
improveforpurposeofaln)' 104 - REBAR
1 pawn r of Ne p(S=.7 am eadconvecting wrN ids:)The com can m _105- ---ANCHOR-BOLTS'
muse'she pmjest(See voa.t.B.I.nrevp area PmfepNm Cods:)The canupmn 106 - SEWER & WATER 1 L•. 1-:' ':' •-• �, ..
Lica. Lb does nos apply m an owner of propcfy who hu Ids or improves thereon,
rod.who cootacts.far: mch.projecu with a conuamrfs)licensed punu d,m da 202. R - PLUMB'
ING -contrac'rs Littpe la R 1-3,am cpt " s " 1— B'&Pc far ad, u°" 203 - UNDERFLOOR` MECHANICAL
204 - UNDERFLOOR FRAME
oMPENsnnoN DECLARATION 205 - UNDERFLOOR INSULATION
IherebY iffirm undNNewry ofperjury orhe,ofthe,followingdeclamti... 301 - ROUGH PLUMBING
Ei "hiveas aill'maw
imah,a'cenieda el
or Consent f-insum for Worker's's 02 - TUB & OR SHOWER
Compensation, as provided for by Section 377 of the Labor Code. car she
Perfonnnium0fdoum ro�whirh;thisrperWtiaissued..,; 303 - ROUGH MECHANICAL
0l haveariE'will dinassinWoker's Compensation lniurnice,as rcc,iced by,Section 304 - ROUGH ELECTRICAL
37M of ihe'Labor Code,for the pufonnmce of the soak for which this permit is 305 - FRAME
honed My Worker Compensation t o Insumried c and Pul cy numre:bs a
H Pobay No 3 Q.6. ._.. OWNS -... -. ...,...„.,_
•Comer ; .s n .. 11
O�+D ,
-CERTIFICATION.OF EXEMPTION FROM WORKERS N ' 1 3 O 7 ” 'INSULATION' �-
COMPENSATION INSURANCE'! -•'' ^
" 308' SHEETROCK-
)s' (Th s action sed nos x compfcted if the Permit i f ne hundred dollen
(s100)o 1 ) 309 - EXTERIOR LATH '
-310 _,. INTERIOR" -LATH
I cenifY that r the performande of the k f r which this permit o issued I -
�ihall d t em IP Y W p g pemmt shall x d1 e waken 311 - SCRATCH LOAT
Compcnano wan
fom
a NOTICE TO APPuc ;Iuli� ,n this of Faemptonn, - "' 313 '' ROOF-- NAIL
-_. ... _. __. ... ....
P Y Y Person 1 y man `r m be' s to th
1,Alisr
PP
youshoust 501 - FINAL EL8CTRICAL"ENERGY '
beeom Subject to the such
ker Compensation rovnrdna d(the Labor Code,you moat
OO mnhwtthedm roman mvramnaarh, revoked. 5.02...7_ FINAL-_PLUMBING.. ENERGY.-___ ._
CONSTRUCTION LENDING AGENCY - - - -_`-
a' Iherebyatd oto ,ssaco mumnnlending g cyr theperPomhmce 503 - FINAL MECHANICAL
fsh ok Fo which this _ .. .. - - _..._ - • .
W`,q -Lenders Nem .. . 505 - FINAL
ENERGY ,
._. .... .- _ -.
Permit[ srssmed(5 3097 ci c) 4 FINAL BUIL
GAS
ST
z Lerner Amro r ELECTRICAL.:
�'0 s 1 cert fy shat 1 hev read Wu eppl c t n and scats Net th bo e s formation is
cortccL 1 agree tq c mply sh all dry and county ordinances and state laws raising PLUMBING
m building construct on,and hereby iumonze onprounu'ives of Nis city to enter upon
W the am•rt-memi.nedprop?mfar_jppectfonpurpoas. 508 - FINAL MECHANICAL
-4; (We)igonel e..md7nndyand keep hertnless the Criy of cupiitno agarol'
Vd lub0mp judgments,costs and expenses which may in any way accrue against said 509 - FINAL
U 7�.
City in consequence ofthp g ring of th pc '. 10 R F A G
APPLICANT,UNDERSTANDS AND WILL COMPLY x ITH ALL NON-PONT"
T4 q
i SOURCE REGULATIONS ISSDe Date
IN
Sigrome ofApplicam/Commctor Re-roofs
1 -,HAZARDOUS MATERIALS DISCLOSURE '` ''
.. ,, WIItheapplicantiu,fumrebuildingbccupmstoic orhandle h+zardoiumweriel TYPeofRoof _..._ _ ... ...
p defined by,Ue Cupemno Municipal Cade.CMponr 9.R and the
-Health end Safe[Y _ ... _ .._ .-. ,,. _ ..,... -.. •.-......
.Code Sas on 255J2IU , 1 :. �,1�..;' '• - .; N.�p rn,. ' - .- ... .,. ,.,.,).: • , ,
flY' C" - "' �" All roofs shall be-inspected prior to.an roofing,P Y g.material.being installed. ,
' Will the applicant orfuNrebuilding Occupant use equipment or devices which If a roof is installed without first obtaining an inspeetion,'Fagtee'to remove
ems herpde s eh contaminants as defined by the Bay Area Au Quality Management
• °o1nn all new materials for.inspection. understands_dersta_nds_and will comply with.
by. - ❑Na - , - all non-point sourcereglatlons:,..I ,.
nee ,
1 have lead N Safety
Codd,maims 2 regmremenu under Chepur 695 of the
@he build Health 5 fcry Code.Sections25505 titin and onsi Iundenotif Nue
dthpratof me resmameav,whichiaunmv that it is my respopibilirymnd'iry Ne -
decupant of Ne requircmenii which inti hemet prior m Issuance of a Cefirs su X
., ocapandr. Signature of Applcaqt Date
Gwne(oreumoneeaagar; Date_. All roof cove Tin gs to be Class B"or'bet ter '
_. .
OFFICE
CITY OF CUPERTINO
BUILDING PERMIT APPLICATION FORM
tContractoLicense
Address:
X06 ROD&GuEs
Name: Phone No:
KE IaMIM gA2rMt�5 (&go 45 i41 300
No:
ColimizTtogrJc-.
Contact• Phone No:
S WEavE2 P2n�r A66R G Gb s96 -5308
Architect/Engineer License No:
S tc0e� SrNeu►rk R55
Applicant/Contractor:
ORE Aftl ormews
Building Permit Info: (circle one)
Bldg Ele Plumb Mech
Description: l rrMAP- RbnlovAnonl rN RBmoti-o Ki BA. )�
PW Wa6ffMjDeYee , MGW WALL A/c N5W Froee c0v6ZAJ&
Residential: Mui.Tr-FANULq Commercial:
Sq.-Ft. Floor Area: 1000 SF $/Sq. Ft.:
APN # (Must provide): 3lil_03-DO valuation
Type of Construction: Occupancy Group: R I
if Fee/D Fee Description Fee Group
Applicable
BTEMPPERM Temporary Bldg Permit BUILDING
BCONSTAX Construction Tax BUILDING
BENERGY Energy BUILDING
I BENERGYADD Energy Add Multi BUILDING
9—OVERTIME Inspection Overtime BUILDING
BPERMFEE Bldg Permit Fees BUILDING
BMITIGAT Housing Mitigation Fee BUILDING
BPLANCHK Plan Check Fee BUILDING
I BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plan Check Repeat Fee BUILDING
BREINSPECT Reinspection Fee BUILDING
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
ESPECIAL Special Inspection BUILDING
BSWIM Swimming Pool BUILDING
ZADDCHG Address Change BUILDING
-447
PCITY OF CUPERTINO -
BUILDING 11 DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
-20030. RODRIGUES AVE # 7L WALDRON CONSTRUCTION COMPANY 02070160
WNER'S NAME, APPLICATION SUB DATE
LAKE BILTMORE APARTMENTS P 0 BOX 598 07/25/2002
HONE
SANDARY NO. CONTROL NO.
(408) 377-8186
Gp ARCH R: - BUILDING PERMIT INTO
pyy BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION'
o z y'i j F.;'? I hereby m(iron Nat lam licensed ander provisions of Chapter 9(commencing Job Description
F_Iz lwith Section 7")of Division 3ofthe Business and Professions Code.and mylicense INTERIOR' RENOVAVATION
�e�0< Licenueelasst4 rceP' ur.x KITCHEN/BATHS REMODEL, NEW WASHER'/DRYER &
H3 G rDma IL - contractor WALL A/C/FLOOR
In . .. ARCHITECT'S DECLARATION
E5
O . o 7,1 understand my plans shall he used as public recoNs
p O Licensed Professional
g,yam Ka ' OWNER-BUILDER DECLARATION
u1 % . , 'I hereby alTam that I am exempt(tom the Comracmr's License Liw for the
CZE ,follow,ngreorm Section 103 L5;Business nnJ Professiam CW<:Any city or<ounry
Y D 'wh h req s a perm t t .i t i ler,improve,demol sh or rcpaa my awnurc
3. s,,w t m arca q th pplic tforsuchpmittofileasigWsment
Ila a I¢�ssedpro itoinega naisardmcaaaatorsureaselaw(chnpm9 Sq Ft. Floor Area, - nation
.... . .
+t mminpBw(itlsScet '7000)"IvisionJoftheBusmegsandPmfessansCodel {"1„'J.,,' ; . .i.'i �:s 9 . $3466V�
or
that he Is tlCem t therefrom and the basis far the allegeq exempuun Any violuuon - i
. -ar seadanaon, 'tray eppbemo bmx pato,n sabiecm the apnoetrm m a d.n penaRv' 3 6 9� � J( . �� Occupancy Type
of nal more
than five huadred dollars(SSoO). m iP\IR'.v,
❑I,ek owner of the properly,ur my employees with wages as their sale compensation,
Lwidt not work,and'thcstructure is not intended'or offered'for sale'ISce:1044;' -'-- " '-' ----'-_---------'—'-'
'Homes trAd Professions Code The Contractors License Law does a.,apply to an 101 — FOUNDAT Ift;luired'Inspections •''�' 't
o e of pony Who buIII p thereon and wh tla h ork hiimdf i
a throsighosoademploy s.pro ided that such improvement.,are n t i teaded a 10 2 - P I ERS
";t, red f- sale IChd to building or top emeni Is old withinone Year or _._... ._-..... _ . .. .___..__— ... .._
,completion the owner. Ider will have the burden of proving that he did not build or 10 3 - UFER I
improvefapurposeafrole.)_ 104 - REBAR
- - -''- -
Iy nerof ihcp party areexclusively co trwi ng with licensed contractors to
or 105 --ANCHOR-BOLTS ..r� I
t the
prole"(See 706, Business d Professions Cade)ThC mmctor s I t I, i t ,
I L ansa Law does n t pply t n own perly of prowho builds p thereon, 106 — SEWER & WATER -`
other anulr dpmaantt me 202- - UNDERFLOOR":PLUMBING— _...._. _ ..__ __. .----------
Complicate,and who conirnctn.f Lich pm)ects w W a c Icor
L¢enu la -
pwaa s 'jkPCbomb ressivers 203 - UNDERFLOOR''MECHANI'CAL
oMPOFtr nnoNDEc-73a UZ_• 204 - UNDERFLOOR FRAME
LARATION 205 - UNDERFLOOR INSULATION
[hereby,Wom undo penalty of pc) ry ha,of chef Rowing declarations: 301 - ROUGH PLUMBING
❑II IV4 rand will Iredroo.'tr Codi( ¢ f Constm to sel6msure far Wolo is 302 - TUB & OR SHOWER
Cnmpenamipa. se-provided-for by setissu ar me Lobar case, for the 303 — ROUGH MECHANICAL
-- Cartomi...t onhe won de wnirn chi.permit is 700 o..
^'0 1 hatottarid'willi m Wok}',a'Campestothasoro sreytiiredbysection 304 — ROUGH ELECTRICAL '
37W'of the'L:borCode:for the serpoloc art,of'me-wan for j
which this c7it is 305 — FRAME -
issaed My Won rs CompensationIns mote comer and Pol ey umbo
306 ' HOEDOWNS - n �
iCmnery ' r`' i rs F.y+i4lol cy No - -inn ,.I t t t s'uv rt'. •..
yt , CeCe
NOPEXEMPTIONFRO WORKERS ' + 7 9 3'07,' eP'NSULATIONt I L� i
y - , COMPENSATION INSURANCE' 4 .'' .. _ - ._-_ - _____.__ .-_._ .__ _........,,,.
(Tits ri `nneeannrx6dmpleteatnhePermitisforonehundrwaallar. '308 ' SHEETROCK y, ,r L 'l . .
309 EXTERIOR LATH
0 7 ,ceelry the,is the perfa p g 10' _ INTERIOR LATH
ce ofth rkf iwhmhths muni sed ,
shill a "ploy'any pe n. any tiunnerlso yy�bei'4i¢sylueayt the W n ri 311 - SCRATCH rOAT
JO IJ CJ 111Y ' t f `
ArAdirepata lows,a(p�fa j17 lZfwL 313....-..,.ROOF-NAIL_ ........ .,
NOTICHTOAPPLICANT It. t1alookingtnsCrif'trmofExempion,you should 501 - FINAL ELECTRICAL"`ENERGY
bac subjecttoW kY Compensation v osis of,h labor Code,y. 'it
00 forth ih comply ih s h provisions r this Perron,skull bed ed revokes.
� __.5.02-___._E.INAL__PLUMB ING._.ENERGY . ..... _. . ..__
a,? ' "iccesrl:uca�ONLENDING AGENcv 503 - FINAL MECHANICAL ENERGY°
I h by'aRirm th uh on wn n lending ag y fee the perform c
acme afar which'his pe t ;issued(Sar7B9TCaC) l; - 504 - FINAL BUILDING ENERGY ( .
aW P -L n r Name . n _ - -
D-Z L e sAddre I'- 505 - FINAL ELECTRICAL :,,,\
U'Q • _ 1 nfyih�ilh ash ppl i nandsiiemot`tn ti f ti is 506 - GAS TEST '
�Tz [�++ i t i ogre t ply with B ty a ty, penance and state laws relating 507 - FINAL PLUMBING
;U mbu ld g onsin¢i n dh by authonze rcpresenedi of city to enter upon
jh oboe micro f pertyr inspectionpurposea,-,,, _. 508 - FINAL ,MECHANICAL
tale) g e nt a e t d M sty and keep harmless the C ty f CalpalminoijainIa
VJ li YI Lies i dgmenu co pix and xpense which may.in any y against said 509 - FINAL RA
APP LICAN'TRUNDERfS'fANDS A�DfWILL`CONPLYWTfHALL'\'O\-FOINT lO F A G
SOURCE REGULATIOgSt,t i!.Al i'iii. + '„,kA Issued Date
Signature IdAPPfBont/Comma n'..( t Dam f : Re-roofs
t i -
HAZARDOUS MATERIALS DISCLOSURE ,
pppl c t o fat building atop t store or handle nasi dws mat nal -Type Of.ROOF -.. .. ._
u def in, by the C p nIn.Mme at Code,Chapter 9.12. d the Health and Safety
Coee s
than,
I n zs53211 11 Jn , a ' a fill roofs shall be ms `
OY - - IY\Yr111Q No i }t C I .}, t ':
A petted.pnorto.anyioofing.material,being.installed
„,m W ll the apple t r tum b ildmga p t e equipment device'which If a roof is in§falled'ivithout first obtaining a''n inspectidri;'Pagree'tis remove
hazaeda s s r c in
ods os deft ed by rVIB.,APto Ail Quality Management
- ' -
P gP PP understands
d will comply with --
District?' a new materials or inspection. Applicant understands an
OY _
i � S�pNo; T-, i e '• :, all non- Dmf source�re alantins -
i.'I 1 have read the hiczardmiundrawfic,14 req trim res underFChater.b 95,oLtnc
Coliform-Health&SalryC d:Sectio 2550525533 had 25534 I understand that
if the bildng does not lornmily have o maam:that it is my, pQib'Ily to notify the ”"'-_.-. ......... _.,__. .__._..-. - ..__ -. ......__ - _.
ac pat of th requmrem' 'i witch must be met poor to ssa e of Certificate f `
Ottop n y `
Signature of Applicant _. _ -, Date
's o a aamanxcd g nt Date. All roof coverings to be Class B or'6'etter '
....OFFICE -...- ._ ..,.