00120097 CITY OF CumilitTINO
I UILDING DIVISION PERMIT CONTRACTOR INFORMATION: � .
xuu.nlNGn12Id01g40 RODRIGUES 11C WALDRON (-,biVS'rRIJCTIDN"rLR,'LiTh`79''ANYtZIQj:L200!'.37-
OWNER'S N.Lhf - IG S B
F�KE BILTMORE APARTMENTS 73 HERBERT LANE APPLICA I2000
I1ONn: - - SANITARY NO. CON TROLNO.
(468) 37'7-81 BE,
ZO ARCHLECrd?NGWEER, , - - - - _ , BUILDING PERMIT INFO
BLDG .IiLECf PLUMB MF:CH .
Is,
LICE NSI D CONTRAC I OR S DECLAR 1 DON
0 z!I2 m 11 h, ffra OF
t l li ,sea J p I Chapter 91 nide mg .': Job Descll ptlOIF --
=yt J sins I rn I: ., flheHu : JP re., cw_ mttyi n - INTERIOR. REMODEL', KT tl�EN/BATHS, .RENOVA'"
S' full f c.andd R I
OLicenic CEaa I p
� N
Dole ear NEW IJAI .I_ A/L'„ , b SIIh_R :>RYF_R UNITS hIEW ,I'
I- pAItCHI'IEM'SDIECLARATEON L
p w I I I dndummred Or,plan,sled be used us public lecordv
WrGO lac dl f..- al
°'%oI OWNIRBUILDER"DICLARAI ION
F so
^ toll I li by still that I at t o theContractor L Lou,Ili,1he
_
p 6 6 Scenes,01111 5 B Placation,( Any ',y - ty
�y�jry ali t I I 1'e 'I, E J I,1 1 y,I- q I'D I
S pr t I' .. I tl' rPl I M1pe 'I l I I 6 J'et tot '
55555- that bel,dcented,ornewsn hunolosioni the Contractor s laoense Law(Charter') Sy. Ft. F] eA '' •Valuation
Rolnntn¢ing x ith Section 70001 Division l of the Bminnsr and Prefessiuns Code)
nr thad he it e,e,vp Ihercho l mid the suis rill the alleged exmnr,io..Any viNxlie. _
or Section 71O L5 by any applicant for a panni,subjects the applicant to a civil Penally _
antand m.n,:elan lice nam n•a„dual,1s5n01.. ,ApN Nuntb Oce pdn6}I' pe,
❑I fth rr l%ly,olin,'eltpl > fli anibil al Ili l
will J ,h k d IE .trut - :n I d a fferei f l: IS 711ii ,�
Hn ne- dP to in C,d TheContractor's Le I d tappbt,an required Inspections' '
otruer of progeny Who hu Ids or impr,,ve the[cun,and xh,J¢s such work h Belt r
r Ihrnuyh his own employees.provided that such intpravemm^s are',intcrefol e,
,,Here,]for tale;If,h„water,the mfdding or i.„ravenacal is said wintm ace year nr 101. — FOUNDATION
torapliaks,m n ld 'pha d n I fp bn h rd ,bI lar -
p I raga: I .1,02 — PIERS
fm P rens mt mil lycontracting 'till e J rI f 103 _ LIFER
I tile Project IS 70Nd B c d Professions Cii The C Irncl
Le.doc,nm ppdy,,,,,, r tFro,ro,wnnhlEl. Rapture, hecotn, ` 1.04 REBAR
and ek
o 1 I' waE mnrde E . u p : ,aI 1n ne 1,05 — ANCHOR BOLTS
viedCan1.w ”
'Ellr �.�N�1� ' B&PCf this wasn't 10E — SEWER R WATER
ELF °� 2 — UNDERFLOOR GLUMBING '
Ehorchy mR.ln limlerpmiaEty,,fi,erj ry Dan none l;tunwiag aeew,ali ,..i?0.3. — UNDERFLOOR MECHANI CAI_' -•
I have endwiu neliatnia a Cenfdome of Consenl a ,e0-hr,arc Her w„rker•, 204 — UNDERFLOOR FRAME
Cateref'od"o. it,rmPruviJcJ far by Scotia„ ,700 of the Labor ewe, far the 205-,1 LII\IDERFI_OOR IhISUL.ATIDN
peranoe,,nntli havdinanthi,pentta 1,issues, - •301 — ROUGH PLUMBING .
3700, nE E n -C� lot-t n t my .AE which l - ',1, 302 — TUB . R• OR SHOWER .
icsmd My WorkcrsClle,sni rhnlrtuu.IrunnJlul eYntbu va. t
303 — ROUGH MECHANICAL
Cant¢ CIiRTIFICNtONOFM;Nil'f10NPROMWORKFRS' 304 — ROUGH ELECTRICAL -
COMPENSATION INSURANCE, 30-9 '=- FRAME 'a
t�rni.aeminit lte�d urn neo„mpin2d h'me pclfidt Ea kn oIto haadmd dtuma x -
fim0)mlea,.); 306 — H01_Dr_1WNS
I ccnify that in the pirforra nr the work fur x6ich,his pe[ai,is tuned,1 307 — INSULATION -
•shall nn,employ any Person in any manner so as,o become subject to the Workers'
Compe I' L fc I Date - ,3218 — SHEETROC)! .
^
Applicant
10AEIneAN1 IE,roller taking Iii,Cf1 c I'I IN, diun,,ou,Imld - 309 — EXTER'IOR' LATH
z ,her 1,(11,li Canpiosal i INo,kion,olth Lahor Core,you land 310 _ INTERIOR LATH
Z O forthwith crand wan an,1 r ,nnsmml it h
IM .all he 1 ed kd
rooe
'F CONS'FHUCTIONLENDING AGENCY 311, — SCRATCH COAT
OG > Enerebyafennma,therek,ac„minleanaleadingageneyfor the pre niece 313 '— ROOF NAIL
of the work lar which Ink pennil is issued(Sri.3097,Civ.C.) 5e
ao 501 '= F'INAL ELECTRICAL ENERGY ',
Z Lent r:Atkinc,
vo Ianfylhtln ea1dl pphahn dttmld a ita nal 502 — FINAL PLUMBING ENERGYw F ea[r t 1 g r, ply wild all cityand county d' J tt l resits 503 — FINAL MECHANICAL ENERGY ”
O U Inn dl 6 ., f to any m p „ Ito ,yl a m. P n '
men - p r 1,l ' .p lir , 504 — FINAL, BUILD EhIEI?GY' '
Bdn'hrlWil6 It I. Id ly dklli .r ml;rriyrrca 'P''t;e:�e 505 — FINAL ELEC L
U Z City n consequence of thegmnng of,h,i ,i 1. y^(]��
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALI,NON-PCINT IS\fledb —` ^�� T �e�Y
' SOURCE REGULATIONS. y Date '.. r/ �)
SlgaaencplnpplicantlC(I....fe Dnln Re-roofs- c 1
HAZARDOUSMA'IrEUAI.'.DEScl-osuRE; 5_08 '-"�`.F.I PIAL MECHANICAL, ' .
wiutile amlicealormtlllel.,dding pant,mrenrhanalenaralrn,n,m,I,fhw Typeo_fRoof 509, FINAL GRADE .
a,cornea nr me caPenina Municipal .chapicr9.a,and me Health and Safely _ .
Care,Suction 25532fa1n
❑Yes 1 t?I — 77hh11ppI PI R N \[
All roofs shall�e mspec�d�poor to an r�oi�i�1 material being installed. '
wulmeappucam,,rt,,„renadd',,tg,,anal),1a1t1,aeilnq,mentordevices which •II'aroof isinsC)dle'fiwith�uilf� �•ot �i Ilttir♦fif�l8 , Iagree to'reirtove
enID humnlnuenire^nmminanls aJeB Enylhnu,IyAreu Air QualE,y Mn1l:Igo111cIu g • 1”'
'I:Irtf? - all new materials for inspection. Applicant understands and will comply,with
El ted o all non-point Source regulations.
1 leave[cad,he helaa]ons Inmcris 2 51)5. 5533,,under Chapter 695 of
'Chi'] iellcullh&Safety C'ndc.Scc,inns 255115.25533 unJ2559J.l nndcntmul lhm _ ,,. -
if'oupIi.dla IOu am currently lmvcatmnun,Ilial iiia my mspumihlli,y tonnllly We ,
return •......cm n which and he ter prior ,I i,smaac 0 v CenlBcaly ill'
F.
ac 9
/// Signature of Applicant Date
W 2/ �9-!D
ownernr I r d _ oa,e All roof coverings to be Class "K or better
OFFICE