01030102 CITY OF CUPERTINO - -
BUILDING DIVISION . PERMIT CONTRACTOR INFORMATION: .
IIUILDING ADDRESS: ' PERMIT NO:
20050 RODRIGUES AV # 1ZH 01030102 "'
OWNER'I NASIE: - _ APPLICATION Suit DATE
LAKE BILTMORE APARTMEN75 °•0.3/20/2001
PHONE: SANITARY NO.' CONTROL NO.
Z, ARCHI'rECrdiNGINEER: BUILDING PERMIT INFO
p4 BLDG .. F.LECr' PLUMB MECH
a
1 ICI:NSLD CONIHACTOH S DECLARATION
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c � lnernhy ilroddlamlect,m 1 ,.1111.:yIK ;S Job Description .
F "� wimS i 7agU or D'v.ioaronne Bo. 1elNofex1 is n,e - ' 'r•
i`.i< .. Fla"n full force °d effectIs Y INTERIOR- RENOVATION INCLUDING':
e,a care 011111.0., n
F.s I It I full
ad G ARCHID::Cf S DIscLAxnnoN" 'REMODELED KITCHEN & BATH(S) ,
q I underM:md mY.111xns shall M used ae LAR TI
NEW WASHER/DRYER9't .NEWT WALL, A/C,.
O\VNI H ItUILDFH DECLARATION
I h by a if d a l 1: matt he r t' t '—IB
- L fi r the' -
��Q tell g e ):03cei d l 70313 ituslne d l +I'�,4fods C 11,An, d,nr c+only - •i - - -
wM1ic1I requires a permit to construct.alter,improve_demolish,or repair any,Immure
3� pII r 1. q o:m 'pr1 tf .acn pemin file i, dartncm '
- ma,1 :1 n11 dd dhe a - f the r traidne,I 1 (cl d ter9 Sq. Ft FloorArea,, Valuatioh .
to. Icing with Section 70001 ht 1)vu m 3 of du Bus m„and l mfics's ns ode)
or that he is exemm
pt emrmm and the hsis fac the alleged exemption.Any violmnio -at Section 7031.5 try an,applicant far a permit subjects the applicmn to it civil.malty
if not anreInudlive lmaereddnpi ($51)(n. . . - APN Number ', - Oceupanc'yType.,
❑I of the poa.�ny.or my employeeswithwages theirc ,A onion. - •. 1 n .
4-2Z U
willdo the k d te stiticnar,is not intended or ofterod for a (See.7041, -
13o d inns o C 1 I'IeCot t I' scI d -, t p,lytoof - -'t• Required Inspections
owner Who III dray '. m 1 d h J I � kh'melt
it or through his 1 p1 ye. provided th t n p tar for intended or -36903008" 00
..
iflandr1 or sale.If,inave,er,da,n ddi y or mr,octruen,is. Id vid.i. ,anrra,ar .
c unletdon,the owner udder will have the burden hd proving dint he did notbald ..
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r p ryd. t.ale.l. 101 — FOUNDATION 1
01 the d the p 1 t7l 'I ly tl f J t -:t, —
t t n p IS 7011 Bui dPoloist...LH :) fl Corridors, 102 PIERS
Licenw law does notapply pply t an owner 11 property wno buidda or improves h reon, _
.t and h t t: In h projects wish a ltramrf,) I p nt dh the 103 — �UFER r .
d Coil d I' r�c Lins. as -
❑lait,IpqplyyJer e B&PIC r thisocs.hn 1014'- REBAR
owls -0,00/01 105. --ANCHOR. BOLTS'
N ENSAr10N DECLARATION
AGe*lr-&)rSX0X 106 — SEWER '`& WATER +
II1er0by:dnrmunder penally ofrvej onocd heGalowdngdoclaraliau` 202 — .UNDERFLOOR, PLUMBING
0 1 have and will 1;lninoin a Cemdowe of consent 10 wlr-in.... For worker; 203 — 'UNDERFLOOR MECHANICAL
CAL
Conlpemmion, n, provided for by Su4ine 3700 of the Labor Code, for the ,
podar nmce,f to work lin which ibis permit i.i-rued. -
204UNDERFLOOR FRAME,
❑I have and will�maintain worker,Campeasadon Insurance,as reaction,it by Snmi'm ` 205 — UNDERFLOOR INSULATION
-3100 ur 1be Lana.Qalc,for the Irerfoml:mce of the work For such this permit is
is-ial.MyW..kors Com.viouni ldl lhsandnce rant;.-and polo,nnoher ane. , 30.1.. —_,ROUGH "P
LUMBT.NG
Carrier: .' - PolicyNo.: 302 TUB &i OR SHOWER•,'
CHHTIFICATION OF E%EMPnON FROM WORKERS'
COMPHNSM ION INSURANCE - • - . 303 — ROUGH- MECHANICAL - -
rndi,wetmnneednmL,e.nmpleledinnepernai,Radius,nllgdreadouaa'' 304' — ROUGH ELECTRICAL .
Iready 305 _ '..FRAME.:. _
certify mai pe�s n innn,I,...net
work rhe when this ct to tis issued,l '
nowt nn1 employ- person m any manner so a:u.nehhmn.nnjec(m mgwarke,11 306- — :HOLDOWNS .
'Componsmian Law.nl Calif rain.Dma
Api...I , - :307 — ' INSULATION -, -
Nat'ICrTOAPPLICANTIf ft king thisCrtfialenfl pt y ushould '
nu 1 : ole ltothew rp
k a ;n1 p ofm Labor Cde}.ammo 308 — SHEETROCK
O z forth 'dl ply with 1 pr v'. ad'. pe H h ll he I 1 ked. -
Z2 309 — EXTERIIOR . LATH'-
F to CONSTRUCTION LENDING AGENCY -
C IhomnyafdmtdIndhooisaOoran
hinflcmlingagencyCarmeperrom�;ddce _ 310 —. INTERIOR LATH
or me work far which this permit is issued(Sec.3097.Civ.C.)
y q 4nder,Nune 31.1. — SCRATCH COAT ,
UzLeal Address 34.3 - .ROOF NAIL
0
1 nryn tlh dd . ,plied Int 1M1atd, � r mason .
it. 501 — FINAL ELECTRICAL ENERGY
E. com t 1 g 1 moat} 1M1 II 'ry node county rJ' antt d.nt \rein ng_ ,
O fey
Fy tabidding .d fH by who 1 dtoc, fm.city marupon '502 FINAL PLUMBING ENERGYm (he1dl p ,yr inspection 1pI'—
A.
" -
Ove) g 1 d n dfya JI eph 11cz,me Cly iCanadian,ags nn
Z) Iabn . jes 1 itesp . swnhnyinanywyu gdntsaid 503 — FINAL MECHANICAL ENERGY
Ula city .eglelaendnekailgenllpmrd. 504- FINAL 'BUILDING EIVERGY,
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:' —
SOURCE REGULATIONS. Y' _ 'te
Signadmx ofnpadeantrcnmmcmn rm Re-roofs506 — GAS TEST .
HAZARDOUS MATERIALS DISCLOSURE t'
Will me ap,licanl nr fnurc building^ccupant>nre nr handle haulNumnninnal Type of Roof 507 — FINAL PLUMBING. _
vxdlldh, Caet M alC Chat J12 � t the Flalld and Sandy
ew ser 553r)1 1508 — FINAL I+IEC ANICAIf
°Y
ON. All roots shall be cted Fr m + materia being installed.
W'ud 'lei - 1 I d n Hr S 111111"AIII 1111 d 1 swrdd , If roof is install�' thout '1 �e k,tion,•bagree to remove
emnl d .grant ras defined by the Bay Area Air Qualm Manage end ��yy 4 1 �I�{
D" 'ore, qN,,.• „ ' all new sl cc ,tiro L 5[ands and will comply with
all non-pot.t'sou Crcl. gutati6tFNR :PUBLIC; WORKS
1 have read he h iaNnu,mmenals as,ilcmcros under Chapter 6.95 of the -
Califnrniu Health&Sanity Code,Scots.,25505.25533 and 25534.1 1mdersand mat -
ifthebuilhu'doesnodcu..ran,haventnnall, 'd,id!"my,y m,pamihl lily donodlythe - -
oOeed�a.:t of 1110 re ui ,m1 h dnuu M met prior m iuo e d a Cerdlfirwc of
p//h)L@VAqtl Signature of Applicant Date
Q
o a Date All roof coverings to be Class"B" or better
OFFICE. "
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