01080076 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION
.B IDI e6DRESS' PERMIT NO
1060 RODRIGUES # 12E WALDRON CONSTRUCTION COM ANY01080076
TXkYAPPLICATION FD DATE
A'9ILTMORE APARTMENTS 73 HERBERT LANE 08/ 15/001
PHONE: SANITARY NO. CONTROL NO.
(408) 377-8186
G m Z ARCHITECT/ENGINEER: " BUILDING PERMIT INFO
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BLDG ELECT PLUMB� LI— I Cl' I_- I_
Z 5 H= LICENSED CONTRACTOR'S DECLARATION Job Description
oi_o the,ebyamnnthe,Ian,licensed order p skmaatChirac,9(commendal, INTERIOR RENOVATION.
F W with Section 7000)of Division 3 dties Business and roof essians Code.and my haemes
N—
�Ys smfnumreeanderfeu. (REMODELED KITCHEN & BATH, NEW WASHER DRY
to Danaecl°': Cont WALL A/C, FLOOR COVERING. )
m S W w Data S DMLrA,
W O ARCHITECT'S DECLARATION
— '.I undec¢antl my plans shall be.,ad as public recaNs
atw
tiro ec O O ..Licemed Professional
OWNER-BUILDER DECLARATION
n&2.,' 1 hereby affirm(hat I an,exempt from the Catnmem,,License Law for the '
F Z< following reason.(Section 7031.5,Business and Professians Cada Any ,city mramm,y
E whim requires a permit m construct,al,ar,improve,demolish,or repair any sanc an,
i -3 11 I. q - N applicant hpe It rile signed.tatement
.._ ._... _..
that ha is dP 'tto o p of c t t r' L L (Chapter Sq. Ft. Floor Area•. $346$r49uadon
(enmmena ng w th section 7UOIp of Div's on3 al the Busmeas and Prorev'ona Cade,) ." - ! ,
at mai he is exemp,Imaefram and the basis Tonne alleged exemption.Any violmian .. -
'of Section 7031.5 by an,applicant far a return subjects the applicem a.civil penalty VOccu
m re Than eve hundred dollar.SS00). 3 6 9.5M IN84t� Occupancy Y Type
ro[Ine prapoty,or my empin,es,with wayes as thewiah,compenwtlon,
w II do due work. ❑ he tt tme is nor intended offered for 7o
Busihess mud Professions Code:The Contractor v License Law does not apply
an - 101 — FOUNDAT ITIWuired Inspections
owner ofprmorry Ole pa at awho a n workn Ir 102 — PIERS
0th ghnis",employees.
ply p 'Jdtht such improvement,me,a,,,intended or
...
offered the
If, Iheb Id 6 .met !thin' . y f .- 103 _UFER
completion,
ner rat of ld will have m wls ae rp ngin did tb 1a
, pm foreseer r I I m 104 - REBAR �
I Iv t ? s m d: , t ` .- .1.05- ANCHOR BOLTS
'� Fie p p nY rth p Ia.(Sec.704q B and P f. Cats )The c I tr, 106 — SEWER & WATER 7/
-L.....Law doe ns ,apply t anowner or Pre,v ly hon Id r p th reon
c a d na comm f such posecta t m
tchi licensed pursuant t,the _ _ ._2 02- -'-UNDERFLOOR`PLUMBING.
° se w,,
of hire as 203 UNDERFLOOR,'MECHAN'ICAL'
Datal7 tl 204 - UNDERFLOOR FRAME
wORKLRs OMPENSATIONDE CLARATION 205 — UNDERFLOOR INSULATION
I hereby affirm underpenalty of , r one of the following declarations: 3 01 — ROUGH PLUMBING
• ❑ 1 n n u r emit I r c earlr
n.se ,n„re for Worker's 3 02 — TUB & OR SHOWER
compensation. previderf far by Seel n 3700 or he Lana, Code. for the 303 — ROUGH MECHANICAL
perfierman,,offfid workfar which this p t is issued. ,.
111 have and will me mt,t 6 Worker si Co mse,t.,aaon Insurance,as inquired by sec ran 3 04 - ROUGH ELECTRICAL
3700 rime Lanar Code,for he Berra}mance of he work far which this pamoit is 3 05 — FRAME
-. dPI y binare:,, a:
G c a t h in, 3 0:6-. HOLDOWNS- ,
, My
t, CERTIFICATION OF EXEMPTION MOM WORKERS't.'�' � 307 — INSUliATI'ON .
COMPENSATION INSURANCE rn c 3308 09 — SHETROCK -
(sunt air ed. n head E
the ac np1 t u r her am, r hundreds Bas RIOR LATH
INTERIOR.._LATH
:. employs ar parr or IN work far which a the- ,, 311 — SCRATCH 'COAT '� •:�'', ..
"ash II ,employ PY p r a ,m arca object I, the w red,i .
-chrnemmmimrrc,w fclmna,Dm •' 313. -. ROOF- NAIL..... .._
.Applicant ... . .�
NOTICETO APPLICANT.Ir, oi:ceni&at Ipain,, on should 501 — FINAL ELECTRICAL' ENERGY '
!Nachars,abit fl W A C'npe to p ioni,l the Loh rCnde,ynu must
ZZ ran th plywtm hp ms ,h partial hallbed a revoked. 502 FINAL PLUMBING ENERGY
_._ .. .. . .. .. -- - . . ... .. __ .- __
' CONSTRUCTION LENDRsGAGENCY 503 FINAL MECHANICAL ENERGY
f1heraby artair that tho t tim leading agy for de per&rnmce
'afro work for alhich this erntsissued(s 3097 Civ C1 504 - FINAL BUILDING ENERGY '
506 GAS
O.F 'mnee"Iareeettoc. j,WitroillciyPan� apa.c,tmace,ane:teId,,`o,laoo ._.. .508 - FINALEPLUMMBINGMECHANICAL .. ..__ ._ ....._.. - .'"_.. .. ..
a 505 FINAL' ELECTRICAL"
507 FINAL
ng
here
atives
to
Wr reemyace.mdanam retain
harmles.the Ch of Chardnna,ains,
on, p a 509 - FINAL GRADE
Z I bht 1dmem c l and xpenes Which may my y.....e against s,eie
U ti 'C ly n onsc urn f lh g nfng of th R t 510 NAL L IMG
'AP Il >'4T N[ A� S AND WILL COMPLY\VITH ° O.
S RC ;uL no " l Issued�y:gQ�� rn�;.aan ;ea .rrr�nx e Date
r
Sguature at ppneandeantn. k Date Re-roofs
' HA.,DO 5 MATERIALS DISCLOSURE
wll'nrappn-a,tar ntmre nwleg p �.tm n n 'n aroaccon, .. Type of Roof .. ,:......,, ..-...:,..,
as defned,by the Cupertino Municipal Code Chapter U2,and the Health and Safety _ ,
p g tan q .p• - ow Yn m ap I t o DNb,.'Id Y e I
All roofs shall-be ms
ected priorroan r
oofingmatenal,bemg.installed
If a roof is mstalled'wlthout first obtaining ._..._
anrinspection;I agree'to remove
to J a re,nt mi t J•T till th Ba Ar A I Alun,g•meni
n t et .
all new materials for inspection ,Applicant and will h
comply with
OY i' [IN., ... ..
all non-point source regulations. .
i co-rirod the n .1 'i mat I q iemx dal Chapter 6.95'af.,he '
if qhb”
ingdoe&Suretynadyhave ans255o5.255A and 25534.I,maerstand than
fIng does is rren0y hnvrt ,,that it ieiny resPonsihilitY w,ndtify@c . - •' '"- ' '- '- ._ _.._. -( .. .. ..
ocf t require nes which inns,be me, aiorto issuance of saltie,to or SignatureofApplicant Date
.O1 rimdngen 8, 10 v. All roof coverings to be Class `B" oe better.. `
r . , .,- . . , _.. .. . _. .. _ .- .._- ... .._ .
.OFFICE -