01080077 CITY OF CUPERTINO
nutuotNc DIVISION PERMIT CONTRACTOR;INFORMATION: a
BUILDING ADDRESS PERMIT NO
20060 RODRIGUES ## 8J WALDRON CONSTRUCTION COM ANY01080077
APPLIc TIO UB ATE
° WAIILTMORE APARTMENTS- 73 HERBERT LANE 0812801
PHONE: SANITARY NO. - CONTROL NO.
i (408) 377-8186
BUILDING PERMIT INFO
t�i O O ARCHITECT/ENGINEER: BLDG ELECT PLUMBMECH
E-
¢u�i
8?i LICENSED CONTRACTOR'S DECLARATION lob Description
o-z=p Ihereby affirm that Iam licensed under provision.,of chapter 9(cammen<ing INTERIOR RENOVATION.
F,;,l-.m with Section 7m0o1of Divisma3 of Bueinessand Professions Cade.and my license
c,.-< is in full force and effect. (REMODELED KITCHEN & BATH,' NEW WASHER/DRY,
S . License Clan Lie.M
K o,, Date Coati for WALL A/C, FLOOR COVERING. )
ARCHITECT'S DECLARATION
o-,0 1 anderaand my plans snail be used as public records
cri
utt
ce C p.0 -Licensed Professional -
c 6z OWNER-BUILDER DECLARATION
�u 1 hereny affirm but I am exempt from the Con ractor'.s Liame Law for the
following reason.(Section 7031.5,Business and Proleo ions Code:Any city or county'
Met p whicheq issuance.raiit to construct alter,improve,demolish,or repair any saveuve
se 3 ei ..p. Permits,titapplicantf such penritt fl signed statement --�.I - -
door be dp trthprevisions of C tract..L e L (Chapter9 ;Sq. Ft..Floor Area _ $346 N"Ouatlon
n
(co menc ag with Section 7WO)of Div s t n 3 t f he Business and Profession,Code)or that he is exempt therefrom:md the bmis for the alleged exemption,Any violation
f Section 7031.5 by any applicant for a porea t subjects the appl'mnnr to a civil penalty
/000mnthan
eve hundred cup... SSW). 3 6 98FAY8Vl0 Occupancy Typee
werorhe
Property,ar my employees with wages Yx their sole compensation,
will do the inwork.and the stnemre is am,intended or offered cr sale(Sec.7044, 101 - FOUNDATII�
Busess and'Piorewme,Cade:The Contractor's License uired Law does act apply to an Inspections
owner ofproperty Whbuilds p thereon,and who does such workit If 102 - PIERS
or through his own employees.provided tit t suall' P t t intended or'officred for 1 If.however. it building r improvement is sold w ithaty
f _ 1 UFER
the msm,,mmkh,,n r p rp 104 REBA
R
as owner arrive property.can exclusively contracting Ithlt od1 1 105 — SER _B �._..-Z.
project(See, D4Business
and
Ponde:)The
Crac`tr's 106 WER & WATERcast h awrartna)1inmanowdPwhabudsTo . Ma d tsn
pra
T temL L
nae oaPc rthnsreson 203 - .UNDERFLOOR'MECHANICAli
o amp
1
.
_.
Dare o m 204 - UNDERFLOOR FRAME
WORKER'S WS ° 205 - UNDERFLOOR INSULATION
',. I hereby affirm under penalty of Perjury one or the following declarations: 3 01 - ROUGH PLUMBING '
0 I have and will maintain a'Certificate at C...art tP self-insure far Worker's 3 02 - TUB & OR SHOWER -
Compensation, as provided for by+Sectmn 37M of the Labor nate, far the 303 - ROUGH MECHANICAL
.'1arr of the work f nthis p tissued, -
o I hose and will m t w xers Carafferearpon insurance as rats red by Sectio 304 - ROUGH ELECTRICAL
3700 of the Labor Cuske,fartheperformance of the work for which this permit N 3 05 - FRAME
issued.Mr Workers c pv , , Insurance i cy No and P 1 y n r are: ' „ . . 306 - HOLDOWNS .. .....,..,..
o.
+ CERTIFICATION OF,EXEM PTION FROM WORKERS' 3O7 '.INSULATION l f
pxs xect da nail not hi carimlatcd one permit is nr. a<h 3 0 9 EXEETROCK_ _
COMPENSATION INSURANCE308
unfired dollars
(Sl Wl ar less.) T'SRIOR LATH '
ldeworkfrrwhich to rmanawoued.I 310 . INTERIOR•• LATH
bill not employ an n' p 1nP 311 - SCRATCH `COAT
I ,:
Data Compensation any
fC 11 a:ohm ,...
.
Applicant � .. . . . �,. ..313 ROOF .NAIL.. ......., ..... ........ .... ._ ...... _.:---
fNOTICE TOAPPLICANT:It,ff. -making n..cnfeatafe -pf ,younuld 501 FINAL ELECTRICAL ENERGY '
z beemame,tobjecturneW kers Cnaffer,aluenpno iml,mth Labor Code,you nus'
O
forthwith comply wthch provisions or this permit shall be deemed ravolkad. 502 FINAL PLUMBING -ENERGY
HO ': cONSTRLCT1ONLENDING AGENCY503 FINAL MECHANICAL ENERGY'
I picarby affirm that thconstructionle,duag ag ,fir for the parfor sante
f the work lor which th recruit,ssissued rs ,a
m o 7.Civ C1 504 - FINAL BUILDING ENERGY
O:z Lew ndare`x , . ` . ......5.06 ...-- GAS TEST , AL,. _. . . ...__... . . . . ... ... .
aft " 9 505 FINAL_.ELECTRIC
UoQ
�cae,Iasince to comply wi
omplyvithallcitya"nd county
o,linoand
nl Istate lawr relating
s
507 - FINAL PLUMBING
constru<tmna,dhereby aumonicmpresemativesormiscity toenter open 508 - FINAL MECHANIC
AL
to building
the:mase-n mioned progeny[or lnspemmn purposes..
rwe erect.suse indemnify and keep harmless the City 6r cupenlno against 509 - FINAL GRADE -
F`V] 1 mems lost,,ad.expam Inch may is a y y e,agalmt said
v cry tie
come g.rth 510 - F NAL L I
A PI I;AN U J' STA DS AND WILL COMPLY WITH At -PO �y,
R c�.AT 'ssr . . O Issued Date
'p t eatpylic. ,/C cror.r,.. ' ' te" Re-roofs
HAZAR US'b1ATERIALS DISCI OS URE
Will the tjipliarat or future builikilie occupant store or handle hausindiaLs material -'Type of.Roof L _.,.. ...
defithe coven Municipal C 1 Chapter 9 12d theHealth and Safety
Coded S Sce i(e,3553 U '.
°v °" All roofs shall be,inspected prior to.any.roofing material.being installed.-. .
AVill the imphoull I.,...hadtfing a,r,aai ,a ampi,priamor dies loch' If a roof is installed'without first obtaining an'ibspectton;'Fagree to remove
emilhazardous an t n l,s deproulby he 13Area Air Q hl,MancoNmard
•
rating? all new materials.for inspection., Applicant understands and will comply with
°t` q". all non-point source regulations._
, tf.,. ,
1m�read mate nk I ems d Chapter m95 or the:
Cali i Health@SafeyCL a,Sects 2550525533and 25534,l,rnaround that
r .if th'bi ding does, t neb,ly hive at- y ospois,b,r'ym notify the. - ... . . - ._. . . ..._ .. . .. .. -.. .._ .. .,. .... _ .
m;ttiot h is m
t.a< Pa of "46i ancer,which most be met prior mc of b C ''i1 to aL
Do p ' �j/�Z O� Signature ofAppli_cant Date
'o tie 'mmlicopi eat .Date All roof coverings to be Class `Bs'or better
. OFFICE .. ... ._ _. ..