01080078 CITY of CUPERTINo
BUILDING DIVISION PERMIT -
CONTRACTOR INFORMATION:
BUILDING ADDRESS' +. PERMIT NO.
20060 RODRIGUES # 7J WALDRON CONSTRUCTION COM ANY01080078
APPLICATIONS B DATE
°EtfXk.1L4A1§ILTMORE APARTMENTS 73 HERBERT LANE 08/15/2001
PHONE: (408) 377-5186 SANITARY NO. CONTROL NO,
O z z ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
=I
i LICENSED CONTRACTOR'S DECLARATION Job Description
o="—o rcbyaffrmmminmllcensedunderprmisiansofChap¢r9lcnmmencing INTERIOR RENOVATION.
m
I-ad with Section 7000)or Division 3 ofihe Business and Professions Core,and my license
i:lnfiallheeanderf«t. (REMODELED KITCHEN & BATH, NEW WASHER/DRY
z.� a License Class Lia.N
xodu }Date SDECLA WALL A/C, FLOOR ACOVENE.m 3 a v - ARCHITECI"S DECLARATION
t,u O a 1 uneersmndmy plans shall be uxd as public recurJs
WN /twin,i p Licensee Professional0OWNER-BUILDER DECLARATION
i hereby affirm that 1 am exempt form the Contractor's License law far the '
(_z< following reason.(Section 7031.5,Business and professions Code:Any city orcuunty-
S i 0 which no,iiine,.pcount t construct..It p e demolish. repair' any lumne
a 3= ,
pruntous issuance,alsoq the applicant forsuch wount torite a signed sneemern - _--
but La licensedp est ounsfo,mn'ril'ims,ofthContract.,,License L (chapter9 i5 . Ft. FIOOf� rea
Auation
(commencingwithSectona000)ofDivson3oftheBusnessandProfessionsCode) . 'L9 , . .. - . . $346��
or no,he in eiempt uarchma and he basis for the alleged exemption.Any violation
-of Section 7031'.5 by any a0plicanl for a permit subjects the applicant to a civil pacify Occupancy Type
of n/n re man fee hundred dollars(1500). - 3694PJ739ol
Ly,l erafthe property,or my employees sarin wages as their sale compensation,
will do the work,and the structure is not intended or offered for.ale(see.7W4, 101 - FOUNDAT IEQquired Inspections
/Business and'Profession,Code:The Can numor's License Law does not apply to an
owner of property Who builds or improves thereon,and who does such work himself 102 - PIERS
.1 through his own employees.pros dad that such inprossuracra.am art itended m _ _ .._....... ..... ._. .. _...... .. . .__ _.... _
..........
-offered for soh.IL however,the building or improvement slam,s-sow within not year of -103 "-"TJFER'
completion fim me owner-nnBaer will nage me Mmlen orpnwing mat hedid not build or 104 - REBAR
i, p f v tp. f l .1 "
105--sANCHOR,BOLTS
w rola p
.
Perry.am Lodusisely-cournmetag th licensed n
construct me project e01a Business and Professions com:7 The Contractor's
106 - SEWER & WATER
Lawdoten .ppI, oa,ownerorpropory who b ld lapin s,M1eeoq
and out for wip ler . m mamo air aapnmPantrom
'.
ch
202 — 'UNDERFLOOR:PLUMBING.
t Loss
Cf ft t v. ner er B&Pcr his 203 — UNDERFLOOR' 'MECHANICAL
owe o,dc8W 2 04 — UNDERFLOOR FRAME
' 7; '\ RKE 'SCOMPENSATIONDECLARATION 205 — UNDERFLOOR INSULATION
1 thereby affirm under penalty olpermrr.'ancof the following a It n: 301 - ROUGH PLUMBING
01 have ad will ism u.Cialifiton,of Consent'a leff-irome ror Worker 1 3 02 - TUB .& OR SHOWER
c cc t aa,Provide s for by s to,-3900 of m Labor Code, for me 303 - ROUGH MECHANICAL
p f , e'of the k f Lch this permit sued.
°IM1 ndwill m t' W1kersC P, i msumnre+sFeq,rdobyseen
an 304 — -ROUGH ELECTRICAL
-`-. 3100 of he Labor Code,for me jerf mrow,of the work ran whim oris peman is 3 0 5. - FRAME
issued MyWorkers C pe t Ina a a,dP y mer." „ ,.--
. :, , 306. HOLDOWNS ,,.
..;'Pour'N, -
i• . !CERTIFICATION OF EXEMPTION FROM WORKERS- 307 ` INSULATION
_.. .- .COMPENSATION INSURANCE -- .3308 09 - SHEETROCK_..
'tTnis sedon m d not becumpleiee if me perm t is ft,mot harmad douem ERI OR LATH
31& - INTERIOR" LATH __.. -_._... ,..,
i
Iciatirythalm the pef ,ce rte d,ba-whiieladhParmils issued,1 311 - SCRATCH 'COATshall mut L'
:NOTICETOA yany aosifC t adin n p so its t lacrossesubjectt m W knrs
Compensation L ....313. ROOF. NAIL
Applicant -- , 501 FINAL ELECTRICA._ E
PrueArrr R rt k n c t r t f E- pi yes n sad _ L ENERGY
Q O~fA 'ne n n) ones LobdrCrad,:,miai
forthwith comply wtn suchp s npt.rbe eked - 5..0 2 FINAL.....P..LUMBING ENE-
RGY
CONSTRUCoONLENDING AGENC503 FINAL MECHANICAL ENERGY '
.
In by R mtmoa � ivgyfrmepdnm,nce _ FINAL BUILDING ENERGY"
Q ,h nrnm pe t a(s iagccltNm , 5 _ FINALELECTTRICAL�,zed Address 50 ..
. _ .. ..... .
GAS . . _ .- ......._.
V-0 1 lonift that l bule readd ppl and Ince 111.1th M f miot .c—
I&
c
i&- set I a t ply th a ity ad ny r ' d t t l retatng 507 - FINAL PLUMBING
O: J nildingconstrucr andnerebyanm representatives sstytoenternp°
U 508 — FINAL MECHANICAL
�+ 'tn above mentioned p p rty f, inspection purposes.
a
to t e ind nary Jk keep m ct5 tCupertino,E last 509 - FINAL GRADE
Z) I b l' tent 1 d e P n h y in any a} c saga -t,mid
Utz etcne ' tin g' n,,ofdavariant. gym"
510S - NA INE
APPL t RS tCD WILL COMPLY NIT N OI.T' IS sued�g: Date
OL A9 �tuft o.
a-ir,mum, Applic ticD - Data Re-roofs
p ILA OUS MATERIALS,DISCLOSURE
Will the applicant or rumrc handling oleamunt store or hairdle anandou,mmerad Type of Roof - - - - - •"" "'""'
°Y °N safety All, shall be er
Code,Chapter 9.1 dtheH It ,s
as defined by the Cupertino Municipal and +
Code.S t o 2553 hal
p cted.prior-to any roofing material.being installed.-
If
nstalled ..
• Will m apps t f n m ng p t ose q 1 m J ie laces If a roof is installed-without first obtaining an'inspection;d-agree to remove
hazard s t t is as Ediradby the Bay Area Air Quality Management
District? all new materials for inspection.,,Applicant understands and will comply,with
❑Y •o hyo
all non-point source regulations.
r '
I h rea0 tM1 Safety
Co uv�niat q nems anderChapter ersta d the
Calf mi, iealth&Safety Code Seu o .255115 5577 and responsibility
1 undemmne tthe _ ..... . . . . . ... .- ..._ ._ -.-
fthtbuil ng does) t-earnestly hate amain,- thin it is
e.p nabJtryao notify the -
ixf pant f t "'Ta"
e4 m i ouch must be' e,Prior to' ce or a Ce I cone of
o<e p >: g Signature of Applicant
Date
'Ohm rr a,mod:ea estt,Dole All roof coverings to be Class "B" or better,'
` L . OFFICE. .. ... . ..