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03010082 CITY OF CUPEWI'INO �% r„rn BUILDING DIVISION PERMIT �CON,TRACTORyINFFFFRMATIONn BUILDING ADDRESS' WALDRON CONSTRUCTION COMPADYRMITNO. 20060 RODRIGUES AVE # 12L 03010082 BE'S 41rNAME P 0 BOX 598 APPLICA'T'ION SHE DATE LAKE BILTMORE APARTMENTS 01/15/2003 PHONE: (408) 377-8186 SANITARY NO. CONTROL NO. ARCHITEC(ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH GZZ LICENSED CONTRACTOR'S DECLARATION HOD LICENSED Description GU¢F I hereby affirm that I am limned under provisions of Chapter Y(commencing P < with Sectio ]IMNp of Division Jof NC Businessand Professions Cnlc'anJ myliwwUB <"a mlull andeit INTERIOR RENOVATION Z O E2 Licen; lazs at.X 0 le—o Da�[�can,4�emr�� REMODEL KITCHEN/BATHRMS/NEW WASHER/DRYER & F set�'y 1X6 ARCIII'ILCI'S�DL}7 RATIOG N j IUnderstand myplans shall Noused prhimrecords WALL A/C, FL COVERING Ua LLia�0 Licensed PmPINAL lessinnal e® SOWNER"BUILDER DECLARATION k v e q I herchy affirm that I em exempt from,he Contractors License Law for,he following reason.(Section 7031.5,Business and Professions Code:Any city or county m MAR`R 2 5 2003 $ which requires a Permit construe,,alter,improve,demolish menu any menany structure prior Or its issuance,also requires the applicant for such Permit tu file a signed somemem that he is licensed pursuant n the provisions of the Contractor's License Law(Chapter 9 Sq. Ft. Floor Area Valuation a (commencing with Section 7011 of Division 3 of,he Business and Professions Code)or BUILD y $ that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant o a civil Penalty of APN Number C e n I ore than five hundred dollars($500). Y EYP I,u owner of the property,or my employees with wages a their sale compew,ian, do Ne work,and the structure is not intended or offered for sale(Sec.7044.Bnittess and Professions Code:The Coutractnes License Law docs not apply to an owner of Required Inspections properly who builds or improver thereon,and who does such work himself or through his own employees.pmvidctl that such imprvommenm are not intended or offered for sale.If, 101 — FOUNDATION however.the building or improvement is sold within one year of completion,Ne owner- 1O2 — PIERS, builder will have,he burden of proving that he did not Wild or improve for purpose o! sale.1 103 — UFER " ❑I,as owner of the property,am exclusively contracting with licensed contractors In 104 — REBAR construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li. cause Law does no apply to an owner of property who Wilds or improves thereon.and' 105 — ANCHOR BOLTS whocontnctifm ch projects with acomractor(s)licensed Varsuanuothe Conuac,or's License La 106 — SEWER & WATER []lame m this . B&Pe mr thlf ream. 202 — UNDERFLOOR PLUMBING �(Cti Dam 0 3 203 — UNDERFLOOR MECHANICAL ORKER'SCOMPENSATION DECLARATION 204 — UNDERFLOOR FRAME Ihereby alrmtunder Penalty ofperjnryone othe following declarations: 205 — UNDERFLOOR INSULATION ❑Thaw and will for byneCion 37 m of the Labor .11 Cods,sure for ecomaCompcm 301 — ROUGH PLUMBING svion,n provided far by Section]700 of the la Wr Code,for the psrtntmancc of,he work for which this permit is issued. 302 — TUB & OR SHOWER ❑T have and will maintain Worker's Compensation Insouciant.as required by Section 3 03 — ROUGH MECHANICAL 3701 of Or La Wr Code,for the performance of the work Inr which this pat is issued. My Worker's Compensation Insurance carrier and Policy theism: 304 — ROUGH ELECTRICAL ca er: I'd , 305 — FRAME CERTIFICATE COMP COMCM PENSATION WORKERS' TIONINSURANCE 306 — HOLDOWNS (Thissection necdno,Wcompmordif,W permit tabronc hundrcddm ($B larsx0 307 — INSULATION `tiles.) 308 — SHEETROCK 1 certify that in the performance of q1Ie wor for which this Permit is issued,I shall not 3 0 9 — EXTERIOR LATH lifo ' a employsny Person inany mantmr t surnectuuW Wo 'Cmeren anon Laws of Cante 310 — INTERIOR LATH Applicant you should 311 — SCRATCH COAT NOTICE TO APPLICANT:11,after making this Cisions 01( xab rtio d y � zbecome subject m the Workers Coons or this provision of the Labor Coke,you mus, 313 — ROOF NAIL forthwith comply with such pmvisionsnnhis Permit shall WtccmcJ revoked. 0 501 — FINAL ELECTRICAL ENERGY CONSTRUCTION LENDING AGENCY Ihercby from Nat there iso consW<tion lending agency for Performance of 502 — FINAL PLUMBING ENERGY C' > ,hcwork for which this permit isissued(Sec.J097,Ch,C.) 503 — FINAL MECHANICAL ENERGY 10 Tandct.INamc D z LcndersAddmss 504 — FINAL BUILDING ENERGY U O I'entry that I have read this application and slam in.,the above information is —505 — FINAL ELECTRICAL 0U umdingcorce,ocomply herebyth lcnhonsy and county ordinances of and slate lawe,upric uthe above-mentioned for inspection purposes. of this city 5 GAS TEST � ahove�mentionhJ pmpcny for inspection purpnsas. O7 FIN BI G (We)agree,o save,indemnify and keep inimical;the City of Cupertino against q rn fund itics,judgments,costs and expenses which may in any way owns,against said Ci IT tj N CAL U in consequence oI thr,�ranling of Nis Permit. ^ APPLICANT fRSTANDS AND WILL COMPLY WITH LL NON-POINT Issued by5 0 Date SOURC-F.R I NS. .14 fiL4 7 Re-roofs 514 — NAL PUBLIC WORKS Siyl rc o pplicankiCimuumr Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future Wilding owupant store or handle hazardous material s debned by the Contour,Municipal Cole,Chapter 911,and,he Health auk Safely h,Section 25532(aD 1/ All roofs shall be inspected prior to any roofing material being installed. ❑Yhs hJ'u` Will the applicant fir future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection, 1 agree to remove emit harardnus air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. District? 1l5<11 `�//N`' ❑Yes 1 N t. obas materials requircmcnu under CWpmr6.95 tritium Califor nits llcai Scninns 23NI5,2551J mJ 25574.1untMn,anJ thmifthe building does nue a mount,dto,i,is my responUility,o coaly thetccuparr of the trimusthotto1. .of.CeniBcamof. cap Signature of Applicant Date Owner Oranlloon,edagw me All roof coverings to be Class "B" or better CITY OF CUPERTINO BUILDING DIVISION PERMI TORIP 4 ' BUILDING ADDRESS: WALDRON CONSTRUCTION COMPM TJERMITNO. 20060 RODRIGUES AVE # 12L 03010082 OWNER'S NAME: P 0 BOX 598 APPLICATION SUB DATE LAKE BILTMORE APARTMENTS 01/15/2003 • PHONE: (408) 377-8186 SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH C 0 (� 0 00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm Out I am licensed under provisions of Chapter 9(commencing Job Description wish Sectio 7")n1 Division 3 of the Busi ea and Professions Ced,and my license is ��„ immula�.mit ffe INTERIOR RENOVATION z Ori'z LicenW�lana o oma— Dab _/�Cnn cow REMODEL KITCHEN/BATHRMS/NEW WASHER/DRYER & J�� ARCHITECTS D ARATIDN wF F WALL A/C, FL COVERING o U lynacatend ter plana small be used p9hrerecnH aH. G Licensed Pmfessmnal OWNER-BUILDER DECLARATION u� Z 1 hereby affirm Wal 1 am exempt from the C.mwMmr's License Law for the 600 following mato.(Section 7031.5.Business and Professions Code:Any city or county %$l which mquims a Permit In construct.alter,improve,demolish,or repair any structure Ho '^ prior m its issuance,also ms the lean for such f,zy tcyui applicant permit to Tileasigned sediment < that he is licensed pursuant to the pmvisionsofthe ContmetohLicense Law(Chapter 9 Sq.Fl. Floor Area Valuation (commencing with Section 71100)of Division 3 of the Business and Profession,Code)or — Nat he is exempt therefrom and We basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty or of core than five hundred dollars(g500). pPN Number cy Type I,aowner of the property,or my employees with wagers Weir sole compensation, W1,- the work,and the suuctum is not intended or offered for sale(Sec.7B46,Business 36903 008 8 d and Professions Code:The ConwactoYs Litems,Law does not apply m an owner of Required Inspections pmperty who builda W s orimprovemon,and whodm3 such work himself or thmugh his own employees,provided Nat such lmprowmenu art not intended of orteted for sale.If, 101 — FOUNDATION however,We building or improvement is sold within one year of rompletion.On owner- builder will ban the burden 9f proving Wal he did not build or impmve for purpose of 102 - PIERS "Id')' 103 - UFER D 1,as owner of the property,am exclusively contracting with licensed contraction to 104 - REBAR construct the project(Sec.7046,Business and Pro(eaions Cade:)The Contractor's Li- temsLaw does noapply toanownerof property who Wilds or improves themon,and 105 — ANCHOR BOLTS whocomtracislbr mpmjecnwithaconlfactors)tiawdpumuantlofheConmctora' 106 = SEWER & WATER License La ❑Is.e m th der . BA,PCorreaanm 202 UNDERFLOOR PLUMBING Owner i Date / 203 UNDERFLOOR MECHANICAL 1 ORKER'S COMPENSATION DECLARATIONI hereby 204 — UNDERFLOOR FRAME • nandwllmmuainaCertifyo(perjmyoneo(the(ollrefor orluersCous. 205 — UNDERFLOOR INSULATION DIhave and will to,by of Consent to Code,for the WorkeBCompere nation.a provided for by Section 3700 or the Labor Coda for the performance of We 3 01 ROUGH PLUMBING work for which Nis permit is issued. 302 — TUB & OR SHOWER D 1 have and will maintain Workers Compensation Insurance,as required by Section 303 — ROUGH MECHANICAL 3700o(Wc Ua rCo ,for0cprfmmanmofoeworkfor It hWis permit isissued. My Workers Compensation lnsunnce caller and ED,Policy Wr arc: 304 — ROUGH ELECTRICAL c' policy 305 — FRAME CERTIFI AThoCOMPENSATION INSURANCE 306 — HOLDOWNS (This section need not he completed if the permit is for one hundred dollamIS I WE 307 — INSULATION I lees.) 308 — SHEETROCK I certify Nat in thein any of a war for which this permit is issued.I:ham net 3 0 9 — EXTERIOR LATH employ any personinany manner • h • subjeu to the Wp 'Camper anon I Lawso(Califon' ate 310 — INTERIOR LATH Applicant. NOTICETO APPLICANT.ILartermaking this Ccnincatc Eacmption.you shcultl 311 — SCRATCH COAT become Object to the Workers Compensation pmvisions of the Labor Code,you must 0z forthwith comply with such provisions mrthis permilshall beaccmcdrcvkcd. 313 — ROOF NAIL y CONSTRUCTION LENDINGAGENCY 501 — FINAL ELECTRICAL ENERGY [. .. I hereby which Oat rmili issconswni097,Clending agency for the Performance or 502 — FINAL PLUMBING ENERGY g thework'sNameichNisp mifisissucd(Scc.7097.Civ.CJ 503 — FINAL MECHANICAL ENERGY Lender's Name ::;) z cod rsAedmss 504 — FINAL BUILDING ENERGY U O 1 century Oat have mad this application and sum Oat the above information is 505 — FINAL ELECTRICAL buildW (_. bandit l agree to comply with y authors oclues o itives Of and rote laws relating to C) U albovcngbotionedionardhemhyauthonp rposes. tiwsofthiscityfoenteruponthe 5 GAS TEST W above-mentioned agree tos save, forinspectionan keephs. O7 FIN BI G gkr (We)a&me to save,indemnify and keep harmless the City of CupcnhO against v) liabilities,judgments,costs and expenses which may in any way accede against said City 5 N CAL / U 7 inconu P3pplicanUCon'tactor rantingO do'permit ate— APPLICASTANDS AND WILL COMPLY WITH LL NON-POINT Issued by. Date SOUR 3 Re-roofs 514 — NAL PUBLIC WORKS Stew rtDam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will We applicant or future building occupant store or handle harallous material sa defined by lie Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Code,Section 25532(.)7 All roofs shall be inspected prior to any roofing material being installed. DYcs o Will the applicant or future building occupant use equipmcut or devices which If a roof is installed without first obtaining an inspection, I agree to remove Omit haardm is air contaminants n defined by the Bay Arta Air Quality Management all new materials for inspection. District? DYcs 3�Nu I hawma the hamNo-uslmaw rials roquimmcnts under Chapter 6.95oftheCalifor- niaHcalth&Sall Code.Seudnn,25505.25533and25534.1undctsundlhmifthe Wilding does.1 c y hews romans,Wm it is my responsibility te notify the mcup.,of OR HIM to I'b!masl OorwhHoNceoraccm"'7 bap c Signature of Applicant Date Owner He euthori.d ager bee- All roof coverings to be Class "B" or better CITY OF CUPERTINO m 1 of 4 PERMIT RECEIPT OPERATOR: 3onniew COPY # Sec : Twp: Rng : Sub: Blk: Lot : APN . . . . . . . . : 36903008 . 00 DATE ISSUED. . . . . . . : 01/16/2003 RECEIPT 4 . . . . . . . . . : 20864 REFERENCE ID # . . . : 030.10082 SITE ADDRESS . . . . . : 20060 RODRIGUES AVE # 12L SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : LAKE BILTMORE APARTMENTS ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : SAN MATEO CA, CA 94403 RECEIVED FROM . . . . : LAKE BILTMORE APARTM CONTRACTOR . . . . . . . : WALDRON, ROBERT LIC # 21547 COMPANY . . . . . . . . . . : WALDRON CONSTRUCTION COMPANY ADDRESS . . . . . . . . . . : P 0 BOX 598 CITY/STATE/ZIP . . . : CAMPBELL, CA 95009-0598 TELEPHONE . . . . . . . . : (408) 377-8186 SE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- -- - ---------- --------- - ---------- ---------- ---------- -- - ------- BENERGYADD PLAN SETS 1 . 00 22 . 20 0 . 00 22 . 20 0 . 00 BPERMFEE VALUATION 34 , 660 . 00 380 . 00 0 . 00 380 . 00 0 . 00 BPFIXTURE UNITS 2 . 00 16 . 66 0 . 00 16 . 66 0 . 00 BPLANCKADD PLAN SETS 1 . 00 22 . 20 0 . 00 22 . 20 0 . 00 BPREPIPE NO OF FIXTURE 2 . 00 16 . 66 0 . 00 16 . 66 0 . 00 BPSEWAGE UNITS 1 . 00 62 . 16 0 . 00 62 . 16 0 . 00 BPSEWER SEWER SYSTEM 1 . 00 19 . 98 0 . 00 19 . 98 0 . 00 BPTRAP NO OF TRAPS 1 . 00 8 . 33 0 . 00 8 . 33 0 . 00 BE`� EC200 METERS 1 . 00 22 . 20 0 . 00 22 . 20 0 . 00 13P ENT UNITS 1 . 00 8 . 33 0 . 00 8 . 33 0 . 00 PPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00 BPWATER UNIT 1 . 00, 8 . 33 0 . 00 8 . 33 0 . 00 BREMAIRHAN NO.UNITS 1 . 00 8 . 33 0 . 00 8 . 33 0 . 00 BREMFIXT NO. FIXTURES 8 . 00 8 . 88 0 . 00 8 . 88 0 . 00 BREMINHOOD NO UNITS 1 . 00 8 . 33 0 . 00 8 . 33 0 . 00 BREMRECEPT NO. OUTLETS 8 . 00 8 . 88 0 . 00 8 . 88 0 . 00 BREMVENFAN NO UNITS 1 . 00 41 . 63 0 . 00 41 . 63 0 . 00 BSEISMICRE VALUATION 34 , 660 . 00 3 . 50 0 . 00 3 . 50 0 . 00 EPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00 MPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00 ---------- --------- - ---------- ---------- TOTAL PERMIT 773 . 16 0 . 00 773 . 16 0 . 00 • a s C '- • • CITY OF CUPERTINO r� o 0�2 CUPEkTINO PERMIT APPLICATION FORINT °3 • APN#' Date: Building Address: ;?evWl 7 ka-Inar Ale, #/vZ L Owner's Name: Phone#: L-AIC6 Bit.rwRe ApAerMaxY5 GSA 5q6-5300 Contractor: License #: R.W aoA �ous-reucno�l (arc. 7��137 Contact: Phone#: 'C-�{tel wgm6lz (kir MAa,A&ee. sa sq 6 -53x 8 Applicant/Contractor: Fax #: LACE L ORt; APAOTMEW� (p Sb 6- 537 _Buil ing Permit Info: i, Bld Elect Plumb Mech`- Job Description: N td2 IZexial� IANC UN nDf.&o KITWvAj � WeW w4swaell /Aei Residential: MtlLT �nM l_ lu Commercial: Sq.Ft. Floor Area: $/Sq.Ft.: 1000 SF. Architect/Engineer: Valuation: kAYMUA100 STAMP-C-9 !S CIfj Q 2$S (060 Type of Construction: Occupancy Group: K1 Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAX13Q Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax -Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V <=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi-Family Res MECHANICAL BNEWMULTI New Multi-family Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL • BNUCOMMM -New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING &a6 6 Iof3 4 :am, CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORINT CUPERTINO Quantity Fee ID Fee Description Fee Group BNUMULTI New Multi-family Res PLUMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINfERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING l BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain&Vent PLUMBING BPWATER Install/Alter Water Pipe PLUMBING BPWHEATER Water HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Re-inspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAMHAN A/C Units<= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL 8 BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rcpt), Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL • BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR I Theatrical Lighting Fix ELECTRICAL 2of3 fr - CITY OF CUPERTINO CITk PERMIT APPLICATION FORM . INO CUPE(Z,T uantity _ Fee ID Fee Description Fee Group 3REMVENFAN Vent Fan Single DuctMECHANICAL _�sREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSF&2FAM Single & 2 Family BUILDING BSFNA Single Family New Add BUILDING BSPECIAL Special Inspection . BUILDING RBTEMPSVCS SWIM SwimmingPool BUILDING TEMP Temporary Power ELECTRICAL TEMPPERM Temporary BldgPermit BUILDING Tem Dist Svcs ELECTRICAL USLIC Business License BUILDING LECTRIC Electricals foot ELECTRICAL PERMITFEE Elm Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILERS Boiler> 1.75 M Btu MECHANICAL • 3 of 3