00080030 qr.
.. CITY OF CUPERTINO "' _ =� "
^ -BUILDING DIVISION PERMIT- ' CONTRACTOR INFORMATION
NADDRESS - PERMITNO BUILD -
r r .I•.tl
!)WNFR'S NA E 4' '. ,1 t' ' APPIJCArIONSUHDAIF .
# 001'0 RODRIGUES .# .9H WALDRON CONSTRUCT'IO do ," IY00070126
PHONE: SANI'IARV NO, CONTROL NO.-
LAKE 'BILTMORE' APQRTMENfS � d7�3 'HERBE'RTkLANE- Idi- `2I/,2000 K 'r
❑W"❑ ARCHITECTBNGINLCR - t, p ' p i BUILDING PERMIT INFO
• may, , v dr J408) 377-818FY. BLDG' EI F.CT PWA113 MI CII
' H LICENSED CONTRACTORS DECLARATION + "Job Description
to
I h by a0 d I I I' - L andl l CI PI 91 g _ 1
OZ E wth dS I 700(b ID 3 IIheB Ilnfe,: C 1 and niyl t r v
q$ i,is r ll f rc d rf 1
Lir ,e Class L # f >9
O a O De Contractor i i.
W a.a ot '1- -ARCHITECT'S DECLARATION •• - `3
1O� I d r d ,P1 ,shllben,rl . Pbrereordn '" REMODEL `-
OWNER BUILDER DECLARATION 1 , w
-m II eny'ff hit Iem
1 e des, II C I I L Ih
F < toll d, (9c 7031.5,Besides,and P f '- CW Ay ly 1)4 r ' (• '
❑ wh b y P II c I nl 'll P d' I'.1 P Y,I Iu • 3 - f 5
P- I c- I y IM1 PPI' f I '1I I 6 1:1 I
mYYY (com 1 In 11 IM1 n -' Ill Contractors L I (Chapsm9 Sq. Ft..Floor Ared . ' � Valuation
(auto na c e with al Sem 21100) t he i f Ih 11 d f: i Cody)
or that he is exc npl therefrom and the basis Por the dlegrJ axe nit , Aly violation "
orSe Aien 7031.5 byny'PPI If P ' bl ,Ina ap,li Ila CI,IPaa-
nr
not 1.1111 lean filed Landlord dollars S500) • APN'Number - Occupancy'Type�
❑I,�,ou le'of lM1e 1 I 31 the[. rr 'In, \ 4 t"'. $PC win VI
-.r.
will tl 11 k PI ITh yl I y 1 I d I r, ft d f (Se 70,14 u ' r
Blamer c Tn C I 1 e 1 t eva P Required Inspections
fP„),art,WM1 mild, P there. r I 1� ,
oorthrough n PI y P l d m In P 1 1 - I I ',`..3891013008 00 :I t
to If I dt.h ih h if g P cl II > I',+
- jam---' -
c III 11 b Id will Ih h d fp glht Id I •'
'PP I P P r ) k' 'x101 .,FOUNDAT'ION•. 1�
Tyr” rn , p Iv Iy lraclin g'wm) I +j l OG --: PIERS . O �
Co 1
c, ],a P 1 I(S "ldt4 B : e P r qd:C'' ) pi c
Lr L does I apply ear - `, P rY n brother P- '.DEER .
Ina n 'Imposed,r n n de<I,wm I ,in, d, nan11 II -. 104. -I REBAR — 1
G I e. 1 _—
❑lanexrn de-Se' R&PCfnnhls re. • ' -
owacrA�/-a'tl'D'fl - t .105 ANCHOR- BOLTS -
10Fa _ 'SEWER d WATER'
WOkKFRS \PF.NSATION DFCCAR(TION ,
rd d> rP I D 1 n1 .r, 11 g I I e _ c0� '-UNDERFLOOR.PLUMRING
n 1 ,
I h u den ri,r aO sale of Consent to Idf-orame clot tWorker c0� "UNDERFLOOR 'MECHANICA(
be aofdaw< kf wnahthis rs „nee.•' _ .,~•-- -R04.,-� IIJNDERFLOOR.-FRAME
❑lo- and 11 amrlw k c Pe 1 r q d by Retails - : ,205 �,— " UNDERFLOOR INSULATION.
- 3900. I IM1 f bor Cod"f B P tlon l Ibn wok f I.1'd i,Per 1 - , I
aMyw k,, C 1P a1 Maur 'and Pol y h , , 301 r ROUGH. PLUMBING .
'.Us ' '- .. - Policy N .t. . . , - 302 TW}3, -d •OR'.,SHOWER .
° CERIIFICATION OF EXEMPTION FROM WORKERS -
w COMPENSATION INSURANCE ROUGH"MECHANICAL
304 ROUGH EI EGTRICAI
(Th I' edn lb mPl Id fII P I'. I one d dtl II ol
-
'+ (suol I >. _FRAME` - ''�, •• t
4 . I Ilya Lind "'fin fm kU- n! nm Pr r ' d 1 ,.306 — 'H01_DOWNS hall ad,
COU and Pi > -vP v n ne<.,to nl n IeW lar,' .-r . 's ,307.•.— nINSULAT,I,ON -
Cu Pc I 1 nw,of r f i a.Data -
NtTICETOAPILICANT II fI k gd C it I 11 li y should 3 f-
",z ' oar 1 ,,b,,,t naw k c n 1 P nn I b c 1 308 r SHEET,ROCK-
OrO redl ithC anywrn I I v,onsorthsperul.dlallbel wireuked. ) x :309 EXTERIOR LATH
cONSTRUCTIONLENDmrAGLNcv _ 310 INTERIOR-LATH,- ,-,
H 1 hereby fr that II I cl 1 ad ng age cy hernia Illy Pcrfurn
W A �n work lr nahm permit ,ame ned(s .3omCI.Cd 311 =, SCRATCH COAT
= z Leader mi Add s: 313. .—' R01_IF NAIL
v O dTythat ln dm': „III that the above information` 1501 r FINAL ELECTRICAL ENERGY'
W Fy,
correct I g k d nNy w 11 11 city I Iy d T a l :Islands, N
O v. Inn 1rg 1 I , dl b> d P Ir nn cityyl I , 1 50?_ — FINAL -PLUMBING. FNERG,Y
the ( dv 4 tyI Pont I to e
H.a
-(Wit) gran 1 . ry lc Pn I therl> fCP e' 6 503' — FINAL•MECHANICAL 'ENERGYr
.. z haM1nc,.lne n, a� n n y l.nv v leag�nl I 504 ' FINAL"�•BUTI_DING -'ENERGY i 'r
C.7 I"L APPf A 1 DERSTA�gry II�ND WIdriLL COMPLY WITH ALL NON.POI q
sor�lf�E�loNf/V�/l.Udi " �_ 1lssuedby: ri01A', -' FINAL ELFSTRT6f1L Dale .
slya r rAPPrcanuL 11 I _ t Dal ` Re-roofs 506
— GAS TEST >~ ,
HAZARDOUS MATERIALS DISCLOSURE dat f1 blrg Pn.i nn l anleal Type of Rol FINAL PLUMBING :
n,definedb>mcPI M PalCor Cltllv0a2'ladd Haid Old Safety .508 FINAL MECHANICAL-
Cod Section 25532f.) � .. � .. ,
CI yet, 'pNo All roofs shaffjoi4nspe¢F'cVWpr t(gRporfing nraterial'being�installed.. ,
W II fn spath o I f 1 not Id g ...... y P I I It 1f a roof IS i1�jl&d_witfiO�l�t 9biLa�gj9g1 if k1spectlon,.1'agree to remove
enllh d rvo1 v,dell Ib)Ih Bay AarIAir Q Ply Mul.g n
Di'dict, _ albnew m2teeif� foTjn p�ql�'�( p.�p ;algt�Jn�J�jy(,��.,W�� and well com 1 with
❑Yen El No f fl.Jfjl._lL,WIJKRO -PY
all non point sourcereg�lhtSdS
.1-lel,t,rod the Iretando., r on,occoact,order Chapter 6l5 of tiro - Is t -
Calhm'He'IIh&Sa(tyCd Scarabs 2550525533' d 25534140IcrvlaWlist ,. '3" r
Ire
11 bill d 1 IlyhI Ilh 11 yr P hl'Iyl II Ih
5 cr 0 Ila be al 1"1 n .eh aIPdnos c IaCrrlllel
°c a� - Signature of Appheant' Date "
o � � DUlev All Kopf covering's to be Class M" or better _
. iOFFICE. , - ., r 4 -
INO
CIBUILDI cmVISION CONTRACTOR INFORMATION: ILRMTreo.
PERMIT
HUILDI NO ADDRESS: '[ - "• r i
SANITARYNO. APPLICATIONSUBMITTAL DATE
OWNER'S NAME: WRLDRON 'CONSTRUC ION COMPA IY00080030
NICCONTROL#
PHONE: LAKE BILTMORF_ APARTME TS 7.3 HERBERT LANE. �� ` 0B/t?14•/2000
ARCHITECTiENGINEER - - BULDIN'O PERMIT INFO
�oo ° (408) 377-8186 .
Z
o i LICENSED CONTRACTOR'S DECLARATION *' •'
OZI hereby afrrra that l am licensed under provisions of chapter 9(commencinti Job Description'
1-nt'+� with sxsion]000)orDlvisionJnrme 9usiMa..red Rnreumn=code,arta my rcevem
'J In full force and effect.
5�o g u ueenK a.ra .. u,:.'« I NTt REMODEL .
u�3,,, Date . .ConVacwr •'
5 a O; - ARCHITECTS DECLARATION
N Y, , 1 und«s my phos sI I M us«I u public roads I
a g ,�
Licensed Professional
u-1 Q�N ', DER s
C n 1 Wmby arcrtn 1hu'f x t f th �•oIsm en Lew f he -
otoll .three. (c. Sohn]WI5,Bu s d nom -'ty« ty
sm, wmrn«�,;Rx°a,,,,'ro m,abp" } -- I - 'S Ft. Floor Area - Valuation
pnmt t amnadsoWBlrt iv tfors roto u fa ret .."Is
mel he a licensed gmuuu the Pr'n m the mcmrr l: (CT 9 - _ -. ,
(comm=ncmgwrm5en 6]000) fDv� o simsv Of f nil Cotl -
thatheWexemptme«rrom.din b rnr .l ed axe pt A im.t�Ia i APN Number r; ; Occupanc$;TFj j00.
Semon]031 5 by any epplieiptaar a �I,uta i t e applicant-to a.wil penalty of
rot moo Nan five hmMrcd dollen(S500).
❑I.aanwmnrdxPmprtr..rmrmWor •withw.gaWmvmh=ompmuov. 3690318ui0�jlnspections --
will doi 0. Ofk.atrdmeaVmtu.l3 trot IntercIntercom!cor oRcnd for We(S«.7W,Dust.. —'—---
and P,ofnaiom Code:The Comrrcror'a License Law des nm apply to an..or a �
property who builds or improves Merton,and who does such work himself or through -
his own employ«s,.pmvidod Net such improvements are not intended m o8cred for - 101• — FOUNDATION -
We.If,however,the wilding or improverni is sold within one yearofconpletion,the 10� — PIERS
ownmWild«will have the burden of proving that M did nm Wild of intensive for pts-
nf""'' 103 — LIFERI.u ower m the property,,B exclusively confessions with licensednntnnon m '
ci mepr}e=use=.]con .aiesaand Professions Code abeContractor's Lt. 104, —!' REBAR'
come law does not apply to an owner of property who builds or improves thereon,and
who romrahfoes Wpm;«ts with aeono-.morf0 Teenage.......the Contratnrx 105 ANCHOR' BOLTS' -- ---
ueenW M .
of m e S'«. B�Pcr thi 1.06 — SEWER R WATER
own« Dain 202 — LINDER FLOOR PLUMBING
WORKER'S COMPENSATION DECIARATION. 203 — UNDERFLOOR MECHANICAL'
• I hereby.Rum and«penwy of p«jury see orme Fnllavine d«Ivetiom: UNDERFLOOR-
p lMve and win mnhuin.Cmifom orcnnagntmreR.mmnf«wmkeracompen- '204 — R FRAME
Winn,u provided For by S«tion 37W of the labor Code,for the performance of the
work for which this Permit is issued. '! '. 205 — LINDERFLOOR INSULATION. -
0 1 have and will mmnuie Workers Compenm um Ino mese,m o9uirest by Section
3700nfine Labor Code,for me poformance off work for which Nis permit is mood. 301 ROUGH PLUMBING. 1 .
My Worker;Compensation lnsunnce cam«and Policy number are: 312 — TUBg. OR SHOWER
Carrier. Policy No.:
CERTIF,CATE OF EXEMPTION MOM WORKERS' 303 _ ROUGH MECHANICAL
COMPENSATION INSURANCE _ -
(This «6606«olnotxcompl«mifineFrm,6forms,h.odreddollaa(Siao) 304 =' ROUGH ELECTRICAL
mem.) ' 'I 305' — FRAME .
Icenify that I. pay Manor
as t week for which this the WorersuCo ph.11ion- , u
WiturLaw,ofifoniArm n«e neato become subject to the Workers enmp n- 306 — HOLDOWNS
' ..tion laws of CaliforniaCiDate - -
Appli`on, 307 - INSULATION
.NOTICE TO APPLICANT' If,after making this Comfic.m of Exemption,you should
b«oma subj«rise me Workers CompenWfion provisions of the Labm Cade,you Nun 308 — 'SHEETROCK
.Nodwith comply with such provisions or this Permit shell W d«med revoked. - .
309 '— EXTERIOR LATH
c0them UC ION comma LENDING AGENCY 310 '— INTERIOR LATH.
p IWrwhichvmt Pem=ro issue (Sm.3nlmdiy,C.)agency for p«fom,uee of ` �s - '
z Newer,for whichmixp mifisissud(Sa.J09],Civ.C.) 31.1 SCRATCH COAT
IY Leader,Name _
I<ttden Address 31:5 ROOF' ,NAIL-
LS7.0 Icenify thu 1 neve read Ods application and sec that me above information is - -
9 c«r�et.l.gWem emplrwim.ucin.ed�ntrmdnn = ndaat=IawaW.hngm 501 — . FINAL ELECTRICAL ENERGY
0
building construction,tied hereby audboriso mOphosentionivoo of this city to enter upon this 502 — FINAL PLUMBING. ENERGY
aboye.menfioned property for Inspection purpose..
0 w �. ' Wo)agree msave.indemnify and keep harmleasthe City ofCu,ertindegaimt 503'— FINAL MECHANICAL ENERGY
V liabilities.judgments,coats and expenses which may in any way oceme agdnst said City
y mi
W incoremrwcofftlimmingofINSPert. 504 — FINAL BUILDING ENERGY
E.., As sV �(ASy�O/P♦P'IGT1'0DWILLCOMPLYWITHALLNON- OIT
DERSTAN
SAN
NSOS — FINAL ELECTRIC,RL
WlAL
,
P //U 506 — GAS TEST
' Nignemroer Appfcenvcomtutor D� Gc .
HAZARDOUS MATERIALS DISCLOSURE 07 —
WillmeepplicantorfumoWikingrccupentatmcarM1andlehaxutlousmelcrid Re-roofs .506 FINAL MECHANICAL
as defined by the Cupertino Municipal Cade,Chapter 9.12,red the Fault and Safetyt
Code.Section 25532(.)'! 'Type of Roof 509 •— FINAL GRADE -
Will the.P,Ii.ntmfuture Wilding occ.p:ntOr se=qui;°rthlor devices which All roofs'shall be`�fl,�$ecteEl Pdrt6laR Nrc��l�ing material being.
emit haurdous an commmimnu usdefrod by me Bay Area An Qtwity Management installed. If a rool59, nstalf'efi�4thRhllBd'1f,ob [iiifig an inspection
• °''"'"] I agree to remove all new materials for inspection. -Applicant
❑Poe ❑No d
Irk.vemoll the
h.uNuuamapAalam9nirotents.werclWla=r6.9lertheeaG" un erstands,and will comply with all non point source regulations.
forms Hoa th ey code,Sectiom 25505.M33 and 25!34.L understand that if the
Wildin mrtamtly My errant,mat it is my ruponsibili"m ily occupant -
ofthe y s s chm b e «miuuaee afeCmjl c
Signature of Applicant - - Date
Owner or uthonzed.sero � ' � �-
All roof coverings to be Class"B•'or better
OFFICE .