02010033 ci O NGDIVISION
UPERTNNO
[BUILDING
PERMIT CONTRACTOR INFORMATION:
I,ID ADDRESS; PERMIT NO.
20090 RODRIGUES C-8 WALDRON CONSTRUCTION COM ANY 02010033
OWNER'S NAME: APPLICATION SUB DATE
LAKE BILTMORE APARTMENTS P 0 BOX 598 01/08/2002
HONE;I. , ,, SANITARYNO. _CONTROL NO.
(, (408) 377-8186
:'GKZ ARCHIl=MI'NGINHER: BUILDING PERMIT INFO
.Poo BLDG III.= P;.UMB MliCH
FL� I_I I_I
Z i7�<y i LICENSED CONTRACT'OR'S DECLARATION ,IOb Description
,.Z14 I hereby affirm that I am licensed under provisions of Chapter 9(commencing
p._$E ,wahsoetion7007orDi.i..inn3oflh.11-in—andProresai„aaC,.le.nndmylicense INT. RENOV. INCL REMDLED KTCHN AND BATHRO
in full force nnJ eRttl.
ce li''iccn,aclaaa Lion WASHER AND DRYER EW WALL cA A/C NEW FLOOR C
u�l B u. Date ,4 ., tractor
ARCHITECT'S DECLARATION �. �G w
kkQS�J.,5�'-' !Ira Ibpd t J at,pI . shall he user us pblc Ra,Ns
" QO r� +:'fn- OWNER-BUILDER DECLARATION E'"'' ` r
u` MAR' 0 3 2001
Phereby af0un that I Inn eae,npt from the Cn.noWl-'s Lkmio,Law for the
C 3 a fallowing reason.(Section 7031.5,Business and Professions C«1e:Any city or county
0 which requires a parnot toconsumer, Ile'. ar,eme.dem lob r.,i,any sarmine
. � pool t ., I q ' .th ,pros tf achl tilt File i,nedmmnmm
tpetMis licensedpu; .
Iloilo,p o. fthe c I Lc seW (chapter 9 Sq..Ft. Floor.Areaualion
(co lie ngwmsel )IXIO)on).i. 3af the Bushes d Pmf<ss ons c.Ne) { (}r�'�•f,nA_11; 1 ' - tis."til: ij�;Q';1sr.
m that hers eRaapl Inerafr:A'aml Ire nnxlx On the alkii.d:iea pgo8.Any.iolaoon ..
of Section 7031.5 by any applicant for a permit subjeuta the applicam to a civil penalty - 6 9�Qfwq -
19r nor more pimtryc hundred dol fo,(S50B, s MI Occupancy Type
01,as owner ohne properly,ur my employees wins wages as their sole mmpimmion,
will do the work,and the smmmre is not intended or offered for sale(Sec.7044, - -'
tBodnfifi aad'rmresxion,C.Ne:The Comraaora Liccom Law dues and apply l"an 102 - PIERS equired lnspections�, . .
caner of properly Who build,or improves themor.and who docs such work himself
or through his own emlnoyces.provided nor such iniprwemem%an not intended or 103 - UFER .
offered for sane.If,however,me building or ln,pnrvcmenl is sold widen one year of
'. pit n hpM lln me WW fp g that head not bole or 104 - REBAR .
on met
r p 'r I ,) 105- - ANCHOR_ BOLTS
qt c f Ih P cWaY e 1 1y c l xl g th l sed t ors m _ .'.I
.t ithproject is nova B .' dr r . :Cm ITi C t <mr's 106 SEWER & WATER tl
License low Jrxs m ppgthan owner rproperly wont Id s. '.hpnwes dcrcon 202 - UNDERFLOOR PLUMBING
and who connote. Ln loch projects with n enmmemgs)licensed promotion to the .. .. _ _.
•- 'cann7nee"r.oca w. GGil� 203 - UNDERFLOOR, MECHANICAL
❑lemcacn run ONKEH'ti CNPENSATIONU-CL,�iPCforthis rcnson
�RRI 204 - UNDERFLOOR FRAMED
°wncf D01e KATION
205 - UNDERFLOOR INSULATION
Ihe.mbynfmm lmder.pcmi iyof pmlJrymlcofthe folmwln,declaration:: 1 301 - ROUGH PLUMBING
pp have wiii n if ntertmdal f c .bow m seir more for Workers 3 02 _ TUB & OR SHOWER
.� capc .1 as Fr lel r ny ser retro of the.Lnbot Ced for d< 303 ROUGH MECHANICAL
nrmneconne, rkbwnixbmiapmhei.'I„ppa_r, 304 - ROUGH ELECTRICAL
1 t I v 9 rcIhYS•cllm 305 - FRAME
row f In k f ' h d IN,per nif a
c n: oPolicy
dPol y be rc 306 HOLDOWNS
- )700oB or m 1 In cos r th IKK .. .._ _ .. .._ _..
1 It
ksu d My Wn kc s compensation
C mrxn at insurance
N. j INSULATION.
.I CERTII9CATION01 COMPENSATION
NCE ” It
1, t "" ' 1308 �- SHEETROCK '
I m.. . r, , need non hcbaS"I INSUR; li v ' _dd•a , t—
fl Tn ' mpieeninne mit hundred dollars 3010 INTERIOR LATH
(51 W)or Icss) ,
1 ocrdr that in the - of of Ihc'w:oik for Which d T
' y . per r this c In the e W ker,' - 311 - SCRATCH ,COAT
Compere ation y wry fC.11 in hnry lisnnmr sons h,ndamtic anhjm-tndo Wnrkcrd 313 - ROOF NAIL
Compensation Laws or cmlmrnm.Date " , . .: .. f .
Applge0 501 - FINAL ELECTRICAL- ENERGY
NOT) TO APPLICANT II' ❑ ski kll Rffatle of l,aenpikm You ehnuld ,
z bec b3ou thew ke,C resat p 'k %ornbelaMncode,you must 502 - FINAL PLUMBING ENERGY '
O .font th cemply-with such provikioa.or this Permit shall be deenhed evoked
f`�” ' 1 ' I,.P• "• '.corvs'1'Rucr1DNl.EramncncrrvcY 503 - FINAL MECHANICAL ENERGY,:. „
lhembyurrrmthat thereidYconstruction lending agency'for meperromhancr 504 - FINAL BUILDING ENERGY•I I
lir he work far which This permit is uti a'se.PWT:civ.C.)
'0C y 505 - FINAL ELECTRICAL
.Iehde:aAdNe
I506 - GAS TEST . .
snacr's AAAresc,
lanifylhl�lhdvereadlhisepplicntumandsoefthattheaboveinformationis 507 - FINAL PLUMBING f
' W' ciirrect,l� greolp•po,nply with all city anA conniy ordinances nnJ smtc laws rdming
O'V totivilJingaondrvdi01,and reach ynmh.lri6cicprc.cmmi4csoflhiscitylaownerupon 508 - FINAL MECHANICAL
the stew<.ahcationeJ pmpeny for inspection Purpose.. 5 0 9 - FINAL GRADE
�.`.4 (W)a, ems rel nfy sock rel I ,'nbb C'IY fC lxri nag list
IA 'liab n judgments,cost and expenses h y. any y recall galoxl bid 510 NA P NG
t, 1 Ciny m can cqucntt of th g I g f th pertnu r'.
,'AI'PIIQAN PUNI)FRSrANDS AND WIII COMA,Y WI'll l All NfIN101N1 I', Issued L5il4 F N RKS Dale
GY I$OORM RLGULA!IONS..' ,.
sign h rnpprn oc roti I - " - n t Rc-roofs
HAZARDOUSMATERIALS DISCLOSURE
Will m applicant t fon building' acc r rel I n dle fooled., aienal Type of Roof
as dcf dfy(it.Cu,.ifio Ml Clark,CI p r)12, ad he Ilarth and Safety
`s n n 255120 I r 'L 1,•�' ''f`i 'v'-' '1 '`i i l
Cod
, ,. 't R " All roofs shall bi inspected prior to any roofing material being installed. -
willtim mnddio,occt ihscccpminddt ar.ic:,rc,4lnm If a roof is installedlwiUlout first obtaining an inspection;f agree to'rcmwe
:mit hniand.di'air elourro :ma us'JcOncd by the Boy Arca Air Qonlhy Manaycmcm
'Lot t 1 „ _ all new materials for inspection. Applicant understands and will comply with
/ ❑r oN all non-point source regulations. „
h I
moo cue Ih h u 10.s „ser i.' q, rt b.)s N'the
Califnrnin Hedlih'h Safely Cute.Scbtions 25505,25533 and 25530.1 understand Inas
if the huileibg d.xs tiol n,rrcnnly have a mhan6lhat ii ii my responobllily Iq notify the
bpA n or Ih ,g'tIlii I. 1 h now h n p' i in is.t c r cedircide of
Signature of Applicant Date
�. owm,alaadodmdagenl- Dam All roof coverings to be Class "B"or better
j J;'„j; .. _ _ OFFICE
BUILDING DIVISION PERMI], PERMIT NO.
BUIL DING ADDRESS: WALDRON CONSTRUCTION M ANY 02010033
20090 RODRIGUES C-8 APPLICATION SUB DATE
OWNER'S NAME: p 0 BOX 598 01/08/2002
LAKE BILTMORE APARTMENTS SAN TARY NO. CONTROL NO.
PHONE:•. (408) 377-8186
(/ BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
ARCHITECTMNGINEER:
e. LICENSED CONTRACTOR'S DECLARATION
Job Description
O'S5b IherebyvRrmlhmlamlicenmdunderprovisionaofChupmr9(commencing INT. RENOV. INCL REMDLED KTCHN AND BATHRO
Kyo with Section 700(l)of Division 3 of the Burinars did Professians Code,and my license
<< islnmRroroeandeffect. Lia 9 WASHER AND DRYER, EW WALL A/C NEW FLOOR C
5�e :Lieense Class Cummcmr_���
p�OiDom '
Ili 3 a ARCHITECT'S DECLARATION
E,0 1 updaktond my,plans shill he used as public moords �/ v
d7rofeuiohal �/
G 0 ,i�ulys ": OWNER-Bl DECLARATION
QH'4.J u, 1 1 hereby affirm that I am exempt from the Contractor's Licrose law for the
C Y< fallowing Mason.(Section 10315.Business and Professions Code:Any wan strueuor m
O which regmces a pernm n construct,alter,improve.demolish,m r poor y nation
$
PO ansi,mance.otmrequirtethcappl¢amfonuchpermiuo0l<o.igrcd(snmgem Sq.Ft. Floor Area,. 5
that h°,is IicemW panum�to the provisions of the Conuvnols Lima.Law Cha cr 9 - \
(so 1hns ha l osemIn trefnmaand thI or 0e bash f the o3 of the 5 ged crevision.udne.and Any,iola�me - r , ,
° I I fora s subjects ad applicant to acivil Penalty Occupancy Type
�yimen r e,it °tea do lots(Swot les
❑1,as owo=r of the progeny,ur my employees with wages us their on.campensmion,
will do the wank,aad the disease is no intended or offered for sale(sea.1044, 10 2 — PI ERS equired Inspections
v'Buai owner of pmors n"pPriyr,sioWhanhu l sr mprov s thereon.and who doedoes
such worklhimself
or throf prhiserty employees.provided mm such improvements arefie intended or 103 UFER
Bemul for.ala.If,however,the building or Improvemcm in sold within one year of
ibiapmian,meaweer-nuilderwill mo,rhebumbaOfprovingthathedidnobuild°r 104 - REBAR
Improva rpurpnuors.le.). 105 _ ANCHOR BOLTS
e _
pgwner of the pmpenyoro esciesively contracting with licensed occasion,to 106 SEWER & WATER
construct the pmjct(Sec.]094.Business and Professions Code:)The Contractor's 202 — UNDERFLOOR PLUMBING
end whoLonands,t.far much projecto an s with erconwnorO Icemedh.brild,Or mp...Into the 203 — UNDERFLOOR MECHANICAL
clormori Lmn or &PCrorthismason 204 — UNDERFLOOR FRAME
❑Ismexen on r
Owner Do" Oa— 205 — UNDERFLOOR INSULATION
ORKER'SC ikfPENSATIONDECLA ATION 301 — ROUGH PLUMBING
. Ihereby arcmmunderrenauyorparieryone arthe following dealamtmns: .302 — TUB & OR SHOWER
o:I nave and will m,;n,in a Cendlcam of Constant to ree.mom,far Workers 3 03 — ROUGH MECHANICAL
'Campcnxmion, as powmed for by Section 3700 Of he Labor Cade. for me 304 - ROUGH ELECTRICAL
performince ti the work or which this permit is issudd. .
❑1 havdond will amimsi,i Wwkdr'c Compenspti°n locum e,as required by Section 305 - FRAME
M of the Loboi Crile,for the performance of the work for which this permit is 306 - HOEDOWNS
jamod.'My Workers Construction lnsumnce canter and Policy number are 307 — INSULATION
.- - Ceder' -'Policy No,
CERTIFICATION OF EXEMPTION FROM WORKERS' `308 — SHEETROCK
' COMPENSATION INSURANCE " 309 EXTERIOR LATH
(Thi,legioncard not becompletedifthepemtitis Forane huntlrcddolly, 310 — INTERIOR LATH
(5100)or less)
I certify that in the performance or me'w°rk for which cis permit is issued,) 311 — SCRATCH 'COAT
.hurl-stat einhlo9 any peva in any manner on as to became subject to the Wari 313 — ROOF NAIL
Compensation nLnwasircmuhmm.D=te,' 501 — FINAL ELECTRICAL ENERGY
Applicant pi hould
NOTICETO APPLICANTtheWrO:es afmrmassfi this CeninofofEmm cartel en,rasa 502 - FINAL PLUMBING ENERGY
z becumciubjeanthe Wohera Compensation provisionsull the lnhoa realm . most
p G •famhwithcomplywribsuchprovisionsorthisPermhannnb=da=mearevakea. 503 — FINAL MECHANICAL ENERGY
- CONSTRUCTION LENDING'AGENCY504 — FINAL BUILDING ENERGY '
Inambyoffidn ohm mcmisaccasonctiml,odingrgere for the perfomsance 505 — FINAL ELECTRICAL
bf ,Me work for which this permit is sided(Sae.3091,Clv.C.)
y.q Leaadarvame 506 — GAS TEST
U O Lem)Address;
cLeaify that i have Muslims appli,suon and state that the above inflnutinn is 507 FINAL PLUMBING
I
ks FForiect.l IS.to,camply with All city roil county ordinances and ansa laws relating 508 — FINAL MECHANICAL
pU to Wilding constroction.andherebyoumdemrepresentativesOfmiscitytoaterupon 509 — FINAL GRADE
>� (rl the above.mentioned property far inspection Imoves.
(We)ngme to save.indemnify and keep litanies ma City of Cupcnina against 510 F NA P NG
aF., la/y liabilities,judgments,costs and expenses which:may in any way accrue against said
:City in'cadequenc=orthe granting ofthn pcmut. n
APPLICANT UNDERSTANDS AND WILL COMPLY,WITH ALL NON-POINT' Issued 41 N RKS Date
REGULAI ONS.
Signammpf AppIcanDDam Re-roofs
-v
HAZARDOUS
MATERIALS DISCLOSURE
Wili the applicant or future bonding ocopam star 11.handle Health ad Safetl Type Of Roof /
as defined by the Cupertino Municipal Code.Chvpter 9.I2,entl the Health and Safety
Code,Section 2553�bd?.
�Y=a.t,, ,. � oN" � All roofs shall 68 inspected prior to any roofing materia]being installed.
applicant or mtaaebuilding«e„p."'aaaequipment sir de:i«,which If a roof is installed without first obtaining an inspection, I agree to remove
WILL emii horardous air contamimali,as derncd by the Bay Area A it Quality Management all new materials for inspection. Applicant understands and will comply with
Dionit". 0N all non-point source regulations.
. 1 '1 have mad the haaMon,mmeriils requirements under Chapter 6.95 of the
Cnlifand Henlm&Safety Code,Soetim,25505,25573 and 25534.1 understand that
if thybalding does not comedy have v Lorimar,thus it is my responsibility 10 notify the
occupant of the requirement which most be met prig to issuance of a Cenircme of Date
GampanLy. Signature of Applicant
Date All roof coverings to be Class"B"or better
Owneror avmmiced agent
OFFICE
0
CITY OF CUPERTINO
BUILDING PERMIT APPLICATION FORM
Building Address: Z00,70 Ooelr s E
Owner's Name: Phone N Sgtm �5�
QHhf)NeS
Contr:act License o:
IA ori oO/JSr2urnv►l Nc.
Contact: . Phone N
Architect/Engineer License No:
1SIM $TAttam 1504A 19
pp
0 MR-
ppliant/Co trac or:
IL t: Pkt2TMlfT
uilding Permit Info: (circle one)
Idg Elec Plu Mech
Job Description: Rt—o N PA10,,A lkx � RBMODE eo IGl C3ATFF
NEW WASaf Qel Dkk\J 'WSW writ. /d�1 IJOW ft GWz c&mjMm e �
Residenttaf: 1, _ L%/ Commercial:
Sq. Ft. Floor Area: DG O S. $/Sq. Ft.:
APN * (Must provide): 31(0101
. 63 - 609 Valuatio ! (Bbq
IFype of Construction: Occupancy Group: C '
Qty. if Fee 1D Fee Description Fee Group
Ap licable
BTEMPPERM Temporary Bldg Permit BUILDING
BCONSTAX Construction Tax BUILDING
BENERGY Energy BUILDING
I BENERGYADD Energy Add Multi BUILDING
BOVERTIME Inspection Overtime BUILDING
BPERMFEE Bldg Permit Fees BUILDING
BMITIGAT Housing Mitigation Fee BUILDING
BPLANCHK Plan Check Fee BUILDING
I BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plan Check Repeat Fee BUILDING
BREINSPECT Reinspection Fee BUILDING
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Inspection BUILDING
BSWIM Swimming Pool BUILDING
7ADDCHG Address Change BUILDING