02060203 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR'INFORMATION °
8°RPbDRIGUES # 9F WALDRON CONSTRUCTION COMP cipMlr'62060203
OEWPATILTMORE APARTMENTS P 0 BOX 598 APPLICA"VJ2`8`72002
PH (408) 377-8186
ONE: SANITARY NO,/ CONTROL NO.
o z' HIARCTECT/ENGI t v
0 C ONEER: - BUILDING PERMIT INFO
U— BLDG ELECT PLUMB MECH
lj ni LICENSED CONTRACTOR'S DECLARATION
nwont,ofemhmat Into rcen,ed anderprn.ny,ns of chapmr.v wammencing INTER.RENOVATIOIk?Jft9R&YRLED KITCHEN AND BA
with s<"tmomwlafoo.o. 3anb"Basme,snmarramssmnsCode.anamyrcem" NEW WASHER/DRYER, NEW WALL A/C, NEW FLOOR
d L'sin full farce and effect. .
irenseClaax Lie tr
o a n
are DEC'L0l' -
0 3+h ARCHITECTSDECLARATION IFB
1 onderstvne my plmu shall be used n,Pnblia recnNs - -
;LLy,
Lieenxd pmfif"innal AUG 2 6 2002
'a OWNER-BUILDER DECLARATION
"1 hereby affirm that I ant exempt from the Con i,cua's License Law for the -
'Fza 'full g ,ISedon 703156us rte. JP f.. rv,Code Anyrtyor county ��'�
W o wnn y permit m coa,tmcl abe p d T,m.or reps,any atraculre $34660
ING
e.3 pn t t 1 q m ppI tl 1 p n fl i,red inferrer,
math ap tt n n' : nn c t- t L L fcnapt v Ft.,Floor Area , , Y Valuation
Ico g Ih5 t J000) fD 'I 1 fth B dP fs' sCod) p�.` s?
of that he is exemptmererromandmehunt.,for Jd,ncgea exempfbd.Any.imati°n 36903'008- 00 .. . .. r
-of Section 7031.5 by any applicant fora permit subjects the applicant m a civil penalt
`of mat more man five hundred dollar,cs50o). y APN Number ... . . Occupancy Type
01 -orme i la<e.wtn„a 101 — FOUNDATION
proper v structure my eiisp y fes n n - 1 ° p<rvwimn.
`Bax'inill ear Profession,mr odeThC mat intended Li en a Lawoodd far sale(Sed.7oaa, — Required inspections
si fame Professions Code:The Comractre s License Law drives such
h apply m an p
owner pro,ow Who balms°r unproven at'r,.am who ages seen winknded of 10 3 — UFER
onhro gn h'. iwn ewl Y the Provided to t m u h rip t n l intended or ...._.. _..-. ., .._ .
-,nrr<mfor.sue.lrn .neelding . .po et' ..m 'tnimnmeyearar � ' 104-' — REBAR
'cp plt usb le nhold the tranden alpinism,thtl did norbilao 105 — ANCHOR BOLTS
' Imp of m
rp :e fsale)
-.1.06 .--. SEWER, &..WATER.
s woe fm p p r 1o' ly t t ,wall n.eJ '.. t ..
I n ce p NsI(S 704 B J P r Code:)Thee I t s 202 — UNDERFLOOR PLUMBING
Laic n c ,c J es nfI pply t f p p ny h 6 la p e. t to t , f
Cmirma hm',Liaen ro such pmlecn with a cammcmr(s)licensed moment to me. . _ ___.__203_ UNDERFLOOR___MECHANICAa
'c°' ' sL"nseL 204 — UNDERFLOOR FRAME' .
❑1 a _ ' ' B&PcrarOasr<asan 205 — UNDERFLOOR' INSULATION
is
u'WORKCR SCOMPENSATION UECLARATI� 301 — ROUGH PLUMBING
A' I hereby affirm under penally of perjuryone of me following declarations: 302 — TUB & OR SHOWER
O I have and will'maiiumn a"Cc-rificate ar Consent m self-insure for Warken 303 — ROUGH MECHANICAL
Xmilpsmoli n, as pr°.Ided fii Senior, 3700 or he Labor code, for me 304 — ROUGH ELECTRICAL
porrormana orthe work mr which this,pemiil is issuea. 305 — FRAME
Of brocauld ll mai t W k :Cmrm�cacsrficm hi,andonein,required by Section
3700 of the Labor Cada for me performance of the work for which this permit is 306 — HOLDOWNS
- - iss J My Workeh C p i o i Insur a 'er ane Pol you he are: 3 0 7 _
.., _.. INSULATION ...... ,
308 i-re
yy
CERTIFICATION.1 .� OM�PHNS Te aainnepenntisrorooeeanamaamlfars h 310 'IXTERIOR_L `-
` IcyN
(Th s scat an OPTION FROM WORKERS 6 E R
7orvmsuRAlvcF' _ -3-0.9-_- _ERTERIOR_.LATH _.
Carttnr r Po ._ .. ._...._.. ...
INTERIOR LATH'
cSIOo)pness.). ,. 311 — SCRATCH COAT i
-.: . ..-
I m login tam p in any earn 1. I`sobco' t tsaea l 313 — ROOF NAIL
shall e t ploy angp s non any sr,all w become subject Ice the Workers '
Compensation California. . r 501 — FINAL ELECTRICAL ENERGY
Appl a t - f n,hi C;hal,bofE ,tion y..,h..Id - -502 FINAL PLUMBING ENERGY 'r - - -
NOTICE TOAPPLICANI If ft k „
� ,I)rt oopl me Wake c' pe t p .onneLardo,, ked. 51 503 — FINAL-MECHANICAL ENERGY
,forth th mpl}with h p � e de J revoked ,
F i' "° 504 FINAL" BUILDING-ENERGY - —
CONSTRUCTION I ENDING AGI NCY "
7In by firmbalm < c sct angng"
y1 hem ¢' 505 FINAL ELECTRICAL.
of e wank f which this p t ed S 3097 CtvC) n ' 11
a'c LeadersrvfameGAS
-TEST . .... ...
Uz Lea Address507 — FINAL PLUMBING
rrythat Ihave read thp,hearmal and sucle thalmoshrmic infatuationis 508 — FINAL MECHANICAL
kT+ E.t �drre t 1 agree to"amply with
all city.end county ordinances and d t t laws rel ting
O%U to b°ilding emisuacticn,-and hereby authorize represenmtives of this city to enter upon 509 — FINAL GRADE
W the,above-mentioned property for inspection purposes,
E.;y', (W) 'g -erosae demmfyadd keep ha I 'ihe'Cty fCpnnoagard'a 510 — FINAL PLANNING
h homilies.nes)dgmrn,c c t e expenses which y' nny y rescue against raid 514 NA P WORKS
C.7 City co equen<e of th rnu ng of hit p t '^ r-,
g. AYPLICANTUx17ER 4 D$ANO WILL COMPLY WITH AL NON'POINT" ! '
SOURCE Rle GQ' Tr �Q � �` ,� Q�. Issued by: Date
Signawr of Aplpl�icant/Co / Dam i Re-roofs
i g P ERIALS URE
w' s r ndthe hfazad material , Type Of ROOF
asdefined tnC n M p ndthH hh nJS Safety -
W 11 me pplH I or Nt b Meta u nt r o
y pe Municipal Cad Chapter 12.
Cad Section25532(a) i .
❑Yes ' ' _ All roofs shall be inspected prior to,any roofing_matenal being Installed.
Wil the apPlica t r t m n 'lag p t eqa p t a c«-wn ci If
" a roof is installed without first obtaining anins ection I agreerthay a se a u I aykf ee q[he B yn A Q I ty Management to remove
Doi °'
/,�'(,","_ _ willcomply with
a new materials for inspection. ,Applicant und_erstands and wil
°Y` " all"non-poi t source iegulatrons: .,
I h e e the hazere mai 'a1 fey Ire 533.nd ae Cb pI 6.95 of Ne
Cal forma Healthe,not ctyClyforci ans255a5at itis ana25534 ymfamil mal
ifcapersoft doesnot wrrenayhs-ealewnt.Iliaitismy responsibility tonotify the "' -
ac pant of tti e9�, w mull held,,Pon,r to issuance of a Certificate of
�•eP yr 1, Wl�tf.Uu'- />-3�� Signature of Applicant Date
Ow o at mor:ee agcut ..Date All roof coverings to be Class "B"or better "
- -•OFFICE - -