10050005 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19920 OLIVEWOOD ST BLDG OFC CONTRACTOR:BKB CONSTRUCTION,LP PERMIT NO: 10050005
ONYNER'S NAME: ESSEX PROPERTY TRUST 2812 TRINITY SQUARE DR STE 110 DATE ISSUED:07/01/2010
OWNER'S PHONE: 6508151622 CARROLLTON,TX 75006 PHONE NO:(972)478-2255
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class � Lic.00 Sr/ r r r
rl ?�f d MECH RESIDENTIAL COMMERCIAL
Contractor KDate
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: EXTERIOR RE-SIDING TO AN EXISTING APT BLDG,NEW
(commencing with Section 7000)of Division 3 of the Business&Professions ENTRY TRELLIS,WINDOW,DOOR REPLACEMENT THRU-OUT-ALL
Code and that my license is in full force and effect. PLAN CK COMMENTS&FEES FOR 29 BLDGS ARE ON THIS
hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$2000000
permit is issued.
APPLICANT CERTIFICATION - APN Number:31643004.OFC Occupancy Type:
1 certify that I have read this application and state that the abo i i s
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regul.tions p e Cupertino Municipal Code,Section
9.18.
Issued�N'� z��Date:
Signature Date
❑ OWNER-BUILDER DECLARATION
RE-ROOFS:
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signature of Applicant: Date:
1,as owner of the property,am exclusively contracting with licensed contactors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penalty of perjury one of the following three
declarations: HAZARDOUS MATERIALS DISCLOSURE
I have and will maintain a Certificate of Consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the 1 have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(x)should I store or handle hazardous material.
Additionally,should 1 use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is issued,I shall maintain co pliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any.manner so as to become subject to the Worker's Health& fety Co cti 25505,25533,and 25534.
Compensation laws of Califomia. If,after making this certificate of exemption,1
become subject to the Worker's Compensation provisions of the Labor Code,I must Ow or a ori a
forthwith comply with such provisions or this permit shall be deemed revoked. — Date: o
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's
correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point source re a Cupertino Municipal Code,Section
9.18. 1 understand my plans shall be used as public records.
Signature Date Licensed Professional
CITY OF CUPERTINO
ITEM 1 OF 1 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN 31643004 .OFC
DATE ISSUED. . . . . . . : 07/01/2010
RECEIPT #. . . . . . . . . : BS000010750
REFERENCE ID # . . . : 10050005
SITE ADDRESS . . . . . : 19920 OLIVEWOOD ST BLDG OFC
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : ESSEX PROPERTY TRUST
ADDRESS . . . . . . . . . . : 925 EAST MEADOW DR
CITY/STATE/ZIP . . . : PALO ALTO, CA 94303
RECEIVED FROM . . . . : ESSEX PROPERTY TRUS
CONTRACTOR . . . . . . . : BRYAN G BROWN LIC # 29820
COMPANY . . . . . . . . . . : BKB CONSTRUCTION, LP
ADDRESS . . . . . . . . . . : 2812 TRINITY SQUARE DR STE 110
CITY/STATE/ZIP . . . : CARROLLTON, TX 75006
TELEPHONE . . . . . . . . : (972) 478-2255
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 2000, 000 .00 80 . 00 80 . 00 0 . 00 0 . 00
1BSEISMICR VALUATION 2000, 000 .00 200 . 00 200 . 00 0 . 00 0 . 00
1RIINSP SQUARE FEET 2, 300 . 00 4594 . 00 1570 . 00 3024 . 00 0 . 00
1R2REPPL SQUARE FEET 2, 242 . 00 2595 . 15 2595 . 15 0 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 7469 . 15 4445 . 15 3024 . 00 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 3, 024 .00 VISA
---------------
TOTAL RECEIPT 3, 024 . 00