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12060085
CITY OF CUPERTINO BUILDING PERMIT BUI LDING A DDR ESS; 19990OLIVEWOODST. CONTRACTOR:ARE CONSTRUCTION.INC PERMITNO: 12060085 OWNF-R'S NAME: ESSEX PROPERTY TRUST 52H E W EDDELL DR STE 4 DATE ISSUED:06/142012 OWNER'S PHONE: 6504943700 SUNNYVALE.C\ 94089 PRONE NO:(408)734-8416 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r License Class Glln13`yLic N rJ l� F r C (— c��n�Ch�a? � n MECH RESIDENTIAL COMMERCIAL ContractorTrm& l �-CI 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:UNIT A,B,C&D:MULTI-FAMILY BATHROOM REMODEL (commencing with Section 7000)of Division 3 of the Business&Professions 120 Code and that my license is in full force and effect. SQFT AND EITCIIFN REMODEL IN)SQFT ADD LAUNDRY ROOM 1 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 We Labor Cade,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 ofthe Labor Code,for the performance of the work for which this Sq.FI Floor Area: Yalualion:$28000 Permit is issued_ APPLICANT CERTIFICATION APN Number:31643003.19990 Occupancy Type: 1 cedily that I have read this application and slate that the above information is 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-p t sourc,reg lit ions per the Cupertino Municipal Code,Section 9.18. Issued by: ��YJ Date: Signature Date ,1..-I, j Z— ❑ OWNER-RUILDF-R DECLARATION RF:ROOFS: hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior 10 any roofing material bong installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for L 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 ol'Applimnt Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sce.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1 hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California[[earth&Safely 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 ol'the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I stare or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued- contaminants as defined by the Ray 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 compliance 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&Safety ode,Sections 25505,25533.and 25534. Compensation Imus of California. If,atter making this certificate of exemption.I become subject to the Worker's Compensation provisions of the Labor Code,I mustwnero\ .ed agent: II forthwith canard with m such provisions or this perit shall be deemed revoked. Date: l ' APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affno 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 hercby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save indemnity and keep hammless the City of Cupertino against liabilities,judgments, Lender's Address costs,and expenses which may accrue against said City in consequence of the granting ollhis permit.Additionally,the applicant understands and will comply ,\RC.III'I'F.('I"S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 understand myplans shall be used as public records. Signature Dale Licensed Professional Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 WY OF Fax(408)777-3333 CUPEkTINO . Building Department JOB ADDRESS: PERMIT #ZZg oog S� - O PHONE # GENERAL CONTRACTOR FAX # I am not using any subcontr ctors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR' ' BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date CITY OF CUPERTINO 9 ITEMS OF 18 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : '31643003 . 19990 DATE ISSUED. . . . . . . : 06/14/2012 RECEIPT #. . . . . . . . . : BS000017070 REFERENCE,ID # . . . : 12060085 SITE ADDRESS . . . . . : 19990 OLIVEWOOD ST SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ESSEX PROPERTY TRUST ADDRESS . . . . . . . . . . : 925 E MEADOW DR CITY/STATE/ZIP . . . : PALO ALTO, CA 94303 RECEIVED FROM . . . . : ALLAN UY CONTRACTOR . . . . . . . : ABRAHAM PONCE LIC # 32833 .COMPANY . . . . . . . . . . : ABE CONSTRUCTION, INC ADDRESS . . : . . . . . . . : 528 E WEDDELL DR STE 4 CITY/STATE/ZIP . . . : SUNNYVALE, CA 94089 TELEPHONE . . . . . . . . : FEE ID UNIT . QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- -ADMIN HOURS 1 .00 41 . 00 0 . 00 41. 00 0. 00 1BCBSC VALUATION 28,.000 .00 2 . 00 0 . 00 2 . 00 0. 00 1BSEISMICR VALUATION 28, 000 .00 2 .80 0. 00 2 .80 0. 00 1EPERMITFE FLAT RATE 1.00 44 . 00 0. 00 44 .00 0. 00 1ERESAPPL NO OFAPPL IAN 2.00 44 . 00 0. 00 44 .00 0. 00 1REMRESBAT SQ FEET 120. 00 588. 00 0 . 00 588 . 00 0. 00 1REMRESKIT SQ FEET 160.00 588. 00 0. 00 588 .00 0. 00 1STINSP UNITS 6.00 780.00 0 .00 780 .00 0 .00 1TRAVDOC FLAT RATE 1.00 44.00 0.00 44 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 2133 .80 0 . 00 2133 . 80 0. 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 301 ROUGH PLUMBING 302 TUB & OR SHOWER 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 307 INSULATION 308 SHEETROCK 309 EXTERIOR LATH 310 INTERIOR LATH 311 SCRATCH COAT 315 EXT SHEAR 316 INT SHEAR 317 MECHANICL ABOVE CEILING 318 ELECTRICAL ABOVE CEILING 400 SEWER/LATERAL 501 FINAL'ELECTRICAI:"ENERGY 502 FINAL PLUMBING ENERGY CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 19990 Olive Street DATE: 06/14/2012 REVIEWED BY: Sean 97APN: BP#: -VALUATION: $28,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY Multi-Family Dwelling Buildina is PENTAMATION 1REAP1 USE: >3 Stories 0 Yes (F) No PERMITTYPE: WORK Units A B C 8 D: Multi-family bathroom remodel 120 sq ft and kitchen remodel 160 sq ft add SCOPE laundry room. IIr,h. 1'!uu t.rirr1, Phimh.1'lun ChcrA Elec. Plan Check 0.0 1 hrs $0.00 ,ll•clr !',•Wait hbr. I'/mrih. PC....a F;,,: Elec. Pennit Fee: IEPERMIT .th-,h, olsp 01har Pll m,h,yp. Other Elec. lnsp. 0.0 IJ,:rfi !mp. 1.t' Phn..1, hi p_ Fve. 0 ' I--- I NOTE: - r- NOTE: This estimate does not include fees due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School District,etc.). These fees are based on the prelimina information available and are only an estimate. Contact the De 1 or addn'I info. FEE ITEMS (Fee Ite.sohaian 11-053 Eff 7111111 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Electrical Suppl. PC Fee: Q Reg. O OT 0.0 hrs $0.00 $44.00 /ERESAPP Appliances PME Plan Check: $0.00 120 s.f. Remodel, Bath (<=300 so Permit Fee: Hourly Only? 0Yes (E) No $0.00 $588.00 IREMRESBAT Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 160 s.f. Remodel, Kitchen (<=300 so PME Unit Fee: $0.00 $588.00 IREAIRFSKIT PME Permit Fee: $44.00 (',qvn 11(lwn 71n: Administrative Fee: IADMIN. $41.00 O Work Without Permit? O Yes (F) No $0.00 E) Advanced Plannin, Fcc: $0.00 © hours Inspections (D Travel Documentation Fee: ITRAVDOC $44.00 $780.00 ISTl''SP Inspection, Hourly 0 541011 1 Motion Fcc: IBSEISA41CR $2.80 Select an Administrative Item Bld,Stds Commission Fee: 1BCBSC $2.001 1 SUBTOTALS: $133.801$2,000.001 TOTAL FEE: 1 $2,133.80 Revised: 06/05/2012 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildina(okuoertino.ora ❑NEW CONSTRUCTION ElADDITION ALTERATION/T7 ❑ REVISION/DEFERRED ORIGINAL PERMIT p PR01EL_(r1 "\S� APNp OWNE .nME v �C fl �^ E-MAIL ^bf STREETTS_ CITYTATE.ZIP `� 2O o� G\O CONTACT NA \C. PHO j, — EMAIL STREET ADDRESS CITY,STATE, ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ACONIRACTOR ❑CONTRACTOR AGENT ❑ ARCHHECr ❑ENGINEER El DEVELOPER ❑ TENANT CONTRA R NAM LI EN TYPE BUS.LIC p COMPANY N It. ,STATE.ZIPPH C^ Q� NE 7�� s4 ARCHITECi/ENGNEER NAME LICENSE NUMBER •+� BUS.LIC p COMPANY NAME E-MAIL FAX STREET ADDRESS CRY,STATE,ZIP PHONE DESCIITION RR _0 ID(ISTNG USE PROPOSED USE CONSTR.TYPE NSTORIES USE TYPE OCC Sp.FT, VALUATION($) EXISTG NEW FLOOR`T DEMO TOTAL AREA AREA AREA NET ARIA BATHROOM /� KITCHEN OTHER REMODEL AREA `' /(D REMODELAREA \101� REMODEL AREA PORCH AREA DECK AREA TOTAL DECIUTOORCCHH AREA GARAGEARFA: DETACH ATTACH 0 DWELLING IR.TI'$: 1S A SECO"UNTr LJvIEs SECONDSTORY OYES BF.NGADDED? []NO ADDITION? []NO PRE-APPLICATION ❑YES IF YES.PROVIDE COPY OF IS ME BLDG AN ❑YES RECEIVED BY: TOTAL VALUATION: PLANNINGAPPL✓ []NO PLANNING APPROVAL LETTER EICHLER HOME? []NO ^0(D By my signature below.I certify to each of the following: i am the property owner or authorized agent to act on the property owner's behalf. I have mad this application and the information I have provide co ect I I read the Description of Work and verifyit is accurate. I agree t comply with all applicable local ordinances and stam laws TelaDp\g to buildin ns ti au orize representatives of Cupertino to enter the above-,dctifcc p pCCrtp Or iMPCCtion purposes. Signature of ApplicanVAgene \ Date: co ` 1 SUPPLEMENTAL INFORMATION REQUIRED PLM CHECK TYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for ftRESS R-TITE{OUVTER BUILDING PL X REMW existing building(s). Demolition permit is required prior to issuance of building permit for new building. t PLM-NTNG PLAN REVTEw _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANoARD ❑ PueLIC WOM form if any Hazardous Materials are being used as part of this project. ❑ r GE ❑ FUtE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ M.UOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRON. NTALHEALTH B1dgApp_2011.doc revised 06/21/ll