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10050041 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10647 ROSEWOOD RDAPTA-D CONTRACTOR:BKB CONSTRUCTION,LP PERM IT NO: 10050041 OWNER'S NAME: ESSEX PROPERTY TRUST 2812 TRINITY SQUARE DR STE 110 DATE ISSUED:07/012010 OWNER'S PHONE: 6508151622 CARROLLTON,TX 75006 PHONE-NO:(972)47&2255 ❑ LICENSED CONI-RACTOR'S DECLARATION r F. BUILDING PERbM I1T INFO: BLDG r ELECT PLUB License Chas Lic.# �T IVI v ECII n RESIDENTIAL r COMMERCIAL Contractor DateT� hereby affirm that 1 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 ENI'RY'I'RELLIS,WINDOW,DOOR REPLACEMENT TIIRU-OUT;SEE Code and that nav license is in full force and effect. 10050005 FOR FEES&PLAN CK COMMENTS. 1 hereby affirm under penalty of perjury one of the following txvo declarations: I have and will maintain a cenificate 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:568965 permit is issued. APPLICANT CERTIFICATION APN Number:31643004.10647.A-D Occupancy'1'y pe: I certify that 1 have read this application and slate that the aby in o n.lio is .correct.1 agree to comply with all city and county ordinances and state law 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 peril. Additionally,the applicant understands and will comply a with all nor-point sours rcguI tiot >er the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. J IssuetE.lry��/��T Dater 1116 Signatu Date ❑ OWNER-BUILDER DECLARATION - RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Lawfor one of All mofs shall be inspected prior to any mofing material being installed.If a mof is the following txvo reasons: installed without first obtaining an inspection,1 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: I,as owner of the property,am exclusively contracting with licensed contractors to construct the pmjmt(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penally of perjuy one of the following three declarations: 1 have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation,as pmvidcd 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 Ibr 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 I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will 1 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 Code,S [tions 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the labor Code,1 must Own f or t oen forthwith comply with such provisions or this permit shall be deemed revoked. Date:_2"�� APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 1 certify that I have mad this application and slate that the above infonration is I hereby affirm that there is a construction lending agency for the perforance 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 conslmction,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 hamileas the City of Cupenino against liabilities,judgments. Lender's Address costs,and expenses which may aceme against said City in consequence of lire granting of this permit.Additionally,the applicant understands and will comply ARCIIITECT'S DECLARATIONwith all non-point source regulatio s per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date 7/ --7—V Licensed Professional CITY OF CUPERTINO CITY OF CUPERTINO GENERAL BUILDING PERMIT APPLICATION FORM D Date: Building Address:_ GUS�uJDU i�c� `-/ 7 G�� (fl 95, /Y K 7 Mailing Addr ss (if different from building ad ress�: Are Hazardous Materials being used as part of this project? Yes ❑ No Y�jllj HOA: (Exterior work only) Yes ❑ No 2r If yes, provide letter from HOA Owner's Name: Phone#: 5,5515-1 oln - &5-- Contractor: 5—Contractor: Phone: ?K3 Fax: (a5(} ^ 37O - Contractor License#: L�q!)" (i Cupertino Business License#: Contact: JIMMGr"h+-146l P one: &SO ,$o2- cog6$ YFax: Lsp . m. oio Residential Commercial Job Description: "j;-. y�_c„d�;l a Zt t �� v�p,r 47yo ,,-1 6w,W t � e� h-rtA,t�CSCJJ / C^'l�Olo"•! �UIO� T1/]l k e2vn2l�T�1!'D Jy�O Building Permit Info: Bldg Elect ❑ Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: H/III/V-A ❑ II/1II B, IV-FIT, V-B d -' Valuation: ' Square Footage: 6� Project Sue: Express ❑ Standard Large ❑ Major ❑ Green Building: Please complete relevant portion of the Green Building/LEED Checklist & attach it to the application or if applicable, include in plan set& the sheet index. Points Achieved: For help, contact Build it Green at www.builditareen.or Revised 07/14/09