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11100147 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10678 MAPLEWOOD RD CONTRACTOR:ABE CONSTRUCTION,INC PERMIT NO: 11100147 OWNER'S NAME: ESSEX THE POINTE LP 528 E WEDDELL DR STE 4 DATE ISSUED: 10/20/2011 OWNER'S PHONE: 6504943700 SUNNYVALE,CA 94089 PHONE NO:(408)734-8416 L LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG� ELECT� PLUMB� License Class Q,C V3,C 3bL,ic.# MECH[_ RESIDENTIAL COMMERCIAL Contractor C,t'\1-Nbate I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:APT A,B&C REMODEL BATHROOM(]20SQFT)& (commencing with Section 7000)of Division 3 of the Business&Professions REMODEL Code and that my license is in full force and effect. KITCHEN(160SQFT)&INSTALL WASHER/DRYER HOOK-UP I 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:$28000 permit is issued. APPLICANT CERTIFICATION APN Number:31643004.10678 Occupancy Type: I certify that I have read this application and state 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-point source regulations per the Cupertino Municipal Code,Section 9.18. Issued by: Signature Date C `- r. OWNER-BUILDER DECLARATION RE-ROOFS: I;.,e,eby affirm that I 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 1,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 contractors 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: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE 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 Health&Safety Code,Sections 25505,25533,and 25534. I 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(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined b the Ba Area Air y y 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 Code,Sections 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,I must Own e r a 1Tl(or a nt: forthwith comply with such provisions or this permit shall be deemed revoked. Date: 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 ig of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION .II non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 9 ITEMS OF 9 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 31643004 . 10678 DATE ISSUED. . . . . . . : 10/20/2011 RECEIPT #. . . . . . . . . BS000015094 REFERENCE ID # . . . : 11100147 SITE ADDRESS 10678 MAPLEWOOD RD SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER ESSEX THE POINTE LP ADDRESS . . . . . . . . . . : 925 E MEADOW LN CITY/STATE/ZIP . . . : PALO ALTO, CA 94303 RECEIVED FROM . . . . : ESSEX PROPERTY TRUS 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 1BAPPLOTHE NO OF APPLIAN 2 . 00 130 . 00 0. 00 130 .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 1MPERMITFE FLAT RATE 1. 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 2219. 80 0. 00 2219 .80 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 2,219.80 VISA --------------- TOTAL RECEIPT 2, 219.80 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ----------------------- 301 ROUGH PLUMBING 302 TUB & OR SHOWER 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 305 FRAME 307 INSULATION 308 SHEETROCK 309 EXTERIOR LATH 310 INTERIOR LATH 311 SCRATCH COAT ( i1 0 01 ` 1 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 LM (408)777-3228•FAX(408)777-3333•building(a)cupertino.org CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/Ti ❑ REVISION/DEFERRED ORIGINAL PERMIT _, D 0 APN# + 4 PROJECT A�DRE S �J '� OWNER NAMEE I PHONEE-MAIL STRE �SS r. CI STATE,ZIP ` \ FAX f� ` CONTACT N.AM PHONE E-MAIL Al _ _ STREET ADDRESS CITY,STATE, ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT A CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LI E E LICENSE TYPE BUS.LIC# 1U E-MAIL FAX COMPANY �s� \ - -� no STREET.ADDRESS TY,STATE,ZIP PHO E ARCHITECT/ENGTNEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DFSCRIPTTON OF WORK It EXISTING USE PROPOSED USE \ CONSTR.TYPE #STpRIES ��� !) USE TYPE OCC. SQ.FT. VALUATION($) EXIST(; NEW FLOOR DEMO TOTAL sem• - 2-3-C, ^ AREA AREA AREA NET AREA V{" BATHROOM KITCHEN OTHER REMODEL AREA ' n REMODEL AREA ,1 r.I� REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? ONO ADDITION? ONO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY: TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVALLETTER EICHLER HOME? ❑NO By my signature below,I certify to each of th foll wing: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have prov correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to build g struction. T authorize representatives of Cupertino to enter the above-idetified pr perty for inspection purposes. Signature of Applicant/Agent: Date: � 1\ SUPPLEMENTA ORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ ExPREss ❑ PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ISO ADDRESS: 10678 mapplewood rd A,B,C,D 7D—AT—E: 10/20/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: 1$28,000 Y°PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Repair PRIMARY Multi-Family Dwelling Buildina is PENTAMATION 1 R2REM USE: 3 Stories Yes (F) No PERMIT TYPE: WORK remodel bathroom and kitchen install w/d/ hook-up SCOPE Mech.Plan Check0.0 hrs $0.00 Mech.Permit Fee: IMPERMIT Other Mech.Insp. 0.0 hrsL4.00 Li NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Thesefees are based on the relinina information available and are only an estimate. Contact the De t or addh7 info, FEE ITEMS (l ee Resolution 11-053 Eff. 7,1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. Remodel,Kitchen(<=300 sf) Suppl.PC Fee: (F) Reg. () OT 0.0 1 hrs $0.00 $588.00 1REMRESKIT PME Plan Check: $O.00F-1-207 s.£ Remodel,Bath(<=300 sf) Permit Fee: Hourly Only? Q Yes G No $0.00 $588.00 1REMRESBAT Suppl. Insp.Feer Reg. Q OT 0,0 hrs $0.00 L—LJ # Mechanical PME Unit Fee: $0.00 $130.00 IBAPPLOT Other Appliance/Equip PME Permit Fee: $44.00 Administrative Fee: IADMIN $41.00 Work Without Permit? 0 Yes (D No $0.00 Advanced PlarininL, l=ee: $0.00 © hours Inspections E) Travel Documentation Fee: ITRA VDOC $44.00 $780.00 1STINSP Inspection,Hourly Strong Motion Fee: IBSEISMICR $2.80 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $2.00 SUBTOTALS: 1 $133.801$2,086.001 TOTAL FEE: $2,219.80 Revised: 10/01/2011 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: Off- PERMIT# a l 4-1 OWNER'S NAME: PHONE# GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: \\ CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRAC RS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. ,, ^ I am not using any subcontractors: �v 1 Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/ Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting /Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date