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11080193 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS. 10706 ROSEWOOD RD CONTRACTOR:ABE CONSTRUCTION,INC PERMIT NO: 11080193 OWNER'S NAME: ESSEX PROPERTY TRUST 528 E WEDDELL DR STE 4 DATE ISSUED:08/25/2011 1'-VNER'S PHONE: 6508491600 SUNNYVALE,CA 94089 PHONE NO:(408)734=8416 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# I(0` 5 4 nn����— MECH. RESIDENTIAL COMMERCIAL Contractor-t'�C� Date �� � I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:APT A,B,C&D-MULTI-FAMILY APT.,REMODEL BATH(120SQFT),REMODEL KITCHEN(160SQFT),ADD NEW (commencing with Section 7000)of Division 3 of the Business&Professions LAUNDRY HOOK-UP Code and that my license is in full force and effect. 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:31643005.10706 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: Date: Signature ' � !� Date ' OWNER-BUILDER DECLARATION RE-ROOFS: I hereby 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: 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 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 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 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 Owner or authorized age forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION 1 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 c,,-.and expenses which may accrue against said City in consequence of the :ng of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION v,._..all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 8 ITEMS OF 24 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 31643005. 10706 DATE ISSUED. . . . . . . : 08/25/2011 RECEIPT #. . . . . . . . . BS000014570 REFERENCE ID # . . . : 11080193 SITE ADDRESS . . . . . : 10706 ROSEWOOD RD 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 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 ---------- ------------- ---------- ---------- ---------- ---------- ---------- 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 2178. 80 0 . 00 2178 .80 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 6, 276 .40 VISA --------------- TOTAL RECEIPT 6, 276 .40 A. J<!� CITY OF CUPERTINO FEE ES ATOR-BUILDING DIVISION ADDRESS: 10706 o ' rood st.#A,B,C,D TDATE: 08/25/2011 REVIEWED BY: bobs. APN: BP#: 'VALUATION: 1$28,000 °`°PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Du lex PENTAMATION 1 R3SFDREM USE: p PERMIT TYPE: WORK multi-family apt. remodel bath and kitchen add new laundry hook-up. SCOPE Mech.Plan Check "00 $0.00 Mech.Permit Fee: IMPERMIT Other Mech.Insp. 0.0 hrs $44.00 NOTE. These ees are based on the preliminary information available and are only an estimate. Contact the Dept-for addn'l info, FEE ITEMS (Pee Resolution 11-053 ff' 1.-'11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. Remodel,Kitchen(<=300 so Suppl.PC Fee: G Reg. 0 OT F0.0 hrs $0.00 $588.00 1REMRESKIT PME Plan Check: $0.00 = s.f. Remodel,Bath(<=300 sf) Permit Fee: Hourly Only? Q Yes (F) No $0.00 $588.00 /REMRESBAT Suppl. Insp. Fee-0 Reg. 0 OT 0.0 hrs $0.002= # Mechanical PME Unit Fee: $0.00 $130.00 IBAPPLOT Other Appliance/Equip PME Permit Fee: $44.00 Acoustical Fee: Yes (F) No $0.00 Work Without Permit? 0 Yes E) No $0.00 PEannin Fee: $0.00 Select a Non-Residential E) Travel Documentation Fee: ITRA VDOC $44.00 Building or Structure 0 Strorijz Motion Fee: IBSEISMICR $2.80 6.0 hrs Inspections Bldg Stds Commission Fee: IBCBSC $2.00 $780.00ISTINSP Inspection,Hourly SUBTOTALS: $92.80 $2,086.00 TOTAL FEE: 1 $2,178.80 Revised: 07/04/2011 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 T ORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228 • FAX(408)'777-3333 • buildlnaga cupertino.orG CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT PILO CT ADME DRESS Q F L ( Lf _3 C �� ' 1 `J / O OWNER NAz PHONE ��_O q G,, i'b�CJWE-MAIL SrREE�DRESS CTr i�STATE.ZIP FAX CONTACT N `\����11 \.,.%ti.. ��c�l•'��,`�� _ ti� i�� EMAIL ' STREET ADDRESS CITY,STATE, ZIP FAX ElOWNER ElOWNER-BUILDER ❑ OWNER AGENT 1�CONTRACTOR ❑CONTRACTOR AGENT 13ARCHITECT 13ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LI SE ER LICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CT ,STATE,ZIP� ` \ PHONE 3� t. - �t�t -'�` t�Y ` �� f �4 f. ` ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE -ESCRIPTION OF WORK,. y r �~�'t���•�\��l ,\�f���`1 f r. '%i'tom \'�C� v"'- i k. ���'�'...�.� �C...�i..%�`•'��.`( `J� " i EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES } USE TYPE OCC. SQ-FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTTER REMODEL AREA y ) REMODEL AREA 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?- []NO ADDITION? []NO PRE-APPLICATION ❑YTS IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY- TOTAL VA L AVON: PLANNING APPL R r1N0 PLANNING APPROVAL LETTER EICHLER HOME? ❑NO / ■ By my signature below,I certify to each of a following: I am the property owner or authorized agent to act on the pr.FTerty owner's behalf. I have read this application and the information I hav ed is 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 b g construction. I authorize representatives of Cupertino to enter the above-'dentifie pro erty for inspection purposes. Signature of Applicant/Ag Date: ��ZS� 1 SUPP INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for ovER-TE&COUNT R BU:UXING PLAN Pa-VIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNRiG PLAN REVMW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS n if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ z'ntE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to El MAJOR El SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTB: B1dgApp=7011.d6c revised 06/21/11 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# G7� OWNER'S NAME: Essex ro �C "� S PHONE# GENERAL CONTRACTOR: pr1 \%IC BUSINESS LICENSE# ADDRESS: ID,./ CITY/ZIPCODE:&AO�D *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 SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: !� 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 Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date