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