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10010116 CITY OF CUPERTINO BUILDING PERMIT PERMIT NO: 10010116 LEWOOD RD APT A,B,C,D CONTRACTOR:GE�IMOR PLUMBING BUILDING ADDRESS: 10648 MAP 2552 SEABOARD AVE DATE ISSUED:01/25/2010 OWNER'S NAME: ESSEX PROPERTY TRUST PHONE NO:(408)855-8348 SAN JOSE,CA 95131 1ER'S PHONE: 6508495835 r... ELECT PLUMB [� LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG � H RESIDENTIAL r COMMERCIAL License Class � Lic.# MEC Date —to Contractor - JOB DESCRIPTION:WATER MAIN SERVICE REPLACEMENT he provisions of I hereby affirm that I am licensed under ttProfessions (commencing with Section 7000)of Division 3 of the Business& 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 Labor Code, he Compensation,as provided for by Section 3700 of the tValuation:$2500 performance of the work for which this permit is issued. Sq.Ft Floor Area: rovided for by I have and will maintain Workers Compensation Insurance,as p Occupancy Type: Section 3700 of the Labor Code,for the performance of the work for which this APN Number:31643004.10648 permit is issued. APPLICANT CERTIFICATION ation is I certifythat I have read this application and state that the abs ands ate laws relating IT EXPIRES IF WORK IS NOT STARTED with all city and county ordinance PERM correct.I agree to comply IN 1 0 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize io renS(We)agree to save r WITH INSPECTION. upon the above mentioned property for inspect purposes. ments, 180 DA ROM LAST CALLED indemnify and keep harmless the City of Cupertino d City tconsequence of the costs,and expenses which may accrue againstsaid understands and will comply _M Date: granting of this pe .t. Additionally,the app Issued by: with all non-poi ou a regulations per the Cupertino Municipal Code,Section 9.18. Date Signature RERE_OFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is V OWNER-BUIL DECLARATION installed without first obtaining an inspection,I agree to remove all new materials for I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. Date: the following two reasons: Signature of Applicant: I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, COVERINGS TO BE CLASS"A"OR BETTER Business&Professions Code) ALL ROOF I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). HAZARDOUS MATERIALS DISCLOSURE hereby affirm under penalty of perjury one of the following three I have read the hazardous materials requirements undor Chapter and 25534.91 of the maintain I Y declarations: ate of Consent to self-insure for Worker's California Health&Safety Code,Sections Code, Chapter 9.12 and the Health& I have and will maintain a Certificate compliance with the Cupertino Municipal Code, tion as provided for by Section 3700 of the Labor Code,for the Safety Code,Section 25532(a)should I store or handle hazardous material. Compensation, P melt or devices which emit hazardous air performance of the work for which this permit is issued. Additionally,should I use equip ' Compens Insurance,as provided for by contaminants as defined by the Bay Area Air Quality Menage ter 9.12 Distri d then I have and will maintain Workers Co p maintain compliance with the Cupertino Municipal Code, P Section 3700 of the Labor Code,for the performance of the work for which this Health ja Code,Sections 25505,25533,and 25534. permit is issued. is I certify that in the performance of the work for which this ec of the issued,I Ow e nt: ..,.an manner so as to become subject tDate: l not employ any person in y Compensation laws of California. If,after making this certificate Labor o e Cobol must Y become subject to the Worker's Compensation provisions oft CONSTRUCTION LENDING AGENC forthwith comply with such provisions or this permit shall be deemed revoked. I hereby affirm that there is a construction lending agency for the performance of work's NT CERT IFICATION for which this permit is issued(Sec.3097,Civ C.) APP LICAation certify that I have read this application and state that the above infoate laws relating Lender's Name I ce fy with all city and county ordinances and correct.I agree to comply n construction,and hereby authorize representatives of this it to savter Lender's Ad ress to building for inspection purposes.(We)agree upon the above mentioned property p ARCHITECT'S DECLARATION unify and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the understands and will comply I understand my plans shall be used as public records. granting of this i Additionally,the applicant with all non-p nt sour a regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Date >( Signatur CITY OF CUPERTINO PERMIT RECEIPT OPERATOR: patg 5 ITEMS OF 60 COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 31643004 .10648 DATE ISSUED. - • • " 01/2512010BS000009613 RECEIPT # . " � 10010116 REFERENCE ID # • • • SITE ADDRESS . . . . . : 10648 MAPLEWOOD RD APT A,B,C,D SUBDIVISION CITY . • • . . , • • . CUPERTINO IMPACT AREA . . . . . . OWNER ESSEX PROPERTY D RD APT A-D ADDRESS . . . . . . . . . . : 10696 ROSEWOOD CITY/STATE/ZIP CUPERTINO, CA 95014 RECEIVED FROM . . . . : ALLAN UY LIC # 27101 CONTRACTOR GENARO MORALS COMPANY GENMOR PLUMBING 2552 SEABOARD AVE ADDRESS CITY/STATE/ZIP . . . : SAN JOSE, CA 95131 TELEPHONE . . . . . . . . : (408) 855-8348 THIS REC NEW BAL AMOUNT PD-TO-DT -- QUANTITY ---- FEE ID UNIT'__--- ---------- ---------- ---------- ------1 . 00 ---- 0 . 00 -- ----- 1 . 00 0 . 00 0 . 00 VALUATION 21500 .00 0 . 00 21 . 00 1BCBSC 1. 00 21. 00 0 . 63 0 . 00 1BPWSVCS WATER SERVICE 0 .63 0 .00 0 , 00 2, 500 . 00 0 .00 42 .00 1BSEISMICO VALUATION 1 .00 42 .00 42 .00 0 . 00 1PPERMITFE FLAT RATE 42 . 00 0 .00 - -----____- FLAT RATE 1 .00 __-___-- ---__---- 1TR.AVDOC ---------- - 106 .63 0 .00 106 . 63 0 . 00 TOTAL PERMIT VOICE ID DESCRIPTION_--- --- VOICE ID DESCRIPTION- ------ ----___- --- -------- ------------------- 106 SEWER & WATER 103 UFER 507 FINAL PLUMBING I (D CITY CITY OF C UPERTINO REPIPE/SEWE R/MAIN SERVICE PERMIT APPLICATION FORM CUPERTINO Date' tirN # ,� ld'n Address r Bui .� _ -_�Le,,�,( AbPhone # Owner's Nam '--� 1 Phone #: Fax Contractor: #: L� 1�-(0- Phone 4: l C— 7-11 LA Contact: LO Fax#: I ' Contractor License 4: Cu ertlno Business License #: ice` Job Description: Commercial Residential ❑ Valuation: Standard ❑ Large Major❑ Project Size: Express ❑ he of the Green Building Checklist & attach it to t Green Building: Please complete relevant portion Sheet index. application or if applicable, include in plan set & the Green Buildin Points: • Fee Permit Type ti Fee ID Fee Description Grou Quantity 1 CPSS IPCSEWER Commercial building p sewer/sanitary sewer JCPRP l BpF EPIPE Commercial re-pipe per fixture P 1 PGASCOM Commercial Gas Piping System P 1-4 Outlets B ALL PERMIT IBCB SC Cal Bldg Standards Commission TYPES Fee P I BSEISMICOM Seismic Commercial Revised 0l/07/09 CtTY OF CITY OF CUPERTINO REPIPE/SEWER/ MAIN SERVICE FEE SCHEDULE CUPERTINO Fee Permit Type ' Fee ID Fee Description Grou Quantity ALL PERMIT IBCBS C B Cal Bldg Standards Commission TYPES Fee P IBSEISMICR Seismic Residential P 1RPSS 1PRSEWER Residential building sewer/sanitary sewer P 1RPRP IPR REPIPE Residential re-pipe per fixture P 1CPWS or 1BPWSVCS Water Service IRPWS RSEWG Private Sewage Disposal System P IPP P 1 PCESS Cesspool I BPW ATER Install/alter Water Pipe P 1BPFIXTURE Plumbing Fixture P 1PGASRES Residential Gas Piping System P 1-4 Outlets P 1 BPG AS Gas Piping System 5+ Outlets 1 PPERMITFEE Plumbing Permit Fee Issuance P 1 PLMBLNCK Plumbing Plan Check P IPLMBINSP Other Plumbing/gas Insp. P VDOC Travel &Documentation Fee B 1 TRA 1 BUSLIC Business License B Community Development 10300 Torre Avenue Cupertino CA 95014 )777-3228 Telephone(408 F;WRIJ a ' Fax(408)777-3333 CITY OF .;UPE TIT . Bui 1 din De art ment ' g S7v/q- PERMIT # OB ADDRE nes G PHONE # OWNERS NAME: FAX # 66-0- GENERAL CONTRACTOR: I am not using any subcontractors: Date Signature and co lete the f ollowin information: Please check applicable subcontractorsE BUSINESS LICENSE # SUBCONTRA CTOR BUSINESS NAM 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 e Date caner/Contr ctor Signature