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10010117 F CUPERTINO BUILDING PERMIT CITY PERMIT NO:10010117 BUILDING ADDRESS: 10668 MAPLEWOOD RD APT A,B,C,D CONTRACTOR:GENMOR PLUMBING DATE ISSUED:01/25/2010 2552 SEABOARD AVE OWNER'S NAME: ESSEX PROPERTY TRUST PHONE NO:(408)855-8348 SAN JOSE,CA 95131 .vER'S PHONE: 6508495835 BFO: BLDG ELECT PLUMB BUILDING PERMIT IN 0 ENSED CONTRACTOR'S DECLARATION ..- COMMERCIAL License Clas Lic.# MECH RESIDENTIAL Date '` �1JOB DESCRIPTION:WATER MAIN SERVICE REPLACEMENT Contractor I hereby affirm that am licensed under the provisions of Chapter 9 commencing with Section 7000)of Division 3 of the Business&Professions Code and that my � license is in full force and elle t. I hereby affirm under penalty of perjury one of the following two declarations: insure for I have and will maintain a certificate of consent to self-Labor Code, the luation:$2500 provided for by Section 3700 of the Va Compensation,as p ESq. Floor Area: performance of the work for which this pe�ation Insurance,it is issued. as provided for by I have and will maintain Worker's Comp ork for which this Occupancy Type: Section 3700 of the Labor Code,for the performance of the wAPN Number:31643004.10668 permit is issued. APPLICANT CERTIFICATION IS NOT STARTED I certifythat I have read this application and state that the above �information laws relating pER�/jjT EXPIRES IF WOE 1 with all city and county ordinances IT ISSUANCE OR correct.I agree to comp y WI'T'HIN 1 DAYS OF PERM to building construction,and hereby authorize representatives of this agree saveOMCALLED INSPECTION. for inspection purposes. (We) OM LAST CA upon the above mentioned property judgments, 180 DA indemnify and keep harmless the City of Cupertino againstity inconsequenceof the /l costs,and expenses which may accrue againstlicant understands and will comply - L/ Date. granting of pe it. Additionally,the app Issued by: with all no p oint so rce regulations per the Cupertino Municipal Code,Section 9.18. _ Date � Signatu RE-ROOFS: of All roofs shall be inspected prior to any roofing material being installed.all ew materialslfor V OWNER-BUILDER DECLARATION installed without first obtaining an inspection,I agree to re I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. Date: the following two reasons: e compensation Signature of Applicant: I,as owner of the property,or my employees with wages as thei saleSec 044 , will do the work,and the structure isnot intended or offered for ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER Business&Professions Code) I as owner of the property,am exclusively contracting with licensed contractors to IV construct the project(Sec.7044,Business&Professions Code). HAZARDOUS MATERIALS DISCLOSURE three ter 6.95 of the affirm under penalty of perjury one of the following I have read the hazardous materials requirements under Chap I hereby Health&Safety Code,Sections 25505,25533,and 25534. I will maintain declarations: Chapter 9.12 and the Health& e for the compliance with the Cupertino MniIpaor Code, hazardous material. have and will maintain a Certificate of Consent to self-insure for Worker's California I Section 3700 of the Labor Code, Compensation,as provided for by Safety Code,Section I use a a)should this perm is issued. Additionally,should I use equipment or devices hic Management District I will hazardous air performance of the work for whichp rovided for by the Bay Area Air Quality Compensation Insurance,as p contaminants as defined by Chapter 9.12 and the I have and will maintain Worker's r t performance of the work for which this 505 25533,and 25534. r� mainta' com fiance with the Cupertino Municipal Code, Section 3700 of the Labor Code,for p $e &Sa ty Code,Sections permit is issued. certify that in the performance of the work for which this permit elo issued, w r th ed agen Date: �1�� I c fy not employ any person in any manner so as to become subject t Compensation laws of California. If,after making this certificate abor Code,I must AGENCY f exemption,I Comp Compensation provisions of the L become subject to the Worker's Comp permit shall be deemed revoked. CONSTRUCTION LENDING A forthwith comply with such provisions or this pis a enc for the performance of work'E I hereby affirm that there isued(Sec. 097,CnvC)agency APPLICANT CERTIFICATION for which this permit I certify that I have read this application and state that the above information relating Lender's Name correct.I agree to comply with all city and county ordinances and state ion and hereby authorize representatives of this city t enter Lender's Address to building construct for inspection purposes.(We)agree t o saveupon the above mentioned property p ARCHITECT'S DECLARATION of Cupertino against liabilities,judgments, i- Minify and keep harmless the City p in consequence of the public records. and expenses which may accrue against said City� fans shall be used as this.pe dditionacr the applicant understands and will comply I understand my p granting oft p with all non-poin ource gulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. j Date____Z '�L� Signature CITY OF CUPERTINO PERMIT RECEIPT OPERATOR: patg 5 ITEMS OF 60 COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 31643004 .10668 DATE ISSUED. . . . . . . 01/203 RECEIPT # . . . . . . . . . : BS0000096 REFERENCE ID # . . . : 10010117 SITE ADDRESS 10668 MAPLEWOOD RD APT A,B,C,D SUBDIVISION • • • . . . : CUPERTINO CITY . . . . . . . . . . . . . IMPACT AREA . . . • • • • OWNER ESSEX PROPERTY TRUST : 10696 ROSEWOOD RD APT A-D ADDRESS . . . . . . . . . . CITY/STATE/ZIP CUPERTINO, CA 95014 RECEIVED FROM ALLAN UY CONTRACTOR GENARO MORALS LIC # 27101 COMPANY . . . . . . . . . . : GENMOR PLUMBING ADDRESS . . . . . . . . . . : 2552 SEABOARD AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95131 TELEPHONE . . . . . . . . : (408) 855-8348 QUANTITY AMOUNT PD-TO-DT THIS-REC_ -_NEW-BAL- FEE ID UNIT QUANT _ ---------- ---------- ---- _____ ------- --------- 0 .00 1 . 00 0 . 00 - 2, 500 .00 1 . 00 0 . 00 1BCBSC VALUATION 21. 00 0 .00 21 . 00 1 . 00 0 .00 0 . 63 0 . 00 1BPWSVCS WATER SERVICE 2, 500 . 00 0.63 0 . 00 1BSEISMICO VALUATION 42 . 00 0 .00 42 . 00 1 . 00 00 42 .00 0 . 00 0 . 1PPERMITFE FLAT RATE 1 .00 42 . 00 ______ 1TRAVDOC FLAT RATE _------ =--------- ---------- ---- 0 . 00 106 .63 0 .00 106 .63 TOTAL PERMIT F PAYMENT AMOUNT' _REFERENCE -NUMBER_- METHOD O --------------- _ CREDIT CARD 1, 279_56 VISA TOTAL RECEIPT 1, 279 . 56 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -- -------- ---------------------------- -------- -- ----------------------- 106 SEWER & WATER 103 UFER 507 FINAL PLUMBING \ C 1 C7 CITY OF CUPERTINO RIPE/SES IN SERVICE EP CITY OF FORM CUPE�TtNOPERMITI� APPLICATION. Date: APN # A -u) Building Address: (/ G A Phone#: Owner's Name: Phone#: -- Contractor: . C Fax#: :%� �� r Phone#. �_�{-��,) .�t C; 7 ) -.-) Contact: 0�\ �"v �- Fax#: Contractor License Cupertino Business License#: Job Description: Residential El Commercial Valuation: 'ect Size: Express ❑ Standard❑ Large Major Prod . El portion of the Green Building Checklist & attach it to the Green Building: Please complete relevant p sheet index. application or if applicable, include in plan set & the Green Building Points: ' tion Fee Permit Type Fee ID Fee DescripQuantity Grou 1PCSEWER Commercial building p 1CPSS sewer/sanitary sewer per fixture P ICPRP 1 BPREPIPE Commercial re-pipe p 1PGASCOM Commercial Gas Piping System P 1-4 Outlets B ALL PERMIT 1BCBSC Cal Bldg Standards Commission TYPES Fee P 1 BSEISMICOM Seismic Commercial Revised 01/07/09 CITY OF C SERVICE PIPEISEWER/MAINRE In ofF EE SCHEDULE CUPE�TINO . Fee Permit Type Quantity Fee ID Fee Description Grou Commission B ALL PERMIT 1B CBSC Cal Bldg Standards Com TYPES 1 Fee P 1BSEISMICR Seismic Residential P 1RPSS 1 PRSEWER Residential building sewer/sanitary SeWer p JRPRP 1 PRR EpIpE Residential re-pipe per fixture 1CPWS or p 18PWS'VCS Water Service 1RPWs 1 PPR SEWG Private Sewage Disposal Sys tem P P 1PCESS Cesspool 1 BPWATER Install/alter Water Pipe P 1 BPFIXTURE Plumbing Fixture P 1PGASRES Residential System P Gas Piping y 1-4 Outlets P 1BPGA S Gas Piping System 5+ Outlets pERMITFEE Plumbing Permit Fee Issuance P 1P LMBLNCK Plumbing Plan Check P 1P Ins P IPLMBINSP Other Plumbing/gas p• VDOC Travel & Documentation Fee B 1 TRA B 1 BUSLIC Business License Community Development 10300 Torre Avenue =� Cupertino CA 95014 ertin Telephone(408)777-3228 Fax(408)777-3333 1 Ct/■ OF "UPE TING 1.0 rtment Build*n De a n� gsolq PERMIT # JOB ADDRESS: ii, c o C cJ l cp .� PHONE # OWNERS NAME: - b ry s �-- FAX # L CONTRACTOR: 1r �� GENERA lam not using any subcontractors: Date Signature . subcontractors and com Tete the f ollowin information : Please check applicable SUB CONTRA CTOR BUSINESS NAME BUSINESS LICENSE # 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 Tile Date Owner/Co tractor Signature