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10010098 CITY OF CUPERTINO BUILDING PERMIT CONTRACTOR:GENMOR PLUMBING PERMIT NO:10010098 BUILDING ADDRESS: 10689 MAPLEWOOD RD APT A,B,C,D DATE ISSUED:01/25/2010 2552 SEABOARD AVE OWNER'S NAME: ESSEX PROPERTY TRUST PHONE NO:(408)855-8348 SAN JOSE,CA 95131 NER'S PHONE: 6508495835 ,,. � r LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB F ro License Clas Date L ic.# MECH RESIDENTIAL COMMERCIAL 3� �.- Contractor _ JOB DESCRIPTION:WATER MAIN SERVICE REPLACEMENT I hereby affAthatNamlicensedunder 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 effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to of the Labor Code,for the -insure for Worker's – Compensation,as provided for by Section 3700 Valuation:$2500 performance of the work for which this permit is issued. ESq.Ftloor Area: 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 Occupancy Type: APN Number:31643003.10689 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the ordinances ands ave te laws relating PERMIT EXPIRES IF WORK IS NOT STARTED ation is correct.I agree to comply with all city and county PE to building construction,and hereby authorize representatives of this city to enter WITHIN 180 DAYS OF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We)agree to save the Ci of Cupertino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless h' costs,and expenses which may accrue against said City in consequence of the /Ge, dditionall ,the applicant understands and will comply Dater' (a granting of this permit. A Y with all non-poi urce regulations per the Cupertino Municipal Code,Section Issued by: 9.18. Signature lAtg � — RE-ROOFS: All roofs shall be inspected prior to any roofing material t ria remove all new materials is OWNER-BUILDER DECLARATION installed without first obtaining an inspection,I agree I hereby affirm that I am exempt from the Contractor's License Law for one o inspection. the following two reasons: Date: or m their sole compensation, Signature of Applicant: Y employees with wages as I,as owner of the property, to P Y will do the work,and the structure is not intended or offered for sale(Sec.7044, BE CLASS"A"OR BETTER Business&Professions Code) ALL ROOF COVERINGS TO I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). HAZARDOUS MATERIALS DISCLOSURE I hereby affirm under penalty of perjury one of the following three I have read the hazardous materials requirement25505 525533,and 25534.95 of the I will maintain declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections Chapter 9.12 and the Health& provided for b Section 3700 of the Labor Code,for the compliance witct on 25532(a)should Ie Cupertino ntoe oral ehandle hazardous material. Compensation,as p Y Safety Code,Se performance of the work for which this permit is issued. for b Additionally,should I use equipment or devices which emit hazardous air as provided y contaminants as defined by the Bay Area Air Quality Management District I will I have and will maintain Worker's Compensation Insurance, Chapter 9.12 and the Section 3700 of the Labor Code,for the performance of the work for which this maintain compliance with the Cupertino Municipal 25534e, 25505 permit is issued. Health S ety Code,Se I certify that in the performance of the work for which this permit is issued,I shall not employ any person m any manner so as to become subject to the Worker's Ow or a or a gent: Date: 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 1 with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCYe�ormance of work's forthwith compy I hereby affirm that there is a construction lending agency fort e p APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.) I certify that I have read this application and state that the and stainfote ation is Lender's Name laws relating correct.I agree to comply with all city and county ordinances to building construction,and hereby authorize representatives of this city to enter Lender's Address upon the above mentioned property for inspection purposes.(We)agree to save unify and keep harmless the City of against said Certino gaimtco sequence othe judgments, ARCHITECT'S DECLARATION and expenses *ch may accrue City plans shall be used as public records. granting of this p rmit. dditionally,the applicant understands and will comply I understand my with all nosh ' t sourc regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. �-�? -A Signature Date CITY OF CUPERTINO PERMIT RECEIPT OPERATOR: patg 5 ITEMS OF 60 COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 31643003 .10689 DATE ISSUED. . . . . . . : 01/25/2010 RECEIPT # . . . . . . . . . : BS000009613 REFERENCE ID # 10010098 SITE ADDRESS 10689 MAPLEWOOD RD APT A,B,C,D SUBDIVISION • • • . . CUPERTINO CITY . . . . . . . . . . . . . IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ESSEX PROPERTY TRUST ADDRESS . . . . . . . . . . : 10696 ROSEWOOD RD APT A-D 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 ---------- ---------- -- ___ ---------- -- ------- 0 . 00 1.00 0 . 00 -- 2, 500 .00 1. 00 0 . 00 1BCBSC VALUATION 2100 0 . 00 21.00 . 1BPWSVCS WATER SERVICE 1 .00 0 .63 0. 00 2, 500 . 00 0 .63 0 .00 0 .00 1BSEISMICO VALUATION 1 .00 42 . 00 0 .00 42 . 00 1PPERMITFE FLAT RATE 0 . 00 42 . 00 0. 00 00 42 . 00 1 . 1TRAVDOC FLAT RATE ---------- ---------- -_________ __ 106 . 63 0 . 00 106 . 63 0 . 00 TOTAL PERMIT : VOICE ID DESCRIPTION VOICE ID DESCRIPTION_-------- -------- ---------------------------- -------- -------- 106 SEWER & WATER 103 UFER 507 FINAL PLUMBING Of .. ............................. ........ ... ... ......... .. . CITY OF CUPERTINO REPIPE/SEWERIMAIN SERVICE CUPERTINO PERMIT APPLICATION FORM APN # Date: a �- I i L) Build* Add e s: 0 NAo ( - G150 tI hf}•-�D A FD;C It) Owner's Name: Phone #: Con ctor: r Phone #: C • Fax #: Z3 Contact: Phone #( 61 )e�l0. ;?1-1 Fax Contractor License #: t Cupertino Business License #: Job Description: .NRkw Residential ❑ Commercial ©� Valuation: ^� Project Size: Express Standard ❑ Large Major ❑ Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, include in plan set& the sheet index. Green Building Points: Quantity Fee ID Fee Description Fee Permit Type Group 1 PCSEWER Commercial building P 1CPSS sewer/sanitary sewer 1 BPREPIPE Commercial re-pipe per fixture P 1CPRP 1 PGASCOM Commercial Gas Piping System P 1-4 Outlets i BCBSC Cai Bidg Standards Commission B ALL PERMIT Fee TYPES I BSEISMICOM Seismic Commercial P Revised 01/07/09 #Tt+' OF CITY OF CUPERTINO REPIPE/SEW ER/MAIN SERVICE FEE SCHEDULE CUPERTI • D Fee Description :Fee Permit Type Quantity Fee I u 1 BCBSC Cal Bldg Standards Commission B ALL PERMIT Fee TYPES IBSEISMICR Seismic Residential. P 1 PRSEWER Residential building P IRPSS sewer/sanitary sewer 1 PRREPIPE Residential re-pipe per fixture P IRPRP 1BPWSVCS Water Service P 1CPWS or ,1 IRPWS 1PPRSEWG Private Sewage Disposal System P 1 PCESS Cesspool P 1 BPWATER Install/alter Water Pipe P I BPFIXTURE Plumbing Fixture P 1 PGASRES Residential Gas Piping System P 1-4 Outlets 1 BPGAS Gas Piping System 5+ Outlets P 1 PPERMITFEE Plumbing Permit Fee Issuance P 1PLMBLNCK Plumbing Plan Check P I PLMBINSP Other Plumbing/gas Insp. P ;JT RAVDOC Travel & Documentation Fee B 1BUSLIC Business License B Community Development 10300 Torre Avenue ' Cupertino CA 95014 yv: ; = Telephone(408)777-3228 Fax(408)777-3333 CITY OF :U PE TIN0 artment Bu*ld* In De PERMIT # C) q OB ADDRESS: � J Com ' ' PHONE # bid `d S OWNER"S NAME: -:�e2- W6,11;,''Q- 19, GENERAL CONT RACTOR:Aox FAX # I am not using any subcontractors: Date Signature able subcontractors and complete the f ollowin information: Please check applicable E BUSINESS LICEN=E # SUBCONTRACTOR 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 Tile Date weer/Contractor Signature