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10010094 PERTIN O BUILDING PERMIT PERMIT NO:10 o 1 o094 4 CITY OF CU CONTRACTOR:GENMOR PLUMBINGISSUED:01/25/2010 DATE BUILDING ADDRESS: 10656 ROSEWOOD RD APT A-D OWNER'S NAME: ESSEX PROPERTY TRUST 2552 SEABOARD AVE PHONE NO:(408)855-8348 SAN JOSE,CA 95131 SER'S PHONE: 6508495835 PLUM CTOR'S DECLARATION B BUILDING PERMIT INFO: BLDG ELECT LICENSED CONTRACOMMERCIAL � MECH RESIDENTIAL C License Class 3mL Lic.# 3 J Date JOB DESCRIPTION:WATER MAIN SERVICE REPLACEMENT Contractor hereby affirm that I am licensed under the Pr f the Business&ovisions of t I heProfessions y (commencing with Sections On full force and effect. 0)of Division 3 o Code and that my license I hereby affirm under penalty of perjury one of the following two declarations: ave and will maintain a certificate of consent to self-insureLabor Code,for the Valuation:$2500 I h Section 3700 of the L Compensation,as provided for by it is issued. Sq.Ft Floor Area: performance of the work for which this Perm as Insurance,as provided for by I have and will maintain Workers Comp Occupancy Type: APN Number:31643005.10656 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION S IF WORK IS NOT STARTED that I have read this application and state that the above information is PERMIT EXPIRE ISSUANCE OR I certify t with all cit and county ordinances and state laws relating IT ISSU correct.I agree to comply y resentatives of this city to enter WITHIN 180 DAYS OF PERM construction,and hereby authorize rep agree to save to building or inspection purposes. (We) g FROM LAST CALLED INSPECTIO • upon the above mentioned property f of Cupertino against liabilities,judgments, 180 DAYS FR indemnify and keep harmless the City P in consequence of the .-1-e- costs,and expenses which may accrue against said City _._-- - Date: this permit. Additionally,the applicant understands and will comply Issued by:s' granting of P Il non- source regulations per the Cupertino Municipal Code,Section with a P 9.18. <� Date Signatur RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is first obtaining an inspection,I agree to remove all new materials for OWNER-BUILDER DECLARATION installed without f Li inspection. b affirm that I am exempt from the Contractor's License Law for one o Date: I hereby licant: the following two reasons: Signature of App the Property,or my employees with wages as their sole compensation, 1,as owner of p P will do the work,and the structure is not intended or offered for sale ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER Business&Professions Code) with licensed contractors to I,as owner of the property,am exclusively contracting HAZARDOUS MATERIALS DISCLOSURE under Chapter 6.95 of the construct the project(Sec.7044,Business&Professions Code). nal of perjury one of the following three e I have read the hazardous materials requirements ns 25505,25533,and 25534. I will maintain I hereby affirm under penalty Code,Sect declarations: IthChapter 9.12 and the Health& ate of Consent to self-insure for Worker's Californianc Hw h the Cupertino Municipal Code,handle hazardous material. I have and will maintain a Certificate comp should I store or h m ensation,as provided for by Section 3700 of the Labor Code,for the Safety Code,Section 25532(a) rdous air Co ed. all should I use equipment or devices which yMan gement District I will P Additionally, performance of the work for which this permit is issu rovided for by the Bay Area Air Quality maintain Worker's Compensation Insurance,asp contaminants as defined by Chapter 9.12 and the I have and will mai compliance with the Cupertino Municipal Code, maintain Section 3 700 of the Labor Code,for the performance of the work for which this Health Safety Code,Sections 25505,25533,and 25534. permit is issued. d nt: -/D �n the erforrnance of the work for which this permit is issued,I shall or ut o' k- I certify that i P Date: to an person in any manner so as to become subject at of exemption,I w not employ y P this certificate Compensation laws of California. If,after making I must o the Worker's Compensation provisions of the Labor Code, CONSTRUCTION LENDING AGENCY become subject t agency for the performance of work with such provisions or this permit shall be deemed revoked. affirm that there is a construction lending g Y forthwith comply I hereby a for which this permit is issued(Sec.3097,Civ C.) APPLICANT CERTIFICATION ation is Lender's Name that I have read this application and state that the ces ands aabove te laws relating I certify t 1 with all city and county ordinances correct.I agree to comply hereby authorize representatives of this city to enter Lender's Address to building construction,and o e yfor inspection purposes.(We)agree to save on the above mentioned p P rtY against liabilities,judgments, ARCHITECT'S DECLARATION up harmless the City of Cupertino g `,mnify and keep in consequence of the plans shall be used as public records. .s,and expenses which may accrue against said City I understand my granting of this p Additionally,the applicant understands and will comply with all of t sou a regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. "�6.�- Date Signature CITY OF CUPERTINO RECEIPT OPERATOR: patg PERMIT COPY # 1 5 ITEMS OF 40 Rng: Sub: Blk: Lot: Sec: Twp: 31643005.10656 APN • " " " • DATE ISSUED: : : : : : ; 01/25/2010 BS000009612 RECEIPT # ; REFERENCE ID # - 10010094 SITE ADDRESS 10656 ROSEWOOD RD APT A-D SUBDIVISION • • � CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . • , • . ; ESSEX PROPERTY TRUST -D A-D OWNER • . . . • ; 10656 ROSEWOOD ADDRESS • • • • " " ; CUIERTINO, CA 95014 CITY/STATE/ZIP RECEIVED FROM ALLAN UY LIC # 27101 • • ' ; GENARO MORALS CONTRACTOR • • • " GENMOR PLUMBING COMPANY • • • " " 2552 SEABOARD AVE ADDRESS . • • • • . . . . ' ; SAN JOSE, CA 95131 CITY/STATE/ZIP . . . . ; (408) 855-8348 TELEPHONE THIS REC NEW BAL QUANTITY AMOUNT -PD_TO_DT_ _ _--------- 4 FEE ID UNIT ____----- ---------- 1 . 00 0 .00 ------ 1. 00 0 00 0 .00 ---------- 2, 500 .00 0 .00 21 . 00 0 .00 1BCBSC VALUATION 1. 00 21 . 00 0 . 63 WATER SERVICE 0 .63 0 . 00 0 . 00 1BPWSVCS 2, 500 .00 0 .00 42 . 00 1BSEISMICO VALUATION 1.00 42 ,00 42 . 00 0 .00 42 .00 0 .00 -- 1PPERMITFE FLAT RATE 1 . 00 _--------- ---------- ---------- 0 . 00 1TRAVDOC FLA 0 .00 106 .63 106 .63 TOTAL PERMIT : VOICE ID DESCRIPTION_-____-_- DESCRIPTION VOICE ID - -_-_ -------- -------- -------------- 106 SEWER & WATER 103 UFER 507 FINAL PLUMBING CITY OF CUPERTINO AIN SERVICE .�,;a_K� REPIPE/SEVVE�► C 1,ITY Of PERMIT APPLICATION FORM CUPEkTINO Date: APN # v= � � 0 c) Building Add ess* At .............................. Phone#: Owner's Name: 0 D (- h #: CLW6) Contractor: ��,v� ��(\� VIN C 71 Phone#. �kc Z-1LA Contact: Contractor License Cu ertino Business License#: �" �', Job Description: Commercial [�-'' Residential ❑ Valuation: Stand........... Major I❑........... rd 11"11111--Large 10 Project Size: Express [] Green Building: Please complete relevant portion of the Green Building Checklist & attach it to thel e sheet index. application or if applicable, include in plan set& th Green ilding Points: Qua Fee ID Fee Description Fee Permit.Type Grou IPCSEWER Commercial building P 1CPSS sewer/sanitary sewer 1BPREPIPE Commercial re-pipe per fixture P 1CPRP IPGASCOM Commercial Gas Piping System P 1-4 Outlets B ALL PERMIT IBCBSC Cal Bldg Standards Commission TYPES Fee Seismic Commercial P IBSEISMICOM ------ Revised 01/07/09 . CITY OF CUPE IN O r - REPIP- E/SEWERIMAIN SERVICE CITY Of FEE SCHEDULE CUPEf�TiNO n Fee Permit Type uantiFee ID Fee Descriptio Qty Grou rds Commission B ALL PERMIT 1BCBSC Cal Bldg Standards TYPES Fee 1BSEISM ICR Seismic Residential P Residential building P 1RPSS 1 PRSEWER sewer/sant sewer P 1RPRP 1PRREPIPE Residential re-pipe per fixture Service P 1CPWS or 1BPWSVCS Water 1RPWS 1 PPRSEWG Private Sewage Disposal System P 1PCESS Cesspool P 1 BPWATER Install/alter Water Pipe p 1 BPFIXTURE Plumbing Fixture P 1PGASRES Residential Gas Piping System P 1-4 Outlets —------------ P 1 BPGAS Gas Piping System 5+ Outlets 1PPERMITFEE Plumbing Permit Fee Issuance P 1 1PLMBLNCK Plumbing Plan Check P 1PLMBINSP Other Plumbing/gas Insp. P l 1 TRAVDOC Travel &Documentation Fee B I B 1BUSLIC Business License Community Development 10300 Torre Avenue Cupertino CA 95014 ` a Telephone(408)777-3228 . Fax(408)777-3333 C[Tlf 0� XPEkTINO ildo De artment inBu PERMIT # JOB ADDRESS: INS (-, . A - PHONE # D OWNE 'S NAME.. GENERAL CONTRACTOR: 0Ak1r I am not usingsubcontractors: any Signature Date subcontractors and complete the followin information: Please check applicable BUSINESS LICENSE # SUBCONTRACTOR BUSINESS NAME 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 Ti1 ; Date Owner/Contractor Signature