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10010119 N O BUILDING PERMIT O:10010119 SIMON CITY OF CUPERTI PERMIT N CONTRACTOR:GENMOR PLUMBING APT A-D DATE ISSUED:01/25/2010 BUILDING ADDRESS: 10677 ROSEWOOD RD 2552 SEABOARD AVE PHONE NO:(408)855-8348 OWNER'S NAME: ESSEX PROPERTY TRUST SAN JOSE,CA 95131 ... 508495835 ELECT PLUMB ,+ER'S PHONE: 6 DECLARATION BUILDING PERMIT INFO: BLD COMMERCIAL C3LICENSED CONTRACTOR'S 1VIECH� RESIDENTIAL COM Lic.# � v License Clas of Date "" DESCRIPTION:REPLACE WATER MAIN SERVICE :I -, JOB Contractor provisions of Chapter 9 hereby affirm tha I am licensed under the Iction 7000)of Division 3 of the Business&Professions (commencing with Se Code and that my license is in full force and effect, pen of perjury one of the following two declarations: I hereby affirm under p maintain a certificate of consent to self-insure Codfor e,,for the Valuation:$2500 I have and will m provided for by Section 3700 of the Lab Sq.Ft Floor Area: Compensation,as p ermit is issued. performance of the work for which this p provided for by Occupancy Type: Compensation Insurance,as p I have and will maintain Woo e for the erformance of the work for which this APN Number:31643005.10677 Section 3700 of the Labor Code, permit is issued. TED APPLICANT CERTIFICATION above information is IF WORK.IS NOT STAR A PERMIT EXPIRES CE OR that I have read this application and state that the abo YS OF PERMIT ISSUANCE I certify with all city and county ordinances of histc city to entering A CTION. correct.I agree to comply�' authorize representatives of agree to save WITHIN 1 LAST CALLED INSPE to building construction,and hereby inspection purposes. (We)ag ud ments, OM 180 DAY upon the above mentioned property o f Cupertino against liabilities,j g _ 1 indemnify and keep harmless the City against said City in consequence of the I_ 6 ( Date: enses which may accrue costs,and exp the applicant understands and will comply Issued by: ranting of th ermit. Additionally,per the Cupertino Municipal Code,Section g oin urce regulations p with all no -p 9.18. Date--I---- '6L RE-ROOFS- installed.If a roof is Signature rior to any roofing material being roofs shall be inspected p I agree to remove all new materials for All roo an inspection, g -BUILDER DECLARATION installed without first obtaining OWNER inspection. Date: m exempt from the Contractor's License Law for one o I hereby affirm that I a compensation, Signature of Applicant: the following two reasons: employees with wages as their sole comp I,as owner of the property, or my OR BETTER structure isnot intended or offered for sale(Sec.704 , L ROOF COVERINGS TO BE CLASS"A'� will do the work,and the AL Business&Professions Codes exclusively contracting with licensed contractors to I as owner of the property, &professions Code). HAZARDOUS MATERIALS DISCLOSURE .95 of the ro ect(Sec.7044,Business ter 6 construct the project e following three 25505,25533,and 25534. I will mai&ai Chapter of the a read the hazardous materials requirement ements under Health penalty of perjury one I have Code,Sections ter 9.12 and the I hereby affirm under p California Health&Safety Chap declarations: compliance with the Cupertino Municipal Code, 'Cate of Consent to self-insure for Worker's comp . hazardous hazardous air if he 532 a)should I store or handle hazardous material. I have and will maintain a Cert Safety Code,Section 25 provided for by Section 3700 of the Labor Code,for ui ment or devices which em ement District I will Compensation,asp Additionally,should I use eq he Bay Area Air Quality Manag ermit is issued. Pr for by Chapter 9.12 and the performance of the work for which this permit Insurance,asp contaminants as defined by Cupertino Municipal Code, maintain comp cc with the I have and will maintain Worker's Comp n S �, ode,Sections 255059 25533,and 25534. COe,for the performance of the work for which this Health Section 3700 of the Labor is errnit is issued,I shall permit is issued. ed ent: Date: certify that in the performance of the work for which th p I c fy manner so as to become subject to the Worker's Owner not employ any person in any this certificate of exemption,I I must laws of California. If,after making of the Labor Code, CONSTRUCTION LENDING AGENCYerformance of wo Compensationensatio p become subject to the Worker's Comp ermit shall be deemed revoked. agency for tip p with such provisions or this p I hereby affirm that there is a coneCru3097,Civ g y forthwith comply for which this permit is issued(S APPLICANT CERTIFICATIONon is Lender's Name his application and state that the abovane d stainfote laws relating Address I certify that I have read t p and county ordinances to enter Lenders A correct.I agree to comply With all city representatives of this city TION construction,and hereby authorize rep u oses.(We)agree to save to building ro erty for inspection p liabilities,judgments, ARCHITECT'S DECLARATION upon the above mentioned property o f Cupertino against public records. nnify and keep harmless the City against said City in consequence of the plans shall be used as p expenses which may accrue 1 I understand my �s,and exp Additionally,the applicant understands and will comply granting of this Pe Per the Cupertino Municipal Code,Section Licensed Professional o' sour regulations with all non-p 9.18. Date Signature CITY OF CUPERTINO RECEIPT OPERATOR: patg PERMIT R COPY # 1 5 ITEMS OF 40 Rng: Sec: Twp: Sub: Blk: Lot:31643005 .10677 APN • • " " ' . DATE ISSUED: : : : : : : 01/25/2010 _ BS000009612 RECEIPT # ; 10010119 REFERENCE ID # SITE ADDRESS • , , , , : 10677 ROSEWOOD RD APT A-D SUBDIVISION • : . • • • CUPERTINO CITY . • • IMPACT AREA . • • • • • . . • • , , , , ; ESSEX PROPERTY TRUST SAPT A-D OWNER ; 10677 OLIVEWOOD RD ADDRESS • " " ; CPERTINO, CA 95014 CITY/STATE/ZIP RECEIVED FROM ALLAN UY LIC # 27101 • ' ; CONTRACTOR • " GENARO MORALSGENMOR 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_ _----___-- ----____-- UNIT 4 ___-- 0 . 00 FEE ID ---------- ----- 0 .00 1 . 00 ___ ____ ----------- 1. 00 21.00 0 .00 VALUATION 2, 500 .00 21. 00 0 .00 0 . 00 1BCBSC SERVICE 1.00 0 .00 0 .63 1BPWSVCS WATER S 0 . 63 42 .00 0 .00 2, 500 .00 42 , 00 0 .00 0 .00 1BSEISMICO VALUATION1 .00 0 .00 4200 1PPERMITFE FLAT 1.00 42 . 00 ----- 1TRAVDOC FLAT RATE -_----- ------ 106 . 63 0 . 00 106 .63 0 .00 TOTAL PERMIT : DESCRIPTION VOICE ID VOICE ID DESCRIPTION_- -__-_ -------- 106 SEWER & WATER 103 UFER 507 FINAL PLUMBING CITY OF CUPERTIN O SERVICE PIPE SEWERMAIN E R RM CITY OF PERMIT AP LICATION FO CO 1 0 CUPE INO Date: APN # � J � jj��,, 1,............ . ............ 14 ... .............. ... Build in Address: Uii Phone# owner's Name: #: CL Phone Contractor: Fax > UN Phone#: Contact: Fax -t-\[�Ail Contractor License cc, Cu ertino Business License:4- Job Description'. Commercial Q--y Residential ❑ valuation* Maj...................... ❑ Large....... Project Size: Express Standard 9 Building Checklist & attach it to the Green Building: Please complete relevant portion of the Green 'cation or if applicable, include in p applelan set & the sheet index. Green Buildin Points: Fee Description Fee Permit.Type Quantity Fee ID Grou ICPSS P "C"D Commercial building IPCSEW.UJIX sewer/sanitary sewer P JCPRP 1P commercial re-pip per fixture IBPREPIP,-, JPGASCOM commercial G s Piping System P 1-4 Outlets dards ComB ALL PERMIT C Bldg S mission TYPES BCBSC Fee IBSEISMICOM Seismic Commercial Revised ol/07/09 CITY OF CUPERTINO ;,�.�..�.. SERVICE 4 IN REPIPEISEV'VE Cjn of FEE SCHEDULE CUPEiNO ^j'yP Type QuantityFee Description GrouFee Permit Fee ID ALL PERMIT B Cal Bldg Standards Commission NPES 1BCBSC Fee P ICR Seismic Residential 1BSEISM p 1RPSS 1PRSEW ER Residential building sewer/sanitarY sewer p 1RPRP _ per fixture PIPE Residential re pipe p 1PRRE 1CpWS or 18PWSVCS Water Service P stem osal 1RPWS S P G Private Sewage Disp Y 1 PPRSEW P 1PCESS Cesspool R Install/alter Water Pipe P 1BPWATE P PFIXTURE Plumbing Fixture 1B p Residential Gas Piping SYstem 1 P GASRES 1-4 Outlets p Gas Piping System 5+ outlets 1BPGAS P E Plumbing permit Fee Issuance 1ppERMITFE P I{ Plumbing Plan Check 1 pLMBLNC P IPL BINSP Other plumbing/gas Insp. Travel &Documentation Fee B IT DOC B 1BUSLIC Business License Community Development 10300 Torre Avenue Cupertino CA 95014 :: Telephone(408)777-322 3 *, =' Fax(408)777-3333 CITY OF .;UPE T1N0 artment Build In D e PERMIT # JOB ADDRESS: 1`CC� PHONE # OVVNER'S NAME: T'X #L GENERAL CONTRACTOR,: ��..�nvwur 1��`� �� FAX I� 1 � I am not using any subcontractors: Date Signature • actors and complete the f ollowin information: Please check applicable subcontractors E BUSINESS LICENSE # 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 ' e Date caner Contractor Signature