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10010105 ISO BUILDING PERMIT NO:10010105 CITY OF CUPERT NMOR PLUMBING PERMIT CONTRACTOR:GE APT A-D DATE ISSUED:01/25/2010 BUILDING ADDRESS: 10686 ROSEWOOD RDAPT SEABOARD AVE PHONE NO:(408)855"8348 OWNER'S NAME: ESSEX PROPERTY TRUST SAN JOSE,CA 95131 �.. NER'S PHONE: 65 08495835 ELECT PLUMB DECLARATION BUILDING PERMIT INFO: BLD r COMMERCIAL LICENSED CONTRACTORS MECH RESIDENTIAL 3 1� � ) .� License Class Lic.# WATER MAIN SERVICE REPLACEME T Dated JOB DESCRIPTION Contractor provisions of Chapter 9 I hereby affirm that I am licensed under the of the Business&Profe (commencing with Section of Division 3 ssions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: aintain a certificate of consent to self-insure CodWorker's Valuation:$2500 I have and well m rovided for by Section 3700 of the LaborSq,Ft Floor Area: Compensation,as P permit is issued. performance of the work for which this p ensation Insurance,as provided for by Occupancy Type- I have and will maintain Worker's for the performance of the work for which this APN Number:31643005.10686 Section 3700 of the Labor Code, permit is issued. WORK IS NOT STARTED APPLICANT CERTIFICATION IT EXPIRES IF NCE OR this a plication and state that the above information relating PIE R�/j I'I' ISSUANCE I certify that I have read p and county ordinances to enter WITHIN 180 DAYS OF PERM correct.I agree to comply with all city representatives of this city WIT INSPECTION. and hereby authorize rep u osiv (We)agree to save LAST CALLED to building construction, for inspection purposes. ud ments, YS FROM 'upon the above mentioned property Cupertino against liabilities,j g 180 DA harmless the City of Cup m consequence of the Date: indemnify and keep accrue against said City costs,and expenses which may licant understands and will comply Issued b ' of this pe Additionally,the app ertino Municipal Code,Section granting regulations per the Cup with all non-point our e reg 9.18. Date RE-ROOFS: installed.If a roof is Signature rior to any roofing material being All roofs shall be inspected p an inspection,I agree to remove all new materials for ER-BUILDER DECLARATION installed without first obtaining � OWN inspection. Date: I am exempt from the Contractor's License Law for one scant I hereby affirm that ensation, Signature of Appl the following two reasons: employees with wages as their sole comp I,as owner of the property, or my OR BETTER structure is not intended or offered for sale(Sec.704 , L ROOF COVERINGS TO BE CLASS"A'� will do the work,and the AL am exclusively contracting with licensed contractors to Business&Professions Code) S MATERIALS DISCLOSURE 1,as owner of the property, HAZARDOUS ter 6.95 of the the project(Sec.7044,Business&Professions Code). requirements under Chap will maintair construct p three and 25534. 1 of perjury one of the following Code,Sections 25505,2553ter 912 and the Health& I have read the hazardous materia s q I hereby affirm under penalty California Health&Safet lino Municipal Code,Chap declarations: cate of Consent to self-insure for Worker's compliance with the Cup ifs e 532 a should I store or handle hazardous zardous air I have and will maintain a CertSafety Code,Section 25 ( ) provided for by Section 3700 of the Labor Code,for the ui ment or devices which District I will Compensation,as pr which this permit is issued. Additionally,should I use equipment q he Bay Area Air Quality Chapter Dist and the performance of the work for Provided for by contaminants as defined by Cupertino Municipal Code, Compensation Insurance,as maintain co liance with the Cup 25533,and 25534. I have and will maintain Worker's ee,for the performance of the work for which this Health of Code,Sections 25505, Section 3700 of the Labor ermit is issued,I shall d.--�� permit is issued. r th ize agent Date: i that in the performance of the work for which this p I certify manner so as to become subject to the Worker's Own person in any tion,I not employ any p this certificate of exemption, must Compensation laws of California. If,after making of the Labor Code, CONSTRUCTION LENDING AGENCY performance of wor Comp ensation p become subject to the Worker's Comp agency for the pe such provisions or this permit shall be deemed revoked. 7 Civ C.) with su p I hereby affirm that there is a const09 n lending g y forthwith comply�'�' for which this permit is issued(Sec. APPLICANT CERTIFICATION Lender's Name is a lication and state that the above information ws relating dress I certify that I have read th pp and county ordinances an to enter Lender,s Ad correct.I agree to comply with all city representatives of this city TION construction,and hereby authorize rep We a ree to save to building for inspection purposes.(We) g ud ments, ARCHITECT'S DECLA ,anon the above mentioned property of Cupertino against liabilities,j g public records. -,mnify and keep harmless the City against said City in consequence of the plans shall be used as accrue ag 1 I understand my :s,and expenses which may applicant understands and will Comply granting of' pe Additionally,ter the Cupertino Municipal Code,Section with all non-poin sour a regulations p Licensed Professional 9.18. Date Signature CITY OF CUPERTINO OPERATOR: patg 5 ITEMS OF 40 PERMIT RECEIPT COPY # : 1 Sec: Twp: Rng: Sub: 81 APN . . . . . . . . . 3643005 .10686 DATE ISSUED. • • • • " 01/25/201085000009612 RECEIPT # . " � 10010105 REFERENCE ID # • • • SITE ADDRESS 10686 ROSEWOOD RD APT A-D SUBDIVISION• : : : : : : CITY : CUPERTINO IMPACT AREA . • • • • • • RUS OWNER . . . . . . . . . . . . : ESSEX PROPERTY R.DUAPT A_D ADDRESS . . . . . . . . 95014 . . : 10686 ROSEWOOD CITY/STATE/ZIP . . . : CUPERTINO, CA 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 UNIT QUANTITY AMOUNT--_ -PD_TO_DT- -----___-- ----____-- FEE ID _----- 1 . 00 0 .00 --- ----- ------- ---- 1 . 00 0 .00 0 . 00 1BCBSC VALUATION 21500 . 00 0 . 00 21 . 00 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 1 .00 42 .00 0 .00 -- ---------- 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 CITy OFCUPERTINO SERVICE r_ pEPIPE/SEWE CATIONPM c1TING PERMIT Y of A FO E T - CUP . Date: + , APN # t 0 C) Build in ddress;;--� Phone#: Name:, � � c C".� cb Owners , A. — 1Li Phone#. ..'D �. � Fax#: � �> Contractor: �'�.\V 1 Phone#: , r,,? contact: "� Fax#: �� Contractor License ess License C- 11ertlno Busin ,. Job Description: \�,-N\CIL, \cl\UAV�AAS Commercial Residential ❑ R Valuation: �-- Ma or Standard Large�' � Pro•ect Size: Express❑ & attach it to the � Checklist ant portion of the Green Building n Building: Please complete relevant Gree licable,include in plan set & the sheet index. application or if app GreenBuildin Points: Fee permit Type - • Fee ID Fee Description Grou Quantity P 1CPS Commercial building 1PCSEWER sewer/sanitary sewer P 1CPRP 1 BPREPIPE Commercial re-pipe per fixture Piping System P SCOM Commercial Gas p g 1 PGA 1-4 Outlets ALL PERMITB Cal Bldg Standards Commission TYPES 1BCBSC Fee P 1BSEISMI COM Seismic Commercial Revised 01/07/09 OF C-U-PERTINO N SIKIRVICECITY ,�: -REpIPE ULE ry �, FFE SCMED ................................................... In permitTypeCUPEk-VINO Fee Fee Description Grou ERMIT • Fee ID B P ALL Quantityfission TYPES Cal Bldg Standards Comm 1BCBSCFee P smic Residential SEISMSel 1RPSS 1B ICR P Residential building 1RpRp 1PRSEWER sewer p Sealer/sancta a per fixture Residential re-pip p i COW s or 1PRREPIPE P 1RpWs S Water Service 1BPwSVC P G pnvat e Sewage Disposal System 1PPRSEW P Cesspool 1PCESS P P Install/alter W ater ipe IBP ATER P E plumbing Fixture 1BPFIXTDRStem P idential Gas Plping SY Res 1PGASS P 1_4 Outlets Outlets Pi In System 5+O 1B pGAS as111111PP tubing Permit Fee Issuance FEE Plu P IPP plumbing plan Check 1PLMBLNCK P Other Plumbing/gas Insp. 1PLMBINSP 1 &Documentation Fee B IT TraVe B 1BUSLI11 C Business License Community Development 10300 Torre Avenue Cupertino CA 95014 s f.; Telephone(408)777-3228 w Fax(408)777-3333 CiTlf�0� '%UPEkTINO v • artment � BuIdlIn e PERMIT # OB ADDRESS: ALA C, �� 1 PHONE # C OWNERS NAME: - - FAX # GFT ENERAL CONTRACTOR: Ozdlt, I am not using any subcontractors: Signature Date subcontractors and co lete the f ollowin information: Please check applicable s E BUSINESS LICENSE # SUB C ONTRACTOR BUSINESS NAM Cabinets &Millwork _i_�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 file Date er/Contrac*tbr Signature