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10010086 TING BUILDING PERMIT O:looloos6 CITY OF CUPER GENMOR PL CONTRACTOR. UMBING PERMIT N • �APT A-D DATE ISSUED:01/25/2010 BUILDING ADDRESS- 10696 ROSEWOOD2552 SEABOARD AVE 8348 PHONE NO:(408)855- OWNER'S NAME: ESSEX PROPERTY TRUST SAN JOSE,CA 95131 �,...,. NE: 6508495835 ELECT PLUMB NER S PHO R's DECLARATION BUILDING PERMIT INFO: BLD rERCIAL 13 LICENSE])CONTRALTO RESIDENTIAL COMM 111110111 MECH � Lic.# License Class Date JOB DESCRIPTION WATER MAIN SERVICE REPLACEMENT Contractor rovisions of Chapter 9 I hereby affirm that I am licensed under the p Section 7000)of Division 3 of the Business&Professions (commencing with Code and that my license is in full force and effect, hereby affirm under penalty of perjury one of the following two declarations: I her y will maintain a certificate of consent to self-insure Code,for the r Worker's Valuation:$2500 I have and wi Section 3700 of the Lab Compensation,as provided for by Sq.Ft Floor Area: permit is issued. provided for by performance of the work for which this pensation Insurance,as Occupancy Type, I have and will maintain oWorker's Code,for the performance of the work for which this APN Number:31643005.10696 Section 3700 of the Lab permit is issued. T STARTED APPLICANT CERTIFICATIONation is EXPIRES IF WORK IS NO EOR this application and state that the above i S arn'laws relating pEi RMIT IT ISSUANC I certify that I have readand county ordinances to enter OF PERM correct.I agree to comply with all city resentatives of this city WITHIN 180 DAYS LLED INSPECTION. construction,and hereby authorize rep We agree to save LAST CA to building ty for inspection purposes. ( ) s ud ments, YS FROM upon the above mentioned prop Ci of Cupertino against liabilities,judgments,o the 180 DA indemnify and keep harmless theCity m consequenc 1 Date: accrue against said City costs,and expenses which may licant understands and will comply Issued granting of ermit. Additionally,the app Cupertino Municipal Code,Section ulations per the Cup t with all non of source reg 9.18. r (� Date RE-ROOFS: If a roof is Signatu prior to any roofing material being installed. All roofs shall be inspectedri n an inspection,I agree to remove all new materials or installed without first obtai g OWNER-BUILDER DECLARATION Law for one of inspection. ❑ t from the Contractor's LicenseDate: I hereby affirm that I am exempt compensation, Signature of Applicant: the following two reasons: employees with wages as their sole, I,as owner of the property, or myOR BETTER e structure is not intended or offered for sale Sec.704 , ROOF COVERINGS TO BE CLASS"A" will do the work,and the ALL Business&professionsCode) exclusively contracting with licensed contractors to I,as owner of the property, HAZARDOUS MATERIALS DISCLOSURE 6.95 of the construct the project(Sec.7044,Business&Professions Code). requirements under Chapter const three of perjury one of the following 25533,and 25534. I will maintain r penalty P I have read the hazardous Code aSections 25505, I hereby affirm unde p Chapter 9.12 and the Health& nce with the Cupertino Municipal Code, ' ns: t to self-insure for Worker's California Health&Safety a or handle hazardous material. declarations: compliance should I store I have and will maintain a Certificate of Consent Safety Code,Section 25532(a) ' ed for by Section 3700 of the Labor Code,for the should I use equipment or devices which emit hazardous str►ct I will ir Compensation,as proved Additionally,sh Area Air Quality Management Perm is issued. rovided for by the Bay Chapter 9.12 and the performance of the work for which this pensation Insurance,asp contaminants as defined by Cupertino Municipal Code, mainta' mpliance with the I have and will maintain r Code, for the erformance of the work for which this 0 Safety oCode,Sections 25505,25533,and 2553 . Section 3700 of the Labor CHeal I shall ' en t: "' 1V permit is issued. r a iz Date: 'n the erformance of the work for which this eC�l is issued, O I certify that p manner so as to become subs tion,I not employ any person in any this certificate of exemption, sation laws of California. If,after making I must Comp ation rovisions of the Labor Code, CONSTRUCTION LENDING AGENCY rformance of wort become subject to the Workers Compens p agency for the pe such rovisions or this permit shall be deemed revoked. b affirm that there is a construction lending ding g y forthwith comply with p I hereby ) for which this permit is issued(Sec.3097, APPLICANT CERTIFICATION Lender's Name this application and state that the above ds ate laws relating dress I certify thation is at I have readand county ordinance agree to comply with all city resentatives of this city to enter Lenders A correct.I and hereby authorize rep to building construction, inspection purposes.(We)agreed save ARCHITECT'S DECLARATION for insp ud ments, upon the above mentioned property. of Cupertino against liabilities,judgments, public records. inify and keep harmless the cru in consequence of the Plans shall be used as accrue against said City 1 I understand my and expenses which may applicant understands and will comp y granting of this dditionally,the app ertino Municipal Code,Section Licensed Professional with all non-p nt sourc regulations per the Cup 9.18. �� • `� Signature CITY OF CUPERTINO RECEIPT OPERATOR: patg PERMITCOPY # : 1 5 ITEMS OF 40 Sec: Twp: Rng: Sub: Blk: Lot: : 31643005 .10696 APN • , , , , . DATE ISSUED. • • • • " 01/25/2010 BS000009612 RECEIPT # • • " 10010086 REFERENCE ID # • • - SITE ADDRESS 10696 ROSEWOOD RD APT A-D SUBDIVISION : : • , • • . CUPERTINO CITY . • . IMPACT AREA . . . . . . • ESSEX PROPERTY R APT A-D OWNER : 10696 ROSEWOOD RD ADDRESS • • • • • . . . " CUpERTINO, CA 95014 CITY/STATE/ZIP • • • RECEIVED FROM ALLAN UY LIC # 27101 CONTRACTOR GENARO MORALS OMPANY GENMOR PL ARDN CAVE ADDRESS . • • • • • . . " : 2552 SEABOARD SA, ' N JOSE CA 95131 CITY/STATE/ZIP TELEPHONE (408) 855-8348 THIS REC NEW BAL QUANTITY AMOUNT -- -pD=TO_DT_ _---_-_--- ----____-- FEE ID UNIT ---------- -------- 1.00 0 . 00 _____ --------- 21500 -00 1. 00 0 .00 0 . 00 VALUATION 2, 500 .00 0 .00 21.00 1BCBSC 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 42 . 00 0 .00 _-_----__ __________ FLAT RATE 1.00 __ ------0 .00 - 1TRAVDOC -------- 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 OF C UPERTIN O :� REPIPCISEVVEWFAIN SERVICE C f.CITY -PERMIT APPLICATION FORM CU kTINO Date: I APN # o"5 1 s: CA F—D Building Ad Phone#: U 7 .......... arne: 6 Lk�C?Owner A-L -?-Phone C-6'5s --7J 4 Co Fax#- 4'5k U- - H Contractor: Lq hone#: Contact: Fax#: Contractor License#: Cu e,tino Business License Job Description: jJ V Commercial Residential ❑ Valuation: Z_ CJT';U P ❑ roject Size: Express❑ Standard❑ Large aj or en Building Checklist & attach it to the Green Building'. Please complete relevant portion of the Green application or if applicable,include in Plan set & the sheet index. Green Building Points: Fee Description Fee Permit.Type Quantity Fee ID Grou 1CPSS R Commercial building P 1PCSEWE sewer/sanitary sewer P 1CPRP 1BPREpIPE Commercial re-pipe per fixture IPGASCOM Commercial Gas Piping System P 1-4 Outlets ALL PERMIT B YPES CBSC C Bldg Standards Commission T Fee P IBSEISMICOM Seismic Commercial Revised O1/07/09 OF CITY CU-pFRTINO ..�.._ IN SERVICE .� pE�SEVVE REFI SC�EDULE CITY of FEE CUPERTINO Fee Permit Type Fee Description Quantity Grou Fee ID B ALL PE Commission RMIT Cal Bldg Standards TYPES 1BCBSC Fee P Seismic Residential 1BSEISMICR P 1RpSS Residential building 1PRSEWER sewer/sanita sewer p 1RPRP Residential re-pipe Per fixture 1PRREpIPE p iCPWS or Water Service p lIZPWS 18P Svcs private Sewage Disposal System 1PPRSEWG P IPC ESS Cesspool p Install/alter Water Pipe 1 BPW ATER p XTURE Plumbing Fixture 1BPFI P Residential Gas Piping System 1PGASS 1-4 Outlets p Gas pi ing System 5+ Outlets 1BPGAS G P Plumbing permit Fee Issuance P 1ppERMITFEE P Plumbing Plan Check Ip LMBLNCK p Ip LMBINSP Other Plumbing/gas Insp. Travel &Documentation Fee B IT DOC B 1BUSLIC Business License Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 1 Fax(408)777-3333 CITY�OF ,.;U PE TINS • ungartment Bu ll De �� PERMIT # YJOB ADDRESS. �1C- 0�I�Ltk PHONE # 'S NAME: �`' t �"(,l'S - OWNER svy. FAX # GENERAL CONTRACTOR: i�-zv It I am not using any subcontractors: Signature Date subcontractors and c om lete the f ollowin. information: Please chRIX applicable s E BUSINESS LICENSE # SUBCONTRACTOR BUSINESS NAM abinets &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 Tire* IL� f � � Date Owner/Contractor Signature