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10010084 RTINO BUILDING PERMIT _ CITY OF CUPE PERMIT NO.1 oo10084 CONTRACTOR:GENMOR PLUMBING DATE ISSUED:01/25/2010 BUILDING ADDRESS: ]0697 ROSEWOOD RD APT A-D 2552 SEABOARD AVE 855.8348 PHONE NO:(408)855-8348 OWNER'S NAME: ESSEX PROPERTY TRUST SAN JOSE,CA 95131 : 6508495835 T PLUMB ,VERS PHONE ELEC CONTRACTORS DECLARATION BUILDING PERMIT INFO: BLDG r �- � LICENSED CONTRA SIDENTIAL COMMERCIAL MECH RE • ..� Lic.# � License Clas IN SERVICE REPLACEMENT Date__) JOB DESCRIPTION:WATER MA Contractor provisions of Chapter 9 I hereby affirm that am licensed under the 000)of Division 3 of the Business&Professions (commencing with Section 7 Code and that my license is in full force and effect. two declarations: I hereby affirm under penalty of perjury one to self-insure the ]lowing Worker's I have and will maintain a certificate of consentValuation:$2500 as rovided for by Section 3700 of the Labor Code,for the S .Ft Floor Area: Compensation, P q performance of the work for which this permit is Insurance,as provided for by Occupancy Type: I have and will the Labor Code,for the performance of the work for which this APN Number:31643004.10697 Section 3700 of the Lab permit is issued. APPLICANT CERTIFICATION above information is IF WORK IS NOT STARTED application and state thatPERMIT EXPIRES I certify that I have read this with all city and county ordinances and state lawn entering OF PERMIT ISSUANCE OR correct.I agree to comply with a ty resentatives of this city t WITHIN 180 DAYS and hereby authorize rep agree to save LAST CALLED INSPECTION. to building construction, Purposes. (We) g e for inspection pure lgp DAYS FROM upon the above mentioned property of Cupertino against liabilities,judgments, indemnify and keep harmless the City in consequence of the Date: s which may accrue against said City� expenses applicant understands and will comply costs,and exp Issued bye,— -� granting of thi it. Additionally,the he Cupertino Municipal Code,Section with all non oint source regulations per the 9.18. 6 Signature Date RE-ROOFS: installed.If a roof is prior to any roofing material being All roofs shall be inspected n an inspection,I agree to remove all new materials for installed without first obtaining OWNER-BUILDER DECLARATION Law for one of inspection. I hereby affirm that I am exempt from the Contractor's LicenseDate: n of A licant: the following two reasons: es as their sole compensation, Signature PP or my employees with wag I,as owner of the property, ��OR BETTER and the structure is not intended or offered for sale(Sec.704 , ROOF COVERINGS TO BE CLASS A will do the work, ALL Business&Professions Code) exclusively contracting with licensed contractors to I,as owner of the property, am construct the project Sec.7044,Business&Professions Code). HAZARDOUS MATERIALS DISCLOSUREr 6.95 of the 'ur one of the following three uirements under Chapte under penalty of perjury I have read the hazardous materials 25505,25533,and 25534. I will maintain I hereby affirm u P Chapter 9.12 and the Health& declarations: nce with the Cupertino Municipal Code, onsent to self-insure for Worker's Calif;;a is Health&Safety r handle hazardous material. I have and will maintain a Certificate of C comp should I store o Section 3700 of the Labor Code,for the Safety Code,Section 25532(a) Compensation,as provair ided for by should I use equipment or devices which emit hazardous tri hick this permit is issued. Additionally, Area Air Quality Management District I will performance of the work for w provided for by the Bay Chapter 9.12 and the tain Worker's Compensation Insurance,as p contaminants as defined by Cupertino Municipal Code, I have and will mainmaintain compliance with the he Labor Code,for the performance of the work for which this Heal afety Section 3700 of t Code,Sections 25505,25533,and 2553 . permit is issued. permit is issued,I shall d agent: I certify that in the performance of the workt for come subject to the Worker's O r Date: person in any manner so as I not employ any p this certificate of exemption, Compensation laws of California. If,after making I must provisions of the Labor Code, CONSTRUCTION LENDING AGENCY ance of work's become subject to the Worker's Compensationa enc for the perform with such provisions or this permit shall be deemed revoked. affirm that there is a construction lending g y forthwith comply I hereby for which this permit is issued(Sec.3097,Civ C APPLICANT CERTIFICATION ation is Lender's Name read this application and state that the aove d stat laws relating I certify that I haveordinances Address---------------- correct.I agree to comply with all city and countytyresentatives of this city to enter Lender's Ad ress construction,and hereby authorize rep agree to save to building tinned property for inspection purposes.(We) g ARCHITECT'S DECLARATION upon the above men p of Cupertino against liabilities,judgments, ublic records. Znify and keep harmless the City against said City in consequence of the plans shall be used as p ,and expenses which may accrue ag 1 I understand my Additionally,the applicant understands and will Comply granting of this 1 Cupertino Municipal Code,Section nt source regulations per the Cup Licensed Professional with all non-p 9.18. Date Signature CITY OF CUPERTINO RECEIPT OPERATOR: patg PERMITCOPY # 1 5 ITEMS OF 45 Rn Sub: Blk: Lot: Sec: Twp: g' 31643004 .10697 APN " " " DATE ISSUED: : : : : : : 01/25/2010 . BS000009609 RECEIPT # ; 10010084 REFERENCE ID # SITE ADDRESS 10697 ROSEWOOD RD APT A-D SUBDIVISION : : : : : : : CUpERTINO CITY . • • IMPACT AREA . . . . . . • ESSEX PROPERTY TD UST APT A-D OWNER ; 10696 ROSEWOOD ADDRESS . . . . . . . . . CUpERTINO, CA 95014 CITY/STATE/ZIP RECEIVED FROM • " ALLLAN UY LIC # 27101 ; GENARO MORALS CONTRACTOR • • • • " . ; GENMOR PLUMBING COMPANY • • " " 2552 SEABOARD AVE ADDRESS • • • • • . . . " SAN JOSE, CA 95131 CITY/STATE/ZIP • : : : . 408) 855-8348 TELEPHONE QUANTITY AMOUNT PD-TO-DT THIS REC --NEW_BAL_ FEE ID UNIT -______--- ---------- ---------- 1 . 00 0 . 00 _----------- 1 . 00 0 .00 0 . 00 ---------- 2, 500 .00 0 .00 21 . 00 1BCBSC VALUATION 1. 00 21 . 00 0 . 63 0 . 00 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 ATE 1 .00 -____---- ------ ---- ---------- ------- 1TR.AVDOC FLA - 106 .63 0 . 00 106 .63 0 .00 TOTAL PERMIT : VOICE ID DESCRIPTION--------- VOICE ID DESCRIPTION--_-_-_-- -------- ___----- --------------- 106 SEWER & WATER 103 UFER 507 FINAL PLUMBING �3 CITY OF CUPERTINO Yg, - REPIPE/SESRIMAIN SERVICE CITY OF PERMIT APPLICATION FORM CUPEkTINO Date: APN � �-p � I BuildingAddrzss: ,-, t, �� .� 1)(71 ' M)S�A1 , Phone Owner's Name --TV Phone#: Co actor: Fax#: Phone#: Contact: Fax Contractor License#: q�-y I Co Cuertino Business License Job Description: As, Commercial [�-' Residential Valuation: .................... ........................................ Stan Large a Valuation: 7 Major 1 Standard Project Size: Express LJ Building Checklist & attach it to the relevant portion of the Green Green Building: Please complete 'r de in plan set & the sheet index. application or if applicableg include Green Buildin Fee Permit Type Quantity Fee ID Fee Description Grou 1PCSEWER Commercial building P 1CPSS sewer/sanitary sewer fixture P 1CPRP 1BPREPIPE Commercial re-pipe per fi IPGASCOM Commercial Gas Piping System P 1-4 outlets ds Commission B A-LL PERMIT IBCBSC Cal Bldg Standar TYPES ---- Fee P IBSEISMICOM Seismic Commercial Revised 01/07/09 CITY 0-F CU-pERTINO 7.: SERVICE REPIPE/SEWEWMAIN SCHEDULE FEE CU pEt�T1N0 Fee Permit Type Fee Description Grou Fee ID ALL PERMIT Quantity Cal Bldg Standards Commission B TYPES 1BCBSC Fee 1 P SEISMICR Seismic ReSidentia 1B 1RPSS ER Residential building P 1 PRSEW 1RPRp Sewer/sanita sewer fixture P Residential re-pipe Per IP PIPE P iCPWS or 1BpyYSVCS Water Service 1RPWS Sewage P 1PPRSEWG private Sa Disposal System g P 1PCESS Cesspool R Install/alter Water Pipe P 1BPWATE P PFIXTURE Plumbing Fixture IB System P 1PGASRE S Residential Gas Piping Y 1-4 Outlets P Gas Piping System 5+ Outlets 1BPGAS P EE Plumbing Permit Fee Issuance 1 PPERMITF P 1 PLMBLN CK Plumbing Plan Check P 1 PLMBINS P Other plumbing/gas Insp. Travel &Documentation Fee B 1TRAVDOC � B 1B USLIC Business License Green Building. Plan Check - e orres - porntslCat g Building Points �ndex of Green Ian Sheet or Page Example of an Index or Table of Green P A. Category Building Points Categories that must be shown and referenced on the Project Plans FSee below _ 2 points ,. 2 points r=:..x rI••r ~: H.E. Irrigation, (details/s.- L-1 ints B. Site 9. Install H Note S_1 5 po 11. Permeable Pavin � 2 points Crete, (note) 1. Use 15% Flyash Con S-2 2 points C. Foundation (See Spec.) S-2 2 points Structural 3. Uses Wood I-Joist, (detail) S-2 D. Str 5. Use Truss with heels, ( 2 points 6 B.OSB Sheathin , detail A-3 2 points Composite Decking, (Note/Spec.) A-4 2 points E. Ext. Finish 1• NotelS ec 4 B. Fiber Cement Sidin P-1 2 points . 1 i es, s W Insulate all H.W• pipes, A-2 10 oint (P F. Plumbing (Note/Spec.) LA 4 points . 5• Tankless •Hank Note/ A_3 11. A 2500 Gal.T S ec 1 point 4. E. Ceiling Fans, (Note/Spec-) A-3 1 oint C. Electrical (Note/Sp A_3 nces 1. Energy Star Dishwasher, NotelS eq. 1 point H. APpl�a Star Refrigerator, A_1 . 3. Ener40 points 1. List Green Features on Plans INTS p, Other TOTAL pO Plan Review Process Wo rk Book Page-12-Revised 3/25/08 Community Development �s 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 CITY OF ,,..;UPE T{NO Buildingy7rtment aERMIT # JOB ADDRESS: f� o A I�A. �r-h�c. C A 1-1� HONE # C � C6� OWNEWS NAME: �`5:7e P GENERAL CONTRACTOR: FAX# Izo L I am not using any subcontractors: Date Please ch Signature check applicable subcontractors and com lete the f ollowin information: BUSINESS NAME BUSINESS LICENSE # =SUBCONTRACTOR 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 r Ti Qner/ ontractor Signature Date