12030059 CITY OF CUPI, RTIN'O BUILDING PERlN11T
IMILDISCADDRESS: 199300LIVEWOODST CO 1'1(,\Cf0l(:ABE peloIrrs'o: 12030059
CONSTRUCTION. INC
ESSEX PROPERTY 'rRUST 528 E WEDDELL DR STE 4 I)XIT ISSUE]):03/13/2012
M`IWER'Spu0NE: 6504943700 SUNNYVALE. CA 94089 pn0M•.XO:(108)734-8416
LICENSED CONII(ACr0It's DE..CL'\R,rlo,N r r
//�� ["��� It1iI1.D1\'C I'ER\I I'I'I\'F(l: oboe r:LF.CI' PLUMB
License Class V C)o Lic.i!� .�3 \ r r r-
3
?IF-CII It F.si DB.I"I'I,\I. C(1?D1rAICIAL
Conlrnctor,y�TTt��3e Duo,
I heretic affirnh Thal [:On licensed under the precisions of hapler 9 •1011 DGSCRII'1'10:\: UNIT'S A,It,C R D-RIi6IOI)FI.BA'I'IiR00%IS 170 SQ I-I'AND
R I'I"CI II:N AREA 160 SQ IT ADD LAUNDRY ROOPI,UPGRADE
(comm
(commencing with Sectian 7000)of Ill%ision 3 of* Business& Professions E p
Code and that my license is in full force and efreet.
I hereby affirm antler penally oh'perjury one of the following two declarations:
I have and will maintain a cenilicate ol'consent to self-insure for Worker's
Compensation,as provided for.by Section 3700 ol'the Labor Code.for the
performance of the work for\chich this permit is issued. Sq.FI Floor Area: Valuation:528000
1 have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 ol'the Labor Code,for die performance of the work for which this U'N Number:31643004.19930 Occupanev'1'vpe:
permit is issued.
J
AI'PLIC\N'I'CERTIFICATION
1 certify that I have read this application and state that Elie above information is PLRD'I FI• EXPIRES II' \V012K IS t\`O'I' S'IA R'IIiD
correct.I agree to comply with all city and count'ordinances and state laws rel at ing WITHIN 180 DAPS OI' P1i 1217 FF ISSUANCE OR
to building construction,and hereby authorize representatives of at
this city to cater
all,
the above mentioned property Cor inspection purposes. (We)agree to save 180 DAV FROA'I LASTCALLED II\'SP1' .'KION.
indcmnily and keep harmless the Cit•ofCupeninoagainst iahilitics•judgmcnts, _
costs,and expenses which may accrue against said City in consequence ol'thc
granting of this permit. Additiolmlly,the applicant understands and will comply Issued by: G Date:
with all non-point source r'gulations per the Cupertino Municipal Code,Section
9.13.
3 . . 1 RE-HOOFS:
tore Date All roofs shall be inspected prior to any rooting material being installed. II a Tool is
installed without first obtaining an inspection.I agree to remEwc all new,materials lin
inspection.
❑ O\\'N Pai-B1i11.D1'.I(DI?CL,\R.\'flO\'
I hereby allinn that 1:nn ruvnpl li'om the Contractor's License[,:ill fur ane ul' Signature ol'Applicane Date
die following two rc:oons: ALL ROOF OOVI'.R[N(7STO BE CLASS"A•' OR IIP:F]*Fit
I,as owner of the property,or my emplovecs\with wages as their sole compensation,
will do the work,and the structure is not.intended or offered Cor sale(Sec.7044,
Business.l professions Code)
I,as owner oRhe property.am exclusively contracting with licensed contractors to HAZARDOUS>IATIRIAIS DISCLOSURE
construct Elie project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements raider Chapter 695 of the
California.]health&Safer'Code,Sections 25505.25533.and 25534. 1 will
I hert•bv affirm under penally or perjury one of the follow'ing three ninintain Cam pl in lice with the Cupertino Municipal Cade.Chapter 9.12 and the
declarations: I Ieullh&Safe['Cotte,Section 25532(:)should 1 store or handle hazardous
I have and will maintain a Certificate of Conserv to self-insure for Worker's material. Additionally.nhould I use equipment ow decin•n\which ennit hazardous
Compensation,as provided for by Section 3700 of the Labor Cotte.lift[lie air conteminanb as defined by the Bay Area Air Quality.\lanagemenl District I
performance of Elie work for which this permit is issued. will maintain Compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will nhaimain Worker's Compensation Insurance,as provided Cor by the Ile:dth&S:d'ety Code,Vection iS115,_5;53):uul '_5534.
Section 3700 ol'the Labor Code,for the performance of the work for which this
permit is issued Owner or autlmnzrd agrm Ila[c:
I certify that in the performance ol'the work for which this permit is issued.I shut]
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of Ca]iRrmia. If,after making this certificate oiexenhption.I CO,INS'1'RUC CION LENDING AGENCY
become subject to the Worker's Compensation provisions ol'the Labor Code,I must I hereby abrin that there is a construction lending agency Ila the petlirtmancc oC
torthwith comply with such provisions or this permit shat]be deemed revoked. work's for which[his permit is issued(Sec.3097.Civ C.)
Lentler's'Name
A I'I'LIG\N'I'CK;Irril:IC\'ll0\' Lender's Address
I certify than I hive read this application and state that the above information is
correct. I agree to comply with all cit'and county ordinances and state Imes relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property'for inspection purposes.(We.)agree to save ,\I(CI I I'1'IiC'1"S DLC L.VL\'I'IUN
indenmit'and keep harmless the City of Cupertino against Iiabilities.judgnhcnts,
costs•and cspcnses Which may accnle against said City in conse<plence of Elie I undersand 111\1 plans shall be used its public records.
granting ol'this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
I
CITY OF CUPERTINO
9 ITEMS OF 9 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec : Twp: Rng: Sub: B1k: Lot :
APN . . . . . . . . : 31643004 . 19930
DATE ISSUED. . . . . . . : 03/13/2012
RECEIPT # . . . . . . . . . : BS000016256
REFERENCE ID # . . . : 12030059
SITE ADDRESS . . . . . : 19930 OLIVEWOOD ST
SUBDIVISION . . . . . . .
CITY . . : . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ESSEX PROPERTY TRUST
ADDRESS . . . . . . . . . . : 925 E MEADOW DR
CITY/STATE/ZIP . . . : PALO ALTO, CA 94303
RECEIVED FROM . . . . : ESSEX PROP
CONTRACTOR . . . . . . . : ABRAHAM PONCE LIC # 32833
COMPANY . . . . . . . . . . : ABE CONSTRUCTION, INC
ADDRESS . . . . . . . . . . : 528 E WEDDELL DR STE 4
CITY/STATE/ZIP . . . : SUNNYVALE, CA 94089
TELEPHONE . . . . . . . . :
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW SAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
-ADMIN HOURS 1 . 00 41 . 00 0 . 00 41 . 00 0 . 00
1BAPPLOTHE NO OF APPLIAN 2 . 00 130 . 00 0 . 00 130 . 00 0 . 00
1BCBSC VALUATION 28, 000 . 00 2 . 00 0 . 00 2 . 00 0 . 00
1BSEISMICR VALUATION 28, 000 . 00 2 . 80 0 . 00 2 . 80 0 . 00
1MPERMITFE FLAT RATE 1 . 00 44 . 00 0 . 00 44 . 00 0 . 00
1REMRESBAT SQ FEET 120 . 00 588 . 00 0 . 00 588 . 00 0 . 00
1REMRESKIT SQ FEET 160 . 00 588 . 00 0 . 00 588 . 00 0 . 00
1STINSP UNITS 6 . 00 780 . 00 0 . 00 780 . 00 0 . 00
1TRAVDOC FLAT RATE 1 . 00 44 . 00 0 . 00 44 . 00 0 . 00
---------- ---------- --- ----- -- ----- -----
TOTAL PERMIT 2219 . 80 0 . 00 2219 . 80 0 . 00
METHOD OF - PAYMENT AMOUNT REFERENCE NUMBER
-------- ------- -------- ----- ---- -----------
CREDIT CARD 2, 219 . 80 visa
---------------
TOTAL RECEIPT 2, 219 ..80
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 19930 olivewood st#A,B,C,D DATE: 03/13/2012 REVIEWED BY: bob s.
APN: BP#: `VALUATION: $28,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Repair
PRIMARY SFD or Duplex PENTAMATION 1R3SFDREM
USE: PERMIT TYPE:
WORK Multk- ily remodel bathrooms kitchens and new laundry rooms at 4 existing apt.
SCOPE
hlech. Plan Check 0.0 hrs $0.00 Plumb.Plan Check Bice.Plan Chock
Mech.Pemti[Fee: 1,11PERMIT Plumb.Peiaeit Fee., Fl,,. Permh Fee:
Other Mech. Insp. 0.0 hrs $44.00 O1/*&-Plumb tarp. Otber Elec.Imp. El
,11'..h. Iasp. Pee.- Plumb.hr;p.Fe.... Eler.Ing, Fee.:
NOTE: This emintale does not include fees due to other Departmeurs(i.e.Planning,Public Works, Fire,Sanitan•Sewer District.School
District,etc). Umve ees are based on the prelininan in ormalion available and are only an estinuue. Cauacl the Dept for addn'I info.
FEE ITEMS (Tee Resolution 11-053 EK 7/1/11) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 = s.f. Remodel, Badt(<=300 so
Suppl. PC Fee: Q Reg. Q OT 0.0hrs $0.00 $588.00 IREAIRESBAT
PME Plan Check: $0.00 160 s.f. Remodel,Kitchen (<=300 so
Permit Fee: Hourly Only? O Yes Q No $0.00 $588.00 IREAIRESh7T
Suppl. Insp. Fee:Q Reg. Q OT 0.0 1 ]its $0.00 F-2---j # Mechanical
PME Unit Fee: $0.00 $130.00IBAPPLOT Other Appliance/Equip
PME Permit Fee: $44.00
Consi mivaul Tax:
Administrative Fee: (ADMIN $41.00 Q
Work Without Pennit? 0 Yes (j) No $0,00 0
Advanced Plannine Fee: $0.00 Select a Non-Residential E)Building or Structure 0Travel Documentation Fee: ITRA6DOC $44.00
Strong Motion Fee: I8SEISkf1CR $2.80 = [its Inspections
Bldg Stds Commission Fee: IBCBSC $2.00 $780.00 ISTINSP Inspection, Hourly
SUBTOTALS: $133.80 $2,086.001 TOTAL FEE: 1 $2,219.80
Revised: 1/19/2012
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE• CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•buildino(G�cuoertino.orct go-300
❑NEW CONSTRUCTION ❑ ADDITION ALTERATIIONITI ❑ REVISION/DEFERRED ORIGINAL PERMIT E
PROJECT AODRE APN q-2') �2t_3 IJ�J p\^
TU
N M W OA I PI V� E-MAI{`
XtIf ,C
S ADORESS �� ATE. ' I FAX
CONTACT NAMA\\(y,^ H Q�v E-MAR
ST= DDRFSS `T` ` CITY,STATE, ZIP FAX
❑OwNER ❑ OWNER-Hunou ❑ O0.NERAGENT ONTRACTOR ❑CONTRACTOR AGENT ❑ AACHTIER ❑FNGINEIX ❑ DEVELOPER ❑ TENAM
CO O L%E CEN BUS.LICA
C HA \
S O 5lL `\ ,( .�j--`C) ,ST TE JVP p I
ARCHITECT/ENGINEER NAME 1 —}�- vLICENSENUNMER BUS.UCa
COMPANY NAME E-NtAR FAX
STREET ADDRESS I CITY,STATE,ZIP PHONE
DESCRJPTJON OF
EXISTING USE PROPOSED CON E IST
r/1 USE TYPE OCC. SQ.FT. VALUATION(f)
US'
E%ISTG NEW FCOOR DEMO
ARES AREA AREA NET AREA `VIYI/C /L�Vj'j`Jl
BATHROOM I:RCHEN OTHER
RIDAOOEL AREA RENfODEL AREA RE00DELAREA
PORCHAREA I ULCAAREI_. TOTALUECxIPORCHARF.1 I GARAGE AREA: UETACH
❑ATTACH
a DWELLING UMTS: ISASECONDUNIT LjYFS SECONDSTORY ❑YES
BEING ADDED? ONO .ADDITION? ONO
PRE-APPLICATION ❑YES IF YES.PROVIDE COPY OF ISTBEBLDGAN OYES RECEIVED BY: AL
-- UATION:
PIANNINGAPPLa ONO PLANNING APPROVAL IETfER I EICHLER HOME? ONO ,I TOTAL V
By my signature below,1 certify to each of the f lowing: 1 am the propeny owner or authorized agent m act on the propery owner's behalf. I have read this
application and the information I hav r vide co ee. I have read the Description of Work and verify it is accurate. 1 gree to comply with rill applicable local
ordinances and state laws relating to oil]df o n ti L T3uthorize representatives of Cupertino to enter the abo'e-I n Emed openy for inspection purposes.
Signature ofApplicant/Age L' Date;
SUPPLEMr,NTAL TNTFOIWATION REQUIRED PLAN CIIECCK TYPE ROUTING SLEP
_New SFD or Multifamily dwellings: Apply for demolition permit for oCT AER-AIF co1nTER LJ BUILDING PIAN REVIEW
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. EXPRESS ❑ PLA.NWING PLA.N REVIEW
Commercial Bldgs: Provide a completed Iiazardous Materials Disclosure ❑ STANDARD O PUBLIC WoutNS
form if any Hazardous Materials are being used as pan of this project. ❑ LARGE ❑ FIRE DEPT
_Copy of Planning Approval Letter or Meeting with Planning prior to ❑ mw.Ioa ❑ SAATTARY SF,wTR DISTRICT
submittal of Building Permit application.
❑-E.\l'IRO\'.SIE.\TAI;FIE\LTII
BldgApp_201/.doc revised 0612//11