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13070048 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10657 ROSEWOOD RD APT AIM CONTRACTOR:ABE CONSTRUCTION, PERMIT NO: 13070048 INC OWNER'S NAME: ESSEX PROPERTY TRUST 528 E WEDDELL DR STE 4 DATE ISSUED:07/08/2013 OWNER'S PHONE: 6504943700 SUNNYVALE,CA 94089 PHONE NO:(408)734-8416 92 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIALE] License Class/0 `A191,ic.# e703 q,5 UNIT A-280 SQFT,REMODEL BATHROOM,KITCHEN, ADD Contractor fi"e C'n5-47LC7/y)?Date 69r/ � NEW LAUNDRY ROOM,UPGRADE ELECTRIC& I hereby affirm that I am licensed under the provisions of Chapter 9 PLUMBING (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$24000 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:31643004.A-DRWD Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FRO 77,TIED INSPECTIO indemnify and keep harmless the City of Cupertino against liabilities,judgments, q costs,and expenses which may accrue against said City in consequence of the O /3 granting of this permit. Additionally,the applicant understands and will comply Iss Date: with all non-point source re ulations a Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signatur Date All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Ba Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cu rtin Mu icipal Code,Chapter 9.12 a I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety ,S ns 2 05, 5 ,and 25534. Section 3700 of the Labor.Code,for the performance of the work for which this permit is issued. Owner or authorize agent: Dater � I I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildingCO)cupertino.orp ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# L 7V ftk-)CTA VC\ V3 00P - 15 .� STREET AD FAX LQ CONTACT N P E-MAIL STREETADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR LICINS SEp US.LIC# CO AME a E-MAII FAX STREET S ,STATE,ZIP iPHO M l CvAr ARCHITECT/ENGINEER NAME TLICENSE NUMBER BUS.LIC# 0.CLl y COMPANY NAME E-SID FAX STREET ADDRESS CITY,STATE,ZIP PHONE DES OF WOR EXISTING USE PROPO S SE CONSTR.TYPE #ST S USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREREMODEL REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY []YES BEING ADDED? ❑NO ADDITION? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY; TO ALUATIO PLANNINGAPPL# []NO PLANNING APPROVAL LETTER EICHLERHOME? ❑NO By my signature below,I certify to each of the following: the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provi d is c rec `I ve read the Description of Work and verify itis accurate. I agree to co ply with all applicable local ordinances and state laws relating to build' co c' authorize representatives of Cupertino to enter the above-identifie f inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMIRALRMATIWREQUIRED PLAN CH_ECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building OVER-THF COUNTERBUILDING PLAN REVIEW permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. ❑ MAJOR ❑ SANITARY SEWER DISDUCT ❑ ENVIIZONMENTAL HEALTH BldgApp 2011.doc revised 06/21/11 Ila. CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10716 ROSEWOOD RD UNIT D DATE: 07/08/2013 REVIEWED BY: MELISSA APN: 316 43 005 BP#: *VALUATION: 1$24,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1 REAP i WORK REMODEL KITCHEN BATHROOM AND ADD N LAUNDRY RM. UPGRADE E ELECTRICAL SCOPE PANEL TO 125 AMPS .o lfcch.Plan Check Plurnb.Plan Check Elec.Plan Check 0.0 hrs $0.00 :.Meeh.Permit Fee: Plumb.Permit Fee: Elec.Permit Fee: JEPERMIT tither A1ech.Insp. Other Plumb Insp. Other Elea Insp. 0.0 hrs $47.00 ,93ech.Imp.l'ce: Plumb. Insp.Fee: faec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(i.c Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). Theseees are based on the prellmina information available and are on an estimate. Contact the De t or addn'1 info, FEE ITEMS(Fee Resolution 11-053 E f 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 125 amps Electrical Suppl.PC Fee: 0 Reg. ® OT —0,01 hrs $0.00 $47.00 1BELEC200 Services PME Plan Check: $0.00 Permit Fee: Hourly Only? ®Yes (j)No $0.00 Suppl. Insp.Feer Reg. Q OT Fo,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $47.00 Construction Tax: Administrative Fee: IADMIN $44.00 Work Without Permit? ® Yes (j) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential Travel Documentation Fee: ITRAVDOC $47.00 Building or Structure i Strong Motion.Fee: IBSEISMICR $2.40 5.0 I hrs Inspections Bldg Stds Commission Fee:. 1BCBSC $1.00 $695.00 1STINSP Inspection,Hourly $141.40 $742.00 o 0'.t�` — $883.40 Revised: 07/01/2013 Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: /010,5-7 UCS PERMIT# OWNER'S NAME: V-AfTtj,,C PHONE# GENERAL CONTRACTOR: o� BUSINESS=T.ICEl*TSE}# , ADDRESS: ,� CITY/ZIPCODE *Our municipal code requires all businesses wortdng in the city to have a City,of Cuperhno.business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S). WILL 'BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL CON C HAVE OBTAINED A,CITY OF Ur BUSINESS LICENSE. I am not using any subcontractors: I Sig ature Date Please check applicable subcontractors and complete the following ini<ormation. V SUBCONTRACTOR BUSINESS NAME 'BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date