14030011 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10649 MAPLEWOOD DR APT A-D CONTRACTOR:ABE CONSTRUCTION,INC PERMIT NO: 14030011
OWNER'S NAME: ESSEX THE POINTE LP 528 E WEDDELL DR STE 4 DATE ISSUED:03/06/2014
OWNER'S PHONE: 6504943700 SUNNYVALE,CA 94089 PHONE NO:(408)734-8416
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO BLDG r ELECT r PLUMB I—
License Class ic.# 111
MECH r RESIDENTIAL r– COMMERCIAL r
Contractor ► ate
1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:APT B-REMODEL BATHROOM(120),KITCHEN(160)ADD
(commencing with Section 7000)of Division 3 of the Business&Professions NEW LAUNDRY ROOM,UPGRADE ELECTRICAL PANEL AND
Code and that my license is in full force and effect. PLUMBING
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.
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 Sq.Ft Floor Area: Valuation:$24000
permit is issued.
APPLICANT CERTIFICATION APN Number:31643003 10649 Occupancy Type:
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 ofthis city to enter
upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this it. A diti the applicant understands and will comply 180 DAYS FR M LAST CAL ED INSPECTION.
with all non-p nt so ce ul on per the Cupertino Municipal Code,Section �.
9 18
k
Issued by: Date:
Signatur Date
❑ OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signature of Applicant: Date:
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(See.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penalty of perjury one of the following three
declarations: HAZARDOUS MATERIALS DISCLOSURE
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 I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material.
Additionally,should I use equipment or devices which emit hazardous air
permit is issued. contaminants as defined b the Ba Area Air
y y Quality Management District I will
I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Health&Saf ty C ,Sections 25505,25533,and 25534.
Compensation laws of California. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Code,I must wner an zc age tt: n
forthwith comply with such provisions or this permit shall be deemed revoked. ate:
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's
correct.I agree to comply with all city and,county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section
9 18 I understand my plans shall be used as public records.
Signature Date Licensed Professional
COMMUNITY DEVELOPMENT DEPARTME14T-BUILDING DIVISION
a 10300 TORRE AVENUE; CUPERTINO,CA 85014-3255
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E n^�- (408)777-3228-FAX(408)777-3333 �uilding(c�cupertino org
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❑NEW CONSTRUCTION ❑.ADPrRONALTERATION/TI ❑ REVISION/DEFERRED ORTG-1O3 oU 11
PROJECT ADD S -ORIGINAL l'�T#.
O APN 9 609
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NAME
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STREET ADDRESS � 1
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❑OWNER ❑ OWNER-BUIIDER ❑ OyNEgAaWr .CONTRACTOR ❑CONIRACTORAGENT ❑
ABCErrECT ❑E40II4EER ❑ DEVELOPER ❑TMWrT
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'USE PROPOSED USE:.. CONSIR.TYPE #STORIES
( NEW FLOOR 0'� —� USE TYPE OCG SQ.FT. VALUATIONS)
AREA AREA I(Do AREA TOTAL.
i Ill �,J .NE1'AREA b cL
RATAROOM KrrCHEN OTHER r 2 2y-I C
REMODEL AREA PM40DELAREA
BEbfODELAREA
POR HAREA DECKAREA TOTALDPGK/PORCHAREA 'GARAGEAREA; DETACH
❑ATTACH
BE
#DWELLING UNITS: ISA SECOND:? .YES SECONDSTORY YES.
WGADDSDT' 0NO ADDMONt E3NO
PRE-APPLICATION ❑YES IF YES, oviDE COPY OF IS TSE BLDG AN
PLANNINGAPPL# ONO PLANNING APPROVAL LETICHLER80NE? I NNOO RECEIVED Y:
TER E, TOTAL VALUATION:
BY mY signature below,I certify to eacb of oll a I; Ob l)
application and the information I have ro P°p�`owner or authorized agent W ct on the property owner's behalf I have read this
p L I d the Description of Work and verify it is accurate, I
ordinances and state laws rrlatia'to represeotatiyes of agree to comply with all applicable local
Signature of Applicaut/AgenC Cupertino to enter the above-i ed property for inspection purposes.
Date: k
SUPPLEMENT ORMATI N U1RED
—New SFD or Multifamily dwellings: PLAN CE9CX TYPE ROUTING SLIP Apply for demolition permit for
existing building(s). Demolition permit is OVER-T1�coU t ❑ B
permit for new building. p pnor to ISSIIanOe of building BLUDING PLAN REVIEW
❑
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure El EXPRESS PLAAWNGPLAN REVIEW❑ ST,�,�
form if any Hazardous Materials are being used as part of Ibis project ❑ PUBLIC WORKS
—Copy of Planning Approval Letter or Meeting.with:planning prior to ❑ LARGE ❑ EME DEPT
submittal Of Building Permit application.
❑ SANITARY SEWER DISTRICT
0 2220NMXNTAL H&ALTU
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10649 Maplewood Dr#B DATE: 03/05/2014 REVIEWED BY: Mendez
APN: BP#: *VALUATION: $24,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY Building is PENTAMATION
USE: Multi-Family Dwelling >3 Stories 0 Yes (F) No PERMIT TYPE: 1 R2RE
WORK APT B - REMODEL BATHROOM 120 KITCHEN 160 ADD NEW LAUNDRY ROOM UPGRADE
SCOPE ELECTRICAL PANEL AND PLUMBING
Gv
Plan('?c :N: 1'l.avi). 111 an Che�c•k Elec.Plan Check 0.0 hrs $0.00
lIf ;#t..l'r=~,ait 1'trz: 1'zrz,r;%. Perm,;?, /'rrt': Elec.Permit Fee: IEPERMIT
o€he Inod;?(sr P IMI—,Insp, Li Other Elec.Insp. 0.0 �s $47_00
;Ve(?, h;,rp. t e : P7ta nt?,Irv, Fee: Dec. hi_sR, i-ee:
NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . These ees are based on the prelimina information available and are only an estimate. Contact the De t or addh I info.
FEE ITEMS (Fee Resolution 11-053 E . ZIZ13) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 =:1 s.f. Remodel,Kitchen(<=300 sf)
Suppl. PC Fee: (j) Reg. 0 OT 0.0 hrs $0.00 $0.00 1REMRESKIT ] A
PME Plan Check: $0.00 = amps Electrical
Permit Fee: Hourly Only? ®Yes Q No $0.00 $47.00 IBELEC200 Services
Suppl. Insp. Fee:Q Reg. ® OT 0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $47.00
Administrative Fee: 1ADMIN $44.00
Work Without Permit? 0 Yes (E) No $0.00 0
Advanced Planning Fee: $0.00 Select a Non-Residential E)
Travel Documentation Fee: 1TRAVDOC $47.00 Building or Structure O
i
Strong Motion Fee: IBSEISMICR $2.40 5.0 hrs Inspections
Bldg Stds Commission Fee: 1BCBSC $1.00 $695.00 ISTINSP Inspection,Hourly
777
$141.401 $742.00 TOTAT,FEE: