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14060011 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10647 ROSEWOOD RD CONTRACTOR:ABE CONSTRUCTION,INC PERMIT NO: 14060011 OWNER'S NAME: ESSEX THE POINTE LP 1233 MIDAS WAY DATE ISSUED:06/03/2014 OWNER'S PHONE: 6504943700 SUNNYVALE,CA 94085 PHONE NO:(408)734-8416 ❑ LICENSED 7 6CONTRACTOO�R''S DECLLARATION BUILDING PERMIT INFO: BLDG I— ELECT f— PLUMB � License Class 13 X IOIC34 Li,.# 39j MECH I— RESIDENTIAL r COMMERCIAL F Conlractor4eE W1V_<)2V(77ON NVC Date 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION APT C-REMODEL BATHRROM(120 SQ FT);KITCHEN(160 (commencing with Section 7000)of Division 3 of the Business&Professions SQ FT);ADD NEW LAUNDRY ROOM,UPGRADE ELECTRICAL PANEL AND PLUMBING Code and that my license is in full force and effect. 1 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 Scr on 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$24000 AA-nit is issued. APPLICANT CERTIFICATION APN Number:31643004 10647 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 of this 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 permit. Additionally,the applicant understands and will comply 180 DAYS FR EAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section / Issued by: Date: Signature - Date / ❑ OWNER-BUILDER DECLARATION RE-ROOFS: 1 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 1,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(Sec.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. 1 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 by the Bay Area Air 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&Safety Code,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 Owner or ho ' agent: Date: forthwith comply with such provisions or this permit shall be deemed revoked. WG 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 CGtMMUKIP WOE1r lOPMENTDEP?RTinEt�� I o BUILDING DIViSIQKI "lO�Otl TOF'R ';lX Ei UE CUPERTING,CA 95414-325 ,:a-r� u""= � �40�)�-73228 m FAQ°408 7�7-3333:"building cs cuo�rtii�o o� NEiu CONSTRUCTION' fiDi?iTION ALTERATIOh1 Y Tl ❑ REVISION/DEFERRED ORIGINAL PERMIT# . � PROJECIADD S ���) „;,�,. �Nn �jaC�Y -:� _ 69.Y' 4✓ �.. Nom: � PTiOISE E-;V,Att STPD' ADDRESS CTfY, .ATE, FAX CONTACT MAIA - E-MAIL - E STREET ADDRESS CITY,STATE,ZT FAx ❑OVrNER CI OWNER-BUILDER ,Q owNERpOEtiT CONT—OR ❑CONIRACTORAGENT ❑ ARCmTEcr t3 EgGamER ❑ DEVELOPER ❑TENAAri CONTRACT -AME LTCf?tSECIM LtcENSE TYPE BUS.LIC y L 1d t CO AI4Y'NANM a _ mwr STREET ADD .. .. Y STATE, HONE 4ir ARCMECT✓ENGINEER NA,:M LICEfISE NUMSEIt BUS.LEC it i i COWANYWAME ,E MAII- FAX slRr"_Er ADDRc'SS CITY,STATE,ZIP PHotvE DES IION OF SPO EXiSTINGUSE PROPOSED U ,CONSTR:'"IYPE �,5rOR1ES _ y*q � J J'11 USE TYPE UCC. SQ-Fr. VALUATION(3') ARBA . AREA AREA !' NET AREA Al"r I 5 C/ t3' P REMODE OM KITCEEtJ OTfiER. REMODn"L AREA REMODELAtjEA, REh60DEL'AREA,_ PORCFAREA DECK AREA TOTAI."DECK/ppR AREA GARAGE AREA: DETACs'i '. _ ATTAW DwELLENG UTl'PS IS A SECOND UN" ❑VES 58COtQp.STORY .❑YES BELtiTGADDED., ONO 'ADDITION? QNO, PRE-APPM-ATION.:❑YES -.IFYES,PROVIt)7r;COPYGF' ISTBEBLDGANg gj�lgDBY: PLP.�i3N32kG APPLn []NOPLANNINGAPPROVALL1IrER EIC8LERHOb3E? ©tti0. T T-a.L VALUATION: By ray siUanatvre below,I certify to each of the followtaaa I am the pioperfy owner or aufharized agent to act on the property owner's be at£I have lead tilts application and the information I have provided is correct I have,read the Description of Work and verify itis accicrnte. I agree to comply with all applicable local ordinances and state laws relating to buil'' tepr@sentatives of Cupertino to enter the above-identified property far inspection purposes• Signature ofApplicant(A.gent Date: SUPPL 1 iQNREQ[III2ED PLAN CBECK TYPE ROUTING SLIP ,New SFI3 or Multifamily dwellings Apply for demolition putt for r ❑ ovER- existing building(s). DemolitionperuufYs rb - T�� ❑ BUILDING PLAN REVIEW Qmredpaorto:issuance ofbuEldiug permit for new building. ❑: EXPRESS ❑ PLANNING PLAN R1 vow _Commercial Bldgs: Provide a completed Hazaxdbus Materials Disclosure ❑'STANDARD El PEIEr zc woRxs form if any Hazardous Materials are being used as part of flus project ❑ LARGE - ❑ FIRE.DEPT - _Copy of Planning Approval Lettez or lkleeting with PIaDniug pzior to submittal of Building Permit applieat o7i ❑ E "OR ❑ a4vIrARY sswEx DISTRICT ❑ &YVIRONMENT4LHF_AALTIi B1d9APP 2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10647 Rosewood rd#C DATE: 06/03/2014 REVIEWED BY: Mendez APN: BP#: *VALUATION: 1$24,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Du lex PENTAMATION 1 REAP2 USE: p PERMIT TYPE: WORK APT C - REMODEL BATHRROM 120 SQ FT • KITCHEN 160 SQ FT); ADD NEW LAUNDRY ROOM SCOPE UPGRADE ELECTRICAL PANEL AND PLUMBING. ; o;i Pla rt C'Farae k phwt h. Plum Uwck Elec.Plan Check 0.0 hrs $0.00 1,1,,cb. /'erwit Fre: Tlumn. Permit Fee: Elec.Permit Fee: IEPERMIT (Mwr F=lurnh Inrsp. Other Elea Insp. 0.0 hrs $47.00 7'lunih. Jrrs{1. eye: /"ie€.?rrsp Fcc: NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc . These fees are based on the prelimina information available and are only an estimate. Contact the Dept-for addn'l info. FEE ITEMS (Fee Resolution 11-053 E . 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 120 amps Electrical Suppl. PC Fee: Reg. ® OT 0.0 1 hrs $0.00 $47.00 IBELEC200 Services PME Plan Check: $0.00 Permit Fee: Hourly Only? ®Yes Q No $0.00 Suppl. Insp. Feer Reg. ® OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $47.00 ('c ns0,it(,,iion Tax: Administrative Fee: 1ADMIN $44.00 Work Without Permit? ® Yes 0 No $0.00 E) Advanced Plannin&Fee: $0.00 Select a Non-Residential G Travel Documentation Fee: 1TRA VDOC $47.00 Building or Structure i Stronfz Motion Fee: IBSEISMICR $2.40 5.0 hrs Inspections Bldg Stds Commission Fee: IBCBSC $1.00 $695.00 ISTINSP Inspection,Hourly "' $141.40 $742.00 TOTAL FEE• $883.40 Revised: 04/01/2014