Loading...
13060208 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10696 ROSEWOOD RD CONTRACTOR:ABE CONSTRUCTION, PERMIT NO:13060208 INC OWNER'S NAME: ESSEX PROPERTY TRUST 528 E WEDDELL DR STE 4 DATE ISSUED:06/27/2013 OWNER'S PHONE: 6504943700 SUNNYVALE,CA 94089 PHONE NO:(408)734-8416 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIALE] License Class —C D G Lic.# Q Ci 9� APT D-REMODEL BATHROOM(120),KITCHEN(160)ADD NEW LAUNDRY ROOM,UPGRADE ELECTRICAL PANEL Contractorppr-- �U,7�t/C � Date AND 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:$26000 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:31643005.10696 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 D F 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 AST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Z �3 granting of this permit. Addit ally,the applicant understands and will comply ed b Date: with all non-point source re ions per the Cupertino Municipal Code,Sectio 9.18. RE-ROOFS: Signature Date W2l3 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 o devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertin nicipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 2 6534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date�*; permit is issued. 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 r CONSTRUCTION PERMIT APPLICATION lam COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION //�� !J O 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 �V GUPERTINO (408)777-3228•FAX(408)777-3333•building(a)cupertino.org 1 ❑NEW CONSTRUCTION ❑ ADDTTION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT RESS APN# `-13 -p O� OWNE NAME �rUl PHO E _ fq _ 3 07MATT STREET ADD S f V\--- OUp r' E Com, S�, Min CA 3 03 FAX CONTACT NAME `b PHONE /15- 'y O 3 E-MAIL STREET ADDRESS - CITY,STATE,ZIP FAX ❑OwNER ❑ OWNER-BUILDER ❑l O�wNER AGENT W-CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR N � `M I\�n LICIN ER CEI r O E BUS.LIC Al E-MAIL FAX Ci C) cGOon,sArLx o fir► '('yotxC, A — t7(lS�rc�cEi�i ,C�o� STREET DRESS A' , W^ V(� 1(TE,ZIP � ONE .1 A L"T"©8 S PH '�-73 y ARCI-=CT/ENGINEER NAME lJ�- LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK r ( --rr I cot-L c4,4 p I LL vv\-,61 n EXISTING USE �PR^OPOSED USE CONSTR TYPE #STORIES I Y\�.�.1 --fl w, USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA I AREA NET AREA A� ,-J. 1 2 Gb 20 BATHROOM KITCHEN OTHERQ /(X REMODEL AREA ; f> REMODEL AREAbi t REMODEL AREA PORCH AREA DEECIK CK/P AREA TOTAL DEIr ORCH AREA I GARAGE AREA: DETACH ❑ATTACH #DWELLING UNTTS: IS A SECOND UNrr ❑YES SECOND STORY ❑YES BEING ADDED? ❑NO ADDITION? []NO PR.E-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES TOTAL VALUATION:_ PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO By my signature below,I certify to h of the following: am th eriy owner or au orized agent to a roperty owner's behalf. I have read this application and the information I h ve provided i rrect have d e Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating o building c on I epresentatives of Cupertino to enter the above-ide ti ed pro for inspection purposes. Signature of Applicant/Agent: ate: SUPPLEMENTAL TION Q PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for El OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building 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 ❑ MAJOR ❑ submittal of Building Permit application. SANITARY SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH BldgApp_1011.doc revised 06121111 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U PE RTI NO Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: d 6 9 6- /2<jK PERMIT# OWNER'S NAME: PHONE# GENERAL CONTRACTOR: ,0t, (` ,� BUSINESS LICENSE#. ADDRESS: tLrj(101�4GJ Sv H CITY/ZIPCODE:. *Our municipal code requires all businesses working in the city to have a City of Cupertirusiness license. NO BUILDING FINAL OR FINAL OCCUPANCY INSP CTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRAC RS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: ture Date Please check applicable subcontractors and complete the following information SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/Glazing Heating h. Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date