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12010003 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10676 ROSEWOOD RD CONTRACTOR:ABE CONSTRUCTION,INC PERMIT NO: 12010003 OWNER'S NAME: ESSEX PROPERTY TRUST 528 E WEDDELL DR STE 4 DATE ISSUED:01/05/2012 OWNER'S PHONE: 6508491600 SUNNYVALE,CA 94089 PHONE NO:(408)734-8416 ❑ LICENSED CONTRACTOR'S DECLARATION '-A BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class -L d'-L 3 6 Lic.# q G 3 013 MECH f— RESIDENTIAL COMMERCIAL� Contractor (Z. DateS 117- I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:APTS A,B,C&D-MULTI-FAMILY DWELLING REMODEL (commencing with Section 7000)of Division 3 of the Business&Professions LAUNKITCHDRY N(160SQFT)&BATI IROOM(120SQFT)AND ADD NEW L Code and that my license is in full force and effect. LAUNDRY ROOM 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:$28000 permit is issued. APPLICANT CERTIFICATION APN Number:31643005.10676 Occupancy Type: 1 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. 40ditionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point ur regulations per the Cupertino Municipal Code,Section 9.18. 1 /0.Z Issued by:--- Date; Signature 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(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. 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 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 Co ,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 auth ed ager •- forthwith comply with such provisions or this permit shall be deemed revoked. Date: © t9� �7 APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 1 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 Hork'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 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: ?6 91&3 e woo c,) �' PERMIT# OWNER'S NAME: 0SS P A , ' f-u PHONE# GENERAL CONTRACTOR: n ,� BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONT TORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. _ I am not using any subcontractors: 9 ature Date Please check applicable subcontractors an complete the following information: 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 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10676 rosewod rd.A,B,C,D DATE: 01/03/2012 REVIEWED BY: bobs. APN: BP#: "VALUATION: 1$28,000 y PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Repair PRIMARY Multi-FamilyDwelling 7>,33L ilding is PENTAMATION 1 R2REM USE: g Stories Yes (F) No PERMIT TYPE: WORK multi-family dwelling remodel kitchen and bath add new laundry room. SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-2 (Apartment) II-B,111-BjV,v-B 0 $0.00 $0.00 T_ TOTALS: 0 $0.00 $0.00 MECH,HOURLY 0 Yes (E) No PLUMB,HOURLY Q Yes Q No ELEC,HOURLY 0 Yes (D No Mech.Plan Check "00 $0.00 Mech.Permit Fee: I MPERMIT Other Mech.Insp. OA hrs $44.00 Ll NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . Theseees are based on the relimna information available and are onlyan estimate. Contact the Det or addn 7 info. FEE ITEMS (I'ee Resolution 11-053 Elf. ,',1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00120 j s.f. Remodel,Bath(<=300 sf) Suppl.PC Fee: (F) Reg. () OT 0.0 hrs $0.00 $588.00 1REMRESBAT PME Plan Check: $0.00 160 s.f Remodel,Kitchen(<=300 sf) Permit Fee: Hourly Only? Q Yes E) No $0.00 $588.00 1 IREMRESKIT Suppl. Insp. Feer Reg. OT0 0 hrs $0.00 2 1 # Mechanical PME Unit Fee: $0.00 $130.00 IBAPPLOT Other Appliance/Equip PME Permit Fee: $44.00 0 Work Without Permit? Yes (F) No $0.00 Advanced Planning.Fee: $0.00 Select a Non-Residential E) Travel Documentation Fee: ITRA VDOC $44.00 Building or Structure 0 Strong Motion Fee: IBSEISMICR $2.80 6.0 hrs Inspections Bldg Stds Commission Fee: 1BCBSC $2.00 $780.00 ISTINSP Inspection,Hourly SUBTOTALS: $92.801$2,086.001 TOTAL FEE: 1 $2,178.80 Revised: 12/04/2011 CITY OF CUPERTINO 8 ITEMS OF 8 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 31643005. 10676 DATE ISSUED. . . . . . . : 01/03/2012 RECEIPT #. . . . . . . . . BS000015638 REFERENCE ID # . . . : 12010003 SITE ADDRESS 10676 ROSEWOOD RD SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER ESSEX PROPERTY TRUST ADDRESS 925 EAST MEADOW DR CITY/STATE/ZIP . . . : PALO ALTO, CA 94303 RECEIVED FROM . . . . : ALLAN UY 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 BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 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 2178 .80 0. 00 2178 .80 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 2, 178 .80 VISA --------------- TOTAL RECEIPT 2, 178. 80 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 301 ROUGH PLUMBING 302 TUB & OR SHOWER 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 305 FRAME 307 INSULATION 308 SHEETROCK 309 EXTERIOR LATH 310 INTERIOR LATH 311 SCRATCH COAT 313 ROOF NAIL 317 MECHANICL ABOVE CEILING l :;2-01000 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 CUPERTINa (408)777-3228 • FAX(408)777-3333 • buildingCcDcupertino.org �{ ❑NEW CONSTRUCTION ❑ ADDITION 1pl ALTERATION/TI ❑ REVISION/DEFERRED/ ORIGINAL PERvfIT# PROJECT ADDRESS�monwo� A C APN L:31 ('4_1-q 3_ �`�•�s f�1Ci� w OWNER NAMEPHONE G E-MAIL 0601 AOK-3"10o r v, C m STREET\Z.SADDRESS STA O FAX CONTACT N PHONE��Q V E MAIL STREET ADDRESS CITY,STATE, ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CO CTOR LI�tVSE E. 1 LICENSE TYPE ` 1 BUS.LIC# COMP \ u E-MAII. C� w J FAX S DRESS �}-- 1 STATE,ZIP u. HO t ARCHITECT/ENGINEER NAME �1- LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIP OF WORK EXISTING USE PROPOSED USE �� CONSTR TYPE #STO� USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL —^ AREA AREA AREA NET AREA "GJ-x" BATHROOM KITCHEN OTHER REMODEL AREA :20 REMODEL AREA Q REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA DETACH ATTACH #DWELLING UMTS: LSA SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? ONO ADDITION? ONO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY: ^ T ALUA0 PLANNING APPL# ONO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO [^� J By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is co ect. ve read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildin co tru tionI a thonze representatives of Cupertino to enter the above-identi ed perry for inspection purposes. Signature ofApplicant/Agent: Date: ` �t SUPPLEMENTAL TI N'REQ=D PLAN CHECK TYPE ROUTING SLD? _New SFD or Multifamily dwellings: Apply for demolition permit for Z-e-eEwTHE-couNTER 4_;-afMG PIAN Rk-V Ew 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 WOF form if any Hazardous Materials are being used as part of this project. 11LARGE ❑ FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANTTARY SEWER DISTRICT submittal of Building Permit application. AL ❑ ENVIRONMENTAL HEALTH B1dgApp_2011.doc revised 06/21/11