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10010115 CITY OF CUPERTINO BUILDING PERMIT CONTRACTOR:GENMOR PLUMBING PERMIT NO: 10010115 BUILDING ADDRESS: 10649 MAPLEWOOD RD APT A,B,C,D DATE ISSUED:01/25/2010 2552 SEABOARD AVE OWNER'S NAME: ESSEX PROPERTY TRUST PHONE NO:(408)855-8348 SAN JOSE,CA 95131 NER'S PHONE: 6508495835 BLDG ELECT r PLUMB ❑ LICENSED CONTRACTORS DECLARATIONBUILDING PERMIT INFO. License Class Lic.# MECH RESIDENTIAL COMMERCIAL Contractor Date �'" JOB DESCRIPTION:WATER MAIN SERVICE REPLACEMENT I hereby affirm that I am licensed under a provisions of Chapter 9 (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 Valuation:$2500 performance of the work for which this permit is issued. Sq.Ft Floor Area: 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:31643003.10649 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is comply y with all city and county ordinances and state laws relating PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to p to building construction,and hereby authorize representatives of this city to enter WITHIN I AYS OF PERMIT ISSUANCE O upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 DAY OM LAST CALLED INSPECTION. costs,and expenses which may accrue against said City in consequence of the _ granting of this pe t. Additionally,the applicant understands al Code,Sectpon ed by: Date: with all non-poin ou ce regulations per the Cupertino Mu p Issu 9.18. Date Signature RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is V OWNER-BUILDER )EC LARATION installed without first obtaining an inspection,I agree to remove all new materials for I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: Date: I,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: will do the work,and the structure is not intended or offered for sale(Sec.70445 Business&Professions Code) ith licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,as owner of the property,am exclusively contracting w construct the project(Sec.7044,Business&Professions Code). HAZARDOUS MATERIALS DISCLOSURE I hereby affirm under penalty of perjury one of the following three I have read the hazardous materials requirements under Chapter 6.95 oft e declarations: California Health&Safe Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain a Certificate of Consent to self-insure re for Worker's Safety Chapter 9.12 and the Health& Compensation,as provided for by Section 3700 of the Labor Code,for the Safetcompy Code,Section 25532(a)should Ie with the Cupertino store orhandlehazardous material. Compe P Safety Co , performance of the work for which this permit is issued. Additionally,should I use equipment or devices which emit hazardous air I have and will maintain Worker's Compensation Insurance as provided for by Aa s defined by the Bay Area Air Quality Management District I will Section 3700 of the Labor Code,for the performance of the work for which this liance with the Cupertino M 3 and 25534e�Chapter 9.12 and the permit is issued. icipa Code,Sections 25505,2553 , I certify that in the per of the work for which this permit is issued,I shall not employ an person in any manner so as to become subject to the Worker's iz ent p y y Date: 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 fo P Y rthwith coin 1 with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCI'performance of work's I hereby affirm that there is a construction lending agency for the pe CANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.) APPLIation is I certify that I have read this application and state that the te laws relating Lender's Name correct.I agree to comply with all city and county ordinances and sta to building construction,and hereby authorize representatives of this city to enter Lender's Address upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION unify and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the lans shall be used as public records. granting of this pe . Additionally,the applicant understands and will comply I understand my p with all non-poi sour a regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date CITY OF CUPERTINO PERMIT RECEIPT OPERATOR: patg 5 ITEMS OF 60 COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31643003 .10649 DATE ISSUED. . . . . . . : 01/25/2010 RECEIPT # . . . . . . . . . : BS000009613 REFERENCE ID # 10010115 SITE ADDRESS 10649 MAPLEWOOD RD APT A,B,C,D SUBDIVISION : : : : : : : CUPERTINO CITY • IMPACT AREA . . . . . . • OWNER . . . . . . . . . . . . : ESSEX PROPERTY TRUST A-D ADDRESS . . . . . . . . . . : 10696 ROSEWOOD RD APT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : ALLAN UY CONTRACTOR . . . . . . . : GENARO MORALS LIC # 27101 CO : GENMOR PLUMBING COMPANY • • • • • . . • . 2552 SEABOARD AVE ADDRESS . . . . . . . . SAN JOSE, CA 95131 CITY/STATE/ZIP • • (408) 855-8348 TELEPHONE . . . . . . . . PD-TO-DT THIS REC NEW BAL UNIT QUANTITY AMOUNT ----____-- ----_----- FEE ID ---- ---------- ---------- ------0-00 1.00 0 . 00 ---- ----- ----- 2, 500 .00 1. 00 21.00 0 . 00 1BCBSC VALUATION 1.00 21 . 00 0 . 00 0 .00 1BPWSVCS WATER SERVICE 0 . 63 0 . 00 0 . 63 2, 500 . 00 0 .00 42 . 00 0 .00 1BSEISMICO VALUATION 1 .00 42 . 00 42 . 00 0 . 00 1PPERMITFE FLAT RATE 1 .00 42 . 00 0 . 00 _ ---------- 1TRAVDOC FLAT RATE ---------- ------ 0 . ----106 . 63 0 . 00 106 . 63 0 . 00 TOTAL PERMIT VOICE ID DESCRIPTION - VOICE ID DESCRIPTION _------ -------- --------------------------- -------- --------------------- 106 SEWER & WATER 103 UFER 507 FINAL PLUMBING CITY Of, ..................................... Cl ILOF CUPERTINO ' REPIPE/SE WER/MAIN SERVICE CU P..ERT-INO PERMIT APPLICATION FORM Date: APN #�3 1 �p 4 (0 0 A Z Buildin Ad ss: r. Phone#: 45,�5 wner's a, e: Phone #: Contracto ( _ Fax#: , rINHumby r Phone #: Contact. Fax#: ly?) q Contractor License Cu erten o Business License #: Job Description: /& /N C .". -A ` i) y 1. t. /� t/ Residential Commercial ❑ Valuation: - • Express Standard ❑ Large Major El Project Size. Exp ❑ Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the �nnli� +� n Qet& the sheet index. �..o._ Cr if-PnlicahlP� in,4111de �n rnl�n eP •-r r-- C Green Buildin Points: Fee Permit Type Quantity Fee ID Fee Description Q Grou I PCSEWER Commercial building P 1CPSS sewer/sanitary sewer P 1CPRP I BPREPIPE Commercial re-pipe per fixture IPGASCOM Commercial Gas Piping System P 1-4 Outlets B ALL PERMIT 1 BCBSC Cal Bldg Standards Commission TYPES Fee P IBSEISMICOM Seismic Commercial Revised 01/07/09 CITY OF CITY OF CUPERTINO REPIPE/SEWER/ MAIN SERVICE FEE SCHEDULE CUPERTINO• Fee Description Fee Permit Type Quantity Fee ID p Grou Cal Bldg Standards Commission B ALL PERMIT 1 BCBSC g Fee TYPES 1BSEISMICR Seismic Residential P P 1RPSS 1 PRSEWER Residential building sewer/sanitary sewer 1RPRP 1 PRREPIPE Residential re-pipe per fixture P Water Service P 1CPWS or 1 BPW SVCS IRPWS .�' P 1PPRSEWG Private Sewage Disposal System IPCESS Cesspool P 1 BPWATER Install/alter Water Pipe P 1 BPFIXTURE Plumbing Fixture P 1 PGASRES Residential Gas Piping System P 1-4 Outlets 1 BPGAS Gas Piping System 5+ Outlets P f I PPERMITFEE Plumbing Permit Fee Issuance P I 1PLMBLNCK Plumbing Plan Check P 1 PLMBINSP Other Plumbing/gas Insp. P I TRAV-DO C Travel & Documentation Fee B 1 BUSLIC Business License B Community Development 10300 Torre Avenue Cupertino CA 95014 < a.:. )777-3228 Telephone(408 w Fax(408)777-3333 CITY OF ,UPS T1N0 Buildi De artment n PERMIT # JOB ADDRES ��0� /L/ Q t r� C� © lq� �r PHONE # SO NAME: C.5e� T"rws �- Oti'VNER S FAX # SCS GENERAL CONTRACTOR. �' ,•,r�: I am not using any subcontractors: Date Signature • subcontractors and com lete the follow in information: Please check applicable subco E BUSINESS LICENSE # SUBCONTRACTOR BUSINESS NAM Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal painting/ wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal .beet Rock T Date /Contrac or Signature