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10010082 --- CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10698 MAPLEWOOD RDD APT A,B,C,D CONTRACTOR:GENMOR PLUMBING PERMIT NO: 10010082 OWNER'S NAME: ESSEX PROPERTY TRUST 12552 SEABOARD AVE DATE ISSUED:01/25/2010 1ER'S PHONE: 6508495835 SAN JOSE,CA 95131 PHONE NO:(408)855-8348 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.#!q MECH RESIDENTIAL COMMERCIAL Contracto Date " 0 I hereby Vtahaam licensed under the provisions of Chapter 9 JOB DESCRIPTION:WATER MAIN SERVICE REPLACEMENT (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:$2500 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 permit is issued. APN Number:31643003.10698 Occupancy Type: APPLICANT CERTIFICATION 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 PERMIT EXPIRES IF WORK IS NOT STARTED to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION. costs,and expenses which may accrue against said City in consequence of the granting oft rmit. Additionally,the applicant understands and will comply ---- '' with all no point§purce regulations per the Cupertino Municipal Code,Section Issued by: Date;. 9.18. Signatur Date - RE-ROOFS: Li OWNER-BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for inspection. the following two reasons: I,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: Date: 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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will ermit is issued. mai compliance with the Cupertino Municipal Code,Chapter 9.12 and the p H Ith&Rhfety Code,Sections 25505,25533,and 25534. 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 w r o o ' d a Compensation laws of California. If,after making this certificate of exemption,I Date: l' 1 become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.) I certify that I have read this application and state that the above information is Lender's Name 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 Lender's Address upon the above mentioned property for inspection purposes.(We)agree to save -mnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION and exp,p s which may accrue against said City in consequence of the granting of is pe it.Additionally,the applicant understands and will comply I understand my plans shall be used as public records. with all no -point so rce regulations per the Cupertino Municipal Code,Section 9.18. Licensed Professional Signatur Date Z— CITY OF CUPERTINO PERMIT RECEIPT OPERATOR: patg 5 ITEMS OF 60 COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 31643003 .10698 DATE ISSUED. • • • • " ' 01 /25/2010 RECEIPT #. . . . . . . . . BS000009613 REFERENCE ID # 10010082 SITE ADDRESS 10698 MAPLEWOOD RDD APT A,B,C, SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . • OWNER . . . . . . . . . . . . : ESSEX PROPERTY TRUST ADDRESS . . . . . . . . . . : 10696 ROSEWOOD RD APT A-D CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : ALLAN UY CONTRACTOR . . . . . . . : GENARO MORALS LIC # 27101 COMPANY . . . . . . . . . . : GENMOR PLUMBING ADDRESS . . . . . . . . . . : 2552 SEABOARD AVE CITY/STATE/ZIP SAN JOSE, 95131 95131 TELEPHONE (4 0 8) 8 5 5 8 QUANTITY AMOUNT PD-TO-DT THIS-REC- --NEW-BAL- FEE ID UNIT ---- --------__ - ---------- ------------- ---------- ------1 . 00 0 .00 1. 00 0 . 00 1BCBSC VALUATION 2, 500 .00 1 . 00 21. 00 0 . 00 21 . 00 0 . 00 1BPWSVCS WATER SERVICE 0 .63 0 . 00 0 .63 0 . 00 1BSEISMICO VALUATION 21500 .00 0 . 00 42 . 00 0 . 00 1PPERMITFE FLAT RATE 1. 00 42 .00 42 .00 0 .00 42 . 00 0 . 00 1TRp,VDOC FLAT RATE 1 . 00 -------- ---------- ---------- ---------- TOTAL PERMIT 106 . 63 0 .00 106 .63 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------------------- -------- ------------- -------- ---- 106 SEWER & WATER 103 UFER 507 FINAL PLUMBING oc� Ay CITY OF CUPERTINO I A MAIN SERVICE ygS REPIPE/SE CITY OF APPLICATION FORM Cu -r �F INo PERMIT . Date: ' 7� , APN # 4 c) 1 BuildingAddress: C Eb �` C- A ��.. . vr.� Phone#: _ e�A G. wner's Name: r �( -S1 J Phone#: - `',� S-� � Contractor: 1 Fax#: - NYa y f� > Phone#: ��> Contact: Fax#: �� Contractor License#: 6f�t)��l (C Cupertino Business License#: Job Description: Commercial Residential ❑ Valuation: Major or ress Standard ❑ Large ❑ Project Size. Exp ❑ . relevant portion of the Green Building Checklist & attach it to the Green Building: Please complete releva P he sheet index. application or if applicable, include in plan set & t PP Green BuildingPoints: ri tion Fee Permit Type Fee ID Fee Desc p[jQj�uantity Grou 1 PCSEWER Commercial building P 1CPSS sewer/sanitary sewer - i e fixture P 1 CPRP 1BPREPIPE Commercial re-pipe per 1 PGASCOM Commercial Gas Piping System P 1-4 Outlets B ALL PERMIT 1BCBSC Cal Bldg Standards Commission PES TY Fee P 1BSEISMICOM Seismic Commercial Revised 01/07/09 ax,, CITY OFCUPERTINO SERVICE REPIPE/SEWERIMAIN CITY Of SCHEDULE CUPE T1N0 FEE k Description Fee Permit Type Fee IDFee D pQuantity Grou Cal Bldg Standards Commission B ALL PERMIT 1BCBSC C g TYPES Fee 1BSEISMICR Seismic Residential P 1 PRSEWER Residential building P 1RPSS sewer/sanitary sewer P 1RPRP 1 pRREplpE Residential re-pipe per fixture :1 Water Service 1 BPWSVCS P 1CPWS or 1RPWS . 1 PPRSEWG Private Sewage Disposal System P 1PCESS 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 1PPERMITFEE Plumbing Permit Fee Issuance P 1 PLMBLNCK Plumbing Plan Check p 1PLMBINSP Other Plumbing/gas Insp. P 1TRAVDOC Travel & Documentation Fee B r 1BUSLIC Business License B Community Development 10300 Torre Avenue w Cupertino CA 95014 Telephone(408)777-3228 CITY.OF Fax(408)777-3333 ;UPEkTINO Building Department JOB ADDR� mltv000� PERMIT #0 ct t , a4tf C � � OWNER'S NAME: PHONE # c ) G- S�)-J GENERAL CONTRACTOR: (``UvvN'r "-Vl�%r FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and co m lete 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 Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock zIe --t5 weer/Contract r ignature Date