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13070049 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10716 ROSEWOOD RD T� CONTRACTOR:ABE CONSTRUCTION, PERMIT NO:13070049 INC OWNER'S NAME: ESSEX THE POINTE LP 528 E WEDDELL DR STE 4 DATE ISSUED:07/08/2013 OWNER'S PHONE: 6504943700 SUNNYVALE,CA 94089 PHONE NO:(408)734-8416 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11S COMMERCIAL (- UNIT D-280 SQFT REMODEL BATHROOM,KITCHEN,ADD teclassac/000-Lic.#i IL L p/ NEW Contractor� ( .GYM 0I M22'J/ad o LAUNDRY ROOM,UPGRADE ELECTRICAL&PLUMBING. I hereby affirm that I am licensed under the provisionsofChapter 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 performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$24000 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:31643005.10716 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 1 O ERMIT 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 LED INSPEC IO indemnify and keep harmless the City of Cupertino against liabilities,judgments, 7 costs,and expenses which may accrue against said City in consequence of the I� granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-point egt ations r Cupertino Municipal Code,Section 9.18. II RE-ROOFS: Signature Date l 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 or 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 A' Quality Management District I performance of the work for which this permit is issued. will maintain compliance wit Cu rtin - nicipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Se tion 2 0 3,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this J 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 shalt 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 Ct1PERTI1d0 (408)777-3228•FAX(408)777-3333•building(a).cuper ino.org n C ❑NEW CONSTRUCTION ❑ ADDIIYON ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT PROJECT ADDRESS ` # L 6z_, OWNER NAMEPHONE -o E-MAUL r� LL ` 9 TAA Q 120 rt (-o 6v\ STREET ADDRES CITY,S Z �� rt I FAX �, b l+� CONTACT NAME P 50-- �15— 140 STREET ADDRESS ,,..,,..,, CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT W115ONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR N LICENSE 3 16�8::7:o BUS.LJC# ? 7QY J O`�.) COMPANY E-MAIL • FAX 1408 4futf- C-52 - r �e` !7 $�YuL'EtCri—itf3�r C'{JM STREET ADDRESS ` ,STATE,ZIP I 1409Y pH��— 73 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAUL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRTPTTON OF WORKe V`O J j t ^ 6�'" Q\l � 'r a'h C oAec-� t EXISTING USE PROPOSED USE ,nyV` CONSTR TYPE #STORIES USE TYPE OCC. SQYT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL ,,,��777 AREA AREA AREA NET AREA p^_[ •' 1 f 3.0 - BATHROOM KITCHEN OTHER U v L REMODELAREA �^ REMODEL AREA I /_ !^ REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCHAREA GARAGE AREA; DETACH ❑ATTACH #DWELLING UN"S: TS A SECOND UNIT ❑YES SECOND STORY OYES BEING ADDED? ❑NO ADDITION? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY. TOTAL VUATION: PLANNING APPL# [-]NO PLANNING APPROVAL LETTER EICE LER HOME? ❑NO &rv-u -- By my signature below,I certify to each of olio : I &Td�e owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have pro ded o t. Iscription ofWork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relatin to buil co aentati es of Cupertino to enter the abov iden ed roperty for inspection purposes. Signature of Applicant/Agent Date: SUPPLEMENT TIO U17tED p CK TYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building couNT�x LY�gU[I DING PLAN REVMW 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 submittal of Building Permit application. ❑ NIAJOR ❑ SANITARY SEWER DISTRICT ❑ ENVMONNENTALHEALTH BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10657 ROSEWOOD RD UNIT A DATE: 07/08/2013 REVIEWED BY: MELISSA APN: 316 43 004 BP#: "VALUATION: $24,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1 REAP WORK REMODEL KITCHEN BATHROOM AND ADD N LAUNDRY RM. UPGRADE E ELECTRICAL SCOPE PANEL TO 125 AMPS NMI IB - �� .A Mech. Plan Check Plumb.Plan Check Elec.Plan Check 0.0 1 hrs $0.00 Ltec1.Permit Fee: Plumb.Permit Pee: Elec.Permit Fee: IEPERMIT tkher.Uecrh.Insp. tither Plumb Insp. Li Other Elea Insp. Tf7.00 I.Alech. Insp.Fee: Plumb. Insp.Fee: Elec.Insp.Fee: 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 or addn'l info. FEE ITEMS (Fee Resolution 11-053 E . 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = amps Electrical Suppl.PC Fee: (j) Reg. 0 OT0.0 hrs $0.00 $47.00 IBELEC2007 Services PME Plan Check: $0.00 Permit Fee: Hourly Only? 0 Yes (E)No $0.00 Suppl. Insp.Fee-.0 Reg. ®OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $47.00 Construction Tax: Administrative Fee: IADMIN $44.00 Work Without Permit? ®Yes (E) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential E) Travel Documentation Fee: 1TRAVDOC $47.00 Building or Structure i Strong Motion Fee: IBSEISMICR $2.40 5.0 hrs Inspections Bldg;Stds Commission Fee: 1BCBSC $1.00 $695.00 ISTINSP Inspection,Hourly $141.401 $742.00 R: .Y ®e' $883.40 Revised: 07/01/2013 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: PERMIT# OWNER'S NAME: —7hV PHONE# GENERAL CONTRACTOR: 9W BUSINESSLICENSE# 1— ADDRESS: CITY/ZIPCODE *Our municipal code requires all businesses workjdg in the city to have a"City d"'. ertiito- usiness license. NO BUILDING FINAL OR FINAL OCCUP , CY INSPECTION(S).WILUtE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL B NT ORS HAVE OBTAINED"A.CITY OF CU ERTINO BUSINESS LICENSE. I am not using any subcontra tors: Signature Date Please check applicable subcontractors and complete the following.information: V 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