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12060086
1 CITY OF'CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19960OLIVEWOOD'ST CONTRACTOR:ABE CONSTRUCTION,INC PERMITNO: 12060086 OWNER'S NAME: ESSEX PROPERTY TRUST r 528 E WEDDELL DR STE 4 DATE ISSUED:06/14/2012 OWNER'S PHONE: 6504943700 SUNNYVALE,CA 94089 PHONE NO:(408)734-8416 LICENSED CONTRACTOR'S DECLARATION r r r BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class�ln?7�13ALic,N - � �'-�( -C �•r' r r r MECH RESIDENTIAL COMMERCIAL 1 hereby affirm[hal I em licensed under the provisions of Chapter.9 - JOB DESCRIPTION:UNIT A,B,C&D:MULTI-FAMILY BATHROOM REMODEL (commencing with Section 7000)of Division'3 of the Business&Professions 120 Code and that my license is in full force and eReeL SQFT AND KITCHEN REMODEL 160 SOFT ADD 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:31643003.19960 Occupancy Type: I certify that I have read this application and state that the above information is correct. I agree to comply with all city and countyordinances 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 E PIKES IF WORK IS NOT STARTED indemnify and keep harnless the City of Cuperlino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHI DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAY ROM LAST CALLED INSPECTION. with all non-poi score regular s per the Cupertino Municipal Code,Section 9.18. _ 2 _ _ _ __�. .1 _•_, Issued by: Date: Signatur le ❑ OWNER-BUILDER DECLARATION, RE-ROOFS: 1 hereby affirm that 1 am exempt fromdhe 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 1,as owner of the properly,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 properly,am exclusively contracting withlicensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1 hereby affirm under penalty of perjury ane of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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. 1 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[he performance of the work for which this Safety Code,Section 25532(a)should 1 store or handle hazardous material. Additionally,should 1 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 Code,Sections 25505,25533,and 25534. Compensation laws of Cali forma. It,alter making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor.Code,I must Owner or outho tze nl. forthwith comply with such provisions or this permit shall be deemed revoked. Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I 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 work's correct.1 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 inconsequence 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. 1 understand my plans shall be used as public records. Signature Date Licensed Professional a Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 MY OF Fax(408)777-3333 CUPERTINO Building Department JOB ADDRESS: PERMIT # 6 OWNER'S NAME: Se PHONE # GENERAL CONTRACTOR AX # S� - 4(-)T- g �1I am not using any subcontractors: \ Si 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 Insulation Landscaping Lathing Masonry Ornamenta ffieet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date CITY OF CUPERTINO 9 ITEMS OF 18 PERMIT RECEIPT OPERATOR: patg COPY # 1. Sec: Twp:- Rng: Sub: Blk: Lot: APN . . . . . . . . : 31643003 . 19960 DATE ISSUED. . . . . . . : 06/1'4/2012 RECEIPT #. . . . . . . . . : BS000017070 REFERENCE ID #. . . . : 12060086 SITE ADDRESS . . . . . : 19960 OLIVEWOOD ST SUBDIVISION . . . . . . . CITY . . . ... . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . : OWNER . . . . . . . . . . . . : ESSEX PROPERTY TRUST ADDRESS . . . . . . . . . . : 925 E 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 ---------- ------------- ---------- ---------- ---------- ---------- -- - lADMIN HOURS 1 .00 41 . 00 0. 00 41.00 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 1EPERMITFE FLAT RATE 1.00 44 .00 0 . 00 44 . 00 0 . 00 1ERESAPPL NO OF APPLIAN 2 . 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 2133 . 80 0 .00 2133 .80 0 . 00 METHOD OF PAYMENT .AMOUNT REFERENCE NUMBER -- --------------- --------------- -------------------- CREDIT CARD 4, 267.60 VISA --------------- TOTAL RECEIPT 4,267.60 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION :121 ADDRESS: 19960 Olive Street DATE: 06/14/2012 REVIEWED BY: Sean APN: BP#: 'VALUATION: $28,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY Buildina is PENTAMATION USE: Multi-Family Dwelling >3 Stories O Yes 0 No PERMITTYPE: 1REAP wORK Units A B C & D: Multi-family bathroom remodel 120 sq ft and kitchen remodel 160 sq ft add SCOPE laundry room. /'L„nh. Plu„Cbc,A Elec. Plan Check 0.0 1 hrs $0.00 11" b P, h 11=r: Phin,i,. P, "w 14 Elec. Permit Fee: 1EPERA11T (A6<a 11:,/,. My, Other Phunb)nap, Other Elec. Insp. hrs $44.00 0.0 JJtrh. Imp. h�'r' Nit...1). hop. NOTE: This estimate does not includejees due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School District,etc. . Thesefees are based on the prelimina information available and are onli`an estimate. Contact the De 1 or addn'I info. FEE ITEMS (Fee Re.solation 11-053 Eff 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Electrical Suppl. PC Fee: (F) Reg. Q OT FO.01 hrs $0.00 $44.00 /ERESAPP Appliances PME Plan Check: $0.00 12 07 s.f. Remodel, Bath (<=300 sf) Permit Fee: Hourly Only? ()Yes t] No $0.00 $588.00 1RE,LIRESBAT Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 160 s.f. Remodel, Kitchen (<=300 sf) PME Unit Fee: $0.00 $588.00 IREMRESKIT PME Permit Fee: $44.00 ('n;U(rn(lian Ten Administrative Fee: IADMIN $41.00 0 Work Without Permit? O Yes (F) No $0.00 E) Advanced Planning Fee: $0.00 © hours Inspections E) Travel Documentation Fee: ITRA VDOC $44.00 $780.00 1STINSP inspection, Hourly Strong Motion Ice: /BSEISMICR $2.80 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: $133.80 $2,000.00 TOTAL FEE: $2,133.80 Revised: 06/05/2012 12 0(' c� CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildinana cuoerlino.ora ❑NEW CONSTRUCTION ❑ ADDITION ALTER(A�TIOONQN/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJEIT- 2W()''j� 1 APNp j _— O N.M - w -MAIL lJ axe 14 V\ STREET.4DD $$✓ \ TATE,ZIP , FAX CONTACT NAM P NE E-MAIL 11Gr� 3 STREET ADDRESS �1�,[/� CrN,STATF ZIP FAX 11 OWNER El OWNER BUILDER ❑ OWNERAGENT '-�N.ONTRACTOR ❑CONTRACTORAGENT 13 ARCH= ❑ENGINE ❑ DEVELOPER ❑ TENANT CONTRAJL�AR NAME �y 1 L114 ER L ICECCI'�;T,yPEBUS.LIC d CO CA CC7�j -`A�1 vb 1 � vv -I �l Tl0"N� O"IT ARCHITECT/ENGMEER NAME LICENSE NUMBER V BUS.LIC 9 "f COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTIO OF WORK_ 1 0C' - YY1 Q1A(\ i 1 EYISTMG USE PROPOSED USE CONSTR TYPEbSTORIES Mu�'vJ_ Ovn 2 USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL p� AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODELAREA 00 O REMODEL AREA 11 O(D REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA DETACH ❑ATTACH b nWELLMG UMTS ISASRCONDUNTT ❑VES SECOND SrONV ❑YES BEING ADDED' [:]NO ADDITION' ❑NO PRE-APPLICATION ❑YES T YES,PROVIDE COPY OF ISTHERLDGAN ❑YES RECEIVED Y: TOTAL VALUATI(O-N�: PL4NNINGAPPLd ❑NO PLANNING APPROVAL LETTER EICHLER HOME' ONO _ / /�O 1VOV i /V 6Z lJ By my signature below,1 certify to each of the following: 1 am the property owner or authorized agent ro act on the property owner's behalf. I have read this application and the information 1 have rovided is Lorre 1 ha e d the Description of Work and verify it is accurate. 1 agree m comply with all applicable local ordinances and sole laws relating to ilding c s c . I 'ze representatives ofCupenino to enter the above-identified prop e foorr'ins/pitcDOn purposes. Signature of ApplicanVAgem: Date' � �'7 /p-0 SUPPLEMENTA ATTON REQUIRED PLAN CRECK TYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition pemtit for OVER-THECOIJNTER BtRLDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. EXPRFSc PLAI%NH G PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ srANDw ❑ PUBLIC WORKS form if any Hazardous Materials are being used as pan of this project. ❑ LARGE ❑ FUZE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to El M.UOR El SA.\TEARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIItONT/ENTALHEALTII B/dgApp_201 l.doc revised 0612//l1