Loading...
10010114 CITY OF CUPERTINO BUILDING PERMIT ppLEWOOD APT A,B,C,D CONTRACTOR:GENMOR PLUMBING PERMIT NO. 10010114 BUILDING ADDRESS: 10639 M 2552 SEABOARD AVE DATE ISSUED:01/25/2010 OWNER'S NAME: ESSEX PROPERTY TRUST PHONE NO:(408)855-8348 SAN JOSE,CA 95131 NER'S PHONE: 6508495835 r ELECT r PLUMB� [] L ENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG , Lic.# / ME CH RESIDENTIAL COMMERCIAL License Class ContractorDate . © � JOB DESCRIPTION:WATER MAIN SERVICE REPLACEMENT I hereby affirm that I licensed and the provisions of Chapter 9 ision 3 of the Bus piss&Professions (commencing with Section 7000)of Div Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two dto self-insure for eclarations: I have and will maintain a certificate of consent of the Labor Code,for the Compensation,as provided for by Section 370 Valuation:$2500 E Area: performance of the work for which this permit is issued. provided for by I have and will maintain Worker's Compensation Insurance,as p Occupancy Type: Section 3700 of the Labor Code,for the performance of the work for which this er:31643003.10639 permit is issued. APPLICANT CERTIFICATION ation is I certify that I have read this application and state thatordinances and ate laws relating PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county or 'on and hereby authorize representatives of this city to entergIN 18 DAYS OF PERMIT' ISSUANCE OR to building constructs ree to save upon the above mentioned property for inspection purposes.inst liabilities,judgments, DA OM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino ag 18U cCity in consequence of the osts,and expenses which may accrue against saant understands and will comply —2�j ` Date: the applicant J granting of th' pe it. Additionally,ati Pp p Issued by: with all non oint sou ce regulations per the Cupertino Municipal Code,Section 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 DECLARATION 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. Date: the following two reasons: Signature of Applicant: I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure isnot intended or offered for sale(Sec.7044, GS TO BE CLASS"A"OR BETTER Business&Professions Code) ALL ROOF COVERINGS 1,as owner of the property,am exclusively contracting with licensed contractors to 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 Sections 25533,andder apter 25534.95 of the I will maintain declarations: Chapter 9.12 and the Health& I have and will maintain a Certificate of Consent to self-insure for Worker's California Health CupertinoMunicipalCode, as provided for by Section 3700 of the Labor Code,for the Safety Code,compliance Section 25532(a)should I store or handle hazardous material. Compensation, mint or devices which emit hazardous air performance of the work for which this permit is issued. Additionally,should I use equip Worker's Compensation Insurance,as provided for by contaminants as defined by the Bay Area Air Quality M enCha ter 9.12 and the ll I have and will maintain Wo P P mainta' coin fiance with the 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this I &Safe Code,Sectio Hea permit is issued. f I certify that in the performance of the work for which this permit the issued, O er aut i age . not employ any person in any manner so as to become subject Date. --------- Compensation laws of California. If,after making this certificate of exemption, ust p become subject to the Worker's Compensation provisshall the Labor revoked. CONSTRUCTION LENDING AGENCY forthwith comply with such provisions or this permit I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CE RTIFICATION for which this permit is issued(Sec.3097,Civ C.) I cern 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 city t s relatingenter Lender's Address to building construction,and hereby authorize representatives of upon the above mentioned property for inspection purposes.(We)agreud mints, ARCHITECT'S DECLARATION to save -unify and keep harmless the City of Cupertino against liabilities,j g as public records. and expenses which may accrue against said City in consequence of the understands and will comply I understand my plans shall be used P giwtting of this p t.Additionally,the applicant with all non-p t soutce regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Date w Signatur r CITY OF CUPERTINO PERMIT RECEIPT OPERATOR: patg 5 ITEMS OF 60 COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 31643003 .10639 DATE ISSUED. . . . . . . 01/ 03 RECEIPT # . . . . . . . . . BSO000096 REFERENCE ID # 10010114 SITE ADDRESS . . . . . : 10639 MAPLEWOOD APT A,B,C,D SUBDIVISION • • • . . . : CUPERTINO CITY . . . . . . . . . . . . . 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, CA 95131 TELEPHONE . . . . . . . . : (408) 855-8348 UANTITY AMOUNT PD-TO-DT THIS_REC_ _-NEW-BAL- FEE ID UNIT Q ---------- ---------- -- -----__ --------- ---------- 0 .00 1 . 00 0 . 00 VALUATION 2, 500 . 00 1.00 0 . 00 1BCBSC 0 .00 21 . 00 1. 00 21. 00 0 .63 0 . 00 1BPWSVCS WATER SERVICE 2, 500 . 00 0 . 63 0 . 00 1BSEISMICO VALUATION 0 . 00 42 .00 0 . 00 1 . 00 42 . 00 42 . 00 0 . 00 00 42 . 00 1PPERMITFE FLAT RATE 1 . 0 . 00 --_ 1TRAVDOC FLAT RATE ______-- ---------- ---------- ------ 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 Y rF .................. ..................... . CITY OF CUPERTINO REPIPE/ SEWER/MAIN SERVICE CUPERTINO PERMIT APPLICATION FORM APN # - 10 �0 311 Date: 0��� Building Ad ress: "150 \ tq-�kv Owner's Name: Phone #: t��� -��.� .- �r rE:!) Phone #. Contractor: �� L � t Fax #: �Z --(c;I�1 C-, � 1 c� Contact: Phone L (b�v�) UL Fax#: Contractor License#: ?)-5-7,7>4110 1 Cupertino Business License #: 'vZ Job Description: Residential ❑ Commercial Valuation: o Pro'ect Size: Express ❑ Standard ❑ Large Majo�rD� J Green Building:: Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, include in plan set& the sheet index. Green Buildin Points: • ID Fee Description Fee Permit Type Quantity Fee Group 1 PCSEWER Commercial building P ICPSS sewer/sanitary sewer 1 BPREPIPE Commercial re-pipe per fixture P ICPRP 1 PGASCOM Commercial Gas Piping System P 1-4 outlets 1 BCBSC Cal Bldg Standards Commission B ALL PERMIT Fee TYPES I 1 BSEISMICOM Seismic Commercial P t Revised 01/07/09 CITY OF CITY OF CUPERTINO REPIPE/SEWS R/MAIN SERVICE FEE SCHEDULE CUPERTINO Type Fee Description Fee Quantity Fee ID Grou Commission B ALL PERMIT I BCBSC Cal Bldg Standards TYPES Fee P 1 BSEISMICR Seismic Residential P 1RPSS 1 PRSEWER Residential building sewer/sanitary sewer P IRPRP 1 PRRF.PIPF Re�ic�ent.i�_1 re-pipe per fixture P 1CPWS or IBPWSVCS Water Service IRPWS S 1 PPRSEWG Private Sewage Disposal stem P y P 1PCESS Cesspool 1 BPW ATER Install/alter Water Pipe P IBPFIXTURE Plumbing Fixture P 1PGASRES Residential Gas Piping System P 1-4 Outlets P IBP GAS Gas Piping System 5+ Outlets 1PPERMITFEE Plumbing Permit Fee Issuance P 1 PLMBLNCK Plumbing Plan Check P IPLMBINSP Other Plumbing/gas Insp. P VDOC Travel &Documentation Fee B 1 TRA � B 1 BUSLIC Business License Community Development =� 10300 Torre Avenue Cupertino CA 95014 tj n,E Telephone(408)777-3228 Fax(408)777-3333 CITY OF 'UPE TINO Puildi�yepart m a nt 0 PERMIT # JOB ADDRESS: (Z- OC-AZ.- q��o h6sct i NSE. PHONE 'S� g4? - 3 S— OVVNER S GENERAL CONTRA4� --- FAX# �. , 0 � C' . CTOR: -en lwi � z� � I am not using any subcontractors: Signature Date Please check applicable subcontractors and co m Tete 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 Ku' e � 20 Date Owner/Contractor Signature