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14020053
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10716 ROSEWOOD RD CONTRACTOR:ABE CONSTRUCTION, PERMIT NO: 14020053 INC OWNER'S NAME: ESSEX THE POINTE LP 528 E WEDDELL DR STE 4 DATE ISSUED:02/11/2014 OWNER'S PHONE: 6504943700 SUNNYVALE,CA 94089 PHONE NO:(408)734-8416 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL F] C�O UNIT C-REMODEL BATHROOM(120 S.F.),KITCHEN(160 License Class ic.# S.F.),ADD(N)LAUNDRY ROOM,UPGRADE ELECTRICAL ( � 2 PANEL&PLUMBING Contractor \ Date I hereby affirm that I am licensed under the 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 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 WITII N 180 DAYS OF PERMIT 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 DA T CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all Uomturc ulations per the Cupertino Municipal Code,Section 9 18. RE-ROOFS: Sign tur Date " 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 ay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance wit the er no 1 a Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Se tions 25 5.255 ;a d 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized age t: ' 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 shall 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 ' PERMIT APPLICATION `�1 COMMI.NITYDEVELOPMENT DEPARTMENT m BUILDING DIVISION 1 ?Q$OQ I ORRE AVENUE s CL)PERTINO,CA 95G14-, 2S5 ERT@ @ (4Q8 7l?7 3 28 PAX(408)777-3333.•buildina(a).cupertino.c,CUP 't ❑NEW CONSTRucno ; ❑fiDI3iTION'., MRATION i Ti ❑ REVISION!DEFm ,F oRIGINAL PERMIT y PRET D AS'NYi -.O�tR1F,R N i STREETADD fj CONTACT WAME STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑OWtR RtT1LDF1� ❑,OWNERhGENT. NTRACTOR ❑CONTRACTORAGF�SY' ❑ ARCHITECr ❑ENCAQE-A 13 DEVELOPER ❑ S7f13T MCMPANYa Bus.t�c 2 83 -k FAX �^,y 6. P ARCFaTtEC1'lEI3GIIv'Ec"R.NAME I3CENz-Nul'SER BUS.LIC# -A1�ANY NP.ME gi,,�Ag, FaX STREET ADDRESS CITY,STATE4 ZIP PHONE DESCRIPTJO OR• an i r Eh15TEdGUSE PRAIb T]sE ;CONSRLT.YPE #ST USE TYPE OCC:' SQ.Fr: VALNATION(s) EXtSTG NEW FLOG ' DEMO TOTAL q AREAAREA AREA NETAREA RATHROOM RTr REMODELARBA02C) I REMOD R6MODELAP.EA PORCHAREA... DECKAREA TOTAL DEt.71PORMAREA GARAGEARRA:........ DETACH ..❑ATTACH,- #DWELLING Mms: TS A SECOND UNIT '- TES- SECOND STORY BF.IPIG.ADDED7 ❑NO . ADDITION7 [1N0 PnEAPPLzc.k'nON ❑YES tEYESy?RQVRTfi OPYOF' j 7STH.ERLDGAN TOTAI:VAL ON: i PLANNWG APPL# ❑NO PC.hNNTNG,APPRT)U,AT;7k7fER FTCBLER 80ME7 ❑NO By my signature below,I ccrtify'to eaeb of oll ur Q I am the property owner or authorizrd went to actin the prnp ehaif.T have read this application and the information luav^ o ' L I have read UTe Desbciptiou of Wank and verify iY is accurate I agree to comply With all applicable local ordinances and stats laws rela' gib, I a rize sentatives of Gtipertino to enter the id tifi property for inspection purposes. Signature of Applicant/Agent Date: SUPPLEMENTt1L lN © TION REQLIItED PLAtV CHECK TYTE ROUTINGSLIP New 5FD or Multifamily dWellmos::APP)Y"fes demolition permit for 0uINTER ❑ BGH,DMG PLAN REVIEW existing building(s). Demolition getnlit i"s cegnirzd prior to issuance of bttildfi permit for new building, ❑ EXPRESS ❑'PL.AANwG PLAN REViEw Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ sTABIDARD ❑' PURLIC WORKS form if any Hazazdous Materials are'being used as part of this prq}eei ❑ LARGE ❑ FIRE DEPT Copy of Planning Approval Leiteff.orMeeting zaiUl P1aTTningpnor to ❑ MAJOR, ❑ sArrrraRY sEu RDIsrRICT submittal of Building Permit application. ❑ F.2QVtRbNA�N'rAL1M--.LTH Bld�pp 2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10716 Rosewood Rd#C DATE: 02/10/2014 REVIEWED BY: Mendez APN: BP#: *VALUATION: $24,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY Multi-Family Dwelling Building is PENTAMATION 1 R2REM USE: >3 Stories 0 Yes Q No PERMIT TYPE: WORK UNIT C - REMODEL BATHROOM 120 S.F. KITCHEN 160 S.F.), ADD N LAUNDRY ROOM, SCOPE UPGRADE ELECTRICAL PANEL& PLUMBING j•: M 50 ;Wec hr Ala-f€:?rPck 1'?arr,b.121rvr C:Ir£:r.,A Elec.Plan Check 0.0 hrs $0.00 !Lr`fcrt_ 111-1 it Fee /'hnnb. /'errs.:'-Fee: Elec.Permit Fee: 1EPERMIT Oi er t'ttnn Ir't..3 3. Other Elec.Insp. 0.0 hrs $47.00 1€.4;rr.f I'iurr±ti.1ss.r3, t£'£': Dec. /,�,in. Fee: NOTE.This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). Theseees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS(Fee Resolution 11-053 E . 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 s.f. Remodel,Kitchen(<=300 sf) Suppl. PC Fee: ie) Reg. ® OT 0.0 1 hrs $0.00 $0.00 IREMRESKIT PME Plan Check: $0.00 125 amps Electrical Permit Fee: Hourly Only? 0 Yes Q No $0.00 $47.00 IBELEC200 Services Suppl. Insp.FeeQ Reg. ® OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $47.00 Administrative Fee: IADMIN $44.00 Q Work Without Permit? 0 Yes (F) No $0.00 G Advanced Plannin&Fee: $0.00 Select a Non-Residential E) Travel Documentation Fee: 1TRAVDOC $47.00 Building or Structure Strong Motion Fee: IBSEISMICR $2.40 =hrs Inspections Bldg Stds Commission Fee: 1BCBSC $1.001 $695.00 1STINSP Inspection,Hourly � - $141.40 $742.00 TOTAL FEE-, $883.40 Revised: 01/15/2014