S 2606 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO IRSILDING-ELECTRICAL - PERMITNO.
BUILDING DIVISION APPLICKPIONWERMIT - PLUMBING-MECHANICAL S 2606
_ . RUILDIN(:I'ROJELTII)i:.NIIF'ICAI'ION
BUILDINGADDRESS &I
"I - SAAPPLICATION SUBMI'EI'AL DATE
A'a& � �� 04� �� Il/ jWll
-
OWNERS All - P N2 CONT BACK NA. ' I.IC NO;
SIC CONTROLM Q
nHCHTT; EEH: .IC NO: kys.5' El
PHONE: FVV+I BUILDING I'8RMI1'INhO L
❑ Consultant FCC$Paid by Applicant(Initial) BLDG ELECT PLUMB MIECH
d- 7I-Q E9� E� fE- 2'
IJCENSIEDCfI RACTOR'S DFAI.ARA'I'ION QTY, ELEC'T'RIC PERMIT' ^' NEI? JOB DE$CRII'I'ION
1 hereby offitm rhm 1.am Iiceh I antler pmvisinn of Cha 9(comma g
'WZ olhSeetiun700) SDlv'l al Ithe Pnxinasum n's al ole,'i rylicdf,J-Iv PERMIT ISSUANCE � •V
1-00° full force an ffen. SFDWI. Lj KUCI TEN RFMODEI.
U License CI s Lic.N
Q. J APPLIANCES-RESIDENTIAL ❑ADDITION ❑PLUMBING RE-PIP'.
F W IAau Cnn"cm
m a ❑Ml1Ll'I-l1NIT ❑$TRDGTHRAI.
ARCIII'1'ELT'S D[C f
p-prn PANELS MODIFICATION
C undersr:n d my tans>hall he used as public records
Oz,,,° UP To 20(l AMPS ❑INTERIOR []CHIMNEY REPAIR
r-1-M Licensed Professional 2014000AMT'S IMPROVI3MEN'IC]SWIMMING POOLS
OWNER-❑UILDER DECLANAI'ION OV13k I000AMPS C1 BATH RENE)DF.1/REPAIR [IDEMOLITION
¢'WW d 1 hereby offset that I ant exempt front the Couraanr'v Licence Law for the
'6°a U following reason.(Section 0031.5,Business and Professions Code:Any city or county SIGNS ELECTRICAL L-10I'I IER
W 3 W y which leytdren a Ismail ,,cors,... ,ober.improve,dcou"ll or repair any xwcture
F'�O< pdminnni'larres'd...requiter)hett,dicient Lnsnch psunit ,,file a signedlatcmem SPECIAL CIRCUS'I'IAf TSC.
y'1 mill he is licensed pursuant n the provision%of the Contractor's License Law(Chapter 9
�;Z (unmm'ming with Section 9000)of Division 3ortire liusinessaud Pral.ions Code)()I TEMP.ME IER OR POLE INST. COMMFRCIA[,
ad
0.6 e W mal he is exempt therefrom and[lie basis for the alleged exemplion.Any violation or ElNEW BLDG/ADDITION [jDEMOLITION
WIm Senior 7031.5 by......lican for v permit subjects he np,li,anuoa civil pcmOtyof POWER DEVICES [I TENANT ❑FOOD SERVICE
not more than five hundred dollars($501). IMPROVP.MFN'I'
fS� ❑1.us omneroDhe pmpcny,army anployres wise xxges as meirsnle compensation. SWIMMINGI'OOLELECIRIC ❑(]IAER
F+ will dome work,and lire slrwnuic is not lntendcdoro0errd forxale(.See 7044,Statutes,
LLUS 3 m and Processions Code The Contractor's License law Astec not apply a,an owner of 011'11,1i19-SWISS CHES-FIX'1'13 RES
Q' property who builds nr improver meram,and who docs wch work himself nr Ihmugb
his two ctndayIs"P.avided Ilan such ilnprnvcriark arc nal included nr ot'I'cfed for NEW R&SIIIENTIAL ELI!CTR SQ PI.
Sale.If.however.the building ar impowementissold wrahitione yeauRrompletion,the -�..k SQ.Pf.FLOOR AREA $/SQ.I°I'.
ner-builder well have the bureau of putting nett he did not build or improve for par- •J ,.� �(./9'�
u eof sole). - J
❑ T,m nwncr of the pu,rt,,a xdtuively enn.mmain,with licensed read.. s m T('
ms¢ncI the pnycct(See 9044,13 mess and Pmferainnr,Coda)The Contractors Li.
cause Use does not apply In an owner of propony who builds a impnwes thereon.and QTY,+, PLUMBING PERMIT I
who contends boli such psajecr,with v comrdchu(s)licensed pursuant m the Contractors ^(J
license Law. PHI!vHT ISSUANCE
❑I am sacred under Sec. .B&P C for hill reason
Owner Slum
ALTER-IIRAIN&VB "'-R Hi A) f] VALU�TION l
Alm WORKEH:S COMPENSATION DECLARATION BACK FLOW PROTECT'.DEVICIi 2 y g
Thereby elfllrt oder penally or perjurya of the fallowing declarations:
IM1ava.sect will reread.n a CL•nificalcol cut Itselfi...re for Worked.Cmnpcn- DRAINS-110014,BOLI,AREA,CONI
14 as prosided for by Stanion 3700 of me taboo Coca,tar he paffarmnnce of the S'I ORIIiS TYPE CONS'I'I4UC'DON
work lin which dl..pcn..it is vol ed, FIX"T'URFS-PCR TRAP
❑I have and Still maintain Workers Ci enpensdian In..nncc,as nu nired by Scanto
3]00ofthe Labor Gale,forrM pert amen Ihass kfocwbichb �IiYk isalad, GAS-EA.SYS'I'EM1f-I INCA OIITLEI'S OCC.GHUIIP APN
My We n Inst and (IS nmah arc
Came,. GAS-F.A.SYS'T'EM-OVER 4(HAS
CE HIS IiOFEXE 'I N W 9W( KN"
)hit, A' 1 GRITASE/INDUS7RLWASTF,INTERCEPTOR BUILDING DIVISII]N I'+ITIS
f ba'eeliun in alnal A:raI rue t epetmit is(art a hundred dollars($I IkD GREASE'I'RAI'
ser letSJ � PLANCHI.g .3e2�
I certify that in the performance ofShe work for which this parent is issued,l shall SIiw13Rr SANI'1'Ak S'I ENERG li
nor a Ploy any person in any lacunae,en m to hecoma vmjed a. he Workers'Coae,a- - ZD
O Z S.,,.a Laws or California.Data WpfBR HEATER W?VBNY/EI.CC I GRAVING VEL
Applicant `
NOTICHI 0 APPLICANT:11,a0ennakmg this Ccuilwalcof Excnlprion, osash...ldWATF.k SVSTEM(�REAfING
I�-+r hcome subject to the Worker's Compensation provisionsm
at the Labor Coda,you must 99
SOUS P '
4fJ L�.I R+nhwlrlt comply with such pmvisi0nx onM1is permit shall hs deemed revoked. WAk Spin ICf:1
a Q
19
CONS hemisa lon,arclion lNOAGENCY NEW_RISIDUN'p'IAL PLMR. [ PAID '4- ,Pr//�r/��
I U0 affirra thisanbureisaed(Secrianle,Us.agency forthe perfonnansxof D°O """""'
the wed for which the permit is ismrd(Sec.3fN],Civ.C.) t �.(,_'- -_.._-,-
s SO U Lenders Name IfYIAI„
T.under'x Address
'�•s W I cantly tbnl I have read thisapplaudSand State thio She above infiltration is - BUILDING ITE. O
i-s Val cameo.I agree to comply with all city and county ordinances and sane laws relating o Q'I'Y. MECHANICAL PERMIT
U ,7. buildingcnnnnedion,andhefehy vull ar"'arsenlaliv"Aliseity tocnterulum the SEISMIC FEE Tt/
ahoveorentianed p,.,ny for inspection pnpo.ccs. PERMIT ISSUANCE - _ e1
(We)agree m save,indatnnify and keep harmless rhe City of Concerns 1'i against ELIiCfRsL
,'abillric,'ta, inenLs,rnusvnd rxpnnrs which may in any way eccrucapatinstsaid City ACI ER OR ADD'IU MECH
PhUMBING Ti
ns 0 aceafinegmating of mi unit.
AP A 'P UNDF, STAND . I WILL COMPLY WITH ALL ON DINT AIR HANDLING UNI'I'ITO 10,00007M)Sr R E EGULATIO A1I!CIIANI 'AL 190E
AIR HANDLING UNIT(OVER 10.WSCFM) CONSTRU N'TAX
St wu of Applicaa at EXHAUSTHOOD(W/DUCT) HOUSING MITIGATION FEE
HAZARDOUS MAI'RRIA S DISCLOSURE
Will HEAHNO UNi'I'(TO 1011,0011 IIIU)
as defined by the Cupartino Municipal Code,Chap¢r 9.13,and the Health and Safety
Cade,Scctin 121534LOp HEATING UNIT(OVER 100,(1 BTUI
Ya `
VEt TILAGON PAN(SINGLE RESID) PAID Date Receipt a
Will the applicant.1 B �re M1uildiag(Serpent nee cyuipmcnt or devices which TiOTLEIi-COMP(3HPOk I00,UW N'I'Ip
'r hamrdous air canraminanrc m defined by the Bay Area Air Quality Maragcmem TO'f,11.:
It HOILEII COM P(OV 17R I oodlim B'TU)
❑} -
Nk CONDITIONER
W
I I I I I t: I Ch'PI l)5 I'tM1e GI ISSUANCE DATE
really ta hit&Saficy hive ycnan,Sections 2551Rt isssY actntoblry l'fr/11 rM1da at l"
nt NI'W RI tiIDCN'IIAL MECH. SQ. �— 9
4 1
li tM p orm ssua ter.ofu Csrtil l
ug Ian Tf)TA ISSUED BY
OFFICE
k" KIHLTHAU, INC. Consulting Engineer
1030 Connie Drive, Campbell, CA 95008 • (408) 379.6561
Kelly-Gordon Development Corporation January 17th 2000
12241 Saratoga-Sunnyvale Road
Saratoga, CA 95070
RG: Supplemental, As-131.1ilt Structural Design Review for the Rough Framing Sign Off
for the Lot 36 Residence, Oak Valley Unit 5 Subdivision, Cupertino, CA (OLn-Joh No.: 99080)
After my jobsite meetings with Gordon on 12/23/99 and today, and my review of the above referenced design. the
following list itemizes both what was visible and verified, and what has been concealed at this stage of construction.
I) Since the plywood floors had been installed prior to my visits, the following items could not be verified as prnherly
completed during this visit. However, they may he verified as properly done by reviewing the City or Cupertino's sign (1li
paperwork.
a) The foundations, underfloor grade clearances, anchor bolt and ground poor holdown boli installati()ns
h) The suhlloor nailing, below walls.
2) Based upon the limitations noted in item (1) above, the only items which could he verified by me at the lime of
these visits are the following. (No(e: All the items listed were found to substantially comply with.thc engineering desi_m
intent).
a) The holdown anchors were visible because the wall insulation had not been installed.
h) The perimeter frieze block shear transfer detail at the exterior roof(o wall connection.
C) The roof strut bracing and ceiling support beams for the roof.
(1) The interior and exterior shear walls and transfer details.
C) 'file sole plate nailing details.
The only items of concern found during my first visit were itemized in a panel) list fashion when Gordon and I
walked through the residence. 'rhe second visit was used to verily that all the requested structural issues had heen
resolved to my satisfaction. A copy of the punch list is enclosed for file purposes only. For my purposes, the seen,,(] �isii
satisfed me that the requested items had been completed.
'['his letter was writtet ndard engineering principles and visual lechniques subject to the limitations noted ah�n
This docum is intends to I supplemental review of the exposed framing visible during my visit and should he
considere as stand alo e dncw ent, independent of the City of Cupertino inspections. Should there be anv additional
questi in,, p1 e do not es fa 'earl-or ax my office at (408) 379-8430.
TiMoill ' M. jlllthSll;,. i lu � (;
9-0+-1999 9:36AM FROM P. 5
7092
��160/NyV,
5
_ - Am
CERTIFICATE Djlffio CONFORMANCE
HE UNDERSIGNED MANUFACTURER HEREBY CERTIFIES
that the products identified below and on attached sheets Nos, are marked with
the Collective Mark of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION(AITC)and were
manufattured in conformance with applicable provisions of American National Standard ANSI/AITC
Al 90.1.1992, Structural Blued Laminated Timber,and that such manufacture ties been at our plant
in Drain. UN which plant has aquality contra system
approved by the inspection Bureau of Ute AMERICAN INSTITUTE OF TIMBER CONSTRUCTION
and Inspected pedodlcaity, by such Bureau.
X*Wmlil. , T. Keller Luudxr Sales, Inc. Eor .StoGk_�,
JDs LDCAroN:- .. Itaddii g$ CQPCO
CU870MEn50RDEn Nn. _.___, 7x192„ _OATfi 12-19-96 MFCR.s ngoaR No..._4177-D
10808 Juniper Court
9i0nnTUgE �—COMPANY,_.., Ihrco-I.attl-
TITLE_t)uall Ly Control � ADDRESs�Box 297, Drain�OK_OAT9 Ol m l l-99
AITC HEREBY CERTIFIES that the said company at its said plant is licensed by trig
AMERICAN INSTITUTE OF TIMBER CONSTRUCTION to use the AITC Collective Mak in respect
of products which comply with applicable provisions of said Standard,that the adequacy.ol the qua[-
ity,control,system In effect at amid plent'is periodically inspected and verified by the Inspection
8ureau'of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION, and that. in the judgement
of AITC,said company is capabloaof.complying with applicable mann acturing and testing provisions
of said Standard In respact of products manufactured at said punt. Conformance with the Standard
in respect of any specific or particular product is the sole responsibility of the manufacturer;AITC'a
guarantee hereunder being that the said company Is qualified to produce a product meeting the said
Standard and trial ifs plant is periodically inspected'and verified by the AITC Ir"acdon Bureau.
AITC Certfffcate No. 92- 0 4 7 818
AMERICAN INSTITUTE OF TIMBER CONSTRUCTION
xrcr,zvEn
JAN 18 1999
%ELLER OR. SALES
m 1984 AMFAICAN INSTITUTE OF TIMBER CONSTRUCTION
ARC FORM IOC _
30 C1 9tSig-Eva-tl£5 57-IVS 2191 ?AN-)-lax t/9S%BQ 66-60-d®g
JRZA
DATE JOB N0.
Consulting Engineers and Scientists , , 1,2 , .�-
425 ROLAND WAY PROJECT
OAKLAND, CA 94621
(510) 568-4001 OCATION
.J-�v. 1-, • � U
Of
L 17�� ,, CONTRACT R OWNER J
Date r"4A'0-I' ICN^lg01ll , •LLi G / WEATHER TEMP. �°at AM
�(, \1 t.! ,,,-at PM
Hours Charged To Project --/ Nuclear.Density Tests PRESENr AT SITE/ rI/ /5
Field Task Number •UI} Concrete Cylinders
THE FOLLOWING WAS NOTED:
• (7,r\ S.1-,� nc r"PlJ/�F+',�-rn� i-r," (/ /•I� .}/� 11 r•,�e,( 1,� 1 \ -e- r1 t n {- ! : ). N 1
}t !^'
7 L
U s
`nn, x 17 C �( V! Y G. 1 ,1 /•. ''—) {l � t•c-.I l ,.�/.� , t. \p.'t' l let-) G.� . G•( �i' , C'�
n4 /0G0Y7. 1-rl F. l 6r ALC A )nIt —111r.4- funl� •,G /.z..
vice
( E
i i"YV(' .Irl `iLI
YA
I
COPIES TO �Ylt([ 2a.., n(` V C 11(t' (�tJ1 FSG.: � IFHE UMQ D O o g,3
SIGNED
AGENCY
MARVIN D. KIIZKE13Y
• 2397 FOREST AVENUE
SAN JOSE, CA 95128 '`
(408) 984-0331
August 24, 1999
.lob No. 99023
Building Department
10300 Torre Avenue
Cupertino, CA 95014
Re: 23667 Black Oak Way
Lot 36, Tract No. 9077
Gentlemen;
Per Section 7014 ol'the Uniform Building Code, we have inspected the rough grading for
the subject lot and hereby state that it is in substantial conformity with the approved
grading plan. Finished building pad was measured to be with 0.2 feet, plus or minus, of
the approved design grades.
If further information is required please contact the undersigned.
o r. truly, ` Q�pPESS10Nq�
p. Ki,9Fyc
rvin D ' Kir<e yNo. 94001 m
Registered Civil Gnginee * EXP 3/31101
sTgT CIV 1\- O��P
P OF CRS\F�
J
MARVIN D. KIRKEBY
• 2397 FOREST AVENUE
SAN JOSE, CA 95128
(408) 984-0331
August 24, 1999
Job No. 99023
Building Department
10300 Torre Avenue
Cupertino, CA 95014
Re: 23667 Black Oak Way
Lot 36, Tract No. 9077
Gentlemen;
Please be advised that the foundation forms for the subject house have been inspected for
compliance with building setbacks as shown on the approved plans. I hereby state that
the forms are as shown on the approved plans.
If further information is required please contact the undersigned. .
Aarvin
4Kieby
pFESS1
Registered Civil Engineer w �e No. 14001 < m
Cr
Exp 3/31/01
sr. CIVV�-
s� P
F OF
J
•