26932 NO,
:0
M1 ME
�Tw.
XWKXWW
rfif ( � No. 921 of
01!
ggl
'ti Tity of (gUPPrUna
This certcate
Issued pursuant to the requirements Of Section 307 of the
Uniform Building Code certain that at the time of issuance this structure-nw.
In compliance with the various ordinances of the city regulating buidin
construction or use. For the following: g
UseClassir'cation . Interior IMPrOveMent
Bldg. Permit No.26932
Group B-2 :
1YPe Construction III
Use Zone Planned Deve I
Ownerof Building Norian _Oj2ment
-------------�Address 10260 Bubb Road
yt
Building Address 10260 Bubb Road
*Occupancy approved excluding Locality _ Cupertino �Cal ; fora ia
Hazardous Material
storage area
By.
Building Orfjcjal
Date: January 6, 1995
�
POST IN A CoN9pICUOU!j t.ACE
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES•USE BALL POINT PEN ONLY
CITY OF CUPE$TINO __ FaTuT ICAI PERMITNO.
BUILDING DIVISION APPLICATION/PERMIT PLUMBING-
BUILDING PROJEC1IDENTIFICATION 26932
BUILDING ADDRESS: 2 - SANITARY NO. APPLI TIONSUBMfITALDATH
w•••�V e) '� UNITY LOT#
PHONE: CON 'S NAME: 5,111
Y1 Y,111191 " l
a N/C COM'R
RC ITECT/ENGINEER: LIC NO: - D ESS:
S Tanta �t.P Y,J �Gouloe CI ❑ � S ��
corrrn PHONE: QTY. ELECTRIC PERMIT FEE BUILDING PERMIT INFO
_ 149_I PERMRISSUANCE HIMP ME
CHr
LICENSED CO OR'S DECLARATION APPLIANCES-RESIDENTIAL 108 DESC PDON
yZ O
Iherehyaffirmthal l am licensed undarpmvisions of L'haptn9(eammencing with
00❑ fail arca fdo Division3of the Business and Professions Cade,and my license is in pgNEL$ 66 f
full force and act. ` Y
F'Z'W License lass Lic.M UP T0200 AMPS
mQ0. Dae Co.,. 201.1000 AMPS
A C ITECTS DECLARATION SQ.ff.FLOOR AREA $ISQ.ff.
OZ�❑ 1 n rand my Ions uxlaYpublicrmnrds. OVER 1000 AMPS
�N Lae t t SIGNS ELECTRICAL
OWNER-BUILDER DECLARATION SPECIAL CIRCUIT/MISC. T
OaU I hereby affirm that 1 am exempt from the Contractor's License Law for the
3 oy following mason.(Section 7031.5,Business and Professions Code:Any city orcounry TEMP.METER OR POLE INST.
(:BOJ which requires a permit to construct,alter,improve,demolish, any amemre
2`f}� to its issuance,ulsore the applicant forsuch it dead edsmwmem POWER DEVICES
prior quires pp perm
�O thatheislicensedpursuanu.the provisions of the Contra r'sLican w(Chapter
p-0.o�' 9(cnmmencingwith Section]1100)af Division J.f the me.and Prof ions Code) SWIMMING POOL ELECTRIC wwVALUATION le
ykf�y melon he is exempnorefrom and the basis forthe edexcmption.Any 'olmiono BTS-SWITCHES-FIXTURES
�zQ Semion]031.5 by any applicam fon permit su '
allies,
nsryo
1] not mom Nan live hundred dollan(f5WI. II pe .
m Elgesmll1,®.wmu.fthepmpeny,mdo N swiN fficastipt ns ' NEW RESIDENTIAL ELECTR 5 FT.on, Q STORIES TYPE CONSTRUCTION
y
will d.the work,andflesuucwre isnot: nded.mff mart,
•fl�l,Busi ss
and Professions Code:The Conwno I.ic La d not a an owner
psopertywhobuildsorwmpmves the n,andwh chwork hipself,aflrough ' OCG GROUP RESUN1'fS
wnemployees,pmvidedihatsce provement Iiot fferMforsal L
however,the buildingurimpm ent is sold n year pletrartheo ner. O
builder will have the burden proving i atldim
er perveforpu scot
ana.). X
❑ amexcl macting with limnsed co torsm QTY, PLUMBING PERMIT FEE FI.00D ZONE APN
construct the project(Sect.0 Business passions Crede:)The onuactuea PERMIT ISSUANCE
License LuwdmsmtaMlyloanu rofprope hobuildsorimpfov Iheommand
who contacts forsuch projects withac tods)IicensWpursuanu EA eContracmr's L'IF.R-DRAIN&VE -WATER 1
License Law. NT )� FEE SUMMARY
❑ I am exempt under Sec. .B C for Nis reason BACK FLOW PROTECT.DEVICE OUTSIDE
SANITARY Y N
owner ate DRAINS-ILOOR,ROOF,AREA,COND. RECEIPT#
M
WORKAN COMPENSATION DE RATION SCHOOLTAX Y •N
❑ Iherebyaffirm Natlh...acenificaeofconsento,self-ivure,on ecnificate of FIXTURES-PER TRAP 0 RECEIPT#
Warker%Compensati.nlnsutance oracertified copy Neanf(Sec.—to bCJwhich PARK HE Y N
coven all employees under this permit. GAS-P.A.SYSTEM-1 INC.4 OUTLETS RECEIPT#
Policy Y BUILDING DIVISION FEES
Company GAS-EA.SYSTEM-OVER 4(EA) PLANCHECKFEE
❑ Certified copy is hereby famished, lJ
❑ Certified copy is filed with the city inspection division. GREASEANDUSTRL WASTE INTERCEPTOR GRADINGFEE
CERTIFICATE OF EXEMPI]ON FROM WORKERS' GREASE$'RAP SOBS PEE
COMPENSATION INSURANCE
(This uotionneednot he completed iftbe permit is fortune h.ndred dollars($100) SEWER-SANITARY-STORM EA.200FT. ENERGY FEE
or less.)
I certify that in the performance of the work for which thispmout is issued,l shall WATER HEATER W/VENT/ELE R
.or'employ any person in any rammer s..m become subject to the Work.' PAID
Z Compensation Lrox.f Celifnnia. Date WATER SYSTEMRREATING Do,. Receipt#
O O Applic#m
NOTICE TO APPLIfANTaf,after making this Certificate of Exemption,you should NEW RESIDENTIAL PLMB. SQ.FT. TOTAL:
become subject o the Worker'a Compensation provisions of the Lehr Cade,you must
forthwith comply with such provisions m this permit shall has deemed¢vaked. BUILDING FEE `�+
W ASEISMIC FEE
CONSTRUCTION LENDING AGENCY
�+ 1 hereby affirm that there is construction larding agency for the performance of
' U Q Na e work for which this permit is issued(Sac.309],Civ.C.) ELECTRIC FEE /.
Lender's No. e�
L'
No.
F Lender's Address QTY. MECHANICAL PERMIT FEE PLUMBING FEE G..b
Q U 1 mnify Na I have mad this application and show that the above informs:..is MECHANICAL FEE
0. correct.la mcompl ithaliciry ab county oNinaaea and amelnwsrelaring to PERMIT ISSUANCE
C) z building vection,vnJh by auNoriurtpreunmtives of this city men¢r upon the GDN$TRDCTIGN TAX
above- moral property f inspection purposes. ALTER OR ADD TO MECH.
( agra to save adird nify end keep hvmless the City of Cupertino against
liabilitisjudgments, start xpenuswhichmayinanywayuee against esid City AIR HANDLING UNIT(TO 10,000CFM)
ceoft gran g fNis,immit. ^
in n. ,� 1-7 I AIR HANDLING UNIT(OVER 10,(100 CIM)
St of u r . I Dee EXHAUST GOOD(W/DUC1)
PAID
HAZARDOUS MATERIALS DISCLOSURE HEATING UNIT(TO 100,000 BTU) Date Receipt#
Will the applicant or future building occupant same or handle havudous materiel HEATING UNIT(OVER I W'"B'N) AIAN--
as defined by the Cupertino Municipal Cale.Chapter 9.12,and the Health and Safety
Code,Section 25532(q? VENTILATION FAN(SINGLE RES1D)
❑Yes ❑No
ISSUANCE DATE
Will Neappiioamorfummbuildingcccupant uuequipmentordeviceawhich emit BOILER-COME(3HP OR 100,000 BTU)
hpoundono eta conlaminanb u defined by the Bay An.Air Quality Management BOILER-COME(OVER 100,000 BTU) PAID
uo el7
❑Yes ❑No NEW RESIDENTIAL MECH.—SQ.FT.
1 have readrd
the haraous maariss requirements mes undef Chapter 6.95 of the NOV
17 ig
California Health&Safety Code,Sections 25505.25533 and 25534. 1 understand that
if the building does not currently have amvnL that it is my responsibility in notify the !xl'/Ty
occupant of the rtyuirtments which must he met prior to isvuanm of a Certificate of CITY/ U/' (,U
Occupancy.
Owners uahnnired.gem Data 473A P ISSUED BY:
OFFICE
® � 1�
. = TESTING ENGINEERS, INC.
40. 2811 Adeline St. PO Box 24075 510 8353142 510 8343777 fax
Oakland, CA 94608 Oakland, CA 94623 800 6603142
Oakland Santa Clara Diablo Valley Monterey
INSPECTION REPORT WEEK ENDING 10/28/94
PROJECT# 35664/DPRO02 TYPE OF INSPECTION.,
PROJECTProof Loading
Norian
10260 Bubb Road PLACE OF INSPECTION:
Jobsite
Cupertino, CA
Permit No. 26932
,
DATE 10/24/94 10/26/94
HOURS 4 4
ZONE/MILES 1 1
INSPECTOR N. Goard N. Goard
•
Reported to Mr. Bob Arata of DPR Construction at the jobsite.
I 9(_4
Applied tension proof load of 6000 lbs. to %" diameter Hilti Kwik Bolt expansion anchors located in the floor and wall
anchoring tube steel seismic reinforcing around newly sawcut doors and windows on line 1 at line B, line D at line 4, line
A at line 5, line D at lines 6.5 and 7.1, line A at lines 5.5, 6.5 pnd 7.2. 63 anchors of a total of 314 installed were tested
representing 20% without visually apparent distress or failure. Proof load values and rate of testing were supplied by
drawing 5-6.1M dated 10/18/94.
Work inspected was in compliance with job plans and specifications including city approved drawing S-6.1M dated 10/18/94.
1 "'94
Applied tension proof load of 4500 lbs. to %" diameter Hilti Kwik Bolt expansion anchors located in the wall at top of
existing panels for roof connections on lines 1, 8 and 9 between lines A and D. Seven (7) anchors of a total of 35 installed
were tested representing 20% without visually apparent distress or failure. Proof load values and rate of testing were
supplied by drawing S-6.1E dated 10/18/94.
Work inspected was in compliance with job plans and specifications including city approved drawing S-6.1E dated 10/18/94.
Reviewed by�
Roger S. Muwtty
C.E. #20132, Exp. 09/30/97
ac: DPR Construction/Dirk Johnson
Rinne & Peterson/Jim Lender
Ehrlich-Rominger/Sue Leferre
City of Cupertino/Building Inspection Dept.
Quality Assurance Service's , C
Materials Consulting
REGE►VED'
• �.,,.,, 1 ; 1994
Testing Engineers, Inc. Wit ►91106
COMPRESSION TEST REPORT
P M
WORK REQUEST NUMBER SAMPLE NUMBER 117776
PROJECT NUMBER35664 DATE 11/14/94
PROJECT NAME TYPE OF SAMPLE REG. CONCRETE
NORIAN
10260 BUBB RD, CUPERTINO
ILE #:PERMIT# 26932
SUPPLIER (CONCRETE) SPECIMENS MADE BY NOT BY TEI
MIX NUMBER WITNESSED BY
DATE SAMPLED 10/14/94
TICKET NO.: TIME SAMPLED
DATE RECEIVED 10/17/94
LOCATION IN STRUCTURE SLUMP
FRESH UNIT WGT. PCF-
AIR TEMPERATURE OF ---
MIXTURE TEMPERATURE °F: ---
AIR CONTENT %:
WE TESTED 10/21/94 11/11/94 11/11/94
ID NUMBER 1A 1B 1C
MARK SPECIMEN
DIMENSION,inches 6X12
AREA, sq. inches 28.0
ULTIMATE LOAD,Ibs. 80000 132000 123000
ULTIMATE STR.,psi 2860 4710 4390
AVERAGE STR.,pai 4550
AGE TESTED,DAYS 7 28 28
DRY UNIT WEIGHT,pel _
EPEDIRED MENM,psi
SPECIMENS NOT SCHEDULED FOR TESTING WILL BE DISCARDED AFTER 28 DAYS OLD
LIMITED DATA DUE TO LIMITED INFORMATION SUPPLIED
REMARKS:SAMPLES TESTED IN ACCORDANCE WITH ASTM C-39-86
CC:
01 D P R CONSTRUCTION
01 RINNE & PETERSON REVIEWED BY
01 EHRLICH—ROMINGER
•11 CITY OF CUPERTINO
YOUNG FT. DAVIS
2811 Adeline Street, P.O. Box 24075, Oakland, Calitomia 94623 •C (510835 3142 B SUPERVISOR
SANTA CLARA • DIABLO VALLEY • SACRAMENTO • MONTEREY