02090137 CITY OF CUPERTINO '
BUILDING DIVISION - PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10690 N DE ANZA BLVD TERRA NOVA INDUSTRIES 020F901137
{ LO PIZZA & BREWERY (BJ) 1607 TICE VALLEY BLV APPLIc019/19 / 2002
(' 'HONE: SANITARY NO. CONTROL NO.
(925) 934-6133
G Q ZZ ARCHITECT/ENGINEER: BUILDING PERMIT INFO
kC BLDG ELECT PLUMB MECH
y= LICENSED CONTRACTOR'S DECLARATION
Z
in 1 hereby alirm that I am licensed under provisions of Chapmr 9(commencing Job Description
El i: with Section 7").fDivision 3ofmcBusinessmadProfessionsCode,andmylicense REVISION- -IN HOUSE USE ONLY
6 $ smrmLrorce-ad effect, TRUSS CALCS CHK 402080073
ne k{ License Class Lic.p
30 Date Contractor ORIGINAL 402050055
ARCHITCC('S DECLARATION
t 0 1 understand my plans shall be used as public records
Sa NY
is.
6 p o Licensed Prxfcssioml
,g OWNER-BUILDER DECLARATION
rn I hereby.(Beta thin 1 1. exempt from,he Cessions or License Lew roethe
h?a following reason. cont. Business and Professions Core:Any city or county
D
which minims npermn construct, per,improve,demolish ores anystructure
$ -pct , tam issuance, l reUml quires res thcaii1m ofaur he Contractors to
nammem
mlhpalepnodjvSmijr,7000PfDiiisintofthemeto L L IChapmr9molim ..,,'sN ,s, 9..ttF,[. ]oor,Area xA k' 8530Hluation
orsho hwngwah5 ne,70W), the Division o the aBugm n,dpomnyvi code) 1_Ln y _4.(?l.. T,.4 u1-,. g.i r'4JgZ i1�A.'?a l4�I�`•: �
or Nat He is xedtbi mprefom and the basis(m the c.,ha exempt bn.Any l Pen nn
--of not ron 7071.5 is hundred
fora permit subjects the applicam to a civil penvlry- ,A.pT.'��ri���� k5s�
;ornm mare than Rae naadrea eogars fsslwr. 316YTG+L IH`S'tPH� PCltli;-�;D Occupancy Type
❑I,as owner of the and
mery,structure
u my employee with wages fesred their sole le sec:wtioa,
B.ib is and Pro and me The
C not Contractor's
Li en a Law'foes not apply to an RAuired Inspections
reusiimi4 aiul Professions Cale:The Comrvctor's License Law Jas not apply to an 101 - FOUNDATI iuY it
owner of pr Pcny Who builds or improves thereon and who does iuch work himself 102 - PIERS
I
or through M1's own employees.provicicol that such improvements am not intended or, ..-_,.,. _ — ...._. .., .. ._.__..
_'_
core d;r ate Hh rtwill has theburenof parsing
'la ndid ode Weld or 103 - UFER- — r:\•" .r..-.n -', .d-tii�
domple for the purpose
of sale.).
will have the burden of prov,ng thnt he did not Wild or
improve for naryott oflale). 104 - REBAR
a6esowner,onne n ----105 = ANCHOR- BOliTS-- --;_.___._.
_ p pc Y.am exclusively comrutin8 with liccnud contractors to ---�'-1:.D'-..�•—:ir iC------------
constrain the project(Sm.7044,Business and Professions Code:)The Contractor's 1 O6 - SEWER & WATER 1 L%L'" :.,+• `lied
License Law does not apply to an owner of property who builds or improves thereon. -" -
l , andwhirmatracu for,such.projects_with,n.cont=tur(s).licensed.Pursum.o.the .._....__....._.2.02.._.-...-UNDERFLOOR--PLUMBING-
l ( ud2,_ eeptndLaw
Set!' PC for this reason 203 - UNDERFLOOR+);MECHANICAL
o e " °I` ate 204 - UNDERFLOOR FRAME
_WORKER'S CO MPENSATIONDECLARATION 205 - UNDERFLOOR INSULATION
_qq Ihereby affirm unlerpesulty,ofperjuiyonaofthe following declamtims:- 3O1 - ROUGH PLUMBING
V i ❑ 1 have'and willmaintain'e'e'kifcata'ofConveou'to self-imme for Worker's 302 - TUB & OR SHOWER
v Compensation, as,prnvided-4orby Section 37W af-,ha Labor Cade, far the
_ - arrom,�ncdanhe work for.1h tip Pe�mi ip issacd.; ,, 303 - ROUGH MECHANICAL
❑I ha
..d'wdi rm W rker',CumPc t o 1 suranc S required by Section 304 - ROUGH ELECTRICAL
3700 of the Livvr'Codc,f r the jxiformanm of the-work for'which this permit is 305 - FRAME
isw d My W k/ C pcnavo 'I u 'c nice end Pol cy robe
IN!pal yN 30.6-----HOL-DOWNS
r �+t - 1_CERTIfICATION OF EXEMPTION FROM,WORKBRSe v" .:',Jird •3OtZ�_ .IB SULAT ION,,)
COMPENSATION INSURANCE . .
- ---'-30'8--,
309 ,SHEETROCK---- -r----•
f;e"t, ITh' ;�in' 'cJ'tot be cddtPlcmJ'nhe perm. sforone hu WrcA dallacs 1 a ),EXTERIOR LATH `r.•.. '.) (.1L:'.i ,r. ,
aslfn) 1 ) .. LATH•-i---•.•.-F
,•-, -330_„-.,.INTERIOR..-.. _-_... .. �_ : .__ _—
Dr, ticthmi rb<Perfarma ec nTthe wolf h chin perms cis ued'1� ..,,..�- - IRS +SC!i Nh,_ . `� 0p.\il
shellt mploy any perm n nay manner a m to bem x a bjec`o the'W y,e . 311 SCRATCH COAT'' 1
cb pcnset++nWwaarcalr .Date -- 3-13_.,-_-ROOF—NAIL_____
..Apel ani ”,-,
NOTICE TO APPLICANT
_Q
txc m Ishebrt;etim'taoffiinemeWCOrNkheIlTf R.CUalCa'rTPC,Oe+kNx'tig this Certificate ICceGratid,AafincG.aEnte Nrocnf rELxeMm cae.y_n
meIa�'t`' ........_.. 5_0..1 - FINAL
ER
GY
forthwithcouply,wimenPs nsn m: pct^""gI be deemed
ked. 502 - FINAL PLUMBING ENERGY
----_, __
503 - FINAL MECHANICAL ENERGY''.'
aG at me kr mm�m F`"`yf a'"eP 504 - FINAL BUILDING ENERGY': I
W r Q Lendef N me a, smut is sxucd(S 3097 Crv.C 1 -.--.- ._-..
"-505' =" FINAli ELECTRICAli-.'L
lcntl r Addrexxi _ t ii.'_1'I,)'1.1
v'o 506 GAS TEST "`� • ' ' "
Lt 1 c may aha I h ve read this app) au m and tine that the h e' r emotion is
�''H imne, )agree to,complywthgll city unJc tc,`rd nvnc send scam laws relining 5 AI
INAL PLUMBING
': Op,V pobmlmngcnnstmatinn;vnd herebyau0uirimiepr,enmiivesn(ihirchymemerupon 5 8 INAL ICAL
�,t;(y nh bo tap t mJP pony for inspect p rpo _ .. -
gL. (W ) g 'e to's ve d-mnlfy and kmeph mal-.s,tie"Cay ,Cupertino against
W IiabJu¢s rydg ems,cot d ePenses, h h ,yin any y aceta against said 5 0 NALzynconsequncof the grrmin8S1O;APPLICANTUNDBRS'rANDS aWILL CI.. , YWITH AL6 YON POI\TSOURCEREGLLATIONS,'s'" '�L`R"'" ' IssueddDate
7. S,Bnaa rc of PPldicpna`Cmdrssomt De
SUE Re 70
HAZARDOUS MATERIALS DISCLO
fe,.s,ideo'OedYbey m+e Cupertinto Mlu,in nt o,, ' 1 .s. til, d o , tr - r- { I ` BATTENS
Vll the applicant r fm re Wilting occupant store or handle de ten pe Of-- RO
FsINPR
RaEt
SS•- r -
,roe•
,,-�•` ��• p `
_ to-any. ..
Zdde Sen n255 (al ;:
AII.roofsshallbe inspected prior roofingmaterial_being installed._,., _..___ON
':;;irs wliu+nappop rte (mrtbuilding ocuparnmaequipment ordeviceswhich - If a roof is insfalled'without first obtaining ati"'inspection,I'agree\toIremove
emu been.. oos air contaminants ns defined by the Bay Area Air Quality Management
Di taco all new materials for inspection Applicant understands Ad will comply.with
C ❑Yes Y , ❑Na- + T Y _ .. .-_
r _ r+ all'non point source regulations e`u;
yrs , - ..: ,i , S; c.,';I•' it
1 h read tike hazardse. mammals rcgmremems d 2 r 4. Por fi stand(that .`
aLe Wil Health&Sa(cur Cade,Sections25505t itis and 25534.I understand to-inif tom
„i(mebo ld gdoeanot currently hichratewaL that .toyIssuaresponsibility
nce of aCrsficale of fir, - -�- _ - - _ -_- __ -- - - - - _ 4✓ —
occ pa t of ape recruitments hmh muit be i prior
/ Oce patt=y i I � `.
Signature of Applicant
-- - - Dae - -
t
O. anon censem t, Dme All roof coverings to be Class."B"orb'etter
OFFICE_
BSK 1181 Quarry Lane, Building 300
Pleasanton, CA 94566
(925) 462-4000 • FAX (925) 462-6283
08 April 2003 BSK Job No. 04-60-2532
RE�'EIVFd�
City of Cupertino APR 1 0 2003
Building Inspection Division
10300 Torre Avenue
Cupertino, California 95014-3232
Attention: Building Official �®
SUBJECT: FINAL REPORT �0(iGrK��
BJ's Restaurant&Brewery
10590 N. De Anza Boulevard
Cupertino, California
Gentlemen:
BSK Associates performed Special Inspection and Materials Testing Services at the referenced project. In
• accordance with Section 1701, of the Uniform Building Code, we are submitting this final report.
To the best of our,knowledge and based on our observations and test results, the work requiring Special
Inspection in the areas of; Structural Steel Welding (Shop/Field), Grout Placement Observations, Cavity
Verifications and Epoxy Rebar Installation Observations, Reinforcing Steel & Concrete Placement
Observations, Concrete & Grout Compression Testing, as outlined in our Reports, 04-60-2532 covering a
period from 31 July 2002 to 15 October 2002 is in substantial conformance with the approved plans and
specifications and the applicable workmanship provisions of the Uniform Building Code.
If you should have any questions or comments, please give us a call.
QRpf ESSio
Sincerely,
BSK Associates ��� R HF��F•y�2
ti O
No. 23872
A
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n R. Hedle C. 6f )Z/05
Princ' al
C/V 1�- �P
JRII:eal
O9CONSTW IDAVI'r04602532.wpd OF CAL�F���
Distribution:,,
Terra Nova Industries; Mr.,Ron Taylor
•
Geotechnical Engineering • Engineering Geology • Environmental Services • Construction Inspection&Testing • Analytical Testing