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30992APPLICANTTO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY CITY OF CUPERTINO BUILDING - ELECTRICAL OFFICE PERMITND. BUILDING DIVISION APPIACATION/PERMIT PLUMBING - MECHANICAL BUILDING PROJECT IDENTIFICATION 3099 2 BUILDINGADDRESS: SANITARYIN APPLICATION SUBMITTAL DATE O :S NA E:ONE: RACE 'S NA IC NO' eyfflk v WC El CONTROL# C 1I LECT/ENGINEER: LIC NO: -`�~��iJ D_ RE$Si - �\ t l� `. ` .. jf 1 {WMV` CONTACr: PHONE: BUILDING PERMIT INFO ❑ Consultant Fees Paid by Applicant (Initial) BLDGELECT PLUMBI MECH I � BQ C1 &V ❑ LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that I not licensed under provisions of chapter 9 (commencing Z with Smtion]gp)of DivisionJof the Busincsyyy��Td ofessio s dm license is in full farce {/ van Y TRIC PERMIT F QTY FLECEE JOB DESCRIPTION RESIDENTIAL PERMIT ISSUANCE and eff J 1 iccns lata 1 is a ` y Dam Cnntracmr ❑ SEDWL ❑ KITCHEN REMODEL ❑ADDITION ❑PLUMBING RE -PIPE, ❑MULTI -UNIT 11 STRUCTURAL MODIFICATION APPLIANCES -NESIDENTIAL A ARCHITECT'S UI3CLANATION Z 1 understand my plans doll he owed Its public records PANELS License) l'rolessional UP TO 2W AMPS ❑INTERIOR ❑CHIMNEY REPAIR 201-10M)AMPS OWNER -BL DECLARATION Q 1 hereby affirm that 1 am exempt from the Contractors License I,aw fur the following reason. (Section ]031.5. Business and Pmfe,siot, CtWe: Any city or county which requires a permit to construct, alter, impmve, demolish, or repair any structureR prior to its issuance. also requires the applicant for such permit to file a signed statement IMPROVEMENT ❑ BATH REMODh:UREPAIR O DEMOLITION ❑ O R �+ OVER I(XNIAMPS SIGNS ELECTRICAL SPECIAL CIRCUIT/MISC. that he is licensed pursuanuo the provisions of the Contractors Limns, law (Chapter 9 )I(ccomareing with Sectio 7") of Division 3 ofthe Bminessand Professions Ctand TEMP. M ETER OR POLE INST. COMMERCIAL: Yll that he is exempt therefrom and the basis for the alleged exemption. Any violation of nSection 7031.5 by any applicant for a permit subjects the applicant) a civil Penalty of not more 'ban five hundred dollam S51x11. 7�r] I. as owner of the property, or my cmployces with wages as their sale compensation, will do Ibe work, and the nrueture is not imendcd m offered for sale (Sec. 7194, Baines, 2 and Professions Code : The Contractor's License Law docs not apply m an owner .1 ❑ NEW BLDG/AUDITION ❑ DEMOLITION ❑TENANT ❑FOODSERVICE IMPROVEMIiN'F ❑ OTHER POWER DEVICES SWIMMING POOL ELECTRIC OUTLETS -SWI]'CHES-FIXTURES property who builds or improve, thereon, and who does such work himself or through his own employees. Provided that such impmvcmcnts are not intended or offered for NEW RESIDENTIAL BLECFR SQ fT. sale. IL however the building or improvement is sold within one year o(asmpinion, the SO. FT. FLOOR AREA SISQ. FT. crbuilder will have the burden at proving that he did not build or improve for par- pose ofsoodo 5Pa p TOTAL: [:] 1, as owner of Ne property, am exclusively contracting with licensed contractors to Y construct Ne project (Sec. 7014. Business and Professions Cde:) The Contractor's Li- cense law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a c(ntrucluds) licensed pursuant to the Contractor'sD QTY. PLUMBING PERMIT FEE PERMIT ISSUANCE License Law. 1 um exempt under Sec. B & P C For Nis reason 111 ALTER - DRAIN &VENT - WATER (EA)Pat BACK FLOW PROTECT. DEVICE 1 Owner pate —VALUATION WORKER'S COMPENSATION DECLARATION I bcr,by affirm under penalty of perjuryane of the following dulerainium: DRAINS- FLOOR. ROOF, AREA. COND, I have and will maintain a Cenificam ofConscnfto.self-inmre for Worker's Carmen- ,.tion, as Provided far by Section 3701 of the Laor Code, for the prof ..tore of the Darn 9.At 5 TYPE CONSTRUCTION FIXTURES - PER TRAP work for which his permit is i,md. I have and will maim# Worker's Compensation Inzumnm, ac required by Section L 'AIl1 CI I V uF (fury �E\\VV Told ofth WorCde.fmthe performance o(Ne Bork far which this permit i<issuW. My Wor s'- do In drier and Policy 1pm�er are_M._ GAS - EA. SYSTEM -I INC. 40UTLEfS OCC'. GROUP pPN Cosier: olicy No.: l `,tj,� _ GAS - EA. SYSTEM-OVER4(EA) CERTIFICATE OF EXEMPTION FROM WORKERS' GREASE/INIIUSI III. WAS YE INTERCEPTOR COMPENSATION INSURANCE BUILDING DIVISION FE&S (This section need oat he conipletd il'Ihe perant iafomnc hnndad dollnw (51 W) on less,) I certify that in the performance of the wild, Far which this permit is is,u.d, I shall not employ any person in any manner sat as in become subject o the Workers' Com Pen- cation anus ofCalifornia ia. Date i Applicata GREASE IRA[' PLANCHECK FEE ENERGY FEE SEWER - SANITARY - STORM EA. 200 FT. WATER HEATER ENT/ELECTR N'/V GRADING HE NOTICE APPLICANT. If. afmrm.kng this Certificate of Exemption. hu become subject to the WorkeCt)ion provision, of hlabor Code, youmost ATRYSTEM/IItEATING SOILS FEE fnnhwithcomply with such provisiomor this permit shall nedmmdrmvked. a WATER SERVICE NEW RESIDLMIAL PLMR. SO, FI'. sl CONSTRUCTION LENDING AGENCY ffirrn ohm int i is ourd Site, um 3097, gency for the performance of I herebywhich the work fur which Nis pumit is issued (Sec. 3119], Co,Civ. CJ PAID Dom Ceip TOTAL', Lender, Name Lenders Aldo, 1 certify Nat 1 have dud his mplPlaitlion and stem that the move Infnnmmion is 7 anrrcel.I agree to comply with all city and county ordinances and state laws Timing to building oamoma tion. and hereby authorae apresemmivemf Nis city m enter upon the TOTAL BUILDING FE QTY. MECHANICAL PERMIT FEE SEISMIC FEE dove -mentioned property, for inspection purposes. (We) agree to save, indemnify amt keep battles, the City of Cupeninn against PERMIT ISSUANCE ELECTRIC FEE ALTERORADDTOMECH. liabilitiesjudgmens. costs ad e:penms which may in any way accrue against said City in granting of Nis .it. u4 PLUMBING FEE �� AIR HANDLING UNIT (TO 10,000 CFM) PLIC DE STANDS AND WILL COMPLY WITH ALL NON -POINT OU RE C' NS MECHANICAL HE AIR HANDLING UNIT (OVER 10,000 CFM) 'L- CONSTRUCfION'EAX Signature of Applicant/Csmtmctor oro HAZARDOUS MAI ERIALS DISCLOSURE EXHAUST HOOD(WIDUC) HOUSING MITIGATIO PEE HEATING UNIT (TO 100,fa) BTI) Will the applicant or future buildingoecupant done or handle hatioduo,material as defined by the Cupertino Municipal Cook, Chapter 9.12, and the Huhh and Safety Colo, Section 25532(,1? HEATING UNIT (OVER 10t),000 BTU) ❑Yes ON. VENTILATION FAN (SINGLE NESID) Will thea applicant or future building pp gMc noteAir to or t hneaNuua air contaminants as defined h the Ba Area Air Qualit Nana emenl Bay trice ❑Yes ❑Nu PAID BOILER- COME DHP OR 100.000 BTU) Date Receipt TO L: 600 BOILER- COMP (OVER 100,000 BTU) AIR CONDITIONER Ih verc the hvmdous mmerials requirements Chapter 6 9 of the Call- h in II th &. fdy Cdr. Sections 255115, 25533 and 25534. 1 unders.ad he if the Iildi enols myhuvcalunmL ohm it in my muPnnstb'ity wnnlifyth t ISSUANCE DATE NF;W RESIIIEN'I'IAh MFCH. SQ, FT. t'lhe mq cmcn and on tQyyj..: nor, G `•( Y: ISSUED BY.- (loner authorl�age: Dam( I TOTAL: OFFICE i/ V WOOD DESTROYING :STS AND ORGANISMS IN ECTION REPORT This is an inspection report only -- not a Notice of Completion ADDRESS OF PROPERTY INSPECTED BUILDING NO. STREET CITY ZIP CWNTY DATE OF NUMBER OF F O ❑ LODE INSPECTION PAGES &92 Elmsford Drive Cupertino 95014 43 02/11/97 8 ow THRASHER TERMITE CONTROL Affix stamp here on Board copy only Avenue A LICENSED PEST CONTROL 805-D University OPERATOR IS AN EXPERT IN Los Gatos, CA 95030 HIS/HER FIELD. ANY QUESTIONS (408) 354-9944 (408) 395-7934 FAX RELATIVE TO THIS REPORT SHOULD RE REFERRED TO HIM/HER. REGISTRATION # PR0240 REPORT # 9710 STAMP # 3882034T ESCRO'J # 768626 ORDERED BY: Best Investments—Patty Glen 11595 Oak Springs Court Cupertino CA 95014 REPORT SENT TO: Chicago Title 20100 Stevens Creek Blvd. #100 Cupertino CA 95014 Dina Marine PROPERTY OWNER: Marina Bessonoff 1192 Elmsford Drive Cupertino CA 95014 PARTY IN INTEREST: Rix Group So.Bay -Ron Moe 19200 Stevens Creek Blvd Cupertino CA 95014 ORIGINAL REPORT ® LIMITED REPORT ❑ SUPPLEMENTAL REPORT ❑ * REINSPECTION REPORT ❑ * *St.ampnal Date ND I N F S F O ❑ E F C E S GENERAL DESCRIPTION: A two story wood frame single family N A O T U R U e R r U N T H A M A R A U E L X C H o residence with Stucco arid rustic exterior. C C E NE 'I rI E R W o O G ❑ S E R P w O T H L T Y L U L E S 5 w E R 5 5 © E P E C T E R N S P R �' N E N D T E R M D R D a 0 O ❑ E O O T E R w O D D G R A D E O 5 E D E V E M O E A K S INSPECTION TAG POSTED: Subarea OTHER INSPECTION TAGS: Orkin...03/17/94. A❑ c H T R S T M O L E R S R E A T I O R r1l E S ❑ T ^' T E 5 N T A E S I 5 T U R S N I C T 6 E E S 1. SUBSTRUCTURE AREA Inspected See 1A -ll,, X1 Ix X X I I X X1 I 2. STALL SHOWER Inspected See 2A -2E'. X Ix X X 3. FOUNDATIONS Concrete _ 4. PORCHES -- STEPS Concrete 5. VENTILATION Appears Adequate 6.ABUTMENTS None 7. ATTIC SPACES Limited Due To Insulation See 7A 7B X _ B.GARAGES Limited/Storage & Close -Wall See 8A -8D X X X X 9. DECKS -- PATIOS Concrete 10. OTHER -- INTERIOR Inspected SeelOA-10D X X X X 11. OTHER -- EXTERIOR Inspected See11A-11C I IIIX DIAGRAM AND EXPLANATION OF FINDINGS (This report is limited to structure or Structures shown on diagrarn) s • I� IH�i� - II, ;B FE9 No�QPPo FNj IA16 l � ` � I g 1P .LB IP G Inspected by Miguel Torres License No. FR20780 v Signature NOTE: Questions or problems concerning the above report should be directed to the manager of the company. Unresolved quasuons at problems with services performed may be directed to the Structural Pest Control Board at (916) 263-2533, or (800) 737-8188. You are entitled to obtain copies of all reports and completion notices on this property filed with the Board dining the preceeding two years upon payment of a $2.00 search fee to: Tha Structural Pest Control Board, 1422 Howe Ave., Ste. 3, Sacramento, California 95825-3280. 4th .-i PAGE OF STANDARD INSPECTION REPORT ON PROPERTY AT: 1192 Elmsford Drire Cupertino BLDG, NO. STREET CITY 3882034T STAMP NO. 02/11/1997 DATE OF INSPECTION 9710 CO. REPORT NO. SUBSTRUCTURE: Item 1G: FINDING: An excessive moisture condition, fungus, fungus damage, evidence of subterranean termite activity, and subterranean termite damage were noted below the master bathroom floor and stall shower area. Leaks at the shower door have resulted in fungus damage to the subflooring and to the 4x6 girder. Additional subterranean termite damage was found at this sae area. CORRECTION: Remove the damaged framing materials as necessary and replace with new materials. We will install additional support at the girder. It may be necessary to install a new pier post at this area for proper support. The repairs outlined in this item will be completed in conjuction with item #213. Also see item #11) regarding the outlined chemical treater-nt for control of subterranean termites. ****** This is a Section 1 Item ****** Item 1H: FINDING: Cellulose debris was noted on the subarea soil.. Form materials were also noted adjacent to the foundation. Fungus infection was detected at these areas. CORRECTION: Remove all cellulose debris and dispose of properly. Remove all form materials as practical. The form materials that cannot be removed will is be treated with a fungicide to help inhibit further fungus activity. ****** This is a Section 1 Item ****** In the performance of the above correction, we propose to use the chemical Tim Bor (Disodium Octaborate Tetrahydrate). Item 1I: NOTE: Periodic inspections of the substructure are advise -x9 to keep appraised of any possible problems at an early stage. ********** Information Item ********** STALL SHOWER: Item 2A: FINDING: Minor cracks and/or erosion were noted at the hall bathroom tubback tile grout joints. No visible evidence of infection could be detected at this time. CORRECTION: Regrout and seal this area as needed. The homeowner should maintain this area in the future. ****** This is a Section 2 Item ****** Item 2B: FINDING: An excessive moisture condition was noted at the master bathroom stall shower. Cracks and voids at the grout joints, and also loose tiles, have allowed moisture to enter. This moisture has resultut in fungus damage to the sheetrock backing. CORRECTION: Remove the complete existing master bathroom stall shower to • included the enclosure door, ceramic tile, sheetrock and shower pan. After the damaged wood members have been removed and replaced (see item #1G) we will reset and replumb the existing shower pan. New sheetrock will be installed at the shower walls, taping and sealing all voids. New ceramic tile will be installed throughout the complete stall shower area. The new tile will be set close joint in a mastic base. ****** This is a Section 1 Item ****** Item 2C: ADDITIONAL CORRECTION: After the shower repairs are completed we will install a new safety glass enclosure door and panel -in-line, silicone sealing all voids. This will also include a new side panel. The new enclosure will have chrome colored metal framework and obscure glass. Any other type of metal. or glass • will be considered an upgrade and extra costs will be incurred. ****** This is a Section 1 Item ****** THRASHER TERMITE CONTROL --- License No. PR0240 THRASHER TERMITE CONTROL 805-D University Avenue Los Gatos, CA 95030 (408) 354-9944 (408) 395-7934 FAX WORK AUTHORIZATION CONTRACT Address of Property: 1192 Elmsford Drive Cupertino, CA. 95014 Inspection Date: 02/11/1997 Termite Report #: 9710 State Stamp #: 3882034T Title Co. & Escrow #: Chicago Title, Escrow 8 768626 SECTION 1 SECTION 2 1B: $ 120.00 IA: Trades 1D: $ 1940.00 2A: Trades 1E: See #1D 8D: Roofer 1F:$ 125.00 1OD: $ 150.00 1G: 380.00 11A: Roofer IH: 100.00 11B: Trades 2B: 1825.00 $$$$ 8A: SeeS#lD00 8B: 120.00 1OA: 395.00 1OB: 515.00 11c: See #1D 'e Authorize the Following .lotion I hems to be Perf rnied. We Authorize the Following Seclion 2 hoop, to he Performed. UNKNOWN FURTHER INSP. 1C: $ 75.00 8C: See #1C 10c: Will Bid Proposed Cost Section 1: $ 6050.00 Proposed Cost Section 2: See Above Proposed Cost Unknown F.I.: See Above Inspection Fee: $ 125.00 Inspection Fee Paid: -125.00 Total: $ 6050.00 ",'e Authorize the Following It,:nu for Unknown Further Inspection. TERMS AND CONDITIONS -A LIEN WILL BE FILED ON THE PROPERTY 60 DAYS AFTER NOTICE OF COMPLETION IS ISSUED. THE LIEN WILL BE RELEASED ONCE THE BILL IS PAID. ,It is understood that these corrections are recommended on the basis of visibly determined surface examination. In the course of work being performed on the basis of this contract, conditions may be revealed which were not evident at the time of inspection. This contract is limited to that which was visible at the time of inspection and of that, only these paragraph(s) herein specified and contracted for. We assume no responsibility for concealed or inaccessible damage or infestation that was not observed by us without excavation or opening timbers, walls, floors, ceilings, moving furnishings, storage, , tc. We shalt not be liable for any damage resulting from probing, cutting, opening, removal or otherwise, of timbers, walls, floors, ceilings or other parts of the building inspected. Our liability for damages by reason of errors or omissions in the I:spection Report shall be limited to the cost of the inspection and report. If additional work should be required by the City or County Building Inspector, such work will not be performed under this contract. THRASHER TERMITE CONTROL AGREES TO FURNISH ALL L;i3OR, MATERIALS, SUBCONTRACTORS (if required), and compensation insurance to complete the repairs as accepted above. THRASHER TER141TE CONTROL AGREES TO USE ALL DUE CAUTION IN THE PERFORMANCE OF OUR WORK, but in no way will we be held responsible for damage to property, plants, or animal life caused by the use of chemicals, gas or equipment in conjunction with these repairs. It is agreed that the contract price shall be paid to THRASHER TERMITE CONTROL upon notice of completion. It is understood that �rvice charges of 1.5% per month on the unpaid balance, or 18% per annum, will be charged on ;r:rdue accounts and if suit is filed • collection of delinquent accounts the customer agrees to pay all litigation costs. At least one signed copy of this contract must be returned to THRASHER TERMITE CONTROL before work is started. This contract must be signed by THRASHER TERMITE CONTROL'S representative to be valid. NOTICE TO PROPERTY OWNERS : (Section 7018 of the California Contractors License Law, Business K Professoriat Code Div. 3, Chap. 9 Provides under the Mechanic's Lien Law any Structural Pest Control Operator who contracts (o do work for you, any contractor sub -contractor, laborer, supplier or other person who helps to improve your property, but is not paid for his work or supplies has a right to enforce a claim against your property. This means that, after a court hearing, your property could be sold by a court officer and the proceeds of the sale used to satisfy the indebtedness. This can h,ppen even if you have paid you contractor in full, if the subcontractor, laborers, or suppliers remains unpaid. THRASHER TERMITE CONTROL GUARANTEES CHEMICAL TREATMENT AND STRUCTURAL REPAIRS FOR 1 YEAR FROM Illi DATE OF COMPLETION. WE GUARANTEE GLASS AND FLOOR COVERING REPAIHS FOR THIRTY '(30) DAYS FROM THE DATE OF COMPLETION. WE CANNOT GUARANTEE WORK COMPLETED BY THE OWNER AND/OR THEIR AGENTS. ANY TYPE OF GUARANTEE SHOULD BE OBTAINED FROM THE PERSON(S) MAKING THE REPAIRS. • I Have Read This Contract And The Termite Report It Refers To. SIGNED WORK AUTHORIZA'T'ION CONTRACT MUST BE RECEIVED BEFORE WORK % ILL BE SCHEDULED. I have read and understand the teens of this work authorir;dion contract and herehy agree to it!, lei -ins thereof. APPROVED AND READ BY: DATE ACCEPTED FOR: DATE THRASHER TERMITE CONTROL