02110102 CITY OF CUPERTINO
ol , '9
BUILDING DIVISION PERMIT CONTRACTOR�INFORMATION:-,>•
IILDING ADDRESS: SOUTH BAY CONSTRUCTION CO LT�M11`140.
21672 GRANADA AV 02110102
NEWS NAME: 511 DIVISION STREET APPLICATION SUR DATE
CHRISTINE HOANG/MICHAEL SHIM 11/14/2002
NIONE: (408) 379-0400 SANITARY NO. CONTROL NO,
A R C I IITE C W,NGI NEER: BUILDING PERMIT INFO
BL ELECT LUMB MIiCI
w00 LICENSED CONTRACTOR'S DECLARATION
us U 1 herchy affirm that 1 am licensed under provisions Of Chapter 9(commencing Job Description
y with Scctinn)IXMq of Division Sof me BusinecsanJ Profession CsaM.and mylicenzers
in full it me and effect, NEW OFFICE 1069 SQ.FT.
Z O t'2 Liermse Cluu Lir.a
G y f,w Dam rS DECLARATION ARCDITECixe DECLARATION /
< 1 understand my plana shall he used as public records
6060
u0'^ Licensed Professional /
soOWNER-BUILDER DECLARATION
e Y 1 hereby affirm that 1 1. exempt from the Cssions ods :Any c Law for the
i x 00 fallowing reason.Permit
i 9(131.5.Raines and improve.
dr ions Cods:Any tiny or manly
w$I prior
rM1 requires a fermi)to tlires de,aper,ire forsu demolish,or repair any statement k.Z} that he in is
censedpruant in the pro visions of Be Contractors
toFile
useigned.aw(Counef9
z�0< manmencing ithSecuany0dofDivinonOfLmammnessanWenselaonsCoo)or Sq. Ft. Floor Area $125YalOation
(vat he
(commencingwithmfro and
of Islason30f LimBusiness
exsaption,Any vi COdn or
i3r$ that he is exempt therefrom and Ne basis for be alleged exemption,to Any violation of
Section OM by any applicant fora permit subjects tM applicant a civil penally of
not.,no man five hundred dollars(osto). b Occupancy Type
C I.M owner of the property,or my employees with wages M their sole compensation,
will do Or work,and the structure is not intended oroffmd for age(Sec.]DSC,Business —
and Pmfessthns Code:The comenu rs License sew Jars not apply to an owner of 10 2 - P I ERS equtred Inspections
property who builds or improves thereon,and who doessuch work himself orthrough his
nwnemmayacs,provided mat such improvements art not merged or offered for MR.If, 103 — UFER
however.me building or improvement is sold within one year of completion,the owner-
builder will how the burden of proving that he did not wild or improve for purpose of 104 - REBAR
I` 105 - ANCHOR BOLTS
1.as owner Of the property,am exclusively contracting with licensed coavactorsa) 106 — SEWER & WATER
u Into the project(Sec.]1M4,Baineess anti Profrssioa code:)The Conoactors Li-
farm Law does not apply reanowner ofpmpenywho Wilds orimproves memon,and 202 — UNDERFLOOR PLUMBING
Liver.who Lacs for such pmjcca wwamnl+mmr(s7lianaed parwam to me conlanon' 203 — UNDERFLOOR MECHANICAL
License law.
Clam exem er5 . ,B&PC for this reason 204 — UNDERFLOOR FRAME
DB
�t"v� 205 — UNDERFLOOR INSULATION
WORKER'S COMPENSATION DECLARATION 301 — ROUGH PLUMBING
I hereby affirm under penalty of perjury one atio
of the allimo ig declarns: 302 — TUB & OR SHOWER
C I ban and will maintain a Certificate of CoRaenl to self insure pe
far Wmker'eCamn-
satims as provided for by Section 3700 of the Iabm Gere,for the performance of the 3 03 — ROUGH MECHANICAL
work ver which this permit is issued' 304 — ROUGH ELECTRICAL
C 1 have and will maintain Wnrkcr's Compensation Insurance,a required by Section 3 0 5 — FRAME
3700 of the tabor Cadthe e,for performance of the work for which this remain is issued.
My Workers Compensation Insurance carrier Md Policy number are: 306 — HOLDOWNS
Carrier. PIONM307 - INSULATION.:
CERTIFOF EKF.MP PON MOM OM WORKERS'
COMPENSATION INSURANCE 308 — SHEETROCK
In lay.)
This section need not k completed Fine,Permit is formse hundred dollars oloid 309 — EXTERIOR LATH
310 - INTERIOR LATH
employ
Iconmaenmyirancoofas work for subject to
permitaiaa Co khannon 311 — SCRATCH COAT
employ any person in any manner an as m become suhjeeuo the Worken Compensation
Lawses California.Date
Applies., 313 — ROOF NAIL
NOTICE TO APPLICANT:IL after making this Cenl fico¢of Exemption.you should 501 — FINAL ELECTRICAL ENERGY
become subject to the worker's Compensation provisions of the Labor Code,you must
Z forthwith comply with such provisions orthis Mon itshalIedeemed ievokod. 502 — FINAL 'PLUMBING ENERGY
ZOCONSTRUCTION LENDING AGENCY 503 — FINAL MECHANICAL ENERGY
t-"
I hereby affirm Oat farm is a construction,lending agency for be Mrformance Of 504 — FINAL BUILDING ENERGY
a > LowerNamefar ichthis pmilisisaucdlScc.itH],Civ.CJ 505 — FINAL ELECTRICAL
Ij1 Q
the
ewrk Name
Z Under'sAddress 506 — GAS TEST
V O 1 crafty Out I have mad this application and sum ohm the shove informonon is 507 - FINAL PLUMBING
(~ conecl.I agree m comply with all city and county ordinances and sure laws relating m
pU Wilding masuuction.and hereby Moonrise repreacnuu.esofhis alyto enter upon the 5 - FINAL MECHAN
� M show-mentioned progeny for inspection purposes. 509 — FIN
1 (We)agree hr save,indemni fy and keep harmless the City of Cupertino against
rF. fA liabilities,judgments,costs and expenses which may in any way accme against said City C, N
V Z in cl,ccofthegraming of NI)4Aspermin Issued Is 1 - WORKS Dale
APPLE N RSTANs AND WJJJtttL COMPLY WITH ALL NON-POINT or 7,
,G AT NS. / —/�
/G�'
Re-roofs 603 — OF BATTENS
11 nWmrc of APP!wmmQlntmmnr Dane
IIAZARDOUS MATERIALS DISCLOSURE Type Of PD04 — ROOF IN—PROGRESS
Will the applicant or future building Occupant store Or handle haiandous material
defined by the Cupenmo Municipal Code,Chapter 9.12,and the health and Safety
r.SectimiY.,25512(a)? All roofs shall be inspected prior to any roofing material bein ' stalled.
Yca I
Will be applicanl it future building oeemam use cquipmeln Or devices which If a roof is installed without first obtaining an inspectionTagree to remove
call us air communion,communion,as dcnncJ by IM1c Bay Arca Air Quality
Tourist'fist' all new materials for inspection.
icf!
❑Ya o
1 have read the barallous malefi ilsor,mrcmcnt,uMk,Chapter 6.95 of the Califor-
niallcalth&Safely Core.Sectisns255n5.25533 and 25534.I undersand thaiff,Wilding
Joeo not currently haw a tenant,than it is my resry,mibility in notify the occupant of the
mom, Ip I(IIssU% ofa Ccmficaw of occupancy., Signature of Applica Date
Owner of on ed.,cut Dam All roof coverings to be Class "B"or better
03/18/2003 12: 00 408-279-7889 SAN JDSE WATER PAGE 01/07
c
San Jose 1265 S BASCOM AVENUE, SAN JOSE, CA 95128
WaterCompany
FAX Date: March 18, 2003
BUSINESS DEVELOPMENT Number of pages including cover sheet: 7
ADMISITRATION
To: From:
Jerry Brager Diane Van Fossen
City of Cupertino San Jose Water Company
REF: Service Sizing Senior Business
21672 Granada Ave, Development Re
Cupertino
Phone: 408-777.3228 Phone: 408-279.7887
Fax phone: 408-777.3333 Fax phone: 408-279.7849
CC:
REMARKS: ❑ Urgent ® For your review ❑ Reply ASAP ❑ Please comment
Enclosed is the review information and calculations for the proposed Office/Apartment located a
21672 Granada Ave., Cupertino
U-7 W/ 714
4
ex
CC
�'
03/16/2003 12: 00 400-279-7069 SAN JOSE WATER PAGE 07/07
- -- - SAN JOSE WATER PAGE 8 /02
QUESTIONNAIRE. FOR DOMESTIC SERVICE INSTALLATIONS
• A Service Application can be filled out only upon completion of this form
(Please Prird and Fill Out Completely)
Date -
S. Consumer's Name:
Service Address:
Consumers Telephone NCY
2. Applicants Name:
Applicant's Addrea;:
Applicard`s Telephone No:
3. Billing to: Consumer ❑ , or Applicant []�
4. Service Size Requested: , Consumer Pipe Size:
5. Estimated Length of Pipe from ery M r to Buildin Ft.
6. Use of Building to be so ed Na.of ApYs:
7. Building will have stories. Lot Size: k�_
8. Has consumer another source of water Supply*? Yes ❑ No LJ
RYes, Source:
8. Will consumer have a pressure system? Yes ❑ No LSI
'10. Will there be any landscape irrigation off this service? Yes No E3
If Yes. A) Quantity ofeprinklerheads GPMe pEC
B) Maximum number of heads used at one time: VUSE ;W4T-
C)
Will the sprinkler system be operated: Fon a time dock N. , manually p , off peak hours ❑ E8 2 Number of oWet connections: usDEVELOpSJW Use Only SJWpuapt&; GPM Total Own ty: GPM
-- Z9 Wash Basin 2 Kitchen Sink 3
7ailet-tank 4.6 _ Dishwasher 2
�— Toilet-flush valve 30 / Service Sink 3
Urinal-tank 4 1 Bath,Bath w/shower 7
Urinal-flushvalve 16 _L Shower 6
Washing Machine 5 3 Hose Bib 4
Miscellaneous Total
12. lea Fire Protection Service requlrad fo is development? Yes ❑ No Lr
13. Applicant's Signature:
14. Remarks:
I
For San Jove Water Co.Use Only
Approval Date E. Irrigation GPM (see item 701j
Size of Main F. Tots)requirement(D�E) GPM
A .Total connections Install inch service: split ❑ , single ❑
B. Flow. GPM install - inch meters
• C. Load factor(based on A) Job No. By
D. Requirement(B x C) GPM G. S.T.O.Na
yw cpo,vao tagp pe:t19T
03/18/2003 12: 06 408-279-7689 SAN JOSE WATER PAGE 06/07
++++++ WATER LINE SI,,aR + + ++++++++ + + + + + +-r+ + ++ + + + + + + +++ 03/10/201
Supply Location: N/side Granada Av, Mercedes Zone
• Supply Pressure: 120.0 psi
Demand Location: 21672 Granada Av, Cupertino
Requiring 27.5 gpm at 35.0 psi
DEMAND REQUIREMENTS ++++ +++++++ +++++++++ ++ ++++++ + ++ +++++++-
System Use is Private System is Mostly Tanks
Fixture Units:
1 Bathtub 1 Dishwasher 1 Washing Machine
1 Hose Connection 10 Lavatory 1 Shower Head
3 Service Sink 2 Kitchen Sink 2 WC - Flush Valv
1 WC Tank Type
46.0 Total Fixture Units
27.5 gpm Total Demand
HEAD LOSS ++++ + +++ + + ++ + +++++++++ + + + ++ + ++++++ + +++++++ +++ +
Valves and Fittings:
1 Corporate Stop 1 Angle Valve 1 Short Elbow
Backflow Prev: psi Water Meter: 1.6psi PRV: psi Other: psi
Sgth of Pipe: 55.0 ft Other Head Loss in Feet of Pipe: ft
vation Change: 3.0 ft
SIZE CALCULATION +++++++++ ++++ ++++ +++ +++ +++++ + ++++++++ ++++
Maximum Velocity: 8.0 fps Total Head Loss: 8.6 psi
Actual Velocity-. 7.2 fps, Demand Pressure: 111.4 psi
Type of Pipe: Copper - Type K Calculated Size: 1-1/4"
r % u
� L -.oma
03/16/2003 12: OE 408-279-7689 SAN JOSE W:;TER P:;GE 05/07
P++++ + WATER LINESIZ;=it ...... . . ... . .... ....... ........ 3/10/20(
Supply Location: N/side Granada Av, Mercedes Zone
• Supply Pressure: 120.0 psi
Demand Location: 21672 Granada Av, Cupertino
Requiring 27.5 gpm at 35.0 psi
DEMAND REQUIREMENTS ++ ++ +++++++ + ++ + +++++ + +++++ + + ++ + +++ ++++ -
System Use is Private System is Mostly Tanks
Fixture Units:
1 Bathtub 1 Dishwasher 1 Washing Machine
1 Hose Connection .10 Lavatory 1 Shower Head
3 Service Sink 2 Kitchen Sink 2 WC - Flush Valv
1 WC - Tank Type
46.0 Total Fixture Units
27.5 gpm Total Demand
HEAD LOSS +++ + ++++ ++ +++++ +++++++ ++++ ++++ ++.++ + +++++ + +++ + ++
Valves and Fittings:
1 Corporate Stop 1 Angle Valve 1 Short Elbow
Backflow Prev: psi Water Meter: 4.8psi PRV: psi Other: psi
Sgth of Pipe: 55.0 ft Other.Head Loss in Feet of Pipe: ft
ation Change: 3.0 ft
SIZE CALCULATION ++++ +++++ +++++++++++++ ++ + + + ++ + ++ ++++ ++++++
Maximum Velocity: 13.0 fps Total Head Loss: 22.0 psi
Actual Velocity: 11.3 fps Demand Pressure: 98.0 psi
Type of Pipe: Copper - Type K Calculated Size: Y
Vv�
BEN
ape
03/10/2003 12: 08 40E-279-7009 SAN JOSE WATER PAGE 04107
MUMSan Jose
Water
Company
Pressure Zone Calculation Program
Project Name: 21672 Granada Av
Project Number: 03-030
Plat Map#; 2209
Cadestral Map#: 81
By: WEF Date: 3/7/2003
Inputs:
Pressure Zone: Mercedes(Cupertino Water)
• Zone Code: 99.00
Highest Site Elevation: 328.00 feet
Lowest Site Elevation: 328.00 feet
Gravity System Pressure Results:
High Pressure at Site: 128.60 psi
Low Pressure at Site: 119.60 psi E U 1 RA.,E;D
Pressure Range for site is 120 to 129 psi
Main on South side of Granada Av
55 feet of service run
Fire sprinklers required? ❑Yes. 0 No
Notes:
• (6'A C)
03/10/2003 12: 08 406-279-7809 SAN JOSE WATER. PAGE 03/07
• Dr. Christine Hoang
March 18, 2003
Page Two
The RPP assembly must be installed before we will allow water use through the service.
To initiate service, you must contact our Backflow Department at 408-279-7872 who will
perform a field inspection and test. Please give 24-hour notice.
If you have further questions, please contact me at (408)-279-7887, or Wanda Folk at
(408) 279-7879.
Sincerely,
ORIGINAL SIGNED BY
Diane Van Fossen
Senior Business Development Representative
DVF:dn*
Enclosures
Granada,21672
• cc: Jerry Braver, City,of Cupertino
Jo Harris, South Bay Construction
Construction, SJWC
ACKNOWLEDGED AND AGREED
Responsible Party
Signature
Print Name
Date
•
03/16/2003 12:08 406-279-7869 SAN JOSE WATEP. PAGE 02/07
San Jose
WateCom BUSINESS DEVELOPMENT ADMINISTRATION
Company 1265 S.Bascom Ave.,S.J. 95128
374 West S elan St.
Facsimile: 688-279-7889
San Jose,caA 95196.a001 Writer's Direct Dial: 403.279-7337
March 18, 2003
Dr. Christine Hoang
4110 Moorpark Avenue, Suite A
San Jose, CA 95117
Reference: 21672 Granada Avenue, Cupertino
Proposed Office and Apartment
Dear Dr. Hoang:
Based on the water questionnaire information submitted by Jo Hams of South Bay
Construction, our Engineering Department has determined that a 1" General Mete-red Service,
with a 1" meter and 1 %" piping to the structure, should be installed for the proposed
office/apartment. The City of Cupertino has reviewed our calculations and agrees with our
findings.
The purpose of this letter is to inform you of the procedures you need to follow to initiate
the new service installation, to any particular service conditions, and costs. First, please sign,
date, and return a copy of this letter to me at the Bascom Avenue address indicated above. You
must include payment in the amount of S418.00 to cover the cost of the meter, inspection, and
the cost to install the meter. Please make your check payable to San Jose Water Company.
Basically, it will be your responsibility to install the new 1" service lateral from the water
main in Granada Avenue to the meter box, and the meter box itself. You will also be required to
retire the existing service. City of Cupertino standards for the service installation mast be
followed, and I have enclosed a copy of their standard drawing, "Typical House Service", for
your use. Your contractor must possess a valid license to perform this type of work, and must
have a permit issued from the City of Cupertino to do the job.
Please call our Construction Department, (408) 279-7330, 48 hours prior to starting any
work so that we can arrange for inspection. A San Jose Water Company inspector must witness
the actual tap of the water main. Once the service lateral and meter box have been installed and
approved, we will install the meter.
It will also be your responsibility to install an approved Reduced Pressure Principle type
• backflow prevention assembly (RPP) on this service. The assembly must be purchased by vou,
and must be installed above ground immediately following the meter. Any deviation from this
location must be approved in advance by our Backflow Prevention Department. We have
enclosed a list of approved models for your information.