S 2758 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES•USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING.-E1,FCI'RICA L PERMIT NO.
BUILDING DIVISION APPLICATIONIPRRMIT rLUnunrvr.-nu?cunryICA l. Q 2758 CO
nuLDING PRO..IecT mENPIF S 5 O NFION L
BU1LDINGADURESS: 1
A 0T SANII'A14 NO. AI'PLICA'HONSUHMITI'ALUSH
1ogOB ✓/ 4,10- 3 -2,3 ��` /
OW !RS� I ♦ >Nlb CON )IfS NAME: .IC NO: NIC CON TROLW
-Ask, 1
I" n;NGI ✓�Ss.y� 1,11" - ADDRESS. oNH !/ ❑ / Z -
coN'I'ACT; U PHOJNE, q.Ql97 " , BUILDING PERMIT INFO
C 6!1 pOY�7 ❑ Consultant Fecs Paid by Nllpplicanl(Initial) BLDG ELECT PLUMB MECII
I.ICFNSFDCONTRAC ORSDFCIARATION QTY' ELECTRICPERMIT FCC
I hereby aPrm m t l r t J p " 1 Chapter 9(,tournament, _ JOB DESCRIPTION
WOO with Srn'ot 91NN1)trlT 'mlu(IhaBw ,.cent 11 rule', nxG Ac radial ...... in 1
WOO PERMIT ISSUANCE
F in full farce and cl'fect SFDW I, ElKI'ICH EN REMODEL
C U License Clea Lou.p
Q U APPLIANCES-RES]DENTIAI. ❑ADDITION El PLUMBING RE-PIPE
�ZW Unm Cannucmr
FDm ARCIII'IECI"S DECLARATION PANELS [I MULE ❑STRUC'I'UkN,
rnZ Iurchramnd my plans,hall be uwJaspublic reronk MODIFICATION
OZ- UPTO2WAMPS
q ❑INTERIOR [I CHIMNEY REPAIR
Ltcceed ProftaiamJ 201-I000gMPS IMPROVEMENT ElSWIMMING POOLS
OWNER-BUILDER DECLARATION OVEHI 000 AMPS
❑BATH REMODELIREPAIR ❑DEMOLI'DON
C C¢ M1erchY affirm Ism 1 Bin esm lla boat the Comracmrx License I.aw for the
d U following reason.(Section 703 .5.Bmioas and It ir,eia i,Code:Any city or coumy SIGNS ELEC71 RICAL El OTHER
LL13 LL N which requires a permit to eninttuet.alter improve.demolish,or repair any structure
prior i its issuance,aka requires the applicant for such pemtit to file u signed setement SPECIAL CIRCUITIMISC.
Gat he is licensed uroa Ito the provisions of the Cnnaaand I Law l Chaptcr9
Wa00 (commencing with Section 7000)aLivision 3 ofthc Business and P..fc,mas C,tda)or TEMP METER OR POLE INS'1'. MaRCIAI"
0.d c rG that he is exempt thcretroni and the havis for the alleged exemption Any violaeon of W BLD IDITION ❑DEMOLITION
4iin Secllnn)IU1.5 by any a,lb ua lar o pcnnil ahlull,me,xP,frml to a ciolbpcm,ltyal POWIi1a DEVICE
m=y ❑TEN ❑FOOD kIIRVICB
rn more than for the pd,,da,,red r ycropl' IMPROV NT
^"Z'Q a. [,:is than ivehundreenyors S500)nyecs x'ith wages as heir sola campensminn. SWIMMING POOL ELECTRIC �Q^,
Y 0 wJl Jn thcwnrk.and thu svuclllre is nal intended nr offered basal,(Sec.9044,Husi nam HR
W 3 m and Prolcssions Cale:'1Te Cio narar'.v License Law does not apply to an owner,of 0MLEPS-SWITCHIiS-FIXI'IIRES
pro,,who huilds or improve thereon,Bad who dues such work himselfor through
his vato,wtemployee.,pmvlded that such ralro vemnns are tet intended ar ufleu,d fur NEW RESIDENTIAL ELECTN SQ PL
sale.If.however the building or impmvamont issold within one year of complctioglhc qq SQ.IT.FLUOR AREA SESQ.Ff.
owner builder will have the bunkn of proving that he did not build or improve for par- 3 IG 2- or
Pu oaf sula.l. ISI
r nl'the property,run exclusively cnntraming whh Ilansed amvunam to 3ey 3 s
omimct the pmjua ISuc.7044,Easiness and Professions Cnde:)'ntc Contmemr'x I., _
n..ni,aw dr,a.nalapplym an owner orpropery who bddds or'toprves thereon,and QTY. PLUMBING PERMIT FEE
wbactimmum 'or xnchprnjectswitbacunttraeorlsllicermdpnrsumn tome Cnntmcmr'n I
License WIN. PERMIT ISSUANCE
❑ I on exempt under Sea. B,F VC rz Ih' mason
hems affimtlunJterpe('OMPENSATIONi7)ECL�ATIOgJalannl„Its: ALTER-OWPROIVEX"-WA'E. (IlA) VALUATION
Owner Dam
j BACK FLOW I'ROI'EGT CE. �Z O
nallyth,ofCroemto J lJ
In.a,and will for
by See it 37amof Ce Lath la Caddnwrefor srft,,uaCompen- I7RAIN5-FLOOR.NfN .GOND. S'IORIE.S TYPE CONS] ACTION
,mien,us provided far by Section J'!00 of the Luhnr CnJc,for the pudonnunec of the
work lite which hit,penny is issued. FIX'I'URCS-PER TRAP
E]1 have and will maintain Workers Compensation Insurance,as required by Section
370dofthe Labor Code.Bn the performance of the work for which lhi,permite,issued. GAS-EA.SYSTF.M-I INC.40UTLE OCC.GROUP APN
My Workers Compensation Insurance carrier and Policy number am: 6/7�
I< Carrier: Policy Ism: GAS-EA.SYSTEM"OVER4UIn)
CERTI FICAI'li OF EXEMPI'I ON FROM WORKERS'
COMPENSATION INSURANCH GREAS Ell NUUSTRL WASTE IN'ITRCFF BUILDING DIVISION FRES
I lc+v7
(This.cehumiaednot heasmpluwl ifthe Nara,is farone hundred Jalfim(S11x0 GREASETRAP
s nr PLANCIiECK FEE
I cenilythm to the p,,E,mnmceof dtc work Emwhich laispermit is issued,l.hall SEWER-SANI'T'ARY-STORM EA.21X1 FI'.
not employ any Person in any noberm so as to bee, nc mhjecl m the WorAen'Cmd,wd. IiNIiRGY ,li11
,Z s:ainn Laws of Califormir.Data WA117R HEATER WN1iNT/ELF! R
Or 2
z,2 Appfiaut GRADI :FE
y NOTICE TO APPLICANT:11,after making Isis Cenilicum of Exemption.Sou sinmhl WATER SYSTVMU REATING
a^ hecone sub,icut to the Worker's Compensation provisions of the Labor Coda,you must SOIIS FIEF4
L1) G fanhwith anntply with such pro.ula,n..,dry pel'Inn shall be deanrdrevnked. WA'I'ldR SERVICE
a �
U O CON9Ie'it'o hmom,LENDING AGENCY NEW RISIDIiN'TIA1.I'LhfB. SQ,PC PAID Date Receipt
I hereby affirm Ihltt them is a ennvmuadnn lending agency lill'the padi,mmncc of
the work for which this pcnnil k issued(Sec 3197,Civ.C.) o 7
U Lenders Name T PA
0 L) Lender's Adilu, F-3
>-
1 tinily that I have read this application and site That the above infiam urian is - r BUILD1 )ITF; Q
Vt
LFi to correct.l agree to comply with all city and county erdinance.s and state laws relating to QTY. MhCHANICAI;I'ERMI'I' _ , FEF,
U � builAingwn.antaliun,xnA hemny umM1nriac rcpru.emotivevnfthivclrytoenteruponthc I SEISMCPL-
aMne"memetard progeny far inepeniom pm,ecv, PERM]I ISSUANCE
(WO agree a,save,indmnnify and keep harm us,the City of"C.per ino againw Elal EF,
G.bilil'ms,jndgtncros,as.1,andcs,dmO1 which utuy in'any way aeon a..innl said City A LE FIR OR ADD TO M I iCH. I (I FEE
be onsc, BE of the graining of this pm�
API LICA ERSTANDS WILI,fiOMP YWITH ALL NON-POINT AIR HANDLING UNI'1'(i'O III,IIfKI CPM) VM. ANICALSO RLG .A FEE
AIRIIANDLINGUNII'(OVER gmOCFM) N'1'AX
Signa ppli'ma/Conwetnr Date EXHAUSTH(lOU(WADUCT) GAIONFIIE
HAZARDOUS MAI'I;R1ALS DISCLOSURE
Wll the applicam or fwum building«cupanumrt nr Handle M1aeallom malarial HEATING UNir TO 100,000 BTU)
ax delined by the Culwrtina Municipal Code,Chapter 9.11,and ilm health and Salary
Cade,Section 255J2(a)'! �✓ HEATING UNIT(OVER 10010011 B'I'U)
Yea Grvo
VF.N'IILATI(IN FAN(SINGLE?RISID) PAID
Date Receipt is
Will Om epplieum or future building occupant use equipment or devices which BOILER-COMP(3HP OR](a)(XN)11'IT)
it hazardous air amtaminuins an defined by the Bay Area Air Quality Management
❑Yee Ervo BOILER-COMP(OVER 104000 BI GO
1 nave road the hmardour nmteriuls mquimntents under Chapter CONDITIONER
6.95 of the Cali" ISSUANCE DATE
h,miu 1lulth ay.Cy�Je,Sections 25505.^_55331md 25534,1 u notify th tient If athe
nt NEW RESI01 N'i'IA].MHCH. SQ.NI'. / �9
form.
it IcnanL lha ' n ilitym notify the occupant f
ofthe -mswhicharmta - afnc,,,0''--nt,I f(kcupancy, Y s
r i—� fI T�
Own dud.,car Dae ( ISSUED BY.
OFFICE
KIHLTHAU, INC. Consulting Engineer
1030.Connie Drive, Campbell, CA 95008• (408)379-6561
Kelly-Gordon Development Corporation September 27111 1999
12241 Saratoga-Sunnyvale Road
Saratoga, CA 95070
RE: Supplemental, As-Built Structural Design Review for the Rough Framing Sign Off
for the Lot 7 Residence, Oak Valley Unit 4 Subdivision, Cupertino, CA (Our Joh No.: 99030)
After my jobsite meetings with Gordon on 9/23/99 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.
1) Since the plywood floors, exterior building paper and the roofing fell had been installed prior to my visits, the
following items could not be verified as properly completed during this visit. However, they may be verified as properly
done by reviewing the City of Cupertino's sign off paperwork.
a) The foundations, underfloor grade clearances, anchor bolt and ground floor holdown bolt installations
b) The sttbfloor nailing, below walls.
C) The roof deck nailing.
d) The perimeter top plate splice straps and collector straps installed on the exterior, and covered.
e) • The exterior shear wall perimeter nailing was covered by the building paper,
2) Based upon the limitations noted in item (1) above, the only items which could be verified by me at the time of this
visit are the following. (Note: All the items listed were found to substantially comply with the engineering design intent).
a) The holdown anchors were visible because the wall insulation had not been installed.
b) The perimeter frieze block shear transfer detail at the exterior roof to wall connection.
C) The roof strut bracing and ceiling support beams for the roof.
(1) The interior and exterior shear walls (except the covered areas noted above).
The only items of concern found during lily first visit were itemized in a punch list fashion when Gordon and I
walked through the residence. The second visit was used to verify that all the requested structural issues had been
resolved to my satisfaction. Since Gordon kept the only copy of the punch list onsite to allow his workers the opportunity
to complete the requested items, you should direct your inquiries to him if you wish to have the list on file. Por my
purposes, the second visit satisfied me that the requested items had been completed.
This letter was writ[ mg Stan d engineering principles and visual techniques subject to the limitations noted above.
This documen ' intended be a upplemental review of the exposed framing visible during lily visit and should be
considered s stand alo docu at, independent of the City of Cupertino inspections. Should there be any additional
questions, a do not sitate t call or fax my office at(408) 379-8430.
^ FESS/p4
9
imoth M. ill to r w
R.C.E. 40834 No. 04ti Am
Exu.3gi
X C V I �P
M��OF
•
FROM PHONE NO. Oct. 05 1999 12:58PM P2
QCT-03-99 7.2 :40 PH VT HLTHAU . tNC. r, ai
o yfi
ho- N ir�yr�yFY�
�y4 •� 6Nrtya Wd.ia. 'faa�aP'9;ti , � �`� /`4Yo.j0+ 9? � w �
c:'J7
u�t � ; u�+7 4 Ld94 AmJ7 v .
Oil:
�� IM114 �G6t4� o;-4 117¢ UISC •
STUDS A 16 ' o.c
FLOOR JOISTS 018-- 'r-
314' TBG.PLYW000 —
SUBFLOOR — SILL/s/`$ t 7'r •Lao Sut..+b
23A SOLE PLATE 8
E.N.
BUUINGPAPEl4
2a RIMJOISTd---
SOLID BLK'G. A 35® $ �o.c•,
• 2AS PTDF- MUOSILL'—"
wJiM1'�xiD" ►..A.
B �I,eO.i, 2 •� .,-YZ'J IT1lt(*or I
FINISH GRADE
1�, 1 I � • n�c4 yi-trie m "
i.. pit
FOOTING BE o ,
EMBEDDED
I] MIN. INTO
NATIVE SANOSTONE
MATERIAL __ IV )
EXTERIQIR- FOQTING._�,
{hoarf=itb 'tor C2%o Loaf. �S) ap44tCaYroN O"Lv �
aTE Job No,
I0 s KIHLTHAU, INC. `PUFF. �Z7•`� yRoso
��By Coaculltng En9lnser . r ,{ L
'�I+q �tN Lc7s 4 sn r/7 5 I
d BY Ute wmh Orin,aeU1eY•G Mal• fddd)7 s-wo
Ali VALi[y r L ur¢�1,.ad of I
FROM PHONE NO. Sep. 27 1999 02:52PM P2
i}f -1499 9:SVO ITPUM �.
7092
--` iA C
CERTIFrCATE OF CONFORMANCE
'HE UNDERSIGNED MANUFACTURER HEREBY CERTIFIES
tltat the prOduate identified balow.end on attached sheds Nos. aro merhad With
the Collective Mark Of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION(RITC?and wars
manufactured in contormanea with applicable provisions of American National Standard AN8VAITC
Al go.t•1992,Structural Blued Laminated Timber,and that such r."nuteeturo has bean at our plant
inDrain CR . which plant has a quality comrol eyelet
approved by the Inspecbon Bureau o the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION
And impacted periodically by such Bureau.
�M6'.- _ ?Geller Ltioli er Salest Ix. for Stock_
JOB LOCATION _ AOdrfin�GI _ .-_. .—. ..•••.—
PW 7092 12=15-98 417.7-D
t.�810MER'S OR06n NO. _.�. _p�T6 .. . Mr{yr'S WIDER>w+0...___.__.
10808 Juniper Court _
;71 2099
co,Nothv_ Q1C'O'�1tl
90NwTUfIB
Tmfi_ Quality Control A0046sS�Box 297, Drain, OR 0a76 01.11.99
AITC HEREBY CERTIFIES that the said company at its said plant is licensed by the
AMERICAN INSTITUTE OF TIMBER CONSTRUCTION to use the RITC Collective Mark in respect
of products which comply with a0pll001e provis;one of said Standard.that the adequacy of the Qual-
ity conlrot system in effect at said stent is periodically inspected and verified by the Inspection
Bureau of the AMERICAN tNSTMjTE OF TIMBER CONSTRUCTION, and that:in the ludgamarrt
of RITC. said company is capable Of ao(TVIVi g with eppfiCe01e manufacturing and testing provisions
of said Standard in respect or products manufactured.at Said ptb M. Corlormance Whh the Standard
in respect of any Specific or particular product is the 0010 responsibility of the manufacturer;AITC's .
Guarantee hereunder being that the said company Is quafit ed to produce a product meeting the said
Standard and 1'tal its pian is periodiraUy inspected'er+d vad&ad by Uv AITC NtepOctlon Bureau.
AITC ceirliftate No. 92- 047818
AMERICAN INSTITUTE OF TIMBER CONSTRUCTION
Rpcv VED
,JAN 18 1999
KELLER LSR SALES
0 tM AM@RIGN INSTITUTE OF TIMBER CONSTRUCTION
• WC rad ice .
26'd 9tS9-Cvz-OE9 53105 M81 UB-3-13N WOt:6O ei6-60-d05
FROM PHONE NO. Sep. 27 1999 02:52PM P3
9-09-1c-GQ 9:9SAH prmj i
18's7.
Glow
• - .prt a r�.e ,
CER CONFORMANCE
1HE UNDERSIGNED MANUFACTURER HEREBY CERTIFIES
,tet t+a products Identified below and on attached Shasta Nos. are marked with
the Collective Meek of the AMERICAN INSTIT•JTE OF TIMBER CONSTRUCION(ARZt and mare
manufactured In cortlormance with appNcable provisfonr of American National Standard ANSUAITC
A190.1•1892.Structural GluedLaminated Timber.an � lar auasbeen ti Botewhichh hsaquacon� ym
infin _...__,
approved by the lnspection 8uMsu d the AMERICAN INST7UTE OF TIMBER CONSTRUCTION
and inspected paMalcaliy by such Bureau.
JOB NAME: Keller Umber Sales, T.I)c, far Stook
Joe I.WATON:
CU6TONERS pgp)i4 N0. 7932 _OAT'.01-21,, MMORS ORl1&k No, 4•j17-�} _-
10808 Juniper Court — —
__— _ OOMMANY�� Duw�fl
SIdNAiuNG .. ••
TI766_. pualiteeol aoonessEOl10%297, Ueain, OA,.oArg�2�C4:a8_.
AITC HEREBY CERTIFIES mt the said company at its said plant is licensed by tete
AME91CAN INSTITUTE OF TIMSER CONSTRUCTION to ties the AITC Collective Mark in rasped.
of products which comply with apptieabIc 040visions of said.Standard,that the adequacy of the qual.
it/ Control systam in effect at sald plant is periodieaily Inspected and verified by the InspeeUon
Buraeu of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION, and that, In Thi Iudgemant
of RITC,said=rnpany is capable of Complyireq with applicable manufacturing and tasting pWvisiona
of said Standard in retpsot of prodlcta menu acturad at said plant.Confonnan0a with the Standard
In respect of any spa &or particular product 16 me 9016 ragponsiolkty of the manufacturer; AITC'e
guarantea narounder being that the said eomparvil is qualified to WOdyCe a W0dUVI me69ng the baro
Standard and that its plant is periodically lnspa&Ud and'vOyl?IW by the AITC InspactiOn&06au.
AITC CerfitLcara No.92- 047913
AMERICAN INSTITUTE OF TIMBER CONSTRUCTION
RF!C.$)vEU
FE P. (r 81899
khll.rki� ��pp aa��''
Q 19M AMEn��%lemic OF TIM00%CONS muc-riow
. .rrra=carr MC
FROM PHONE NO. Apr. 22 1999 04:11PM P2
MARVIN D.KIRKEBY
2397 FOREST AVENUE
SAN JOSE,CA 95128
(408)984-0331
April 22, 1999
Job No. 98060
Building Department
artment
10300 Torre Avenue
Cupertino.CA 95014
Re: 10808 Jupitcr
Lot 7,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.
o rs truly,
C QPCFDSS&
Matvin D. Kirkeby yQ``e�`� ki9��Fyc,
Registered Civil Engineer
�? 2 No. 1400i
�'r Exp.i"111.1 ,�:./