00050161 TY
RTINO
CI sutt,DF c DP ISIONPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: - .. PERMITNO.
10496 MANZANITA LT30 00050161
OWNER'S NAME: APPLICATION SUB DATE
THE OBRIEN GROUP 05/23/2000
r.HONE: SANITARY NO. CONTROL NO,
ql O O ARCHITECT/ENGINEER: BUILDING PERMIT INFO
kL"w- _ BLDG ELECT PLUMB MF.CH
_ is ', rete m Job Descr
m- 1'�fhr<by:' < SED CONTRACTOR'S DECLARATION 1 h0❑
O O .w,o Iuohereby,of P nthat l am licensed under provisions of Chapter 9(commencing p
���": LICENSED
Fyhw vision3oftheBusines.sredprofessionsCode.andmyliccnu 3582 LIVING SP. r 481
=z z a License Class Lic.a GARAGE
°'o i u Date Contractor
3 a-Fa ARCHITECT'S DECLARATION
t=O 5 1 understand my plans shall be, ud as Public record
yg
u
w i O O Licensed Professional
rc OWNER-BUILDER DECLARATION
to w 1 hereby a0itm that 1 am esempt from the Commas •s License law for the
F' following reason.(Section]031.5.Business and Professions Code Any city or county'
Sd x p which requires a permit to construct,alter,improve demolish,or repair any stmaom
e 3_ no file o signed....at
w $ .Oat henaysumcgalsomgmreetaappaam for sue perm,
Oat he provisions or the License law(Chapter 9 S Ft..Floor Are uatton
(commencing with Satwn,]tX10)of Division 3 of the Bu;mess and Professions Code) �. (1"L ,• iti Sq.
��{l:rr`-rJ ilh
or that he W endm6l'Oetefm,h ung the basis for the alleged e¢emption.Any violation
.of Sectiam'103L5byanyapplican tura Pem,in suhjeaLa the upplicnnt too civil penalty OQ
ofna.room 0nfive hundred call am(s500), writer ., ' .t. •i'I"•�^ Occupancy Ty pe
❑1,as owner of the property,or my employees with wages us their sole compensation,
will do the work-and the stmntrc s not intended or offered for sale(See.7044, _ - - _---- --- ------ - --- -'Business and'Professions Code The Comme ora License Law does not apply ro an 102 - PIERS Required Inspections ^ ' •
owner of property Who build or improves menton,and who does such work himself
or through his own employees.provided that such impro morns are not intended or __ 10 3 - UFER
.offered for sole:If.however;the building _,mom is sold within'one-car'of ' -- ___103_-
-- -'-' - " '""""'--""-"-""'_.__.
i In the owner-builder will have the burden of that he did not build or 104 - REBAR
io np c ion. Proving
mprove for purpose of tele.), 105 - ANCHOR BOLTS
P P r s -106 � SEWER & WATER
con aw of the m rt 4. I . t t tCo d contractors; _
Lconsumer t nh P 9vU(S ]IWJ B : .:and Professions C d )Th Contractor's F'1 t
ecom Law does not apply to an owner of property who builds or improves thereon 202 - UNDERFLOOR PLUMBING
Fond who,baa Tres for such,projects.with a.cammetorfs).lice ood.pursuam to.the _._.__...._.-..__.___
❑I pt d' S B&PCforshisreason 205 - UNDERFLOOR _MECHANICAL
Caro t r L Ea 203' UNDERFLOOR•,
T. FRAME''
ow '' `Dat INSULATION -
WORKER S COMPENSATION DECLARATION
301 - ROUGH PLUMBING
11 Inereby antrm aaa<r,pemm�yarP rJury nnepl the following aeelarm un,: 302 — TUB & OR SHOWER
❑ 1 nave dad svm'arrom.o a'cenir,.m of Coamr,to relf-m:are for Wmkeri 303 — ROUGH MECHANICAL
Co ,cm,aion, ae pmvided for by Section 3]00 of the labor Code, for the
prannanaeunne'wmk1. 1.rymiaprmiti.isseJ. 304 - ROUGH ELECTRICAL
❑1hve d nmaitanworker Componsationlreamence.scandFurmcdbySmion 305 - FRAME
4]00 of 4,h -Wbo Code fo the perfo a e f the hT h h th permit is
ON INSURANCEI y hr 306 HOEDOWNS
1.
Cyn S iac: :al X .;PrLY '' . ..,307., ,- :INSULATION_, ,•,.
.l 0 )r CERTIFICATION OF EXEMPTION FROMNQRKERS Q '! ' 3'08 =t�SHEETROCK` 1 t t
J. ,I. ..-_..__.__ _ J...............
..r.. COhI1- , 'I _ ._-.._,...__._. .._.
'o' „ ernrs ee<ttun need not Ise miaphddd if the Pemt t is Tar one haadred dalam 3 0 9 "r EXTERIOR" LATH a i.
,,. 310 - INTERIOR LATH ,
P3,11..._-. SCRATCH COAT-- - -, - t -
I it f d't"th t o t the k for which this front is issued 1
"sfi511 n t e v!Y nY',Pertan n any ma as a become subject m the Workers 313 - ROOF NAI L
Cbmpcn no Laws of Calf Date- `
APPh t - - - ---... _ . 315---EXT SHEAR----- --. .._. -.. _ ... .. .. ......
NOTICE TO APPLICANT:[Lultor taking this Cmntivftre orE pi you should
Z become, the mpn n pnvannsbfthekaborChleyaumost 501 - FINAL ELECTRICAL `ENERGY
Zforhavith complywitn och provisionsonh pconfilOuillb a medrcvuked _ 502. ---.FINAL. PLUMBING_ ENERGY ... _ _. ...
V (CONSTRUCTION LENDING AGENCY - -,
F h' byuffmnhnh J g6ge yf n preimaace 503 - FINAL MECHANICAL ENERGY;.'
of the work far likhhis Permit issmed(See 3097.cs.c) 504. -, FINAL BUILDING ENERGY.
Londe sN s _ ., .s._ ., .._. .... .. - ....
3 .Z
Lower's Address 505 - FINAL ELECTRICALcr
y .
ertrrintll o mitudii,application ad dine that the b'oveuaunasuann 506 — GAS TEST .... .. , .._
n I gree ro comply th all city's J my iliaa m d state laws relating 507 - FINAL PLUMBING
'Ott to 6a,ng<onsnN<ran..artaner<bydumanaerepmsentans^<sonnisdtymemerup,m
.� tnegna,<.menhano,,Pmrnyfurin'I"coonpurposes. 508 - FINAL MECHANICAL
(•" y (Wq aaree'io sm'e.inJn,ihify mA kicp harmless the Ciiy of CUPenmo u'mm,
.m liabilities,judgments,costs and q,P<n:<ahich may in any way accrue against said 509 FINAL RA
'U,r Ciry in conuqucncc of the g'mniing of this perin.I
-- APPLICANTUNDERSTA`ID,S•AND WILL CO\IPLV WITH ALL SON=PINT" ISSnCd 1.0 ?j �+ I G Dale
SOURCE REGULSIIONS': 't s ', 'r t. 1"
Signature fApprcanvCaatma Date Re-ro4s] 66 - FINAL BUILDING
7. 1 HAZARDOUS MATERIALS DISCLOSURE
wll to ppl'tc t tt n'le' g pm.i
" reah dl Azardousmnal xType� & f.rRO.OF
,rand the Health ant _.PLYWOOD..NAIL,.,..
AIL,. ..
as deforest the Cupertino Muntm I,Code.Chapter 9.11 d Safety '
• . ., ' 6031ROOF—BATTENSs«r�zssJ2 )l kQQ�&SBgmaterialbeinginsta
Oyc,� islle.d.led._All rod6ball•bRNWd#i& . _
Will th,applicard ormine looldon,oc,ipant_ . aq P t a ct e.which If a rob0l3instal&41CSMBktIf"EXDUISng an inspection;I agree:toremove -
emthn rdo ' cot n t. sd<fned by nh
B.yAm.Ai1QmdbyM zg em
•
District', all new materials for inspection. Applicant unde_rst_ands and will-comply,with
:'ON.-
oNor
❑Y , all non-point source regulations: -
I ha c r,od the hazardous mamnal requirements under Chapter 6.95 of the
California Health&Safety Cod:.Sections 25505,35533 and 25534.1 understand that '
if th bld' ¢d«s notcunendYhavearcn rth tlis mY opo sblrytn naufYJhe '- - - - - -„ - - -
re, Iint f d re,morm ns winch mut do, t p for m is. f u Cenifican,of
°` ° `r Signature of Applicant _ Date _
owner or a! .treg ngcnr Dane All roof coverings to be Class "B" or better
a•
...OFFICE- - ... ... ... _ ... .. . ..... . . .. _..-.
O'BRI EN
PGROUP
Patrick Burke
From: Jim Rlploy�SMTP:rlpleydg®pacbell.neQ
Sent: Monday, March 08, 19992:26 AM
To: PAT BURKE
Subject: OAK VALLEY '
Pal Burke
Oak Valley
Cupertino, CA
Reference: Linear parkway planting.
Pat,
All plantings within the linear park are consistent with the landscape '
construction documents prepared by this office and reviewed by the city
on March 1998 and conform with the preliminary approval doumenls.
James A Ripley
Ripley Design Group, Inc,
•
'ARD WAY,SHITE 200,SAN MATEO,CALIFORNIA 94404.2473 TF.ITMONF f6501177.ninn r.rcn
E-;aura I :Nllyara a Planners
November IS,200D .
9GOD69.50
ChuckSchoenhargor
O'Brien Group
2001 Windward Way,Suite 200
San Ars...,CA 94404
Sul4crtt Usk r auey-n uunddacloll"'el'ivaaan
Deer(]tuck, '
On November 8,2000 we performed a field survey of the location of the foundation forms for the buildings
being ceaalru t�—an Lots 110,3-31.,3.59,3.60 and 3.61 of the OF&V altnv nmlpnt In Cupertino.
Tho rmuits of flus;zaiNay cld"y show that the location of die foundation form arc i:.::stant and in
conformaneo with the design location of the buildings,as said locations aro shown an die plans prepared by
our firm.
Thla letter is Intended to provide you with the vertSoadon of those units per our survey, If there arc any
other Question:cen.__rning:hese locadons,please do not tw,c;mtn to roll.
• Sincamiy,
r Y
o
SPUR'Mori ?OL2IC e"I SIiCOtkY A,BA50 1
Bradley A.Hilbo 1711;j 41 �� ` EV 8!31!02
Project Manager
Survey Department
OF f?tS'.;,rr
640 Arita Avenue • Rildwood City,CA 64063 a 16601482.6300 a FAX(8601482-8389
•
D
1
Oak Valley, Cupertino
1
ENGINEERING t7/ESTO INC. �-'
OBSERVATION CNART PM.O.=PatOWNat Observed O
0"VALLEY DEVELOPMENT CUPERTINO.CA. N
UNIT Lar Plan OPf1ON Fdn. 1st floor Raul Eat Sec.M.n Basic r 7 N
3 1 8D 3CARISON 425.2000 6.2}2000 09!75!2000 09!158000 t0O 10-0300 1 P/N. .:s01 d s
3 2 38 3C3CAR 4-25-2000 6.1}2000 091722000 ORMWO0D 10/238M00
3 3 2A 3CAR 4.252000 10O62Op0 8-29-2000 849-2000 1025!00" 09262000
• Ow
J 4 4A 3CAR 425-2000 5.31.2000 8-15-2000 8-75.2000 1023/2000 &25.2000 Z
3 5 6E MARMON 412-2000 5.26-2000 8-7-2000 8.7-2000 8-252000 O
3 6 4C 3CAR 412-2000 526-2000 7-31-2000 7-31-2000 OB-02.00 1 OB-02-00 P/N.O.:Br
3 7 SC 3CAR/BON 412-2000 8-16.2000 09rf920pp 09-20-00 10.7400 1 t0-16-00 1 PM.O.:N Z
m
3 B BMR 521-2000 slab 10/120000 10/12/2000 10.18-00 1 10.18-00 1VN.O.:N m
3 9 BMR p
3 10 10 �+
412-2000 7fi•2000 176010000 I 11018000 n.a. 11/010000 2
3 11 50 3CAR/BON 412.2000 5.10-2000 7-T&2000 7-26-2000 8-30-2000 8-142000 G1
3 12 49 3CAR 412-2000 570.2000 7.20.2000 7-2112000 &30-2000 7-11}2000
3 13 IC 6-27.2000 95-2000 f0OYL000 10030000 10-23-00 1 11.0&00 PM.O.:M F
3 14 3C 6-27.2000 8-5-2000 10!',102000 11/010000 11.03-0 1 11/030000 PM.O.:Or m
3 15 3C 3CARlBON 6.27-2000 B-5-2000 1103-0 11:6-7 1 11-07-00 1 11.10-00 1 PM.O.:Or ad shr -I
3 16 6C BONUS 1 8.142000 / 11-06.00 11-10-00 72-01-00 PM.O.:Idn roofn
3 17 3E 3CAR 627-2000 8-15-2000 110312000 17-14.00 1 17.11-00 7 12-04-00 1 PM.0.:Br ddo nl
3 18 BMR 1 slab 11088000 11-14-00 1 12/080000 12MI/200D P/N.O.: .nl
3 19 BMR
3 20 tB3-30-2000 OSM28000 06r9M200O OBr"2000 n/a 7-20-2000
3 21 3A 3-302000 5-10-2000 7-20.2000 7.20-2000 07-12-00 B.d-2000
3 22 fA 7.242000 8-204000 11028000 17/178000 n/a 12-14.00
3 23 aC SCAR 7-202000 8-20-2000 11-28-00 11-28-00 12-14-00 12.14-00 A
. 3 24 38 3CARAnN 7-202000 OB-29.W-/ 12011(2000 12-20- 1 12-14-00 1 01-02-01 1 P/Nfb's hr -"Mi O
3 25 68 3CARl8ON 1-202000 9-1-2000 12-20-0 12-20-00 01-08.01 1 01-11-01 PM.0.:fb 0)
3 26 2C 3CAR 7-202000 41-2000 1240-0 12-22-00 01.1"1 1 O/-16-M P/N.O.,fb
3 27 BMR 7-202000 NA 12-08-00 12.08-00 12-14-00 1 01-02-01 PlN.O.:M N
3 28 BMR 81
N
3 29 78 7-20.2000 41-2000 12438-00 124600 n.a. 07.16-01 f+
3 30 SA BONUS 114)8-00 12-11110 1 02/0681 1 0207101 11) 0281101 1 PlN.O.:Irani N
3 31 28 SCAR 11-08-00 12-71-00 7 02107101 1 S.P. V
3 32 4C 03!010001 O
3 33 6A 07-10001
3 34 7A 0380(2001
3 35 50 FumNouse 04-372001
3 36 3C CraOsman 04-312001
3 37 6E
3 38 58
3 39BMR A
'- 3 40 BMR-A
3 41 6D I lowwixv
• - 3 42 5C 1 103802001
O
N
19-Apr-2001
-n
rn
W
t
m
TABLE m
Harza Compression Test Report m
L840-T Oak Valley Residential
m
ab Date Area Represented Sample Location Sample Air Slum Compressive Stren th(psi) Day Strenn a
at 9 Cast Type Cont p(in.) ___ A e Tested da s -_-_.._-.—__ Y p• >;f
("/o) 6 7 27 27 28 28 25 56 Stren.(psi) (psi)
33 121100 Unit 3 l of 23,26 Lot 23 Concrete -- 4 - 2550 -- — 3470 3490 — — 3460 2500
�5 7 p6 I D
487 8!7!00 Unit 3 Lat 24,25 Foundation Stem Wall Concrete 4 — 1 2010 -- 2760 3350 -- 3055 3000 N
NW Comer Lot 24 Cylinder i D
Beit �� ��•�U I m
488 8RI00 Unit 3 Lot 29 Foundation Stem Walls Concrete 4 — 1860 - — 3010 3140 -- — 3075 3000 Z
B Comer Cylinder " rn
M
707 IU9100 Unit 3 Lots 30,31 Foundation footings Concrete 4 -- 2240 - — 2860 3020 — - 2940 2500 z
9 e* Lot 30 Cylinder
I. U
'108 1119100 that 3 Lots 59.60, Foundation walls Lot Concrete — 4 112 1910 — — 3010 2680 — — 2845 2500
59 Cvlinder '
1
r161 11117100 Unit 3 Loa 54,55,58 Footings at rear wall or Concrete — 4 314 — 2540 — -- 3490 3560 I -- 3525 2500
garage Lot 58 Cylinder '
t
r1 1/17/00 Unit 3 Lots 51,61 Right Side Lot Si Concrete -- 3 12 -- 2900 — -- 3610 3840 -- -- 3725 2500
Cylinder
1227 12,8!00 Unit 2 Lot 14 Well footing east wall Concrete 4 — 2270 - 3340 3360 — 3350 2500
7 Lot.14 Cylinder
f _ _ __ "
7263 11/19!00 Unit 3 Lots 52,53,56, Contractor cast Concrete -- -- 2490 -- i -3090 3410 I I 3250 2500 to
cylinders Cylinder m
r
7317 12128100 Unit 3 Lou 48,49,50 Lot#50 footings at Concrete — 4 -- t 2180 � — — 3700 3750 — 3725 3000 m
svcsi&south sides of Cylinder
M
-- 3760 3810 — — 3785 3000 ry
7318 12/28/00 Unit 3 Lots 48,49,50 See remarks - Concrete — 5 — 2420 — a
Cylinder
- - m
112101Page 6 of 7 m
• •
•
W.-ARZA Engineering Company, Inc. • Page "Of
425 Roland Way,Oakland,CA 94621 Tel: (510)568-4001 Fax:(510)568-2205 DSA File,l(:
2601 Barrington Ct.,Hayward,CA 94545 Tel:(510)636-2162 Fax:(510)670.0127 - ,
14 Spreckles Ln.,Salinas,CA 93908 Tel:(831)455-8180 Fax: (831)455-8181 . :D*SA Application#:
• FIELD REPORT - NARRATIVE
Project Name Datel i., r ,-r Job No.
PrcjefLLocation Weatther Temp.
LI V;V]S-- I/i: ✓
Range
Client-- Present t
r _
"Contractee• .... . _,.. ...._.. . .Rep
Projgt'Ma]]PY.er„', Arrival Time
l.)Task Hours 2.)Task Hours 3.)Task Hours
Code Code Code '.
The following was noted: !
{ ,1Li
L. •, ,r r c { L, I�, ^ GI r L(
/'
v It,/ (i 3 Y ;LII'/ 'L ^V•^ ''G
Lr, �:rC' �'Lrl.: :.i i(I 1 L:'(iI N!'i L-. r',:Y�,�'L! ✓VY/A—.
rr
_ � e' Vt(r(JttiLv1_i; vt
✓
• lr. .. -F �. Ii"1I I
------
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U ?(_ y�j���',,�;I,(,
u, Iv1c � UfV..k ' � r v9r,y'ct
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t,
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.�,�!' r'/ I:I. L•' UIL.-((l.- U ��t- Il _�(��i/Jt� /lL(_i`-' /�.._ i irl!,�` I. �. - ',
1
The following report orms are attached: - r I: N. V✓ L' I�,�.�- Y ✓(,P- !'l VL'(
i
All tests and inspections were performed in accordance with(check one) Bldg Dept. appr. plans and specs❑ DSA approved requirements
•a All materials inspected MEET the requiremitats of the(thea one): Bldg.Dept appr.plans and specs. F.1 DSA approved documents j
Some materials inspected DO NOT MEET ttl�!of thd•(�hef{dotral:- v I�` ❑ Bldg.Dept appr.plans and specs. DSA approved documents
Drawings: .. Dated:.
Non-compliance and Discrepancies reported to: Report copy left at thejobsite with:
_77• Insp.Natrirty< V r, j r.. „ Signature: . --- """ Certification#:
FOR DSA PROJECTS: COPIES TO BE MAILED TO: (•.. Copy Left Onsite w/Project Inspector JOR's Name):
The School Dist and Rei r Structural Eng.and Rep:
Architect and Re : DSA and Re
�\ WStandarWSpecial ImpectioMQAPROCRAWaster Field ImWtion Form TieldReponNamtive6-14.00(form for printers.dot Day]
CITY OF CUPERTINO
BUILDING 1�IVIIION 7' 1;r11T ;ICONTR`?iICsJ OR INFQMMA1II,
9U11,T)INO nnusess r¢uMl I ND,
OWNER SNAd,x" 1 ,61 )01H OfiN. III y� '� Arrlxnl(i1R1iD13'''I1r�re 1:, `
_—
JUNE: I I Al i 11 l' — 0 / S SANLARY,_@O, (ONTRUI.NO.
ARCIII'1'F.CTIPN�'1 1) PHONE ft - ULIILUIN01'pRMll'INP��
��ff"".�� _ IfLUG tiLLC'I' PLI1M8 MITA
0
0m>0�w isI*Na13?02Pt4 iYL .,' I
'JC-
TO ARRANGE INSPECTION
'
TOAtRANGFINSPECPIONCTIDATEINI ,Ilit DLKCUP'll( N
CALL 77R 3228 MONDAY-FRIDAY 24 HOURS IjI 5IIfIzN I'IAIr_
HF.FORERH UIRED INSPEC'[ION..JOB ADDRESS
o m$ FOUNDATION/PIERS/H.D.S. U V� Q I_7 SFDW1. ❑ KI'I"CHIiN ItEMUUIiL
AND PERMIT#ARE NEEDED WHEN PHONING.
CI ADDITION L STRUCTURAL RE-NPI':
PIPE
OPER GROUND I.:I MUCI'I-LINT"I' ❑S'I'NUCTIIItAI.
xqad� PAU/.S E'I'13ACK-CFIZ'f RESIDENTIAL COMMERCIAL_ __UI'HHRMODIFICATION
0 r GARAG'SI ABS/I1W.GUNI II -- I'.:I IN'I'OlOOK IJ CHIMNEY 14F,PAIR
.. .. iltV(dI1g7U�17i2IXA IM I1R0VHMENT I.1 SWIMMING POOLS
POUR NO CONGRETH'UN'�IL'XABOVE HA.'tBL/I SIGNED:'i
f� I BA'1'II II MODFIAREIAIRII DEMOLITION
❑ YES -
�oo UNDERGROUND/SLAB 11y,: dcOh,, lams CII,,nml„��.sp-
PLUMRIN('� - -- GHHER
z x o ELECTRICAL - C] NO Naial _- 1 C.13 O h
u 5�':IDO NOT POUREf 0012 UNTCh`ABOVF.RA$IBEB> NEDi'i+!/,: I YIS'fl�'C_L2QOP(�IVllltly(: �IM17-PFi C.l2I
PLUMBING krVA SW Q!7I'.I NEW BI DC/AUDITION 1.1 DHMOI JI ION
MECHANICAL (y Nun111r1 f uxIIUnE coverinha CI IENANI11 FOODSERVICE
11 MPRo VHML'N'I'
ELECTRICAL 'I'n he mnmvcd IL hu msnlncd CI OTHER —_-
FRAMING VENT'S
INSULA'T'ION
TYPE OP ROOF COVERING
I�PLAC6 N6AgBFW04IlN)PII.aADaV6- A'SI ELN SI(stSl Doh -t
ROOF SHEAT I UDIAPH RAM -�� L'XI&IJN�a'L I'Rsl)4)S
PLUMBING Zia CI B 11-1;1,lhmf CI Buill-UplLutf
'PUBS&SI IOW EI (I A,pl,AR ShlugWn CI A.vphah Shingle.,
MECHANICAL3 rf.• d ❑ WoodShak, CI WoodShnknv
ELECTRICAL/PDOI,BOND CI Woad.Sh'mglcv I.1 Wood Shingle,
FRAMING/STAIRS/E.EGRFS..S f] Olhe,(Spedfy)____,____ I:1 011ar(Spceil'y)__
INSULAIION/VENTILATION 14vvIAc LC.B.(1.Rcpoil No,
COVE RLNO,WORKUNTIUABOV("HASIBEENj 1UNNUVL;41+';§% tl`o I'rovlde Mfg, nmlliion Spec:_
!XTEMAL SHEAR/HOLD DOWN
INTERIOR SHEAR/1101_1)DOWN J / -- -- ----------- ---
1NSPECIIDN SPECIAL. INSPECTION REQUIRED II DA:fF. INSINS['_,SHI_IIl'ROCK/SFICETROCK SHEAR
_EXTERIOR LATA/W-SCREED
SHOWER LAI
?ANO TAPE dR,tRENSTER UNTIU'ARJVEfHAS,BFEIN St I)1;7;Kh f 1
SEWERPAINIHIR e
TEMPORARY APPROVALS -- ”- ---- —"---"
OCCUPANCY
{!;P1NA1 s�l�sai`�"<a I)} •3i-�.:1.. '' i'6'�_,�(.`i'.��I X, , .4r i;�_:n ---- — - --- --- ---
Z PLANNING 777-3308 _
O O GAS'TLSrGRADE(P.W,7773354)
6^O/ -- --- -- -- --
�a
Wu FIRE ---— — -- -----
HANDICAP — -- ----- - ----
V O ELECTRICAL
OU PLLI M B I NG - --- --------
W MECHANICAL
rHi rn ENERGY
V ,moi. VISUAL FINAL ONLY
BUILDING ------- -------
BUILDINC
�CCUPANCYOFBOIEDfNCISINOTPERM".ED
UNTILBUILDINp FIYALISsS{ONFDBI BLIIEUINC
"t°dsecc'FpR. •'? `. - , -�� +'' CC R'I'1 h'ICATE OP OCCUPAN '
I
PRE-INSPECTION PLYWOOD: - IN-PROGI L..SS
INSR_-------- DATEINSP. __._._ DA I'r. IN.S P. DATE_
_
—.__._....._._.____ -..
TE,A R OFF INS PFCTION: BA'TTE'NS: _ FINAL:
INSP. DAT6 ._. INSP. UKPE_ INSP. DA'I'14___ _
NOTE: OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR INSPECTION
APPLICANT'S POSTING COPY
.INSTALLATION CERTIFICATE (page 1 of 4) — CF-6R
—Trto Address
ermd um er
An installation certificate is requited to be posted at the building site or made available for all appropriate inspections. (The
information provided on this form is required;however,use of this form to provide the information is optional.) After
completion of final inspection,a copy must be provided to the building department(upon request)and the building owner at
occupancy, per Section 10-103(b).
HVAC SYSTEMS•
Heating Equipment
Equip. 9 o Efficiency Duct Duct or Healing Healing
Type(pkg. CEC Certified Mfr Name Identical (AFUE,etc.)' Location Piping Load Capacity
hcat um and Model umbo S stems 2CF-IRvaluc atticale. R-value Btuthr Bluthr
7 80 _
20 vAuacrA - �_ . Ao ,o grrrC
Cooling Equipment
Equip. CEC Certified Compressor q of Efficiency Duct Cooling Cooling
Type(pkg. Unit Mfr Name and Identical (SEER,etc.)' Location Duct Load Capacity
hcal um Modd Number S 5tcros CF•IRvalue attic ale. R-value Blulhr (Btu/hr)
26', 70 0
1. >reads greater Phan or equal to.
I, the undersigned,verify that equipment listed above is: I) is the actual equipment installed,2) equivalent to or more
effcient than that specified in the certificate of compliance (Form CF-IR) submitted for compliance with the Energy
Efficiency Standards for residential buildings, and 3)equipment that meets or exceeds the appropriate requirements for
• manufactured devices (from the Appliance Efficiency Regulations or Part.6),where applicable.
Signature,Date Installing Subcontractor(Co.Name)
OR General Contractor(Co.Name)OR Owner
WATER HEATING SYSTEMS:
Distribution If Recir- Al of Rated= Tank Effi- External
Heater CEC Certified Mfr Type(Std, culation, Identical Input(kW Volume ciencys Standby' Insulation
Type Name&Model Number Point-of-Use) Control Type Systems or Blulhr) (gailons) (EF,RE) Loss(%) R-value
2 For small gas storage(rated input of less than or equal to 75,000 Btu/hr),electric resistance and heat pump water heaters,list Energy Factor.
For large gas storage water heaters(rated input of greater than 75,000 BwAr),list Recovery Efficiency,Standby Loss and Rated Input.
For Instantaneous gas water heaters,list Recovery Efficiency and Rated Input.
Faucets &Shower Heads:
All faucets and showerheads installed are certified to the Commission,pursuant to Title 24,Part 6,Subchapter 2,Section
1,the undersigned, verify that equipment listed above my signature: 1) is the actual equipment installed;2) is equivalent
to or more efficient than that specified in the certificate of compliance (Farm CF-IR) submitted for compliance with the
Energy Efficiency Standards for residential buildings;and 3)the equipment meets or exceeds the appropriate requirements
for manufactured devices(from the Appliance Eficiency Regulations or Part 6),where applicable.
• Signature, Date Installing Subcontractor(Co.Name)OR
General Contractor(Co.Name) OR Owner
COPY TO: Building Department
Building Owner at Occupancy
A o,,:oad Marsh 1. 1996
O'Brien Group HVAC Commision Check List
HVAC Contractor r`i rolect a—\V- Release 4 Phase Lo& Date
Street Address - city State Zip Code
Date when notice to commision system was given. I_I_
.- - - Resched. Date
Rem check Yes No If no,list corrective action and reschedule date Date Complete -
1 Gas meter is installed. / / ! /
2 Power/electrical supply is connected.
- 3 Breakers at sub panel are on. !
4 Bus fuses are installed at disconnect
• 5 Disconnect is switched on.
6 FAU swdeh is on. -
7 Gas supply iso en at whip. ! 7 1 7
ti ZTE system is wired in. ! / ! / -
9 FAU housing is dean and damage free. -
10 Condensate lines are set with positive slope.
11 Condensate lines are set in specd sequence. K / ! /
12 Condensate pan is dean and damage free. ! f
13 Refrigerant lines are seated at FAU /
14 Duds are sealed and unrestricted.
15 T-stat connections made at FAU.
16 FAU housing panels are secure. /
17 Condensor and cooling fins damage free-
18 Condensor to pad straps rolled in for safety. - / / ! ! -
19 Condensor penetrabons into wall are sealed- /
20 Dis-similar metal contact se rated at Condensor. YL !
21 T-stat connections made at Condensor. K - !
22 Condensor and pad are level. ! -
23 System filled with refrigerant ! !
• 24 Refrigerant lines and caps are leak free.
25 Condensor housing panels are secure. j
26 Condensor and FAU connected to T-stat - / /
7 Furnace and AIC run and tested - X / / / /
28 Ambient temperature measured at random areas. -
29 Registers balanced through out house. - - ! / / !
30 Registers are damage free.
31 R isters are free of insulation/debris" -
32 R isters are set level to nearest wall.
33 Air filter is installed per option.
HVAC Technician signature &LZ0 Dad I_I '
Both signatures required when system has been fully commissioned. : .
O'Brien Group Mgr.signature - Date!/_ Tum in to quality control prior to quality assurance inspection" -
Ct7AlI9f insulation Contractore. Inc. INSULATION CERTIFICATION
1088 N. 11th St. • San Jose, CA 85112
This is to certify that Insulation has been installed in conformance with the current energy regulations,
• Californla Administrative Code, Title 24, State of California, the building located at:
SITE ADDRESS:
FLOORS:
Manulacturer OWENa cOANIN . Thickness/type ,a j 175 R-Value
EXTERIOR WALLS:
Manufacturer._OWENS COANING TNckness/Type -,1.'=J R-Value
CEILINGS:
BATTS: Manufacturer OWENSS rORNING Thlcknessffype /'{}, R-Value
BLOWN: Manufacturer OWENNS r-_OpNINa ThlcknesslType ll I R-Value
Welght/Bag - _ 35 Sq. Ft. Covered_ 111.33
4 # Bags used
AIR INFILTRATION SEALANT INSTALLED: Y& , NO E]
• GENERAL CONTRACTOR `"" •_c_ .,;` j4:�, •__.I•.: 1-15\s,_) LICENSE #
S
BY: TITI- 'I DATE
COAST INSULATION CONTRtCTORS, INC.
.
. CPSE
BY: �
TITLE: t _
1 DATE:
--..•.'.i) oar'v: ,-a k+rh?-J4sulr.iF.. ji 1 _.:- .. -; . . -_ -
67r11'5_'A1 r Mz&?4/f y 9-v
Commercial Roof Management San Jose, Inc.
Residential Roof System Application Inspection Report
In�s�pection Date:
'/ /
Project:Me
Address�s: 14OZO 7-#4 CT
City:` 4/b?T, O State: &,
Client: 711,6 6'SRliW 6Rf/3
Contact:
Roofing Contractor: ��T14) 0147- Raote W4
CRM Inspector: C✓fiP15TOFF
Lot Number Phase
TYPE OF INSPECTION: FELT FINAL
TYPE OF ROOF: ASPHALT SHINGLE k--_ TILE
• UNDERLAYMENT: ROOFING MANUFACTURER & TYPE:
SHEET METAL FLASHING: GUTTERS:
SKYLIGHTS: ATTACHMENT:
VALLEYS: RIDGES: EAVES: VENTS & PIPES:
-------------------------------------------------------------
Comments/Observations:
i, FTAIAL OK
INSPECTORS SIGNATURE:
• REF:rnmsysam .
yKevin Visser dba - No
A_AAAAA Leak Finders & Repair lob Work Order/Invoice
P.O. Box 3091 Please Pay From This Invoice On Presentation DATE _
Santa Clara,CA 95055-3091 ;:HCl f
Leaks Located Electronically In: Pools,Spas, NECHANIG HELPER TI
STARNG DATE
Buildings&Underground Pipes,All Types of cUSTONER'S ORDER NO. PHONE OF PARTY 61LLEO
Plumbing Repairs Made;
Contractors Lic.#699113 81UL To ORDER TAKEN av -
;(209)941-0440 (510) 839-5898 (707) 552-1120
'(408) 288-6932 (650) 366-0111 (916) 331-9999 ADDRESS
- %(415) 979-9509 (707) 527-7035 (925) 939-2359F 5 " WORK DONE ON
All Other Areas Fax cm STATE - aP cooE CONTRACT BASIS
1-800-573-1234 (888) 296-4882 - -
' JOB NAME AGGRESS
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= X
-- - - NB:TOTAL AMOUNT DUE IS PAYABLE ON PRESENTATION OF INVOICE. CITY - STATE aP Joe PHONE
✓i a C � 'Y_;,L. -"L4- REFERRED BY: ;
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'-' � c a a ��a � N3,NO OTHER LEAKS WERE APPARENT AS AT TIME OF TEST
PHONE: TOTALS
ORDERED BY:
THE OWNER OR TENANT HAS THE RIGHT TO REQUIRE THE CONTRACTOR TO HAVE A PERFORMANCE AND PAYMENT BOND.
I FIND THE WORK SATISFACTORY AND THE CHARGES AS AGREED, AND AGREE TO PAY THE TOTAL AMOUNT DUE ON PRESENTATION OF
�^ THIS INVOICE WITHOUT ANY DEDUCTION WHATSOEVER. I FURTHER AGREE TO PAY REASONABLE CHARGES FOR COLLECTION, INCLUDING
ATTORNEYS FEES, IN THE EVENT OF MY DEFAULT, AS WELL AS PENALTY INTEREST AS ALLOWED BY LAW.
E518NED BY: DATE
COMPLETED
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