S 2847 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING-ELECTRICAL PERM
BUILDING DIVISION APPLICATION/PERMIT Plumama-MecxprvlcAL C
, + .AEA�E�
PLUMBING
'I ENTIFICATI N.:t
BDILDINGAR�: J
SANITARY NO. APPLICATION SUBMITTAL DATE
OWNER'SN MB; PH NE: CONTRACTOR'S NAME: LIC NO:
NIC CONTROLM
�IMFpRCH EER: PC NO: ADDRESS: .❑
CONTACT. PHONE: r;.I.`f„ i,''BUILOWG'PERMITINFO,' i
❑ Consultant Fees Paid by Applicant(Initial) 'BLDDGG ELECCTT PLUMB MI EACH
I. NSE CONT CfORS DECLARATION Qq'y t ELECTRICS PERMITr� "r ;' tit '.FEE I, .
rn 04Z ARCHITECT underprovisions ofChapter
tie(my
It g JOB DESCRIPTION
I hereby offinn that I a licensed
g0.'Z with ]II00)ofD vtvt iof tM1e Bus Ess andP f.wio score and mylice es N
WOO wi PERMIT ISSUANCE - r
F N full form and i3 WL ❑KITCHEN REMODEL
C License Cl Lic.N
-II .APPLIANCES-RESIDENTIAL El ADDITION [I PLUMBING RE-PIPE '"
F Z W Date Contranor
'S DECI.A ❑MULTI-UNIT El STRUCTURAL
yZ I understand my plans shall be used as public records PANELS MODIFICATION
.ZO.Z-rO _ UP 9'0200 AMPS INTERIOR ❑CHIMNEY REPAIR
F
car l"' Licensed Professional 201-1000AMPS IMPROVEMENT SWIMMING POOLS
OWNER-BUILDER DECLARATION OVER 1000 AMPS El BATH RF,MODEWRePAIR El DEMOLITION
C W d I hereby afilrm that I am exempt from the Contractor's License Law for the
O 0.V following reason.(Section 903I.S,Bandanas and Professions Cade:Any city or county SIGNS ELECTRICAL, ❑OTHER
w 3 2 y which ne,fres a permit to unarmed,alter,improve,demolish,or repair any structure
pnor o itsissuance,alsomqulres the applicant for such permit to fi le it signed stammer[ SPECIAL CIRCUIT/MISC. _
�aily [bat be is licensedpursuantmme,m,piomsof the Contractor's License Law(Chapter 9
W�,qp (commencing with Sectinn"]000)of Division3af the Business raid Professions Code)nr TEMP,METER OR POLE INST. COMMERCIAL:
that he is exempt therefrom,and the basis for the alleged exemption.Any violation of ❑NEW BLDG/ADDITION ❑DEMOLITION
Sermon 9031,5 by any applicant for a permit subjects the applicant no a civil penalty of POWER DEVICES [I MEANT [I FOOD SERVICE
yt more than live hundred dollars($500). IMPROVEMENT
�d0 ❑L,as owner of the properly,or my employees with wages as their sole compensation, SWIMMING POOL ELECTRIC
F will do thewmk,and the structure isnot intended m0e
ored for sale(Sec.9044.Business COMER
P I
and Professions Code:The Contractors Lice.,.Law does rat apply to as ownef of OUTLETS CHES-FIXTURES
G property who builds or improves(herwn,and who does such work himself of through
his own employees,provided that such improvements are not intended or offered for NEW 1 ELECTR SQ IT.sale.If.however,the building or improvement is.sold within one yearofcompletion,the SQ.PT FLOOR AREA $/SQ.FE
con l lder ill have the burden of proving that h did t build p for',
f�
Fast, f ) T2 lr SV--r
El 1 f theproperty em exclusively contracting with licensed c i t t T l
ort t the project(Sec 901 Business and Professions Code.)Th Committees L" , ! ' I:} V", � �'�
cen.a La d t pplyman owner ofp perry whobuildsp there n and Q'jY;?. ' - liUMBING ERNA rj " FE jisl}
who cottraUs for such pmjeces with a cremations)licensed pursuant to the Conoacto(s 1 -"SI .*=ix . w ) . it
License Law, PERMIT IS C
❑I am exempt under Sec. ,B&P C for reason
ALTER-DRO T-WA -R
Owner Dam (EA) - VALUATION
WORKERS COMPENSATION DECLARATION BACK FLOW PR ,CT. ICE 1
Iherehy affirmm underander penalty of pejury one of the following declarations: e- !l V
E)I have and will maintain a Certificate of Consent to aelf-irware for Worker's Compen- DRAINS-FLOOR,ROO,A ,COND. STORIES TYPE CONSTRUCTION
smion,as provided for by Section 3700 of the Labor Code,for the performance ief the
work for which this Permit is x,,rad. FIXTURES-PER TRAP .. 1
❑ ^
I have and will maintain Worker's Cona,deadan Insurance,as required by Section
3900 nfill Lb or Code,for the rrormunca o[tM1e wed for which this permit is issued. GAS-EA.SYSTEM-I INC.40UTLETS OCC.GROUP APN
My ce 'erdolicyro GAS-EA.SYS'fEM-OVER4(EA)
Grier: O �4
CERTIPIC OP1 '1PROM WORKERS'
COMPENSATION INSURANCE GREASElINUUSTRL WASTE INTERCEPTOR . DIV9510NP' va., i
(This etc' nn t GeomplGed,(ff�e eft f r ayC/1 sy�rs f$I W) GREASE TRAP q
orlessJ it, (V e/ /�s PLANCHECK PP.E `-ZF
icenifyt ati he pe rte (the work forty ¢ this btsi sued,lshallSEWER-SANITARY-STORM F.A.200 FT.
ENERGY FEF.
not employ any person in any manner so i s m become subject the Workers'Compen- 2- Id
sation Laws of California.Date WATER HEATER WNF.NTIELECTR
0 Applicant - GRADING FEE \
ar
NOTICE TO APPLICANT:IL after making this Certificate of:Exemption,you should WATER SYSTEMrFREATING SOILS FEE
become subject to the Workers Compensation provisions of the Labor Code,you must
W, forthwith comply with such provisions or this permit shall he deemed revoked. WATER SERVICE
Uz CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PLMB. SQ.FL PAID pate Receipt#
n I hereby afford that there is a eradication lendingvgency for the pminumande of
G the workfor which thperms is issued(Sec,3097 C' C)
LL t-'
Lend N � T3
TOTAL:
Lend IAdd U q2 building construction, ndh' by th p ' I ^ pr - . i ! BUILD
county that l have d this application and state that theinformation s
correct i ogre t ply m all city and countyordinances n sl tela I t g t QTsM=CHANICALPERM' i
lel mmi,equi enter apthe E
= -
P
nSe15
amer menioed property f inspection p p . PERMIT ISSUANCE ,q�
(We)agree to save, ndemuify and keep hamness the City of Cupertino against ELL iyI EE �^
Iiabilities,judgments,cos,tnd expenses wbichmny in any way aceraeagaiwd,.ia City ALTER OR ADD'TOMECIT
incense enc
eofthegramagoRhls per nil PLUMBI FEE
AP TUNDERSTANDS AN ILL COMPLY WITH ALL N- INT AIR HANDLING UNIT(TO IO,IN)fICFM)5 URC: EGULATION$� " MECHANICAL EE
AIR HANDLING ON["r(OVER 10,000 CFM) CONSTRUCTION TAX
St ore of Applicanl/Cnn Detc EXHAUST HOOD(W/DUCT) HOUSING MITIGATION FEE
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or future building occupant store or handle hazimpus material HEATING UNIT(TO 1116,000 BTU)
as defined by the Cupertino Municipal Cale,Chapter 9.12,and the Health end Safety
Code,Section 25532(x)? 1' HEATING UNH(OVER 100,00(1 BTU)
Elite, - VENTILATION FAN(SINGLE RESID) PAID
Data Receipt N
Will the applicant or future building occupant use equipment or devices which
emit hxzanlous aircontamlmams us darned M1y the Bay Amo Air Quality Management BOILER-COMP UHP OR 100,000 BTU) p
0 DistrietyQj BOILER-COMP(OVER 100,000 BTU)
DWI 'I &_
1 mix ad thetwzard Se,[anterial,requiremems under Chapter 6,95 of the Cali- AIR CONDITIONER ISSUANCE DATE
fornix h Sareay CodeSections 25585,25533 and 25534.1 understood th t if the NEW RESIDENTIAL MECIL SQ.FP.
Fo3m-ni
tcuvea m Nat it is my tespovsibilityron fyt acupem
ofb w riot to issunnw oft Cenif c '
0
O ate ISSUED BY:
OFFICE
RUG. 5.1359 6:52ri1 BRAN KANGri3 FOLLK N0.093 P.22
.Brian Kangas fount
Engineers • surveyors • Planners 0
• August 9, 1999
960069.30
Chuck Schoenbetyer
O'Brien Group.
2001 W!ndward Way,Suite 200
Sas Masao,CA 94404
Sabjtett Oak Valley—Fbendatan Verification
Dear Chuck,
On August 3, 1999 We Performed er field survey of the imdon of the foundation fortes for the buildings
befog constructed on 1pn;5.21 1•21 garage,3-22,and,5.2'3pthe Oak Valley project in Cupertino.
The results of that survey elaerly show that the location of the foundation forms aro consistent end in
confannance with the design location of the buildings,as said locations are shown on this plans prepared by
our firm.
This latter is intended to provide you with the verlficatlon of those units par our survey. If there aro any
otxr questions coneeming that locstion,pions do not hesitate to call.
Sincerely, �0 LAND A,U�
ro `o
- BgADI.tYa e1laD �
BRIAN KANOAS FOULK x M/02
• Bradley A. anion P.L.S.6141 1 Mo.0141 �t
Project
Department
Manager �r`COF C
SuALtf�Q�
649 Pts Avenue • Iledwood Chy,CA 84083 • 166o1482S3oo . FAK IBg31482.8388
•
ENGINEERING WEST INC.
OBSERVATION CHART
OAK VALLEY DEVELOPMENT CUPERTINO,CA. PAGE 2 OF 4
4.21-2D00 at eoa # ea. .n 05a
of ID I N dn. —04114/99 /
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5 8 2A 10101199
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5 8 20 3 04119199 06111199 09108199 09/08/99 9 1
3D 9 8 9 9/0319 �$/03M 098 /9D
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5 10 BB 2/BONUS C4It9199 0512619910828199 0198
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5 12 110 3IBONUS 04101199 0521199 0823199 011!13199 0 3/99
5 13 3C 3/80N 5 04101199 0627199 008118/99 08; 198 0
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5 29 10 2 05.10.99 07109188 1011&99
5 30 BM
5 31 BM 10.27.90
5 3 0528199 07!28199 10'22-99 10.22.99 11 -80
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5 33 2A 3 05107199 07112!99 1102199 1x29_99 1 •199
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•(1)LOT B PLAN 2A 6 LOT 7 PLAN 5C (4)A.B.'s e1 Damn front
•DID NOT OBSERVE PIERS. (5)ahrnney5
••
•(2)DBL SIDED SHEAR WALLS
(S)FLR.NAILING
O BPJ EN
/GROUP.
B ULka
Jim Rlpl0y(SMTPlr(pl0ydg0pacWII,n0I)
Monday, March 06, 1999 2;26 AM
PAT BURKE
OAK VALLEY
CA.
Linear parkway planllnp.
S within 1110 Ilnoar park era conalalonl with Iho londsoapo '
n documents prepared by Ihls oh1ce and rovlowed by the city
998 and conform wllh the prollminery approval doumenls,
ipley
;n Group, Inc,
SIIITH 2O0.SAN MATEO, NLIPOHNIA 0404,2475 TURPIIONN(64(l)377.0300 FACSIMILE(640)349.2441
p.vlul March 1, 1996
1'". IIIIJ V.11V"C_" laif
CITY OF CUPERTINO /1 '� PERM •• I
BUILDING DIVISION RUIEDINO PROJECTIDENTIFICATIO. Am
FNILDING D R SANITARY NO. APPLICATION SUBMI'1.1'AL
J. . -7_/� v
OWNE 'S N 1� PH E: CONTRACTOR'S NAME: LIC NO'.
NIC CONTROLN
CHIT EER: JICNOI ADDRESS: ❑
BUILDING PERMIT INFO
INSPECTIONS DATE.,. INSPEC. ❑ Consulnlnt Fees Paid by Applicant(Initial) BLDG ELECT PLUMB MECH
2" Er Q_
• FOUNDATION/PIERS/H.D.S. INSPECTION RECORD JOB DESCRIPTION
UFER GROUND NOTE: ALL GRADING AND DRAINAGE
PAD/SETBACK-CERT SHALL BE INSTALLED TO COMPLY WITH WL [I KITCHEN REMO[
THE APPROVED PLANS AND CITY OF ❑ADDITION ❑PLUM BING RE-PI
GARAGE SLABS/PREGUNITE CUPERTINO STANDARDS. ❑MULTI-UNIT CSTRUCTURAL
MODIFICATION
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED TO ARRANGE INSPECTION C INTERIOR ❑CHIMNEY REPAI'.
UNDERGROUND/SLAB CALL AFTERNOONS (1:00 PM - 4:30 PM) IMPROVEMENT CDEMOLINGPOOI
❑BATH REMODEL/REPAIR ❑DEMOLITION
PLUMBING 777-3228 MONDAY TO FRIDAY 24 HOURS BE- ❑OTHER,
ELECTRICAL FORE REQUIRED INSPECTION. JOB ADDRESS
AND PERMIT#ARE NEEDED WHEN PHONING.
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED COMMERCIAL
PLUMBING ATTENTION CONTRACTORS: CNEWBLDG/ADDITION ❑DEMOLITION
NO PERSON(S)SHALL PERFORM WORK ON ❑TENANT ❑FOOD SERVICE
MECHANICALTHIS JOB SITE WITHOUT BEING IN COM- IMPROVEMENT
ELECTRICAL PLIANCE WITH WORKERS'COMPENSATION ❑OTHER
FRAMING VENTS INSURANCE REQUIREMENTS.
INSULATION INSPECTION SPECIAL INSPECTION REQUIRED ❑ DATE IN!
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROOF SHEATH/DIAPHRAM CO
PLUMBING &,too 15L
TUBS&SHOWER PAN ein to w 07
MECHANICAL V�92 all
ELECTRICALIPOOL BOND
FRAMING/STAIRS/E.EGRESS _
INSULATIONNENTILATION ` CW
• COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
EXTERIAL SHEARMOLD DOWN ',4zJ
INTERIOR SHEAR/HOLD DOW
SHEETWROCK/SHEETROCK SHEAJJ A) Oil
EXTERIOR LATH/W-SCREED
SHOWER LATH X.;E '
NO TAPE OR PLASTER UNTIL ABOVE HAS SWIG
SCRATCH COAT
SEWERIWATER
TEMPORARY APPROVALS
OCCUPANCY
ELECTRICAL
GAS
>idi� ,W ;xit
GAS TEST
GRADE
FIRE
HANDICAP
ELECTRICAL
PLUMBING
MECHANICAL
ENERGY CERTIFICATE OF OCCUPANC
VISUAL FINAL ONLY
BUILDING IMPORTANT: ISSUANCE DATE
.00CUPANCY„OF,:BUI0ING§ ePERMITTED 1"'. PLEASE READ REVERSE SIDE BEFORE 7"' i % 7
UNTIL`BUILDING,FINAL IS SIGNED BY"BUILDING' CALLING FOR FINAL INSPECTION!!
ISSUED BY: "7
nor' IrA MTC Pr1CTINI�rtOPV
�---�
• Y: I DATE JOB NO.
Consulting Engineers and Scientists
PROJECT
425 ROLAND WAY
OAKLAND, CA.94621 LOCATION
(510) 568-4001 „
CONTRACT R OWNER
TO
Y 9
WEATHER 1 ^ TEMP. r•l�^at AM
Da a I—!� 1 '1r .. IIG11\-�1 . ':f.(G,I ,. -, *at
PM
PRESENT AT SITE
Hours Charged To Project Nuclear Density Tests /r^7� ^, . - _ •�,� - I i �, i'l l
Field Task Number • C-r 1• Concrete Cylinders
r r
THE FOLLOWING WAS NOTED:
� ct
1 171 . � V , L'lr� l rif r 1 "/ il 1rrr 1111 Ix ` '1F CI f jr—
1 1 0l O I I
i rh r oC' l
r^ 11 I ( 'r
I ,r
rlri
lee-, r 1L.Cif.
.
r 1 '11111 ,;fir 1 r'�L _,,; l�lf •r ^� I I-i �r r �n•, 1 ( �T I-C
1
�ES TO
FIELD 5 F7cRU
SIGNED �" � 4
AGENCY
.INSTALLATION CERTIFICATE (page I of 4) — CF-6R
Site Address Permit imumoer
n installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The
formation 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. aof Efficiency DuctOuct or Heating Heating
Type(pkg. CEC Certified Mfr Name Identical (AFUE,etc.)' Location Piping Load Capacity
heat um and Model yumber Systems 2CF-IR value attic etc. R-valva tu/in) (Btu/hr
l ST. Y
2ND B �_ A tC
Cooling Equipment
Equip. CEC Certified Compressor 0 of Efficiency Duct Cooling Cooling
Type(pit& Unit Mfr Name and Identical (SEER,etc.)t Location Duct Load Capacity
heat um Model Number Systems KF.lRvalucl fattfetc.) R-value tu/hr twW
O —.700
All! .�,,, eo
1. >_reads greater than or equal to.
1, the undersigned,verify that equipment listed above is: 1) is the actual equipment installed,2)equivalent to or more
efficient 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,
/
,�i����r5�%/ ,,.r,./� ,'-.Z�-� ��S6�f�.GII� Hr�PIYIfJ�.il•/�lc��
• -Signaturee,Date Installing Subcontractor(Co.Name)
OR General Contractor(Co.Name)OR Owner
WATER HEATING SYSTEMS:
Distribution IfReeir- 0 o Ratede Tank EIB- External
Heater CEC Certified Mfr Type(Sid, Million, Identical Input(kW Volume etencys Standbys Insulation ..
Type Name&Model Number Poinl-of--Use) Control Type Systems or Btu/hr) (gallons) (EF,RE) Loss(%) R-value
r.
2 For small gas storage(rated Input of less than or equal to 75,000 Eustis),electric reststanee and heat pump water heaters,list Energy Factor.
For large gas storage water beaten(rated input of greater than 75,000 Bhilhr),list Recovery Efficiency,Standby Loss and Rated Input '
For Instantaneous gas water heaters,list Recovery EfRelency 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
111.
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 (Form CF-1R)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 Efficiency Regulations or Part 6),where applicable. ;
Signature, Uate Installing Subcontractor(Co.Name)OR
General Contractor(Co.Name)OR Owner
�OPY TO: Building Department
Building Owner at Occupancy
. C
COAST Insulation Contractors, Inc. INSULATION CERTIFICATION
• 1086 N. lith St. • San Jose, CA 95112
This is to certify that insulation has been installed in conformance with the current energy regulations,
California Administrative Code, Title 24, State of California, the building located at:
SITE ADDRESS: S �Il Oa �.lall�-u_ ymPr-�n r4 6
FLOORS: �J
Manufacturer OWENS CORNING/MV Thickness/Type R-Value
EXTERIOR WALLS:
Manufacturer OWENS CORNING/MVThickness/Type R-Value
CEILINGS:
BATTS: Manufacturer OWENS CORNING/MV Thickness/Type Lk_ R-Value. l
BLOWN: Manufacturer OWENSI-QORNING Thickness/Type R-Value
Weight/Sag 35 Sq. Ft. Covered # Bags Used
AIR INFILTRATION SEALANT INSTALLED: YES NO F-1GENERAL CONTRACTOR`�11�C . (y�)Sr l6I C*dfA/ LICENSE #
BY: TITLE: DATE
•
COASt INSULATION ACTORS, INC. LICENSE # 465440 C-2
BY: DATE: �—
•
[ENGE0 GEOTECI-INICAL
AND ENVIRONMENTAL CONSULTANTS
I N C O R P O R A T E D MATERIALS TESTING
•
Project No.
4136.4.050.01
May 22, 2000
Mr.Pat Burke
The O'Brien Group
2001 Winward Way, Suite 206
San Mateo, CA 94404-2473
Subject: Tract-Oak Valley
Lot 5-18,Permit Number S2844
10908 Sycamore Drive .
Lot 5-21,Permit Number S2847
23645 Oak Valley Road
Lot 4-33,Permit Number S2840
23515 Oak Valley Road
Cupertino, California
• SEISMIC FRAME INSPECTIONS
Dear Mr.Burke:
With your authorization,ENGEO Incorporated performed special inspections and ultra-sonic testing
related to the seismic frame installation at the subject properties located in the Oak Valley
subdivision in Cupertino, California. This report is submitted in accordance with Chapter 17 of the
Uniform Building Code.
Observation and testing services were provided using the approved plans for the following:
• Field welding of the seismic frame moment connections.
Feld welding of the framing straps.
• Ultra-sonic testing.
To the best of our knowledge and based on our observations, the work requiring special inspection
and testing is in conformance with the approved plans, field recommendations of the Structural
Engineer, and the applicable workmanship provisions of the Uniform Building Code.
2401 Crow Canyon Road •Suite 200•San Ramon,CA 94583.1545 • (925)838-1600 •Fax(925)838-7425
www.engeo.com • E-mail:engstaffna enReo.com
The O'Brien Group 4136.4.050.01
Tract-Oak Valley May 22,2000
SEISMIC FRAME INSPECTIONS Page 2
• We make no representation as to the accuracy of dimensions, calculations or any portion of the
design for this project.
If you have any question or comment,please do not hesitate to contact our office.
Very truly yours,
ENGEO INCORPORATED Reviewed by:
Robert X.Jo a Son Dan Haynosch V
Q pFESSI
rxj/ce:seismic 5. HqY .
cc: 1 –City of Cupertino
I –The O'Brien Group,Mr.Gerry Ploof Na MMMaI
bq� '1.11-0
840
OF� � %.
•
/