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S 2742 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY CITY OF CUPERTINO BUILDING-EI.ECTRI CAL PERMIT NO. BUILDING DIVISION APPLICATION/PERMIT PLUhIRINGMI?CILANICAI. /� IIUIIAING 1'RfUF.CT 111ENTIFIL`Al'II N L� BUILDING ADDRESS'. ` I SANITARY NO. APPLICATION SUBM/TIAL DATE OWNER:` 11i� PHONE V'^ CONiR^�OR'S NAME: LIC NO: • �4 N/C CON'fROLp ARMINCER: NO: ADDRESS: JV CON'A-T: PHONE BUILDING PERMITINFO - ft.A ® ❑ Consultant Fees Paid by Applicant(Initial) BLDG ELECT PLUMB3 MECH- LICENSED COKTRACTORS DP.CLARAI[ON QTY. F:LIECIRICPERMIT FEE Lad 1 hereby anirnt atm 1 ant Errnuea andrr provkdo..of Ch qac,9(rmnoureng _ JOB DESCRIPTION �0Z with Section]fXNpo1D nn Sof the Onsiness undP Tena e,and my llcen.c is ' I00 nsCyJ PERMIT ISSUANCE (r Be P: infullfn" and eta a SPDWh ❑KITCHCN RI3MODEI. �UU Lie"cle Clas Is Liv. APPLIANCES-RESIUENI'IAL 4i Dom Conuecm ❑AI]DITION PLUMBING K6PIPIi RCHITECTS UISCh ❑.MULTI-UNIT' ❑STRUCTURAL PANELS zpNZ Iundoratmuln,don,shall bcust,despublich,cood, MODIFICATION oz-A' UP T02(XIAMPS 4F'Q ❑INTERIOR ❑CHIMNF,YREPAIR Licensed l'mfesional 201-1000AMPS IMPROVCMI;NT E]SWIMMING POOLS y'e�� OWNER-BUILDER DECLARATION OVER IfI(NIAMRS [I BATH RP.MODEIJREI'AIR [I DEMOLITION 4 C W 6 1 hereby affmt Ihn 1 ain event from the Contractor-,License Law for the k 30.U following mason.(Stenon 7031.5,Bulinus and Professinns Code:Any city or countySIGN51?LECTRICAI. ❑OTHER ati O yQ which acquires a perno, it c,houom alma impmvc,dcmolleb,of mpalr any structure y.] priorm its issuance.also requires the applicant for stab penniuo rile a s'ignedxlatement SPECIAL CIRCUIT/MISC. E;!ly that he is licensedpurchat mtheprovisionsofthe Commnnr's License law(Chipter9 Iy'r 0 (convnaming with Section]lNM)lof Division3ofnc�ltusinc.xntW Pmfcssinm CMe)or TEMP.METEROR POLE INST. COMMERCIAL: a a e2 that be is exempl therefrom and the basis for the alleged exemption.Any cardinal of ❑NEW BLDG/ADDITION ❑DEMOLITION y— Wo, Srctian 70315 by any appbcatn fora pennh.stilErGx thenpplicant w a civil penally of POWER DEVICES W-' ❑ M [I FOOD SF.RVICF. IMPROVEMENT I„ y nl more Nun five hundrul dnllnrs(55(X)), MPROVEMP.NT []Lss owner of Ne property,or my employees with wngen as their sole campensmion, SWIMMING IK)OL ELECTRIC py�b5.,� will Jnlhe work.ondthexwcn,rci.run inondcJ oroRercdf carte(Sec.7(119.Buslnoss ❑O'fIIL'R 41 a and Prnfexsinn.Gide The Contractor's Licence Wit dims not apply ,,an owner of OUTLIi9'S-SWI TCHES-FIXTURES F profmny who builds of improves thereon,and who dw.rs such work him etrbr through his own rmpinyecs,provided Ihvt such Impmvemena are not amended x of .it lin NEW RESIDENTIAL ELECTR SQ FT. sale.If,however,the huildingorimpmvemcnl is,nld wi@in nuc year of aomplaian,the SQ.FE FLOOR AREA ESQ.19'. owncnhuilde,will havethe built.of proving lhat he did not build nr intpfove for pur- povc of sale.). - �f•'� 1,as owner of the property,mit exclusively contracting with licensed hottmetmc m 7OTAI 3 .Q$'V mnmuct the phocer(See.70,W.looincs.and Phot,"imts Cove., av Conlrador',Li- - repace Law does not apply to au owner of property who build,or Improves mefenn,and QTY. . PLUMBING PERMIT t FEE who contracts for such projects with a cnmracmgs)licensed pursuant to the Contractors A /Z License Low. PIRMITISSIIANCE 6 L.7 I am exernpl under Sm. .B X P C for Ihisw rsnn ALTER-DRAI ATHR HDO VALUATION Owner Date WORKER'S COMPENSN'ION DECLARATION RACK FLOW PROTECT.DEV 'F. O Z I hereby anind that,penalty of perjuryone of fv follawinF Jwlarutipns: Pe l hocand will ntainmin aCenifcae of Consent to,elf-mourc for Workrr's Contpen- DRAINS-FLOOR,ROOF,AREA, Sq'ORIIiS TYPIi C(1NSTRUCTION sution,a provided for by Section 37(X1 of Ion Labor Code,for the performance of the "or k(a,which do,permit is i.sued. FIXTURES-PER TRAP 2 /, 1 have and will mainaln Worker's Cnmltunsmion Ineurnece,as required by Sectio V 3700ofrhe labor Coda,foz Ore perI ..ran eoRhework lax wM1ich Ihis permit is issued. GAS-EA.SYSIEM-1 INC.4OUTLETS (ICC.GROUP APN My Woken,Carensmionhnumncea yy��'Policyoumherare: GAS-' /J Caniee eljrtliT,lf ' LA.SYS1EM0IVER4(EA) ,y IL T b (I� COM10 CE GREASUINDUS'fRL WASTE INTERCEPTOR ., UILUINC DIV I) 'IRS t (Utissectiont rdnotb, ,n - It, IaYaa ff MdBl GREASIi TRAP alt or less.) PI N F. t Iccnify lhalinlhc perfprm:m¢.ofnc�work Gn'whicb this pcmtitisissdcd,Inhall SEWER-SANITARY-STORM EA.200 FL , (T not emm ployany perin any nmnner.so as to becomesubiver lo he Workers'Contpen- EN RG P'_ 1,0 z7., suion Luw.r of Califoram Dam WATER HEATER WNEN9'/IiLEC'fR Applicant GRA NG I7171i NOTICE TO APPLICANT:If,are,ranking this Crnlfcute cf Exemption,you should WATER SYSTEMC REATING q 4 becomesuhj., itthe W..Gies Coullonoton provisiu,of the labor Code,you thus, ROILS FE W funhwith comply with such pmriatur,or this pe rout shat l bcdrenud revoked. WATER SERVICE Q a CUNST'RUC'I'ION LIiNUINC,AGENCY NEW RESIDENTIAL PLMIt. SQ,Flt IU U 0 IherebY alf nn char there i.ncu,ssvudion leading.gencyfor the pedrnnanco n( Ume keceE,n P the work for whiduhis permit is issued(Scc.30)7,Cie C.) Q Lender's None TOTAL: r µlLender's Addrevv TOTAL: I cedify Ihnt I have read this application and sate that the above of pori is RUILDING P 14p .mat.I agrecm complywith all city and couidy ordinances crumble laws midnight QTY, MECHANICAL PERMIT FEE Z M1uildin6 congrvnimt and hereby:wthnrize repreunwlivex Nlhi.city menmr upon rbc SEISMIC •E O- ahoce-mentioned proprdy for impohirn ioupsoe.- (We)agree ill save,indeonily and keep harmPEkMIT ISSUANCE,less the City of Cupertino against 'e ELECTRIC F- Iiabilitics,judgmcm,e-shod will whirdnnny in any way sec-heagamd,dd City ALTERORADDTOMECII. PLUMBING 3E (, in consequence ofthe granting of thus person, APPLICANT DERSTA.NUS ANDWILL COMPLY WITH ANON-POINT T AIR HANDLING UNIT( CI-M) SOURCERU \- � MECHANIC FIRE AIR HANDLING UNIT(OVER 10.I000 CFM) CONSRUCTIG TA X Stgnmre ptcunVCouil nr Opole EXHAUST HODD(WIDUCT) HOUSING MITIGATION FEB. HAZARDOUS MATERIA S DISCLOSURE Will the applicant or future building occupant sort,or handle haaadlous intend BEATING UNIT('1'O 100,I0ill B'Ol) as defncd by the Cupenina Municipal Code,Chapter 9.12,and the Hevlat and Safety Code,Section 25532(a)? HEATING UNIT(OVER IWAX)it 111) [:I yr, PAID VENTILATION PAN(SINGLE REST D) • e Will then licanl nr forum building tecu t use e r or Acvices which _ Date RceeTP1 M PP b he .AllQn BOILER-COMPQHPORI (gnBTU) mil hunminus air cnnlarnn,mrx os def red by rhe tlny Arca Air Quality Maoagemenl � AI' District pOILER-COMP(OVER I00,I100 R'Tll) Vas I have real the ha'runloas Materials m is under Chapter 6.95 o1 the Cal l- AIR CONDITIONER gniremcn p " ISSUANCE DATE Ervin Henl0&_ hty Cade,Sections 25505,^_5533 and 25534.1 undersand that if the NEW RESIDENTIAL MECH. SQ.FE. �1 nodding hoes ndybave a tenantejE ,Thal ir's .pm:.ibilaYmnmlf eoem ant Z O q / of We require e r n,n no fa Cenifem r Au (/ Owner or authorize agent DatF I TOTAL: ISSUED BY. OFFICE 5.1399 b:52k'I BRIT" KANGAS FOL.LK NO.3cri P.2/2 Brian flanges Iwk Engineers • 9urvaYero • Plannefs ' August 9, 1999 v 960069.30 Chuck Schoenberger O'Brien Group 2001 W!ndwed Way,Suite 200 Sea Mateo,CA 94404 Subject: Oak Vs11ey-Foundation Verification Deer Chuck, On Au9u6:5, 1999 the performed s.fleld survey_oftbq IogUimi of the foundation tbrms far the buildings being constructed on Lots 5.2 1.5-2 1 gsrage�,515422"anQ'S•g7 0l he Oak Valley project in Cupertino, The results of that aurvoy Clearly dhow that the location of the foundation forms aro consistent end in conformance wllh the dssfp location of the buildings,as said locations are shown on tha plans prepared by our firm. This lermr is intended to provide you with the verification of those units per our survey. If there era any other questions Coneeming that location,ploese do not hesitate to call. Sincerely. I� 4AN0 SUR i ` • c7bBRADLEYA BILRD BRIAN KANOAS FOULK * W.M/02 � Bmd;ey A. Bllbo P.L.S.6141 took No.6141 err project Manager Survey Department Or CAUFBQ� • 849 fto Avanuo • Iledwood City,CA 84063 • 16501482.6300 • FAX(8531492.8399 • ENOINEERINO WEST INC. OBSERVATION CHART OAK VALLEY DEVELOPMENT CUPERTINO.CA. 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(5)chmnsys • •(2)DBL SIDED SMEAR WALLS (3)FLR.NAILING ! LAIZZA E" ! I DATE -T 0e N0 Consulting Engineers and Scientists PROJECT 425 ROLAND WAY }', ? v . '• t'OAKLAND, CA 94621 OCATION (510) 568.4001 / CONTRACT R OWNER t ) ,. ,WEATHER TEMP. A, at AM Date ar ;ir �.. '1( '' ICrC,C1 1%L % i ':f.�G�` r /(°r •„ I „ cat PM PRESENT AT SITE Hours Charged To Project Nuclear Density Tests �.-- ^ 1 ' . .. Field Task Number Concrete Cylinders --- r,(. THE FOLLOWING WAS NOTED: If C.-i(l 1' t- !I h I ir fenr 1 �I �r II r l /•' 1 / � 'r (.,,( l l �r'(`l i-/ r 11 =,.. . r.< I � I ,I-C/' � i' (� to T' 0% •7—/,�- Lf I II r I I(-( lel l '( IL.('`, i 1 I \ 1 1 l H6, I r I I-r �r r �i.� 1_Lyr 1'C— ri PIES TO SIGNEDZe2 AGENCY POST THIS CARD NEAR FRONT OF BUILDING"' CITY OFCqPERTINO KWTNO. BUILDING DIVISION F,-) 2742 BUILDING PRALI BUILDINGADDRESS:/ " M SANITARY NO APPLICATION SUBMITTAL DATE 'CM VIEW" 1.1 I '­ R'5 LIC NO: ro—w NAME: PHONE: CONTRACTOR'S NAME: w CONTROL 0 Ak'Ill=r&NUIN111PIL AOIAINS; tv .-I BUILDING PERMIT INFO . INSPECTIONS DATE INSPEC'.' El Consultant Fees Paid by Appilunt(initial) BLDG ELECT PLUMB MECH .1 EEI in n Fc UNDATION/PIERSIH.D.S. 9)CLQ INSPECTION RECORD JOB DESCRIPTION uFER GROUND NOTE ALL GRADING AND DRAINAGE pisipENTIA i SHALL BE INSTALLED TO COMPLY WITH '0 SFDWL [I KITCHEN REMODEL PAD/SETBACK-CERT 1k THE APPROVED PLANS AND CITY OF OADDITION EI PLUMBING RE-PIPE GARAGE SLABSIPREGUNITE CUPERTINO STANDARDS, 0 MULTI.UNIT OSTRUCTURAL MODIFICATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN S D TO ARRANGE INSPECTION 0 INTERIOR 0 CHIMNEY REPAIR IMPROVEMENT OSWIMMINOPOOIS .UNDERGROUND/SLAB CALL AFTERNOONS (1:00 PM - 4:30 PM) 0 BATH REMODEL/REPAIR 0 DEMOLITION PLUMBING 777-3228 MONDAY TO FRIDAY 24 HOURS BE- 0 OTHER ELECTRICAL FORE REQUIRED INSPECTION. JOB ADDRESS DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED AND PERMIT#ARE NEEDED WHEN PHONING. COMMERCIAL, ATTENTION CONTRACTORS: EINEWBLDO/ADDITION ODEMOUTION PLUMBING NO PERSON(S)SHALL PERFORM WORK ON 0 TENANT El FOODSERVICE MECHANICAL THIS JOB SITE WITHOUT BEING IN COM. IMPROVEMENT ELECTRICAL R. PLIA CE WITH WORKERS'COMPENSATION DOTHER FRAMING VENTS llve)LfL INSURANCE REQUIREMENTS. INSULATION vj INSPECTION SPECIAL INSPECTION REQUIRED ❑ DATE INSP. PLACE NO SURFLOOR UNTIL"ABOVE HAS BEEN SIGNED ROOF SHFATH/DIAPHRAIVI PLUMBING TUBS&SHOWER PAN MECHANICAL rvp-lcicw ELECTRICAL/POOL BOND CEO, COVER INTERIOR MING/STAIRS/E.EGRESS rV@&LJI(CV L SULATIONNENTILATION S' C COIVERNOWOPKUNTTL'ABOVE A BEEN SIGNED; OV E,XTERJAL SHEARMOLD DOW (71 :M INTERIOR SHEARMOLD DOWN SHEE7WROCK/SHEETROCK SHEAR 'J.00 EXTERIOR LATH/W-SCREED OLIs OU SHOWER LATH fh cv NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED- SCRATCH SCPATCH COAT 31��OU (7 SEWER/WATER TEMPORARY APPROVALS OCCUPANCY ELECTRICAL GAS I-,"..e2,4Cjp rZ . .. ........ GAS TEST GRADE FIRE HANDICAP ELECTRICAL PLUMBING M MECHANICAL ERGY 1S,UAL FINAL ONLY CERTIFICATE OF OCCUPANCV442l� BU BUILDING IMPORTANT ISSUANCE DATE YOCCUPANCY(OF BUILDLNG4S NOI'TERMITTED'M' PLEASE READ REVERSE SIDE BEFORE VVBIJIL6114' CALLING FOR FINAL INSPECTION!! iINSPI26TdIc"'m ,fN N"'e'w Is, 111ILD ly: 03PU EN GROUP ' Bee Jim RlplOy(SMTP,rlploydg®pacbell,nol( Monday, March 09, 1990 226 AM PAT BIJRKE OAK VALLEY iy CA Linear parkway planllnp, a wllhln the Meer perk are conalslonl wllh Iho londsoapo ' n documenis prepared by Ihls office and rovlowed by the clly 999 end.conform wllh the prollminary approval doumoms, ipley ;n Group, Inc, FINAL PLANNING SIGN OFF DATE ---5-1.2..Ylv� SIGNATURE , ------------- SII IS n,SAN MAT 00, C A L I HORN I A 41104.2,113 TIMP I ION H(630)371,0300 FACSIAIILO(640)314.2112 pwlu ( Mernh 1, 1996 .INSTALLATION CERTIFICATE (page 1 of 4) — CF-6R rte Address PerMIENUMDer An installation certificate is required 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. 0 of Efficiency Duct Dud or Heating Heating Type(pkg. CEC Certified Mfr Name Identical (AFUE,ate.), location Piping - Load Capacity heal m and Model Number Systems F-IRvalue atti etc. R-value tuthr (Btu/hr) Cooling Equipment Equip. CEC Certified Compressor 0 of Efficiency Duct Cooling Cooling Type(pkg. Unit Mfr Name and Identical (SEER,etc.), Location Dud Load Capacity heat um Model Number Systems CF-IRvalue atti etc. R-value tuthr tutor 1 _ o0 1. >_reads greater than or equal to. I, 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 Ejiciency Regulations or Part.6),where applicable. • ;;������sae .�.-.,�;z7-�9 � Ses�/'oat/' ,r1.� 9� �i'i Signature,Date installing Subcontractor(Co.Name) OR General Contractor(Co.Name)OR Owner WATER HEATING YST .M& Distribution If Reeir g of Rated' Tank Em- External Heater CEC Certified Mrr Type(Std, crilation, Identical Input(kw Volume cieney' Standby' insulation Type Name&Model Number Point-of-Use) Control Type Systems or Btu/hr) (gallons) (EF,RE) Loss(Y.) R-value - a 2 For small gas storage(rated input of less than or equal to.75,000 Bluthr),electric resistance and heat pump water heaten,list Energy Factor. For large gas storage water heaters(rated input of greater than 75,000 Btuthr),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 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-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 Effrciency 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 • COAST Insulation Contractors, Inc. INSULATION CERTIFICATION 1066 N. 11th 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, StateofCalifornia, the building located at: 11 SITE ADDRESS: 5' � 1 IL- ��I'll - -1 Cwt Ott of a FLOORS: Manufacturer OWENS CORNING/MV Thickness/Type R-Value EXTERIOR WALLS: Manufacturer OWENS CORNING/MV Thickness/Type � R-Value R , CEILINGS: BATTS: Manufacturer OWENS CORNING/MV Thickness/TypeFI-Value. ` BLOWN: Manufacturer OW NORNIN • Thlckness/Type —� R-Value Weight/Bag 35 Sq. Ft. Covered # Bags Used AIR INFILTRATION SEALANT INSTALLED:p�YES 0,_ NO ❑ GENERAL CONTRACTOR`�,1� - l )�Cl f l� dfA� LICENSE # • BY: TITLE: DATE COASt INSULATION O RACTORS, INC. LICENSE # J65440 C-2 BY: Y-d DATE: i