00100029 CITY OF CUPERTINO
IIUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: YIiItMI'I NO
OWNER'S NAM122623 I - APPLICATIONS 011"I'd
PHONE: GAT SMITH SANITARl'No 1 IRI
0 ne O ARCHITECT/ENGINEER: OUII.DING PERMIT INFO
w—
RI.DG FI.EC'I' PLUMH ME if
t;U U - CI CI f=J LJ
O Z I.ICENSHI)CON9'RACrOR'S DECI.ARAr1ON Job Description
- I hereby alfirm.that I:an If rr,d under provisions nl Chapter 0(rnnnmm�a ng
0:' wih Section200(nof Division 3ofthc Hismesanal Profecal...Cale andnrylicenw
Y is in full lurce a el(yst.
a O w< en. CI.I, ry Co ntra
tr_
D.°`�/ � ARCHHECf:S DECLARATION TERMITE REPAIR
I unJemmaJ n,y plm.s.boll be nmJ m public reanJs
ad i C O License)Pndas.innal
ad o`F that I in cUIIDER UECLARAnION
,t� =•v 1 hereby air scif that 1 o.m e14 ,2 .be Cmnr.,,Co e:Air, Iy,, for he
C=a a Gllawing,ees a fsa-lion 7011.5. t,afters and improve.
deimm Cale:Any city or Bounty .
7=0 which requires a permit m conwrvc6 after.improve.JenmlisM1,or repair any stmaure
ce— prior to its issuance.also requires the applicmt tin such pcnniuo file a signed..metra
that he is uteri prmaatmme provi.i,.m,anec Commons Lia,.se Law(Chapter Y Sq. Ft. Floor Area Valuation
Ieunou,ne'ag with Sr,r 900(11ofDiv'uin 00 0 the Busim,"and I"cli,"in is Code)
nr that he is exempt therefrom and the Iasis for the alleged escmption.Any violation
of Section 7031.5 by any applicant for o Permit abject-the applicant to a civil penalty
,.Fail,n c than five handreddnuar.ill APN Number Occupandy�,Fytl71L?I
❑I,as twnerofhe proper,,or my employees with nages as ahcirsolaa.mpen.mmd,
rill Jo,he work.and thc stracmre is am intended or offered for sale(Sec.'/1134. X42]Sal]
Ha.iaes-.and Proley.inn.Code. [he caatraaar:Liee.tc 1.aw doer no,apply to a 6 RLgMred Inspections
r at property Who builds or improves thereon.and who does such work Idmnolf
owner
his own employee,provided that such improvemcris.are not intended or
anerad for.ale.If.however, he building or improvcmem is old asiddo ane year of 516 — FINAL 8U I LD I MG
...pletion,rhe owner-bidder will owe the hmdei ofprovillg teat ba did nor build or
6nnpr ne tar parpo,e of,mic.l.
0 1,as owner ol.ts p puny exclusively t i g ithl -dant m'he
lm I II .......I IS 7044H w 11- f .C J ) [heC
ice 1 d ,apply it, ofp pert n Mold p . mer n,
and b contracts f such p d ,. with a e t a rt I licensed pursuant in the
Conrai lAccuse 1dz
❑Inn Muupt finite SO, ,H&ICC nl e.
owner ENS
W(yRKER'S COMPENSATION DECLARATION
I hereby anion under penahy of perjury ane m file following Jedafatlons: l
❑ I have and will maintain it Certilieaaot Con.enl it,elf-ir,am for Wnrkor'.
Cnmpnlsmiou, a, pnrviJeJ for by Section 3700 of tee Labor Code, far the
performance of he work for which this permit i.issued. Q
Cl I hove and will nminmin Worker's Cmnpemadon Insurance,n,required by Swoon
3900 ill the Inlet Code.for the perfornem,or the work for which this panni,i.
issued My�Worl,St. �npenncmion Insurance roamer adSPoliI inner arc:
Carrier/.Q1, .,A1'I()N 0I7 E\I mrd LION FROM W"ORK1'COMPENSATIONINSURANCE
fIu,section ,,,it nuI be colnPlewd irdw permit Is far one hundrW dols.
(SIM)or It
I mods thin in the perfimnnnce of the work for which this permit is issued,I
shall not employ any person iu any tanner so m to because subject to the Workers'
Co..pensotion laws of California.Date
Applicata
NOTICE:TO APPLICANT IL Idmr making his Cenificonu of Exemption,you should
bi t,bj,,, ,,the Workcl'x Cntnlemmion provlxion,ol'n he Labe Coote,y ounm,I
Q 0 forthwith comply with such provisiam or this permit shall be deemed revoked.
z (Z) CONSTRUCTION LENDING AGENCY
1 hereby allinu that here is a cnn.bn acla lending agency Iia the performance
if the work for which this permit is iuued(Sec.May.Ci,C.)
Q 1.cnJar's Name -
Z) z Inkier'.Addreea
V 01 mi-Sy that l have mad this application and state that he above infommtion is
W F.. eo,rc t I iii to i,.,ply ifit all city and m t ly miduvar,c,andside koi,relating
h: II' y' t- tion JI itch,i neral Ira five,. fid' lyl ter'upo.
} �] the above f d property for inspincionpurposes.
E•, a (N )agreeto sac indemnify and keep huI .:the City ofCu sonar against v
rn IluMbde.,jndgmcm......1, ,..it ex,co,e,word,nay at any war acerin mg:an..said
V z Cry in conscquamc of the grunting of this,pcm.il.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NO -MINT ISs db Date
I st �i
s.gi p1 :n✓c Iraemr Re roofs
fIA9ARDOUS MA'I ERIAI S DISCLOSURE
Will.he applicant a furore building rccupann store m handle M.did!1i'm os n.aedd Typ
w dctitled by the C.mcrino Municipal Coda,Chillier%12.and one Ilcnlm and Safety
Code,Seelloo 25532ialy
0 Yui ON. All roofs shall be inspected prior to any roofing material being installed.
Will de,apPEcar,m kms,building mccupaiaam M uipm.cut sur devkcs wIii,h If n roof is installed without first obtaining an inspection, I agree to remove
etnit haini air cunmminnna as deincd by the Bay Arca Air Quality Management
District. all new materials for inspection. Applicant understands and will comply with
°Yes 0N all non-point Source regulations.
I have read the hstard......erials requirement.under Chapter 6.95 of the
California Health K Safery Code.Sections 25505.25511 and 25534.1 undemmnd ha
it the building does not cutremly haveatenant,dna Ii.nay re,ran,ild0ty to rally the
ecupcut of he r,riren,ent,which nntl he nmI prior bo i®came of a Certilicme of
Occup try.
Signature of Applicant Date
owner sur atilt agent Dam All roof coverings to be Class •B" or better
OFFICE
WOOD DESTROYING PESTS AND ORGANISMS INSPECTION REPORT
This is an inspection report only not a Notice of Completion
ADDRESS OF PROPERTY INSPECTED
Building No. Street City Zip County Inspection Date Pages
22623 Woodridge Court Cupertino 95014 43 5111/00 6
Prime Exterminators of Northern CA Affil stamp here on Board copy only
CONTROLLICENSED PEST
1752 Angela Street OPERATOR IS AN EXPERT IN
San Jose, CA 95125 HIS/HER FIELD.ANY QUESTIONS
RELATIVE TO THIS REPORT
Phone(408)275-0364 Fax (408) 275-0365 SHOULD BE REFERRED TO
Tax ID 77-0509573 HIM/HER.
Registration# PR 3506 Record# 3480 Stamp# Escrow#
Ordered By: Century Medallion 10370 S.De Anza Blvd.Cupertino, Ca 95014(408)725-4000
Report Sent To: Cynthia Cohen 85 Oakwood Drive#1 Redwood City,Ca 94061 Gr5 0 - 34 is- 7 3 8 0
Property Owner: Ronald&Linda Summers 22623 Woodridge Court Cupertino,CA 95014
Party In Interest:
Original Report V1 Limited Report Supplemental Report LJ'Reinspection Report Original Stamp# Date
I N F e O F O D E F C E S
General Description: 1 Story Siding and Frame Residence Furnished and N O U B R U T A A A E x H
A T R Y N H M R U L C O
Occupied with a Wood Shingle Roof and Attached C T E W G E P T L L E W
Garage on LIN roved Underarea C I H e o U R W H T U S E
g P E N E R O S O Y L S R
S 5 R A O W O W O 1
s P N O O D O G S V L
I E I E T R O O R E E E
Inspection Tag Posted: Garage B C N N E D T D A A
• L T s R D E D D M K
Other Inspection Tags: Max's Termite 2/8/00 E E P r M R P R C E E 0 S
D E E I Y E M O B I
A C R T S I N L R S
R T N E RT T T E I T
E I T S O S E A V S U
A O E T s C E R
S N g T L E
r
1. SUBSTRUCTURE Damp-Muddy, See Findings,See Notes X X X j j I X X
2. STALL SHOWER Tested See Finding,See Notes X
3. FOUNDATIONS . Concrete Above Grade
4. PORCHES STEPS Concrete Sealed X
5, VENTILATION Poor See 1E
6. ABUTMENTS Wood porch column X
7, ATTIC SPACES Insulated See Findings,See Notes X
B. GARAGES 3 Car Attached See Notes
9. DECKS PATIOS None
10. OTHER INTERIOR See Finding,See Notes x
11. OTHER EXTERIOR See Findings,See NotesX X
DIAGRAM AND EXPLANATION OF FINDINGS(This report is limited to structure or stuctures shown on diagram)
11A 11B
I16
IF 16 1A �1 IB
F
2A J 7B
• 10A �1H 7A
F 7A
/ 7B 7B
13 X6 7A 16
1 6A
J IC IC
-1HiG� 1CID1C 4A �c M
18 CID
l5
IJ note D
I see ` s1Ew pCT 0 4 2000
L
notes 11C
11A y
IE
116 gy
Zotcale
Inspector: Patrick Smith License OPR9987 Signature
THIRD PAGE OF STANDARD INSPECTION REPORT OF THE PROPERTY LOCATED AT:
Address of
Property
Inspected: 22623 Woodridge Court Cupertino 95014
Bldg No. Street City Zip
5/11/00 LC 3480
Stamp No. Date of Inspection Co. Report No Record Number
Section I
Substructure
Finding: 1A Evidence of fungus infection or dryrot noted in rim joist as indicated on the diagram.
Recommendation: Remove surface fungus and treat area(s)with registered fungicide.
Substructure
Finding: 113 Evidence of cellulose debris noted in subarea with subterranean termites and fungus as indicated on the
diagram.
Recommendation: Remove cellulose debris of a rakeable size from the sub-area and take away from the premises.
Substructure
Finding: 1C Evidence of subterranean termites noted in soil, porch, piers and framing as indicated on the diagram.
Recommendation: Chemically treat the soil at probable termite entry points at all areas of property for the control of
Subterranean Termites. In conventional construction, this may include, but is not limited to, rodding or
trenching the soil around the foundation walls, piers, and plumbing pipes in the subarea; rod-ding or trenching
• the soil around the exterior foundation; drilling attached slabs (or black-tops) such as patios, porches,
sidewalks or driveways that abut the structure; drilling brick or stone veneer that extends below grade level;
treating voids in the foundation walls or piers. Remove the termite shelter tubes(if present)from the
accessible areas.
The front porch and all subarea soil will be treated. We will be as careful as possible not to damage porch
tiles. If damage occurs a supplemental report will be issued.
Substructure
Finding: 1D Evidence of subterranean termites noted in see 1C as indicated on the diagram.
Recommendation:
Remove migration tubes from approximately 400 square feet of subarea framing including several piers.
Substructure
Finding: 11E Evidence of fungus damage or dryrot noted in subfloor, rim joist and floorjoist as indicated on the
diagram.
Recommendation: Remove and replace
floor joist, plywood subfloor, install approximately 7 new vents. The interior hardwood floor will be removed to
perform these repairs. Owner is to contact a hardwood flooring contractor to replace floor at areas removed
Substructure
Finding: 1 F Evidence of fungus damage or dryrot noted in rim joist as indicated on the diagram.
Recommendation:
Remov exterior siding and trim to replace approximately 20 feet of rim joist. Repair plywood subfloor as
necessary. Treat areas with fungicide. Install new siding, vents and re use baltons.
Substructure
Finding: 1G Evidence of drywood termites noted in sub floor as indicated on the diagram.
Recommendation: Cover or remove accessible evidence of Drywood termite infestations. This is required.
Oubstructure
Finding: 1H Evidence of a moisture condition noted in subarea soil as indicated on the diagram.
Recommendation:
Install a visqueen moisture membane over subarea soil to help in decreasing moisture on subarea framing
due to condensation.
Porches/steps
Finding: 4A Evidence of fungus damage or dryrot noted in porch column base as indicated on the diagram.
Recommendation: Remove and replace :
2x8
Attic Spaces
Finding: 7A Evidence of drywood termites noted in attic framing as indicated on the diagram.
Recommendation: Due to the nature of these infestations, it will be necessary to seal the entire structure and fumigate it with
Vikane(Sulfuryl Fluoride), using Chloropicrin as a warning agent. The entire structure must be vacant for at
least 72 hours for this process. We will shut off utilities to this structure prior to fumigation; however, it will be
the owners' responsibility to contact P G& E to have the utilities turned back on when the fumigation is
• complete. We will use all due caution in our operation; however, we assume no liability for any damage to the
roof covering, solar panels, TV antenna or plantings adjacent to the structure. The occupants must sign the
Occupant's Fumigation Notice and comply with all of the instructions.