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99120032 (2) CITYAPPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN-ELEC Y O CITY OCy COPERTINO BUILDING.ELECTRICAL P' N}�O. RUII,UI VG UIVI$fI7N APPLICATION/PERMIT PLUMBINGMECHANICAI. r ♦ __BUILDING PROJECT IDENTIFICATION BD2.'6a5uaaYofJ �A►( g{Y I - SANITARY NO. API'LICAT ION SUBMI'I'fAL DATE Z OWNER'SNAME: IHONII: COIGRA NA LIC NO: 12 —Z 1 FG W5u11� MboO 05,10700 NIC coNlxQLa RARCHITECOHNGINEER: LIC NO. ADDRESS: ❑ FA Afta Ti4W?_UtA RI G-19 5 ,I ' CONTACT: ,,, c PHONE: 'BUILDING PERMIT INFO y I �+,I_ 1 Ln sCAX/� Gso 323 74oa ❑ Consultant Fees]laidby Applicant(Initial) HLD ELE PLUMB MECII DECLARXI with 5eI hereby ereb affix that I am Lich ed underaSJ ismr.of Cm,m 9 ob l aver,i, QTY ELECTRIC PERMIT / FEE JOB DESCRIF"fION Z yv p p WOO Y i'IiRMiI'ISSUANCE � TI ' F� f all force and'Ben. ,FOWL - ❑KITCHEN REMODEL �ZW License Cines Limp APPLIANCES-RESIDENTIAL• ❑ADDITION ❑PLUMBINGRE-PIPE anse o. Date Cl+nlraelur ARCHITECP:SDECLAGUION - ❑M1fULTI-UNIT ❑STRUCTURAL Z F h PANELSO nZ Iunderstend my plana shullbeu.cd nx publk rcwrda MODIFICATION OZ'y••0 UPTU2110AMPS ❑IN'T'ERIOR ❑CIUMNEYREPAIR 'Pnuinw Lnenced professional 201-1006AMPS IMPROVEiMEM' SWIMMING FOOLS OWNER-BUILDER DECLAMATION OVER 1000AMPS ❑BATH REMODELMITAIR El DEMOLITION W=<Q 1 hereby aRnn that I.,,I exempt firm+the Comraruas License Law for the _ W06 V following reason(Section 7031.5,Incince,and Profusions Coda:Airy city clcounty SIGNS 1;LIiCTRICAL ❑OTHER O0which require,a permit la umstrimt,she,imprcve,demolish,o,repair any ormame prior to itsissunc ae.also require.the applicant forsuch permitto file asigned statement SPECIAL CIkCUI'IWISC. yIhatticklicensed pursuantmthe pmvisionx of the Contmmors Licehm Lnw(Chapmr9 �GO (commencing with SwEen 7000)of Division 3 of the Business and Professions OxE)nr '1'EMPMUI'ERORYULEINST COMMERCIAL: a a 06' mm Le is exunpl thomfrum and the basis as Iha ullegW reen,ti... Any,I fi io.of _ ❑NEW BLDG/ADDITION ❑DI:MOLI'I'ION 'y Satins IlP L56y m+y vpplicum forvpcm+il subjects the upPliwnuo acini]pewlly of POWER DEVICES El TENANT ❑FOOD SERVICE Z not more than five hundred dollars(55110).>• IMPROVEMENT' E]Lo the wtroftbdflico etm Mitatimy endedoyces waitwagesNepal, sal,(See 7044pBt.... e, SWIMMING Iro01.F.LEC1'RIC ,111 do the work,and the she Comes not s Livens or tlw do far sola(Sec,9f W4,owner of ❑O'1'HEk 0.3 m a,,.Professions Codon:The Cunlmcmr's License Taw docs not apply to an owner of OU'i LF;'TS-NWITC1113S-PIXTVRfS his own who builds pe videlt s tl+such i and who dress suchtwork muJ himself or Through his own employeese pmlding Ihat rov improvements arc not intended or offered for NEW k1iSIDCN"PIAL ELECT SQ sale.IT building and or rof p cm is at he bad act year a,emprosetto, the Q SO IT FLOOR AREA SISQ.FI'. ,builder will hove IM1e underof proving that neon diA not bnlld or impmve for per- - po 1,its ow 7. S ❑ stns owner of the property nm exclusively containing with licenced coms to '(UTA 1.: construct theproject(Sec JBW B d ProfessionsC d�)TheContractor:C - c ee la d I ppiv t an a rp pcny 1- n m. - 1 .B d QTY�. Ii.'PI I G PERMIT ' , FEE 'J whocontracts fr suchp'ciects 'Biu cutout (s)lunsdpar. auathe Cmara n o Q 2— 1 License Law. I'ERMI'T ISSIIANC. lamcxemptundef Sec. ,B&PCfertliku on Owner DamALTER-DRAIN&VENT- +R(HAI VALUATION WORKER'S COMPHNSAE ION DECLARATION BACK FLOW affirmPROTECT'.DEVICE /� OO I hereby arm under penalty of perjury one of the following declarations: 1 I have and will maintain.Cenifcateof Consent m self-insure far Worker's Co.,,,- DRAINS-FLUOR.ROOF,All COND. STI OIt1EN TYPECONSTRUCTION t, v smion,as provided for by Section 370 of the labor Code,for the abomitance of the work for which this permil is i...ed. FIXTURES-PER TRAP El 1 have and will maintain Worker's Compensation Insurance,as required by Section 3700oflhe labor Calm for the petfornme,ofthe work for which this prm+h is issued. GAS-EA.SYSTEM-1 INC.40U'1"LEES OCC CROUP APN My Workers Compenset ion Insurance carver and Policy number am: Cartier. Policy No.. GAS-EA.SYSTEM-OVER 4(FA) CEM IFICATH OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE GREASE/INDUS'I RI,WASTE INT FRCEPPOR BUILDING DIVISION NBES (Thissectionnecd net beunnplemlif the pe.,it is font.landaddollars(SI0) GREASETRAP or Iso.) PLANCIIECK PEL I certify that in the peritatence of the am k for which this Wrmit is Issued,I shall SEWER-SANITARY-STORM EA.210 nt sol employ any persue m any..]anon sa us m become subject m aha Workers'Compen- ENERGY IEE Z ,Z nation Laweor California.Date WATERHEA'fERW/VP.N/ELECI'R Q Applicant t GRADING FEE ��1I rNr NOTICE TO APPLICANT':If,muo making this Ccrlilicate of Exemption,you should WATER SYS TEM/1'REST INC F" become sahjm to the Worker's Comlxnsation provisions of the Labor Cade,you must SOILS FEE forthwith comply with such provisions or this permit shall he deemed revoked WATER SERVICE aQ CONS FROM ION LENDING AGENCY NEW RESIDE N'fIALI'LMB. SQ,Fr. PAID - Date U QkIicw union art Wcrc ixaro (So,.ionlending agcnry]Dobe prrinrlmu¢e of the work Ert which his permit is issued lSa.3fM)],Civ.CJ x11 2J V D' F•' lender's Name T( 0. lender's Address TOTAL: .(U1. Ly 1 certify that 1 hue ad M application and state that Ih ti e mf m f , t Y F. VI cortect.l agrccmcomply '11 II 1y dLuu ny and nu uxs: LII P int gl Q7.'11 /; ME CHANICAL PERMIT `',FEE SEI. IC FEE C�'Z. building consvucome and hereby a thor m representatives of thiscity ro anmr upon the atone-lnenlioned propcny for inspection purposes. PERMIT ISSUANCE (We)agree m rave.indemnify and keep families,the City of Copeflinb against IiLECTRIC FEE liabilities,judgmenrc,casts and expenses which may many way accrue agaili't Ad City ALTER OR ADD TO MECH. _ an nwgacnca ul'the granting al this p nait. �'IL4fAUVGTEG" APPLICANT UND17RS'I'ANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNI FEE 010,000 CFM) MECHANIC PEE SOURCE REGULATIONS. AIR HANDLING UNIT[OVER 10,000 CPM) CONSTRl1C1'ION TAX Nigeria,¢of A,Ixent/Commuor Dam EXHAUST FOOD(W/DUCT) HOUSING MEVIGATION FEE HAZARDOUS MATERIALS DISCLOSURE. - Wililheapplicantorfumrcbuilding occupant store or handle haardous material HEATING ON IT(1010,00 BTU) as de0nul by the Cu vino Municipal Code,Chapmr 9.12,and the Health unit Safely Code,Section 255321.1! HE60NG UNI'i'(OV ER I W.W)B'I'U) Yes No VENTILATION FAN(SINGLE BESIDE PAID Date Receipt# Will the applicant nr taloa building by the Be,use ea Ait u or devices which emir hozardous ulz comaminvnk as del sed by the IfAre Ait Quality Management BOILER-COMP(311P OR 100.I1IX113TU 'x01 . Jlsvlin4 F1 Yet No BOI LFR-COMP(OVER Illi BTU), ❑ I have mnJ the b;valloua matuials reyuircmenle undo,Cbvplcr 6.95 of the Call- AIRC(INDHIONL'R ISSUANCE DATE folia Oman,&Sanely Code,Speno.,25505,25533 and 25534.1 understand that if the NEW RESIOENFIAL MECII. SQ.ET. building do.sol currently have a tenant,that it is my mspansibilay In notify the tacapznl of the renplirensnts which must be tact poor to issuance of a Cenificme of Occupancy. Owner or allumi agent Date TOTAL: ISSUED BY: OFFICE Bent Byt HOHBACH-LEWIN, INC. ; 850 617 6832; Aug-22-00 3:43PM; Page 112 �! .� CH-L INC. armucTVRIL FA10INi6019 tae Shedden Avenue,66Ba 100,Pak Atm,CA 14808 • (IS/)617-6X10 • Fax(8601617.!032 t STRUCTURAL SITE.VISIT REPORT DATE: July 17,2000 PROJECT: PPC-Oak Valley lot 2-M NO;arts 22160 Canyon Oak Way, Cupertino w Hohbaoh-Lewin Project No. 9MG.2 K • DATE OF VISIT: June 28 and July 13,2000 PRESENT; Josquim Roberts, Hohbach-Lewin, Inc. George Fontelera, Hohbach-Levin Ino. Kan Johnson, Str udure Construedlon Co. Erie Sundblad, Pacific Peninsula Group PURPOSE OF VISIT: Final rough framing review. OBSERVATIONS • The mWorlty of the house is framed. The major structural elements have bean Installed. The joists and rafter and their support beams are in place. The wall*, floors and root shes"g are also in place, The lateral fora resisting elements and hardware were observed. The following are Items requiring additional work: The collector strap Indicated on sheet 52.2 above the garage at the 8.76x16 GLB was not yet Installed. e One of the second fear joist above the garage was improperly cut. INFORMATION OR ACTION REQUIRED The dome noted above will need to be Installed. The out)Diet will require to be headed off, We suggest Installing double joists on each side of the cut joist. The electrical panel Installed on the outside shear wall at the garage will need to be strapped, Use detall SASS.I. it Is acceptable to Install an under floor vent under a shear wall. The continuity of the SOW plate allows additional let"force transfer to the mud sill, • 1104M16M31CM. /4. ar�avx�. 51 1 AMW rM of Sent By: HOHBACH-LEWIN, INC.; 850 817 5932; Aug-22-00 3:44PM; Page 2/2 07/17100 Structural Site Visit Report Page 2 of 2 Because of the limited length of plywood panels, k Is acceptable to splice the plywood between the sole plate and the mud sill provided proper nailing of these two piece Is provided. Use nailing, bolting, and or framing dips between these two elements. It Is our opinion that the rest of the framing Is In general conformance with the approved documents. If it Is acceptable to the buNding department and after the missing Items above are provided,finishes may be Installed. oc: Eric Sundblad, Pacific Peninsula Group•job site fax: eco/891-9882 Paul McLellan, Pacific Peninsula Architecture•fax: 850/323.0825 Mail to: Pacific Peninsula Architecture, 718 Oak Grove, Menlo Park,CA 94026 • • AUG-28-00 12:13 FROM-61G CREEK LUMBER WATSONVILE ••-- - 8317611634 T-087 P.03/Od F-186 09 OF ti""Ap All FA C1 • CERTIFICATE OF CONFORMANCE HE UNDERSIGNED MANUFACTUREIEREBY CERTIFIES that tno products identified below and on attached sheets Nos.. are marked with the Collective Mark of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION (AITC) and were manufactured in conformance with applicable provisions of American National Standard AN8VAITC A180.1-1882. Structural Glued Laminated Timber,and that such manufacture has been at our plant in ATt ]pA�] Which plant has a quality control system approved by the Inspection Bureau of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION and inspected periodically by such Bureau. JOB NAME: ST ///////MfiORWA PAC=CC P08AT'MN JQa LOCATtON: ' ` CUSTOMER'S ORDER NO. pAatV,221142 BATE_0413 W -wra oRnER No. 12036 GL11&.MU4MAiSF1B/IARM24F-d4, ARCFBTECTURALAPPEARANIM Ryp W .NO 13,C�SC1A�SfD-D.NO 3I�Y8.3500 CAD�EiL • �COhiPANY l �t$CODBt'ALVY BlONATURC 7tTLE Q.C.8171 V1�0$ AODRESS PO 1651 tnn AL = osTs AITC HEREBY CERTIFIES mat the said company at its said plant is licensed by the AMEF41CAN INSTITUTE OF TIMBER CONS-MU=ON w use the AITC Collective Mark In respect Of products which comply with applicable Provisions of said Standard,that ma adequacy of the qual- ity control system in effect at said plant is pariogtcally inspected and verified by the Inapaotion erriGnt Bureau of the AMERIOAN INSTITUTE OF TIMBER CONSTRUCTION, UCTI aeturlrtA enand d taetingin the 1pdtrh®naiohs of AITC,said company is Capable of corttplyirlg with app of said Standard in respect of products manufactured at said pians. Conformance of he me until the r; AIT rd in respect of any specific or particular product is tines SOIG etlptco produce a product moeAinBrthe said Standard andrthattiits Plants is pr being eriodthe ica y inspecteaid d and verified by the AITC InepaetlOn Bureau_ RITC Car1fficutO NO- g2® 0 5 9 2 9 8 AMERICAN INSTITUTE OF TIMBER CONSTRUCTION ®>ISS2 AMERICAN INSTITUTE OF TIMSPH CONgTRUCTION • IRs•110W isc AUG-28-00 12:13 FROi"IG CREEK LUMBER WATSONVILE 8317611834 T-087 P 04/04 F-100 • i • $HEFT OYo. TTACHMeNT NUM6'ER TO ITC Csrtiflcats of Conformance jya,�?1Js' 8 Dated�... .. job lom aan L4cwfw1: L✓�17"r�Nui Ll F cis ooame. mftec On r bo. r't fokkmV+ASfmfrmsThe fres Gnd IF-=fhe Besw 502011 O"mn dw+ �"e.wftd an"do W A - Now eum ORD 8001 WoolRon t pwA iTc! ? QIIF�It ClA11W m@I �nC �.ca�awi YIpM ��. I _ Z013pW� i O 1Rd swrMF.°wIm M R�iY C • AUG-28-00 12:12 FROM-BIG CREEK LUMBER WATSONVILE 6317811854 T-087 P 01/04 F-I88 CERTIFICATE OF AN C0NF0RMANC Elm �lE UNDERSIGNED MANUFACTURE IEREAYare ERT' 'ES that the products identified below and on attached sheets Nos_ �— the Collective Mark of the AMERICAN INSTITUTE OF TIMBER CONSTRUCT JON(AITC)and were manufactured In conformance with applicatrie provisions of American National Standard ANSI/AITC ATSO.1 1992, structural Glued Laminated Timber,anws pauuaa�bcosytet which hasagntra system in approval by the 1 .2 actian Bureau of the AMERICAN INSTITUTE OF TIMBER CQNSTflUCT10N and Inspected periodically oy such Bureau. ADBNAME: S1OMH8AIAWI!!1//// iAPACMCWQR+TMN .���ocaTr6N: NSWAR�°� CUSTOMBRB ORDER NO. L711dW�384� DATE 4411100 MFGR'a ORDER NO. 12M mmwjmGLTJLDOUGLASSM"MnL241-V4, A1It:HTMALAPPEARAN ,NO ONSffiW VM D.NO XHM.3S00 CAbMM • COMPArvr JRXWG AXY SIGNAT � URE .+1 nDREssTIP 'f.�V18t3�t _J Fd 18s HoUNDA E.W DATE Q.C.SMM C—/ AITC HEREBY CERTIFIES mat the said Company at its said plant is licensed ray the AMERICAN INSTITUTE OF TIMBEoa,CONSTRUCTION of id Standard.to use the lTO t atthelective dequacy of the ark in respect products which comply with app provisions ity control system in effect at said plant is periodically inspected and verified by the inspection Bureau of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION, and that, in ins Iudgament of AITC, said company is capatifoOf tlucts man aeturedith pat said plant. Conurfonm nncce with tine Standard of said Standard in respect of p of the in respect of any specific: or particular proTOs duct is the sualifiedole Ro produce a product meeting the said guarantee hereunder being that the said company q the AITC Inspeetion Bureau. Standard and that its plant is periodically inspected and verified by AITC Csthffccrfo Na. 92- 059298 AMERICAN INSTITUTE OF TIMSER CONSTRUCTION 0 tea2 AMERICAN INSTITUTE OF TIMElER CONSTRUCTION AUG-28-00 12:12 FROM-BIG CREEK LUMBER WATSVNVILE 8317611634 T-067 P.02/04 F-186 • SMELT NC• MACHMEW NUMBER ro A �lrc QC4e_1tificate of Conformance 1Va` -04 9 S Dated.Z'3.t® Jap Euro: _ /3JCc_. Z.+~E7t Groes clods. n;a• ? Ei�1ae � , WJL odor J' . X36 T10 fano+ m idsnn#ms nos t-a, wes and g^Rs dw ho"wrAm"am Nim wum Uum�vWx mix • GC/�s F�� /fid►` ghmbw a� NOWe QUMTw "m C; _ "UTZ of nu% P-,- J, ARi Fsanw wav r+� ITc l� 6 iSB�raa.awe•+�nwr c w9C llFa�B+O • INSPECTIONS DSA File A Division of REED& GRAHAM INC. DSA Appl,# 690 SUNOL STREET• SAN JOSE, CA 95126•(406)268.6460•FAx:(408) 271-0902 OSHPD# VL INSPECTOR DAILY REPORT / Structural Steel / Welding '�' Date/Day: ''>%/ Project Name: < ,J < , y �' ,) y Project No.: i� T%1 ._ Address: Permit No.: Inspection Type(s)Coverage: © Welding ❑Continuous ❑ Bolting JX Field ❑ Shop ❑Periodic ❑ PT ❑MT ❑ UT Welding Process: ! Ix ElectrodeType Z7,1T Welders)Name(s): " / Inspections Made: f<) _> " j�% c. ; . r' [�/�� '� CC + //V `•; ' (,i)177 , T Items Requiring Corrections/Corrections of Previously Listed Items/Previously Listed Uncorrected Items/ + Changes to Approved Plans Authorized by Architect or Engineer: s Results: Comments: C F lie best Of my knowledge, work inspected was in accordance with the building department approved design drawings, specifications-and applicable workmanship provisions of the U.B.C. except as noted above: Signed: / 9 , .— i"i /. � , 'e I.D.Number: 7— . /f Print Full Naffie: Exp.Date: _ INSPECTIONS DSA File# A Division of REED&GRAHAM INC. DSAAppl.# 690 SUNOL STREET•SAN,JOSE, CA 95126• (408) 288.8460• FAx:(408) 271.0902 OSHPD# SPECIAL INSPECTOR DAILY REPORT / Structural Steel / Welding /Countyof:— -)NU Date/Day: Project Name: `1`1 r a � ilJ�Tc,� Project No.: Address: / / Permit No.: Inspection Type(s) Coverage: ❑Welding ❑Continuous ❑ Bolting Qg Field ❑ Shop ❑Periodic ❑ PT ❑MT ® LIT Welding Process: ElectrodeType 0 �- Welders Name (s): Inspections Made: !% C,IY—L Cr 17 C11 K cc rr_� e AMk Items Requiring Corrections/Corrections of Previously Listed Items/ Previously Listed Uncorrected Items/ Changes to Approved Plans Authorized by Architect or Engineer: Results: Comments: r r-%: t =r . 3 1 j ni l • C ' ,� •�: .,�,: , Q �- Ire •��� / e best of my knowledge, work inspected was in accordance with the building department approved design drawings, specifications and-Erpplicable workmanship prnvigfons of the U.B.C.except as noted above: Signed:_ ;f::�"t':; I.D.Number: Print Full Name: /_: l % 1 l/�/`✓C Exp.Date: -