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04050150 (2) CITY OF CUPERTINO `^ . spa BUILDING DIVISION PER 5'tC�NTRACTOR INFORM QN : �a>b ix 'h cW-°' =i 6Ya &'Ldp' BOILDINQADDRESS: CLEAR OAK DESIGNS PERMIT NO 04050150 10143 HILLCREST ED OWNER'S NAME: reRMrT issue DATE ROBERT BRUSHWYLER 1723 B RO 49 NE: SANITARY NO. CONTROL NO. (408) 436-5448 ARCHITECTi'ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MF.CH uOp LICENSED CONnsed a&, moviCmasorCON Job Descr� ALED e u C I hereby affirm the I am licensed TOR S DEC A of IO pltr Y(commencing �Za wiBa Senion 7Q3U)of "si fNyBusneven Poressi sCadc.adry licluc is <n in fullfnme$nee I " KITCHEN REMODEL Lieenu 61aSa LIe � RCHITECLAIN �j Offal •i 2004 �i 1 1 1 um ndeasRmyn plaabaft he used v sed"p public records DyU BUILDING S o y Licensed Pmressinnel `/U I L D I■ �/ S OWNER-BUILDER DECLARATION a� I artery affirm Nal 1 am exempt from Bac Conmmors License Law for the E p o following mason.(Seeliun 7101.5.Business and Professions Code:Any city.11...ly m which requires a permit In construct.alter,improve,demolish,of mpnr any structure nno Poor its issuance,oleo"Lima the applicant for such perm it to file axigncd statement Ft. Floor Area Valuation —�a that W pursuant is licensed pursuano she proLa visions of she Contractor's License w(Chaver 9 Sq. (commencing with Section 7000)of Division 3 of the Business and Professions Code)or a. $ that he is aempt thetefram and Ne buts far the alleged amialtion.My violation of 2nG Section 7031.5 by any applicant for a permit subjects dic ri'licanuo a civil penalty of $RtFnber00 Occupancy Type not more than eve hundred dollars(5588). 1,as owner of mproperty.or my employees with wages a their sole compensation, west do the work.end the smcture u not intended or o@ted for fall(Sao.7044.Business Re uired Ins ections sun Pmrso siau Code:The Committer:Liaise law does 441 apply to in,owner of q P properly who builds or improvra thercon.andwlte doessuch work himulfor through his Own employees,provided that such improvements are not inmaded oro@red for sale.If howevea the building or imprawmmt is said within one year of completion,me What- builder will ave the burden of pmving that Ire did oat build in imprew for purpose of .;a.). 1,as owner of Lie property,em exclusively contracting will licensed eonaatmrs to construct the pmjecs(Sec.7044,Business and Professions Code:)The O nfectars Li. cense law docs not apply t.an owner of property who Wilds car improves th rs.m.and, who contracts for such p rjeels with a eommcter(s)licensed pu suam to due Ourractoh License Law. ❑1 am camp,under Sec. B A P C for this..an Owner Data WORKER'S COMPENSATION DECLARATION 1 hereby dorm under penalty of perjury one of the following declarmose: 1 have and will maintain a Certificate of Chosen,to self-insure fm Worker'sCumpcm cion,a provided rat by Section 37W of are labor Code,for the performance of Be work for which this permit is issued. 1 have and will maintain Worker's Compensation tauten,as xquimd by Section 37M of thIa Life bm Code,for Ne Performance of the work for which this permit is issued. My Worke! Co. aodon�,�1lns���0�ca((ll'i�er and Miey nu bas am' MisIamr.�LL PP4 No.: UL C FlCATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thu section need not W completed film Permit is for one hundred diallers(51 W) ales'.) 1 certify that in asst performance of Bac work for which this pctmit is issued.I shall not employ any person in any manner so is,to become subject to the Workert Compensation Laws or California.Date :Pplicdnt NOTICE TO APPLICANT:IL after making Nis Cea fiare of Exemption,you should become subject in the Waaers C.mpcaerion pmvisioa of the Labor Cade,you mus Z fodhwith comply with such pmviona,to Nis Permit shall be deemed revoked. 0 �C9 CONSTRUCTION LENDING AGENCY �.r I M1crehy affirm that drcrt is a mnstmminn lending agenry for the Performance of Q' 7 the work fur which this permit is issued(See.3097,Civ.C.) f51 Q 1<ndcr'a Nam. gL Lenders Address U O 1 certify 0.11 from teed Nis application and stem the the aWve information is Fcorrect.1 agree or comply with all city and county ordinances and state laws relating to �U building contraction.)Light1.sam,cmhyauthmd keep hcntadvapf this city men¢no against alrovcmchrit nod property for inspection purposes. (—' VI (We)agme to cove,indemnify and which harmless Ne City of Cupertino against tYl liabililies,judgmcnu.cosssLord expenses which may in any way eccmc against said City U Z in consequence of Ne granung of this permiL Date r-. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOURCE REGUI;ATIONS. ,<< ,�S—i-S�-�-�_. z-`' Re-roofs Signate ApplicanufConarector HAZARDOUS MATERIALS DISCLOSURE Dam Type of Roof Will the applicant or future building occupant store or handle notorious mournal a defined by the Cupertino Municipal Code,Chapter 9.12,and the Hcalth and Safety Code.Section 25532(031 r—t a��� All roofs shall be inspected prior to any roofing material being installed. ❑Yes v Will the applicant or future Wilding aceupxnt esu equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove til hmardous air contaminants a deGnod by the Bay Area Air Quality Managcman all new materials for inspection. iserict9 ❑Yes L7*u I have mad the bvardous materials requirements under Chapter 6.95 of the Califon nia Health&SOL Calc,Sections 25515.25533 and 25534.1 understand that if the building does not cumemly have a mmnt.Nam i1 is my responsibility,or notify ttm occupant of he mgaimments which mal W met priorwissuanceor a cctificale car ecu cy Signature of Applicant Date k,,� QZ All roof coverings to be Class"B"or better Owner or authorived agent Dam ( - ITY OF CUPERTINO • S � s� \ CITY OF PERMIT APPLICATION FORM CUPEkTINO N # a / o S-2 Date: b z a Building Address: Mailing Address (if different from building address): Owner's Name: (WC21 At U L-6� Contractor: , D /� NS ic s (554(� Contac :,), w Phone upertino Business License#: 13� . Fax: _ g Building Permit Info: 6.0?)4 --/Q , "y-b (J kzo q _ Bld ftp Elect LK Plumb (t]� Mech I5� Job Description: Residential [� TCVV73N� OnEC_ Commercial ❑ Sq.Ft. Floor Ar $/Sq.Ft.: Cost of Pr j ct: Occupancy Group: 4v o Type of Co tructi Please check this box if the project is a L, second-story addition: ❑ o'ect Size: Standard Fe Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> IOOK to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1 M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax–Resi/Mobile BUILDING BELEC1000 Elec 600V <= IOOOA ELECTRICAL BELEC1001 Elec 600V> IOOOA ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3 2� �� 3oo. s Ep- «TY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPEkTINO Ouantity Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTWE Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pb1g Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rirIklerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain &Vent PLUMBING BPWATER InstaWAlter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfrn MECHANICAL BRENVIAIl2HAN A/C Units <= 10,000 cfrn MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Fumace> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL 2 of 3 eps , ISCITY OF CUPERTIN(* CITY OF PERMIT APPLICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group BREMRESAPP Remodel Res Appliance ELECTRICAL BREMSIGNAD Rmdl Sips Add Branch ELECTRICAL BREMSIGNS Remodel Sips, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIIv1 Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Ternp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Change BUILDING 3 of 3 W 9213 13 R'Itot zq ze tctL Ad IS cj Jill 81=49E-ot, (X) OZ 91L O/L 9L ZbL A A OIL WL t, 7T— � Sy>Ir �a; as;aii..' a; Iir A,N n � L] —69 �+r Zbl z/Lo---r— ze SL�.+k-068—}-SL l'E Lzt L 3 p L NIS �N I � I I I I I I I N B N III i �NpNII m II 0 0 m m d� OIL Q11 8/L B6 I 4/L se—mak e 8b OZ 8/L 96 8/l SL IR 2 w ro 1� .wv:ycW\q1 • _ 1 J � f Av bL zq 9 bZ9 Ob6S I/90S6ZLL N u'll I m �7- ) 7 f� I N II \„ l M m I all o � bL O 9E—+k 8 Ili 6IL 86 Bb 1 OZ-0— B/L 90 to en zbL ca v G BILMLb STRUCTURAL CALCULATIONS Project: Brushwyler Residence Address:10143 Hillcrest Rd., Cupertino, CA 95014 Owner:Robert and Ann Brushwyler Client/Contractor: Clear Oaks Design— Sue Lane, (408)749-1622 Structural Design: O Martina Treister, Professional Engineer C-50684. Address: 340 A Street, Suite 206, Ashland, OR 97520 Phone: (541)4884889, Fax: (541)482-3153 Project Description: Residence remodel—ceiling/floor beam and foundation Building Type: Single family residence Building Code: Structural design is based on the current edition of the Uniform Building Code, including wind and seismic loading, where applicable. • Soils Report: NA Phone Number: Date of Report: Soil Bearing Pressure: 1000 psf 0TF;R Limitations: These calculations are based on information provided by the owner or client. Design is limited to the specific members shown in the calculations. Where no soils report has been provided the engineer assumes no responsibility for soil or subsrtace conditions. Unless construction drawings are prepared by this office it is the responsibility of the ect designer to see that structural design information is incorporated in E documents. The owner is obligated to engage a qualified person to re cTtq�. d verify that the design has been followed. Any discrepancy between design�asa tip tons andacr'}'u -�, field conditions must be reported immediately. Ror AUF� �P imp Structural Calculations MartinaTreister-Engineering Project T04-18 Page • Brushwyler Residence 348 A street,ste.206,Ashland,OR 97620 Date 4130104 1 10143 Hillcrest Rd., Cupertino, CA (541)468-4889, FAX(541)482.3153 Revised / 'f �2CbFI6clu TIAL _i �N) %Y) i I , r ! I , r , L. I I Shan ) 1 1b � E �� acic �I G Zx(p �9 �+ I f �) 24 2i cl L ' \ I I I, u ) N I � / `\ I j ;S I I i r ' r G UNG, SEAM Ir r I I r � I l Kickey r . I r r i , 1 r i r r StructUralCalCUlatlons MaRlnaTrefsterEngineering project T04-18 Pace r . BfUShWylef R8S[det[C@ 340 A Street Ste 208,Ashland OR 97520 Date 4/30/04 ; ! 10143 Hillcrest Rd., Cupertino,CA (547)488-4889, FAX(547)4823153 -Rev -d* i r I r � r q.o- dj Io _ - - I --i — i I _ I I I' p I I _W I olio. l2-Sf_!� -, G,U COP I�Js - _ I I I I lco I L I : I I I I ; j i l i i l I I i t I : I — - Ma neerin g Page — I 340 A Street, 9 Project 704-1 Brush 'ler Residence t MaSte306,Ashla d,OR 87$20' Date ! 4/30/04 Structural Gatculatons , 9 143 Hillcrest Rd:, Cu ertino, CA ' (541)488-4889, FAX(547)482 01 -3153 Revised : I Fouts OL)POq / I=c•2 f za r<< ,14 Pc,,4 we • - q -- =�-- ; -. - - -U CASs i. f rim j I LJ I I , : : i I i A I•..-..i � ' � li i ..,I ;I .�. it i � ' i- I� UA . C l: I mi, a� r BY) un[o. 14tGG I I I : i Structural Galcula$ons _ ineerin9 Project Toa48 Pase Martina TrelsYer Eng • Brushwyler Residence 340 A street Ste los,Ashland!OR 97520 Date 4/30/04 10143 Hillcrest Rd., Cupertino, CA (541)488-4889, FAX(5,41)482-3153 Revised i L �O z'EA/n FD/R L.Oqb D/nG�z�,Ms • fes!/nilu�n lead in ,E/F --- �� Un *rm load in �/f 4�n albvo !ua// Zelaw ............... 62�uin9 Guall Alvue - .36 \I8 a/m n Land in kips �\/O-<— Cancen�ra`ed had 14M a�ncr� Un Aarm ;/mad ,Fla 23x.42 mbinefion aF uniFvrm and �trictnyuiar loaclm,y /urns Triajyu/ar l7nr/!�/, >poinfs to s red/er R ,A// lAtL< in dips. -�=S n�resf.2s' UniFnrm loaG klF �I SIGN 6F W000 F5EAMa E UIVALENT -TAOULAR LoAf)e The Ghar� "m 'wo s1 i mils 0o- various W-�vd Rrida�ion 6F JMpoKrfies is stidrun L�laur: ar bcnAdin : �cl'ion modulus 'S- ��2 and 5implelm�mMambrit t>7 = w �2/e ar WL/g &joired pian hodufus Por I jwri mamar� Is Sr�d = 12 MJ�b . 1her�Fore bd2 12 WL volving far .WL w l bc�2 fib. xF� Flq � P. F D U rufion r- 0h)r f�Drll�n l shear : Amax = I. 5 R'/rV j R i7��le��ian : l W/12 . Far �imFle5 beams,de,Ped'lon undor Uhil'Drm (4514 i5 A 5 � � Jr- / � = 1.6xIDF i ) 5 w k L,,I x 240 x 1000'11/ 'r in' x 144 In 2 12." 384 x voo 00 bd 3 _ , 25 W L � �i viding this � -thy expressia>7 �,- ber.�in9 i2 17d 9 __ .25 jL� �Ivi far L, 3404 d X E I2 �r� Fb , l J rh I gOO LA = -Ehe lower fimi� Where ddte,,�lian mil & orn over IerndiT �r equivalent Tabular 140s. need tvL L-6invev,✓s¢i�aunle55 i Structural Calculations Martina Trelster•Engineering project mala Page • Brushwyler Residence 340 A Street,Ste.206,Ashland,OR 67520 Date 4/30/04 5 10143 Hillcrest Rd., Cupertino, CA (541)48&4866, FAX(541)482-3153 Revised I SAM �SSIC�hI {�t &ORE: 05IN6i TABLE given onMulti uivalcnt -�+bula,r' ;off, using the Facfars page 7 Mul�tily e%,' :aivalent �Abultr' Ieaol x _V4 W'xL . �leot a beAm IQ,rjer than - he XT value alto edfromrw6fi . 2. Norisantal Shear: IF oxeeeds the UaIue, on page d' 9 deduct loads with in one yam dep+h d- the supr�or� : R'= K - d-w/12 . V f�` exceeds allcwableI__in a,�a alloomble ohcv by Gmi�in9 s�liE I�nyFh Pr ty�5 tevise� [uproot , IN, TaWe¢c, or incrwse be,�m size. �. Cai ec>`io�I : I� the, g�an L i5 .greater .than .fhe dgFI& ion span Limit L6 pa9� cam pure the rdquirea mornenl o� incrto using yk= .25 WI L2 mdd ivied r �allawable ar)d ✓✓ • 7 s is jmn rally 6mservAhvc. 1. Sanding : P= 2.6 k to , 20 k/A , L= 2a ) q= R , h= 11 ' 0. )� = 1.0 b P a W '= �2x2o + Zx2) a gk (sezp. 7 ) < L/2W'L= 8x20 = I60k- • From page ._1� 3elccE 5%"x I2�6iu1� L - IRlo.t3 > )(oo.o o.K . . R� > RA ; . 12 = �20X 20y2 4 IIx 2),� < 3. 10 < 5.q5= R o,k• OrT rcquircd s . z�= ,25X � x 8x w'— g47. O6 � dR= 2x_84"7. 06 = 12.56't 5. f 25 USE 5%b x 13 '/2 61ul�un , =10�.7�1 7 847. o6 QK. ; W'L aVoctycl = 245. 04 kA- h- Ah- rzduced Imo x24Q� = 1s�2 < 12� 2L}5,04 i • Stuctural Galcuiatons Martina Treister-Engineering Project T04-18 page Brushwyler Residence 640 A Street,Ste.206,Ashland,OR 67526 Date 4130/04 10143 Hillcrest Rd., Cupertino, CA (541)4884569, FAX(541)482-3153 Revised ivalent Tabular Loads wSimple T� n 'Want uAth uniform Haj'p� le °r uniFarm toad load W'= 1.0xwL . . . . . . . . .. • W'= wL W'- wL z `` Conc6ntraf6d load a+ mid- p Proud CrIntilevcr-Concenlra hpan simple beim K— lAa at W2.0 P W'. 3p/a n b hjmple beatrn Conr2ntratadload 13A ends Pixel- uniform land / ny point AL a/L k k 4--L—J" ,05 .36 -� 1.66 W'= bPab/L2 .10 72 .35 1,02 W'=2wL/3 I5 1.02 .40 I.92 Rath ands fixed cancarrtrated k eab/L2 y 1.50 2�0 load at canter W Sim�le, beach Loadincrwln� 'An ti lever beam • Ioalincreasin9 ' Uniformly �o one end � uniformly -to one end. W. W W,= yimle beam- Load increasiT w 6intjlever Inam-uniform load. univnnly to eenl�or • ii U if L L f Sim�c beam 4- or valleey� CantilcvGr boom- eoneeRha+ed IW in9. RI=,4 W R2=. 5W Load at end . RI L R2 W=aZw/2 , and L= 2'1 L W ` a= uarc dimension Wra or 117�;� .f w� w r {.irf;W!y distrftW uniform P ` �4b L a I Qad. IP wa > wa/t- tract the load at any point. L diffiirencc a5 R rancerltr4fed �� W'-wa+k(w,n W load rt centar cf a. W'= 01'a L w Continuous bmmn-Twoequal P Continuous beam- Two egual �11s-uniform load on Dnc 5rAAs eOOntratulloadAt L I L anf6r of One. bran: W'= ,766 wl $tfUCh1r31 C81CU19tl,Ofl3 Ma►YinaTrefster-Engineering project T04-18 Page • Brushwyler Residence 340 A Street,ste:206,Ashland,OR s>•szo Date i 4/30/04 10143 Hillcrest Rd., Cupertino, CA (541)488-4889, FAX(541)482-3153 Revised L, -SPAN LIMITS FOR WOOD BEAMS . 5/94 Beam Properties Bending Horiz Shear Deflect Allowable Stress Sect Mom of Load Span Limit Max Load Span - width depth Bend Shea ME Area Mod Inertia Size Normal 7-day Norma 7-day Limit in in psi psi x10A6 int in3 in4 Fact k-ft k-ft k k ft • Size I b I d Fb I Fv E A S I Cf I W L I W'L R' R" Lmax 2x4 1.5 3.5 1510 95 1.6 5.25 3.06 5.36 3.08 3.85 0.33 0.42 6.18 2x6 1.5 5.5. 1310 95 1.6 8.25 7.56 20.80 6.60 8.26 0.52 0.65 11.20 2x8 1.5 7.25 1210 95 1.6 10.88 13.14 47.63 10.60 13.25 0.69 0.86 15.98 2x10 1.5 9.25 1105 95 1.6 13.88 21.39 98.93 15.76 19.70 0.88 1.10 22.32 2x12 1.5 11.25 1005 95 1.6 16.88 31.64 177.98 21.20 26.50 1.07 1.34 29.85 2x14 1.5 13.251 905 95 1.6 1 19.88 43.89 290.78 26.48 33.10 1.26 1.57 1 39.04 2-2x4 3 3.5 1315 95 1.6 10.5 6.125 10.72 5.37 6.71 0.67 0.83 7.'10 2-2x6 3 5.5 1140 95 1.6 16.5 15.13 41.59 11.50 14.37 1.05 1.31 12.87 2-2x8 3 7.25 1050 95 1.6 21.75 26.28 95.27 18.40 23.00 1.38 1.72 18.41 2-2x10 3 9.25 965 95 1.6 27.75 42.78 197.86 27.52 34.40 1.76 2.20 25.56 2-2x12 3 11.25 875 95 1.6 33.75 63.28 355.96 36.91 46.14 2.14 2.67 34.29 2-2x14 3 13.25 790 95 1.6 39.75 87.78 581.55 46.23 57.79 2.52 3.15 44.73 4x4 3.5 3.5 1315 95 1.6 12.25 7.146 12.51 6.26 7.83 0.78 0.97 7.10 4x6 3.5 5.5 1140 95 1.6 19.25 17.65 48.53 13.41 16.76 1.22 1.52 12.87 4x8 3.5 7.25 1140 95 1.6 25.38 30.66 111.15 23.30 29.13 1.61 2.01 16.96 4x10 3.5 9.25 1050 95 1.6 32.38 49.91 230.84 34.94 43.67 2.05 2.56 23.49 4x12 3.5 11.251. 965 95 1.6 39.38 73.83 415.28 47.50 59.37 2.49 3.12 31.09 4x14 3.5 13.251 875 95 1.6 46.38 102.4 678.48 59.74 74.68 2.94 3.67 40.38 6x6 5.5 5.5 1300 85 1.6 30.25 27.73 76.26 24.03 30.04 1.71 2.14 11.28 6x8 5.5 7.5 1300 85 1.6 41.25 51.56 193.36 44.69 55.86 2.34 2.92 15.38 f 6x10 5.5 9.5 1300 85 1.6 52.25 82.73 392.96 71.70 89.62 2.96 3.70 19.49 • 6x12 5.5 11.5 1300 85 1.6 63.25 121.2 697.07 105.07 131.33 3.58 4.48 23.59 6x14 5.5 13.5 1300 85 1,(3 74.25 167.1 1128 144.79 180.98 4.21 5.26 27.69. 3-1/8" 3.13 9 2400 145 1.7 28.13 42.19 190 1 67.50 7� 0.63 Wide 3.13 10.5 2400 145 1.7 32.81 57.42 301 1 9 4. 3.1 2.40 Glula 3.13 12 2400 145 1.7 37.5 75 450 1 1 -. 0 6 4.17 Beams 3.13 13.5 2400 145 1.7 42.19 94.92 641 0.99 14 4.08 5.10 15.94 3.13 15 2400 145 1.7 46.88 117.2 879 0.98 182.91 228.64 4.53 5.66 17.71 3.13 16.5 2400 145 1.7 51.56 141.8 1170 0.97 218.99 273.73 4.98 6.23 19.48 3.13 18 2400 145 1.7 56.25 168.8 1519 0.96 258.11 322.63 5.44 6.80 21.25 3.13 19.5 2400 ,145 1.7 60.94 198 1931 0.95 300.23 375.29 .,5.89 7.36 '23.02 3.13 21 2400 145 1.7 65.63 229.7 2412 0.94 345.34 431.68 6.34 7.93 24.79 3.13 22.5 2400 145 1.7 70.31 263.7 2966 0.93 393.41 491.77 6.80 8.50 26.56 3.13 24 2400 145 1.7 75 300 3600 0.93 444.42 555.52 7.25 9.06 28.33 5-1/8" 5.13 9 2400 145 1.7 46.13 69.19 311 1 110.70 138.38 4.46 5.57 10.63 Wide 5.13 10.5 2400 145 1.7 53.81 94.17 494 1 150.68 188.34 5.20 6.50 12.40 Glula 5.13 12 2400 145 1.7 61.5 123 738 1 196.80 246.00 5.95 7.43 14.17 Beams 5.13 13.5 2400 145 1.7 69.19 155.7 1051 0.99 ,)A9.08 311.34 6.69 8.36 15.94 5.13 15 2400 145 1.7 76.88 192.2 1441 0.98 '307.50 384.38 7.43 9.29 17.71 5.13 16.5 2400 145 1.7 84.56 232.5 1919 0.97 372.08 465.10 8.17 10.22 19.48 5.13 18 � 2400 145 1.7 92.25 276.8 2491 0.96 442.80 553.50 8.92 11.15 21.25 5.13 19.5 2400 145 1.7 99.94 324.8 3167 0.95 519.68 649.59.1 9.66 12.08 1 23.02 & cturalC.alcula't1onS MaRlnBTrelster-Engineering project T04-18 pagan • B(UshN/)tle(Residence 340 A Street,Ste.208,Ashland,OR 97520 Date 4/30/04 M 10143 Hillcrest Rd., Cupertino, CA (541)488-4889, FAX(541)482.3153 Revised VVV LASPAN LIMITS FOR WOOD BEAMS • 5/94 Beam Properties Bending Horiz Shear Deflect Allowable Stress Sect Mom of Load Span Limit Max Load Span width depth Bend Shea ME Area Mod Inertia Size Normal 7-day Norma 7-day Limit in in psi psi x10A6 int in in4 Fact k-ft k-ft k k ft Size b d Fb 'Fv E A S I Cf WL W'L R. R" Lmax 5.13 21 2400 145 1.7 107.6 376.7 3955 0.94 566.37 707.96 10.40 13.00 24.79 5.13 22.5 2400, 145 1.7 115.3 432.4 4865 0.93 645.20 806.50 11.15 13.93 26.56 5.13 24 2400 145 1.7 123 492 5904 0.93 728.85 911.06 1 11.89 14.861 28.33 6-3/4" 6.75 9 2400 145 1.7 60.75 91.13 410 1 145.80 182.25 5.87 7.34 10.53 Wide 6.75 10.5 2400 145 1.7 70.88 124 651 1 198.45 248.06 6.85 8.56 12.40 Glula 6.75 12 2400 145 1.7 81 162 972 1 259.20 324.00 7.83 9.79 14.17 Beams 6.75 13.5 2400 145 1.7 91.13 205 1384 0.99 328.05 410.06 8.81 11.01 15.94 6.75 15 2400 145 1.7 101.3 253.1 1898 0:98 405.00 506.25 9.79 12.23 17.71 6.75 16.5 2400 145 1.7 111.4 306.3 2527 0.97 490,05 612.56 10.77 13.46 19.48 6.75 18 2400 145 1.7 121.5 364.5 3281 0.96 583.20 729.99 11.75 14.68 21.25 6.75 19.5 2400 145 1.7 131.6 427.8 4171 0.95 684.45 855.56 12.72 15.90 23.02 6.75 21 2400 145 1.7 141.8 496.1 5209 0.94 1793-80 992.25 13.70 17.13 24.79 6.75 22.5 2400 145 1.7 151.9 569.5 6407 0.93 911.25 1139.06 14.68 18.35 26.56 6.75 24 2400 145 1.7 162 . 648 7776 0.93 1036.8 1296.00 15.66 19.58 28.33 N 9 2400 145 1.7 78.75 118.1 532 1., 189.00 236.25 7.61 9.52 . 10.63 10.5 2400 145 1.7 91.88 160.8 844 1 257.25 321.56 8.88 11.10 12.40 12 2400 145 1.7 105 210 1260 1 336.00 420.00 10.15 12.69 14.17 13.5 2400 145 1.7 118.1 265.8 1794 0.99 425.25 531.56 11.42 14.27 15.94 15 2400 145 1.7 131.3 328.1 2461 0.98 525.00 656.25 12.69 .15.86 17.71 16.5 2400 145 1.7 144.4 397 3276 0.97 635.25 794.06 13.96 17.45 19.48 18 2400 145 1.7 157.5 472.5 4253 0.96 756.00 945.00 15.23 19.03' 21.25 19.5 2400 145 1.7 170.6 554.5 5407 0.95 887.25 1109.06 16.49 20.62 23.02 21 2400 145 1.7 183.8 643.1 6753 0.94 1029.00 1286.25 17.76 22.20 24.79 5 2400 145 1.7 196.9 738.3 8306 0.93 1181.25 1476.56 19.03 23.79 26.56 2400 145 1.7 210 840 10080 0.93 1344.00 1680.00 20.30 25.38 28.33 5 2400 145 1.7 223.1 948.3 12091 0.92 1517.25 1896.56 21.57 26.96, 3{0.10 8.75 27 2400 145 1.7 236.3 63 14352 0.91 .5 2400 145 1.7 249.4 11085 16880 0.91 1895.2 23 1 } 316,5 2400 145 1.7 262.5 1313 19688 0.9 2100. 4. {�Y 35.rt2 .5 2400 145 1.7 275.6 1447 22791 0.9 2315.2 94.06 6.64 33.30 37.19 2400 145 1.7 288.8 1588 26204 0.89 2541.00 3176.25 27.91 34.89 38.96 .5 2400 145 1.7 301.9 1736 29942 0.89 2777.25 3471.56 29.18 36.48 40.73 6 2400 145 1.7 315 1890 34020 0:89 1024,00 37K,00 30.45 38.06 42.50 a. Glulam beams over 5 1/8"x12"x2l'long have to be adjusted by a volume factor per I tyD$ I rvis d q.,pr(enwvd ,Ta5le 58 b. Deflection Limit indicates the shortest span for which deflection can govern. Deflection need not be checked for spans shorter than Lmax. c. Horizontal shear need not be checked unless the reaction is greater than,R' d. 7-day loading values have been increased 25% for short term loading. e. 2" lumber assumes 24" max spacing for repetitive stress values. Use 87% for single use. f.Values for 4x and 2-2x assume single use. Increase bending load 115% for repetitive use. g.Values for 2x and 4x lumber are Douglas-Fir No. 2. For 6x DF No. 1. h.Values for 2x and 4x lumber per Western Lumber Grading Rules 1994. Martina Page project T04-18 • ! Structural Galculatiorts . Brushwyler Residence 340 A Street,Ste.206,Ashland,0 97520 Date 4/30/04 10143 Hillcrest Rd.,Cupertino, CA '(541)488 4889, FAX(541)482-3153 Revised Deflection Factors • W, in k/(t,; to kips, L a-, d a in Feob.)- E=_I.6xIOL 'i; A = L 240 W hirtr�fehzn Unirarm hard ^ �2 4inrpleZn-Concer(ttzErd � a Load at center • Q�= 25,'23 U wkL3 02 r L X�= , n� k 3/S Za=.40 p L� I w Iiro ed Cal'rEllever yiPrap��d can�ilev�r, uni ,"rnrad �anntrated foadatc�nr p � ,00519 wk L4/r Amax-'CoOg4 1'L3/I Ia= ,104 wk L3 rrz= ,1761f L2 W F Fixed bah ends yi P n9am i(f& bo✓= ends uni arm load — �o>IcPr7^t^rated load a�cent¢r L e¢-,o025 wk L4/1 L 0 = ,W5 �k 23/� .T"= ,05wk L3 n I ` 0,10pkL w Over�i!�( beam- �- n r a yimple ,fztn,-tub�mmelriall urlflarm Io�YaC Gonc¢ntrated loads a L 64=.04 roka. (4A2L-0+343) L �Imme•trlGa,lly X146¢4 x I�>,8 luk(4a1L-L3+343) I�=D.SPka (3L'4a2)IL a w Over InOver� beam,uniF rm x=V-t Ov¢rh inq I�zam,loncen load an overhang V �`� trafzd 4 ori ovorWS • ti L 1%,=.1(0 wka3(L+,"15a)1I � L I Aa=,32 rA'(L+A)/I Tot-- 3.2 wka.2(L+.-75a) �x---308wkct� LZ�S;Ix� 6,1(owkLa2 Ax = PaL�i ; � _ '` .L w GU¢rh� lazarn, uni�rrn t' y2 Gvi� - � 'n9 . f • n load battvecn 3tiu a L Qa = -.00 L% (up) a L Act',04 v a L/I (.uFward) wkLZ �a= 1.2P' L2 lantil¢ver lxam, uitiro m P (tnblever lWam,cancen- l�ad braked load aL end A = •12wkL4�I � L Q=.32 �kL�/r • ���__L IR_ 2,4wkP IR= (a.4pk L2 w.. Ov¢rha�gi beam variable W simple o 00 e'ymme r%Af loads oyY= aWoverharq �rianguldr load a Pa= ,04w(4A'64+,?5a)-cnL3) L Q�=,016 W L3�I c, w%w Za=,�w 4a2 Lr.�Sa)-Gl3A R_. ?,2 14' L�. StrueturatGalculatwons MartinaTrelster-Engineer(ng project T04-18 Paye • Brushwyler Residence 340 A street,ste.200,Ashland,OR 97520 Date 4/30/04 10143 Hillcrest Rd., Cupertino, CA (541)4884889, FAX(541)482-3153 Revised �O�u m n ��Sitih T i E= 17ooOcy N D5 19V 3.77 Foy 1 c4-ya11 j u o sup poo kcZ (a t w m-s CPt/c1/z : VISUGIIy �{fQG7PCl `,�il�7N tGlNivP✓ : C - • g, �G�c ' • 3 .1 2--L 4k ¢ 4x6 . 4x8 . 6x6 FcE 498 678 678 673 M7¢ S I FG ' 436 S57 557 557 94 5 R, ¢ loo,) 410o. 1O�700 14, boa 261160 • h Q) fc - 3 q 536 536 53& 132 3 q1 F� 357 Q63 43 43 803 F3) 800 6, 60o 8, 90o 12,1550 .24)3(90 'uv I I 319 434 434- ¢ CWL • n l0( FG' 3o2 410 410 P� 3, /70 5;02o 7, 4oO 0)760 22j1712 ti FcE X63. 358 359 35S 995 III Fc' ,747 327 327 327 6G � Pc, 2 boo goo 5 6, 390 8 58o ,70111 © FGE 221 30/ -30/ 30/ 74d- 12 4d121 Fes' ,710 .29 254- 294- 593 �x ph- 2,2oo 3,48o . 51470 .7, 450 17, 940 FCC 721 - 221 221 547 )10 ,2/0 .21a q70 'PA 2570 4;o 4o 5,5/0 l 4,220 • Structural Calculations MartinaTreister-Engineering project T04-18 Page Brushwyler Residence &49 A Street,Ste.208,Ashland,OR 97520 Date 4/30/04 10143 Hillcrest Rd., Cupertino, CA (541)488-4889, FAX(541)482-31 53 Revised ` _► OFEFwil�lG - p�rzT�/�C • • N040 ¢X Her. w o T E -' _. J LeJ�Ycr OK r i 3 : -Jc i.\ T G UNG, 3EAH r , 9) k : ev rclC 1 1 ; F�S %r1A T q isFy Cr A b : OF CAt\FD stucturaI plans and Details Martina Treister Engineering project T04-18 i Page ..... w.. Brushwyier Residence 0a0 A Street sie 205,Ashtand,OR 97520 Date :4130/04 _.. .. //.- 10143 Hillcrest Rd., Cupertino; CA' (541)4884889, FAX(541)482-3153 Revised - 1l F(�cerl(jai 1�aq RL : c db° a 1 . �t a KF j : , 4 , : i : : v J , s I I o� �.ccho PP�\NA T9 a C- 0684 D P l ' ' r .. _ .,.. OP CALIF Brush ler Residence 340 A . $tUCtufal PIanS and Details Martina.Treister-Engineering. ,Project T04 18 Page: .., .Street,Ste.208,Ashlgnd,OR 97520 ..:_Date 4!30104 `HY ✓ 101'43 Hillcrest Rd., Cupertino, CA (541)4884889, FAX(541)482-3153 Revised (E)Lx purbri/hip/ridge v+' 6LB 31/8 x 15 or better. support To remain a.,heMU occu rs+�Ii with \ Simpson A35 framing clip or cap or equiv.to supporting ; ; po5t5:Cut and rernove(E) equiv.to new girder• \ \ tnp plates as regi Bred for Cut and remove(E) ceiling I /— new post,strap with Simpson Joists as required for(N) j / 570224 across plate splice. girder, hang with Simpson LU5 If new girder is Installed dropped hangerorapproved equiv. Wowexiotiny ceiling,install 2x Contractor to provide adequate i foist blkg.above girder temporary shoring prior to j removal of(E)bearing walls or girder i (E) CEILING JOISTS TO NEW GIRDER 20108 Mi 1994 t ,,QPOFESS/p ai��QQP�\NA Tiq �s lF'yc r 050584 m �P 0 Stuctural Plans and Details Martina Treister-Engineering project Toa-18 Page • Brushwyler Residence 040 A street,ste.206;Ashland,OR 97520 Date 4/30/04 .3 10143 Hillcrest Rd., Cupertino, CA (541)4884889, FAX(541)482-3153 Revised r- r • Simpson ECCQ or approved equiv. j 2-2x top plater, If C61410 Beam it dropped Wow top plater, install / 5impson 5T6224 arrow splice in top plates. Fill all Ceiling beam -see framing • nail holes with 10d nails. plan, i Port,multiple studs or beam -see framing plan • CEILING BEAM CE Copy POSTMALL 1026A l0)Mr 1994 PPOFESSiC�q . `NA TgF�s�9�yZ ac C m s �P �p CAU Stuctural Plans and Details Martina Treister-Engineering project T04-1e page • Brushwyler Residence 740 AStreet,Ste.206,Ashland,OR 97520 Date 4/30/04 S �' 10143 Hillcrest Rd., Cupertino, CA (541)488-4889, FAX(541)402-3153 Revised • �Iternate:Cut and remove(E) t floor 61heathing ar required to ! New port with (2)5impron extend new port continuous HGA10 or equiv.to base plate to (N)foundation. Install 2x bike. • around post to support Sheathing 5impron CCQ column cap or equiv. 9 p . New or exirtlne double / Existing wall framing joists,4x blocking or girder under new port i New port- 51mpron CB or ID column i came rize a6 above base or equivalent Fi E I Il NOTE:If base thickness #4 012"o.c. exceedr,12", inetall 2 -#4 each way(3 -each _e y p barb ea.way a to ° 12"a care e way min) � q , ° : r e 2'-6"r uare 3"clear t yp. . NEW POST AND FOOTING AT EX. FLOORC404913G ����� �OQPOFESSII c��Q`PP�\NATq�/S gym c C 0684 xp o IL P "FO ­;Stctural Plans and.Details Martina Tfeister-Engineering project T04-18 Page .... • Brushesyler Residence 340 A Street,Ste.206,Ashland,OR 97320 Date 4/30/04 10143 Hillcrest Rd., Cupertino, CA (541)488-4889, FAX(541)482-3153 Revised •••••J// FOUNDATION NOTES have been corrected to conform to the approved plans and specifications or to revised details General approved by the Building Officer prior to final. Treister Engineering will be available for 0401. Verify all dimensions with architectural inspections on the first and third Monday and plans. Report any discrepancies between actual Tuesday of every month. condition and design assumption to the engineer immediately. Structural details are schematic and 450. Framing plans show size and spacing of mem- not to scale and reflect only the structural bers but may not show all blocking, double joists, construction requirements. Additional foundation milers and other members required by the building and framing work may be required due to code. Structural details are schematic and not to fiieldcondition encountered during construction, scale and reflect only the structural construction Design and construction to be in conformance requirements. with current Building Code. 451. Unless noted otherwise, all wood beams, joists, 402. Foundation design is based on UBC Table 18-I- rafters, blocking, plates and filler are Douglas Fir- A. Larch (DF-L) No. 2. Solid sawn wood beams 6" or wider are Douglas Fir-Larch No. 1, unless noted 403. Footings were designed for soil bearing pressure otherwise. Studs are 'Stud' grade or better. Posts are .of 1000 psf. Douglas Fir Larch No.l. All multiple members to be internailed with 16d @ 6"o.c., staggered unless 404. Bottom of all footings are to be level and rest noted otherwise on plan. 'on undisturbed soil regardless of elevations shown on plan. 452. Unless noted otherwise Glulam Beams (GLB) are: 2400 psi bending stress; 165 psi horizontal shear 409. All foundation to consist of reinforced concrete. stress; standard 2000' radius camber (installed up- Unless otherwise noted, concrete strength is 2,500 ward). All GLB's to be exterior glue and industrial psi minimum. Reinforcing steel yield strength is grade, 24F-V3 for simple spans and 24F-V8 for 40,000 psi minimum. cantilevered beams. Submit ATC Certification to building department prior to installation. GLB's 413. At existing concrete, neatly saw-cut any con- exposed to weather shall be pressure treated with an crete to be removed. approved preservative or be manufactured from wood of natural resistance to decay like Alaska 414. Where new concrete is poured against existing, fellow Cedar (confirm allowable stresses of material contractor shall thoroughly clean existing concrete to used to be adequate). expose solidly embedded aggregate. All continuous &10e�iiiliijg reinforcement shall be doweled into existing concrete 456. is not shown on the details con- using epoxied dowels of equal size. form , /Tabl 3-II-B-1. All exterior nails are to be galLarZtzed fiAils,shall be common wire '417. Site preparation, grading, drainage, etc. shall be nails. All bolts`shQl be/sWdahr. 07 machine bolts in accordance with current Building Code. with standard cut �rfasl�ers�4rnd r heads and nuts. Each bolt hole to be drilled 1116" larger than the 418. Temperature of mixed concrete at time of nominal diameter of the bolt. placement shall be at least 50° F and not more than 90° F. Keep surface wet for 7 days immediately fol- 459. All metal hardw F$s s, strap lowing placement. ties, holdowns, etc.) Rs¢t ed by Simpson Strong-T' Y. ? per 419. It is recommended to retain the Engineer of manufacturer's sp ins with in rjn her Record to provide structural observations and of fasteners. All ontal ��memb of documentation in accordance with UBC section 1702 framed across orting mernliers s P be note #5 for the foundation and the major framing supported by jo am ger xt 'or members. Contractor or owner to notify engineer in a hardware and hard uSee 5n c call * ted timely manner for all inspection required A written wood to be galv ed. se fQ n s or r p°:r5img e. vtsth► Tre - Pro • en m... a an "w et er"any o served' deficiences Brushwyler Residence 340 A street,ste.20e,Ashlar ll,gg VaM ate _ anger 10143 Hillcrest Rd., Cupertino, CA (541)488-4889, FAX(541)482-3153 Revise 1 41 lire CITY OF CUPERTINO BUILDING DIVISION PERMIT CONTRACTOR4NF0 MATIOO N e BUILDING ADDRESS: CLEAR OAK DESIGNS PERM""°'04050150 10143 HILLCREST Rn OWNER'S NAME: PERMITISSUE DATE ROBERT BRUSHWYLER 1723 B RO E: SANITARY NO. CONTROL NO. (408) 436-5448 ARCHI]EC iENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 LICENSED CON'TRACTOR's DECLARATION Job Description o wF I m 70 affirm Nat 1 am licensed undo provisions of Chapter l(commencing !D` with section)id a)af " 'si east Norman Code. myliccnx is in roll rarer�pnae .j KITCHEN REMODEL D E2a Dare' OYts 'c.N ✓✓ 73 RCHHECTS DECLAKAHUN 'y z 1 tinders my plana shall he used u public mentos ` 7 / JC. GG Licensed Professional 3 OWNER-BUILDER DECLARATION Q— qy I bachy alum Nal I am aempt from the Contracmfs License Law for the C 00 rulnwing mason.(Saturn 7031.5.Business and Porfassiom Cade:Any city or county C><V400nn .t S�i which requires a Permit to conslrua.alter.improve.dcmoliah,or repair any structure °iy priorm its issuance.also requirs the applicant for such Permit to Ole a signed statement s< thatheisliccnmdpuumnunthepmvisiomoftheCmamcmr'sLtmnmlaw(ChaperY Sq. Ft. Floor Area Valuation iF$ (mmmcncingwiNScction7")o(Divaion3afth,Businaaand Dofaaiom Cnde)ur But he is eeempt thcrtfrom and the huts for the alleged exemption.My violation of Section 7031.5 by ary applicant for a permit subjects the applicant to a civil penalty of 3aftwbbiberu 0 Occupancy Type not more than fire hundred dollar.(1500). ❑I.as owner dins pmpeny,or my employees with wages as their sole Compensation, will do the workand thestructve isnatintaMed oroffdred fonate(Soc.70",Businev Required Inspections and Professions Code:The Contractor's Limns Law does Out apply to an owneer of q P Property who bui Ids or i m proves thermn,and who does such work himself or through his awnemployms,provided that such improvements and not intended arafrrrtd forSak LL however,the building or hnprowment is sold within one year of mmpleuon,Ne owner Wilder will love the burden of Proving for M did not build or improve for puryow of aale.l. ❑1.as owner of the property,am exclusively contracting with licensed convectors m conswn the project(Sec.70".Business and Profeuiom Code:)The Comncsfs V- denad Law docs not apply to an owner of property who builds or improves themon,and who contacts for such projects with a conrraetor(s)licensed pursuant to the Convecmr's Limn.Law. ❑I son exempt under Son. ,B&P C far this resson Owner Data WORKER'S COMPENSATION DECLARATION I hereby affirm wWer penalty of perjury ane of the following dalaraiora: an and will mainain a CcniOcate ofConsem w self-inure for Worker's Compere ,u provided for by Section 37M of the Latim Cade,far the performarec of the for which this permit is issued. ❑1 have and will maintain Wmicefs Compar uuon Irauonde.as required by Section 37W of the Labor Cade,for the perfmmanee of the work for which this Permit is issued. My Woha' Com motion Ins na carirl and//Po� licy nu lbcq�r ares:(� I v Carrier.—�,.�,j{p_c PplRy No.: `rI-�`'� '-� CE FICATEOFMEMFrIONFROMWORKERS' COMPENSATION INSURANCE (This section need not becompleted if the Permit Is Imam,hundred dollen(SIM) or las) I certify that in Ne performance of the work for which this Permit ts issued.I shall nut employ any parson in any mannerso as b become subject to the WorkaR ComPcnSauon Laws of California.Dae Applicant NOTICE TO APPLICANT:If.after making this Ccnificate of Eacmption,you should become subject to the Worker's Compensation provisions of the Labor Coda you must Z foMwort comply with such provisions or this Permitnhall be domed revoked. Z O CONSTRUCTION LENDING AGENCY � hereby affirm Wt there Us eonstuctinn lending agercy far the perfmmarcc of lYi > the work fur which this permit is issued(Sad,3091,Civ.C.) {T.7 Lcndee:Name D. lenders Address U 0 1 amity that I have read this application and state dm the above information is lT. f- COMM 1 agree 10 comply with all city and county Ordinances add sure laws relating to U building construction.and hereby authodm rtpraenmivcs of this city to doter,upon do r Is1 .hove-mentioned property for impaction purposes. ,r CL (we)agree to taw.indemnify and keep Idnalas did City of Cupertino against N Iiabiliuo,judgments,eon and expeasa which may in any way see=against Said City U Z in consequence of the granting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Dale SOURCEREG gATIONS. .� ZS Re-roofs Signso Apel Mot/Contractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant Sort or handle hazardous maeri l in defined by the CupeNno Municipal Code.Chapter 9.12.and the Hda th and Safety Code.Section 255324)7 All roofs shall be inspected prior to any roofing material being installed. AML ❑Yds L]�� Will the applicant ar future building occupant ae cquipmut or devices which If a roof is installed without first obtaining an inspection,I agree to remove haxardnus.ir contaminants m defined by the Bay Area Air Quality Management all new materials for inspection. id" o r 1 have real the basardmrs maerials rtquiremcnts under Chapter 6.Y5 of the Glifor- SiaFkalth&Safety Code,Scetiota 255(15,25577 amI755Ja.1 understand thaif the Willing oma not cumnthy haw a unana that it is my rasponsihility m nodly We occuPent of the requiremerm which tier lz met priorwissraec ole urufiue or Ocm Signature of Applicant Date 0��� All roof coverings to be Class"B"or better wnerror authorieeJ agent Datc