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13030042CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS:. 20064 JOHN DR CONTRACTOR: ZL CONSTRUCTION CO PERMIT NO: 13030042 OWNER'S NAME: MICHAEL TIMPANARO PERROTTA 1765 ARKELL RD DATE ISSUED: 03/08/2013 OWNER'S PHONE: 4088214086 WALNUT CREEK, CA 94598 PHONE NO: (925) 899-5704 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIALO ❑ LI SED CONTRACTOR'S DECLARATION SIC8: 77 SFDWL POOL DEMO 592 SQ FT License Class` Lic. # 6� Contractor vv Date I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business &Professions Code and that my license is in full force and effect., I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $7500 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 36934027.00 Occupancy Type: Section 3700 of the Labor. -Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 00 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAY OM LAST CALLED INSP TION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, City in of the �" costs, and expenses which may accrue against said consequence Issued by: Dater granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signature Dater All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and.the structure is not intended.or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE , construct the project (Sec.7044, Business .& Professions Code). I have read the hazardous materials requirements under Chapter 6.95 -of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation; as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: Date: permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all city and, county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon; the above mentioned -.property for inspection purposes. (We) agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature. __ Date CUPERTINO SWIMMING -POOL I SPA PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION A? 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 oU (408) 777-3228 - FAX (408) 777-3333 - building(Dcupertino.orq (\� JV PROJECT ADDRESS %� ©©� / o j / Y_ y) !_/ ('+ ' ,,% OWNERNAME //�� 1 ,kiQp7 I I r4 9 G<.I`J G�,,i•C% PHONE oo`o sel _%1 ` &MAIL STREET ADDRESS / f (DO ` V � (,/ `� CITY, STA ZIP FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP TF ❑ OWNER - ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT -7 CONTRACTOR NAME / _ y��[ �u j �� �j? LICENS 032 LICENS EL BUS. LIC # COMPANYNAME L_ CO(� / f� E-MAILZ�1 ` '7 LQ�S_ Y�(�+�1 FAX STREET ADDRESS DORES17S �• bi2�� 17 tE7 CSG ' ZIP ' ' S 9 6S --666 ARCHITECT/ENG INEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ///��� DESCRIPTION OF WORK / 0 � ► /©o _ f _ ak (�� V(CrI� �(_(�� ✓I�4 % C, cam/' `� f}� `� CIA- USE OF ❑ SFD or Duplex ❑ Multi -Family STRUCTURE: ❑ Commercial TYPE MATERIAL TYPE (CODE) AREA (SQ. FT.) VALUATION (S) POOL S`� �7 ` L 75 O > POOL/SPA MATERIAL TYPE CODES: V - VINYL -LINED - FIBERGLASS G ' GUNITE PREFABRICATED SPA DEMOL U _ By my signature below, I certify to each of the following: I am the property owner ofa—utholized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Descriptio ofWork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize re3MC49entatives of Cupertino to enter the above-ide ]ee �or�spection purposes. SignatureofAppiicant/Agent: ` Date: S SUPPLEMENT ORMATIONREQUMED _ Commercial or Multi -Family Buildings with Public Swimming Pools: Department of Environmental Health approval required OMWH AIV CHEp^� _11 MINIMUM-e ARDlPUBLIGVfr01 MAJOR.`-�` ,�_� � C'DEET:� SANiTARYSF�WEKDI_STRICT SwimPoolApp_M Ldoc revised 03/16/11 CITY OF CUPERTINO wimir ucmTnR A rrniD — U1T1F]F 11TNf_' IIIViRT(1N Ilech. Plan Check Mech. Permit Fee: Other Alech. Insp. Mech, Insp. Fee: Plumb. Plan Check �Elec.Plan Check Plumb. Permit l ee: Elec. Permit Fee: Other Plumb Insp. Other Elec. Insp. Plumb. Insp. Fee: Elec. Insp. Fee: NOTE: This estimate does not includeDees aue to otner meparmtents (i.e. rturernng, r u..«... �• n,, _ �• ��•••-�• . - • �. _ _ _. ___, _ ___ _ _ _ b d th /'mina —formation available and are onlyan estimate Contact the De t or addn'l info. lua=et etG . These ees are ase on a re t FEE ITEMS (Fee Resolution 11-053 E . 7ff /1/12) FEE QTY/FEE MISC ITEMS ADDRESS: 20064 JOHN DR DATE: 03/08/2013 REVIEWED BY: Mendez # Swimming Pool 1DEMOPRES Demolition BP#: *VALUATION: 1$7,500 hrs APN: PME Plan Check: $0.00 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex Permit Fee: PENTAMATION 1 SFPOOLDEM PERMIT TYPE: i USE: 0.0 hrs $0.00 WORK PME Unit Fee: $0.00 SCOPE Ilech. Plan Check Mech. Permit Fee: Other Alech. Insp. Mech, Insp. Fee: Plumb. Plan Check �Elec.Plan Check Plumb. Permit l ee: Elec. Permit Fee: Other Plumb Insp. Other Elec. Insp. Plumb. Insp. Fee: Elec. Insp. Fee: NOTE: This estimate does not includeDees aue to otner meparmtents (i.e. rturernng, r u..«... �• n,, _ �• ��•••-�• . - • �. _ _ _. ___, _ ___ _ _ _ b d th /'mina —formation available and are onlyan estimate Contact the De t or addn'l info. lua=et etG . These ees are ase on a re t FEE ITEMS (Fee Resolution 11-053 E . 7ff /1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00F$306.001 # Swimming Pool 1DEMOPRES Demolition Suppl. PC Fee: Reg. 00 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 .Suppl. Insp. Fee -0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Conswitction :Tar: ,4dministrative Fee: 0 Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure. A Travel Docutnentatifin Fees: Strong Motion Fee: IBSEISMICR $0.75 Select an Administrative Item - Bldg Stds Commission Fee: 11BICBSC $1.00 $1.75 $306.00 - _ �_ " $307.75 Revised: 01/01/2013 civic, 1-0 N 0 ent OFFICE COP" A. V, AR 0 8 2013J. 11 n' MSAVOR CODE��AWCE Reviovad By* " " I I jCOMMUNITY DL---!PL0PiNiE-NT C=Z� BUiLD!NG DiVi&ON - CUPERTiN APPIROV D C) ',-Ic This set of plans and specifications MUST bek.p,-J at job site during construction. It is unlawfu to nn -..`,e .-my cha naes or altera-LJmns on Same, 01, therefrom, without approval from the Bui dflr!g The stamping of this plan and specificatior s SHALL NOT be held to permit or to be an approval of ilhev;.jiatlon f y City Ordinance ()r State Law. of any provr so any Ivb( -0 Vi" BY e% DATE PERMIT NO. LA :5 JOB ADDRESS: PERMIT OWNER'S NAME: PHONE #� � GENERAL CONTRACTOR: 2� /'(� ' BUSINE:S' LICEI�Ty#' . ADDRESS: CITY/ZIPCODE.` *Our municipal code requires all businesses working in the city to. have a City o Gupeo, business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S),:. WILL -TBS+ SCVEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE ,.OBTAINEDA`CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: ignature " _ ate Please check applicable subcontractors and complete the following in%rmaton . V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Y" Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing ... .. Heating Insulation s.. °' Landscaping k Lathing Masonry Painting / Wallpaper4Y,1.`: Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock" Tile +t Owner / Contractor Signature Date Robert B. Rogers Geotechnical Engineer P. O. Box 1456 303 ooqa Antioch, CA 94509 Ph: (925) 778-4950 FAX: (925) 779-9890 28 March 2013 FILE �3 Mr. Zali Lorenz ZL Construction 1765 Arkell Rd. Walnut Creek, CA 94598 Compaction Test Results for Swimming Pool Fill at 20064 John Drive Cupertino, California Gentlemen: At your request, I reviewed the Field Density Test conducted by Construction Materials Testing of Concord, CA dated 3-18-13 (copy attached). They conducted three field density tests.all at finished grade. A sample of the backfill soil was taken to test point which gave the maximum compacted dry density of 125.9 PSF at 10% moisture content. This result is consistent with a sandy silt. Based upon the full compaction curve, all three field density tests passed the minimum 90% relative compaction. The field test dry densities ranged from 119.0 to 122.6 PCF with 13.9 to 14.7% moisture content, which was wet of optimum. QUALIFICATIONS The undersigned holds a Master of Engineering graduate degree from U. C. Berkeley, 1980, with a major in Geotechnical Engineering and a Geotechnical Engineer certificate from the State of California Board of Registration of Professional Engineers and Land Surveyors GE -2041 granted by the first written test given by the Board in 1988. 1 have practiced Geotechnical Engineering, predominately in Contra Costa and Alameda Counties, since 1985. CONCLUSIONS Based upon the field density test data the subject swimming pool was backfilled in accordance with good geotechnical engineering practice with properly compacted backfill, with 90% of the maximum dry density by ASTM D 1557 test procedure maximum dry density. Very truly yours �2 4,- Robert B. Rogers G. E. 2 41 Encl./ Exp. TECH�`����� ATE OF CP��F I LLV IJ J•I II I I i 11 1 Q/.Li.. 4Vii�6•:V4UVI1 \; V:JG.JTV•JVVVJ {1Ct�C I I I 1 1 CMT, INC. R DAILY FIELD REPOS � "=T HAW .l�if `61, tot, $1 CUE NTORC E.R 7 Z— DAY FIELOREPOIRTSEOU"r N0. WAPALOCATIgN9FIVOW t3L��E11AI. COPT CPt ZL TYPE OF WORK c t! 1'•U ICY G .E i eil UMg�V•aE/BR43Rt'�1ENTSREPAESENTATIVE DATE tltl �} L1AYdF9€it GRAOM CC aUCTOR PROJECT $hk3tlOM SUP b'LSfSR WRACTOR SgSUPEIRWENDENT OR FOREMAN C� Mau — SGURCk ANO pl Ag�TgN �3F flLi IAATEPtWt T, 5ST5) .^y •`+ WEATHER B� '8.,p�a�i 5'4, Gam+C� �t'na l,...'9 i�t1 +�, _._�.�d",'`� TECSR,tICiAN SGR,@E lS3ED FOR MAIXNJpi SPREABdV ,1bATE RM, CONtNTSONM. ANQ WMFACT ( 17 d. 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