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14040160CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19970 PEAR TREE LN CONTRACTOR: HAULING PROS PERMIT NO: 14040160 OWNER'S NAME: ANSHENG LIU PO BOX 4033 DATE ISSUED: 04/23/2014 OWNER'S PHONE: 4084061860 WALNUT CREEK, CA 94596 PHONE NO: (925) 682 -8987 JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ ❑ LICENSED -CONTRACTOR'S DECLARATION REMOVE (E) SWIMMING POOL & FILL TO 90% License Class Lic. # " l COMPACTION / FOR FUTURE BUILDING AREA A, Contractor �[ I vlo► / "yS i � � 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 mpensation, as provided for by Section 3700 of the Labor Code, for the Valuation: $6000 erformance of the work for which this permit is issued. Sq. Ft Floor Area: e I have and will maintain Worker's Compensation Insurance, as provided for by ction 3700 of the Labor Code, for the performance of the work for which this APN Number: 31631003 00 Occupancy Type: 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 180 DA IT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter 180 D OM C LED INSPECTION. upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, the Z3 costs, and expenses which may accrue against said City in consequence of Issued b Date: granting of this permit. Additio ally, the applicant understands and will com with all non -point source tions per the Cupertino Municipal Co e, Secti n 9 18. RE- ROOFS: � n Signature Date C/ 3 r All roofs shall be inspected prior to any roofing material being installed. If a roof is inspection, I agree to remove all new materials for installed without first obtaining an inspection. ❑ OWNER- BUILDER DECLARATION Date: Signature of Applicant: 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, do the work, and the structure is not intended or offered for sale (Sec.7044, will 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. 1 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 will maintain compliance with the Cupertino Ipal Code, Ch ter 9.12 and performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by the Health &Safety C=LENDING 2550, and 25 �/' Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized ate: G x 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 C Compensation laws of California. If, after making this certificate of exemption, I become 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 subject 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 / SPA PERMIT APPLICATION 0 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION O 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 A S P (408) 777 -3228 • FAX (408) 777 -3333 • buildincl aacupertino.org \� PROJECT ADDRESS y 6 AN 3 ( O Z OWNER NAME 114 � 4el/ L PHO E -MAIL STREET ADDRESS , �- /y /J� ` �f ( / rite C CITY, ST E, ZIP FAX CONTACT NAME � PHQ�I)r, � � /r � L E-MAIL STREET ADDRESS � U /,� o X ? 3 n❑ CITY, STATE, ZIP/� �� FAX ❑ OWNER ❑ OWNER-BUILDER OWNER AGENT ' CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ! /�� f / V �/ w C r LICENSE NUMBER J�/ W LICENSE TYPE BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS %�%t �O ? J CITY, ST'�E, IP� /y �� `7 2' 7 r ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK d C) � V ^c k 11 ca M J04 C /- C11) ./� a v 1 . USE OF ❑ SFD or Duplex ❑ Multi - Family TYPE MATERIAL TYPE (CODE) AREA (SQ. FT.) VALUATION ($) STRUCTURE: ❑ Commercial POOL POOL/SPA MATERIAL TYPE CODES: SPA V - VINYL-LINED /n F - FIBERGLASS DEMO G - GUNITE P - PREFABRICATED TO6 V &V N: By my signature below, I certify to each of the follo am the pro wner or orized ag to act o the property owner's behalf I have read this application and the information I have provide ect. I have scription of Work veri s accurate. I agree to comply with all applicable local ordinances and state laws relating to buil ' ilstruction. I adMorize representatives of Cupertihbenter the above- identifi �7pr�oope for inspection purposes. Signature of Applicant/Agent: Date: �` SUPPLEMP.YAL INPORMATION REQUIRED _ Commercial or Multi-Family Buildings with Public Swimming Pools: Department of Environmental Health approval required. SwimPoolApp_2011.doc revised 03116111 CITY OF CUPERTINO D FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 19970 pear tree In DATE: 04123/2014 REVIEWED BY: melissa APN: 31631 003 BP #: *VALUATION: 1$6,000 *PERMIT TYPE: Demolition Permit }1::. V C:;:I:II' <- /� "1''/'/`: PRIMARY PENTAMATION 1SFPOOLDEM USE: Swimming Pool, Res. PERMIT TYPE: WORK remove a swimming pool & fill to 90 % compaction for future building area SCOPE t1a,:., r ,.. J ST, L i.ai •' 4,, hg' {'R' S f 'f,. P!o 1?sc'3, x3t'Zr'fsi3I .Sf;. I sYsv' I� u ...______.__ n. in- a --i - F...n Qn..itnn, Rawer nistriet. School NOTE: This estimate does not tncivae fees aue to outer jjepu....t -- i..-. _ .w••••.••b, - - -� -__ .. _..._, _ _ _, District, etc.). These fees are based on the relimina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11- 053�f. 7/1/.13) FEE QTY /FEE MISC ITEMS F Plan C.'he�, Fee: Plumb, .'.:1Vh:,; -, iii {'w Permit Fee: $319.00 Suppl. Insp. Fee: Reg. 0 OT 0,0 hrs $0.00 {Sal „ §`P r'dC' bfiPa k a : ploanv'��Io' bees” Strong Motion Fee: iBSEISMICR $0.60 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 $320.60 $0.00 .- TOTAL k $320.60 Revised: 04/01/2014 E �11 m-, 0 License # &U630,9254334448 v&#KE: A rnsl,e?oc./ ('i u - koPW5'. t?970 JyVe t-n, SCovo& I 'V ey%lo � re&vVG enH.Ad tv QC1 70 fi -- �uf jd,,L Ie O rPCA. pal, js Ca(.No a t6J ^ r-e ADO rt C�. d- R rp, 1 PLOT cftcx 609 `?�- z S W67 17.90 1190 POOL to be removed Area= 346.84 sq ft Perimeter= 74.85 ft 107.00 Propertv line i CUPERTINO BuNding Department. Q i O COMPLIANCE D`= PA;;TMENT ' REvIEWE - B`UILCIN DIViSION - CurEERTiNO ' 107.00 19 WE 11 ■ tom: DATE PERMIT NO. oil, 0� "'° i o° N d4 a4 Qa o CU ,rty line APR 2 3 1014 bo �o BY i 19970 Pear Tree Ln Cupertino, CA 95014 scale 1":10' This set of plans and spe 1fica,i . s M UST be at the job site during construc Ion. It i unloviful to rn'a.�) any cl.langeS or alterati ris On s 11G, Or to 0'0viti4 Building O�iciai. therefrom, without app val from the The stamping of this plar and sp cif !cations SHAI! L N'OT be held to per . i al of the vioWicn of ovisionS ance or Siatel Law. B I �m DATE PERMIT NO. oil, 0� "'° i o° N d4 a4 Qa o CU ,rty line APR 2 3 1014 bo �o BY i 19970 Pear Tree Ln Cupertino, CA 95014 scale 1":10' Const�'` GeoEngineering Consultants (GEC) 7567 Amador Valley Blvd., Suite 108 Dublin, CA 94568 Phone: 925 -321 -5550 Mr. Ryan Crownholm Hauling Pros, Inc. Subject: Proposed Pool Demolition 19970 Pear Tree Lane, Cupertino, California GRADING REPORT Dear Mr. Crownholm: Project No. P14.0206 May 6, 2014 co FILE In accordance with your authorization, GEC has provided observation and testing services during mass grading on the subject property. This report summarizes our observations and the results of the laboratory and field density tests. The existing pool was completely demolished. All the decking and swimming pool equipments, concrete and rebars, pool structure bond beam, electric conduit and gas lines were removed. The pool was backfilled with import fill. All fill soils were compacted to a minimum relative compaction of 90% at or above optimum moisture content. The satisfactory placement of fill was determined by visual observation, manual probing, and performing in -place field density tests and laboratory compaction tests. Laboratory compaction tests were performed to determine the maximum dry density and optimum moisture content for the subgrade and fill materials. The compaction tests were performed in accordance with Laboratory Test Procedure ASTM D1557 -91 by others. In order to determine the percentage of maximum dry density (relative compaction) and moisture content achieved during compaction, in- placed densities and moisture contents were measured using nuclear gauge density test methods generally in accordance with ASTM 6938 -08a. The in -place test results, including the relative compaction achieved, are summarized in Table 11. Project No. P14.0206 19970 Pear Tree Lane, Cupertino, CA May 6, 2014 Should you have any questions relating to the contents of this report or should you require additional information, please do not hesitate to contact our office at your convenience. Very truly yours, GEC Kamran Ghiassi, Ph.D., P.E., G.E. Registered Geotechnical Engineer Attachment: Tables I and II GEC. Page 2 TABLE I Geo Engineering Consultants Client: Ryan Crownholm Hauling Pros Date: May 6, 2014 Project: Pool Backfill, 19970 Pear Tree Lane, Cupertino, CA Project No.: Project Location: 19970 Pear Tree Lane Cupertino CA Maximum Density /Optimum Moisture Determination Sample Material Description Max Dry Density Optimum Moisture #1 * Reddish Brown Slightly Clayey Silty Sand & Gravel 128.5 11.4 #2* Olive Yellow Sandy Silty Clay W /Some Gravel 118.7 14.4 *Testing performed in accordance with ASTM D1557 -07 B TABLE II Geo Engineering Consultants Client: Ryan Crownholm Hauling Pros Date: May 6, 2014 Project: Pool Backfill, 19970 Pear Tree Lane, Cupertino, CA Project No.: Project Location: 19970 Pear Tree Lane Cupertino, CA Density Determination Testing performed in accordance with ASTM D6938 -10 Percent Comp. Curve 95 #1 94 #1 93 #2 90 #2 Moist. Dry Test Date Elevation Test Location Cont. Dens. 2014 Pool Backfill #1 511 FG -2.0' 9'S & YE of the WSW Corner of House 15.2 121.6 #2 5/1 FG -2.0' 24'S & 6'W of the WSW Corner of House 14.0 121.3 #3 511 FG -1.0' 27' S & YE of the WSW Corner of House 18.3 110.1 #4 511 FG -1.0' 12'S & 9'W of the WSW Corner of House 120.2 106.4 Testing performed in accordance with ASTM D6938 -10 Percent Comp. Curve 95 #1 94 #1 93 #2 90 #2