14050017CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10245 SCENIC BLVD
CONTRACTOR: PHILLIP D BJURMAN
PERMIT NO: 14050017
OWNER'S NAME: SANJEEV MAHALAWAT
1250 HIGHWY 101
DATE ISSUED: 05/01/2014
OWNER'S PHONE: 4088622064
AROMAS, CA 95004
PHONE NO: (650) 906-7533
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL E]
❑ LICENSED CONTRACTOR'S DECLARATION
DEMO (E) GUNITE POOL & REFILL WITH ENGINEERED
A- Lic. # r< b%Zsb
BACKFILL TO 90% COMPACTION FOR POSSIBLE
License Class
�Q� `/� nate S^
Contractor, " {
FUTURE
BUILDING
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: $10000
e and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 35702003 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 180 DAYS OF PERMIT ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
the above mentioned property for inspection purposes. (We) agree to save
180 DAYS FRO ASI. D INSPECTION.
upon
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
"—mss
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Sec
9 18.
'� ^ l
RE -ROOFS:
Signature �{ n / Z Date C
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
of the work for which this permit is issued.
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
performance
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sectiolm 25505, 22n553`3, and 25534. 3--(
^ ( VSection
3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: J r '--- 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
918.
Signature Date
CUPERTINO
SWIMMING POOL / SPA PERMIT APPLICATIO
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building aacupertino.org
PROJECT ADl>$SS2� 1 Ste. t�, 1 ,/� APN #
OWNER NAM\\E��JJN/W pj�OtNE g6L�2>`LF E-MAIL
STREET ADDRESS W } CITY, STATE, ZIP FAX
CONTACT N` l� , Lrlr PHONE `- Y --?3
�3 E-MAIL
STREET ADDRESS CITY, STATE, ZIP !'_ FAX
�� ./dais Vt1le Ar1,L iVIA�L. /�✓lE C� !?�(° 2
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTR� OR NAME ^ LICENS UM$ER LICENSATYPE BUS. LIC #
COMPAN NAME 1 AIL FAX
15� � (AAI, & �d . e�H G I r.n�-1 I -. � , 1 �
STREET ADDRESSvl�n
cln `OP IaekL
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
C
L -AC, rn iFL/_ h,0- `kP' l:(
USE OF ❑ SFD or Duplex ❑ Multi -Family TYPE MATERIAL TYPE (CODE) AREA (SQ. FT.) VALUATION ($)
STRUCTURE: ❑ Commercial POOL
POOLISPA MATERIAL TYPE CODES: SPA
V - VINYLLINED
F - FIBERGLASS DEMO
G - GUNITE
P - PREFABRICATED - TOTAL VALUATION:
I RMM- / U uv
By my signature below, I certify to each of the following: I am the wne o act on a property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Descri ork and verify I I I agree to comply with all applicable local
ordinances and state laws rela ' o traction. orize representatives of Cupertino to enter the above-iden roperty for inspection purposes.
Signature of ApplicanUAgent: Date:
SUPPLEMENTAL INFORMATION REQUIRED
Mtiro
Commercial or Multi -Family Buildings with Public Swimming Pools:
Department of Environmental. Health approval required.
SwimPoolApp_2011.doc revised 03/16/11
CITY OF CUPERTINO
rr, r rQrr7nR A'Tfli? R7T-- .-ITN(` 11lVlCl(-)N
1C
i'1J 1I
ADDRESS: 10245 SCENIC BLVD
DATE: 05/01/2014
REVIEWED BY: MELISSA
ii- a
APN: 357 02 003
BP#:
*VALUATION: 1$10,000
PERMIT TYPE: Demolition Permit
PLAN C HLCK 7 I'l,
PRIMARY
USE: Swimming Pool, Res.
PENTAMATION 1 SFPOOLDEM
PERMIT TYPE: i
WORK
DEMO E GUNITE POOL & REFILL WITH ENGINEERED BACKFILL TO 90% COMPACTION FOR
SCOPE
POSSIBLE FUTURE BUILDING
0,0hrs
L e<:ir. 7'Crxr £ � clr llhwib, Plea? C hecA' Lr'Ut.. 1' <an Ch'vk
W"c't. P -rani Fee.: F tt�r 1. f'c »zit Fee;
r)=iarr .11��c':ia. fn"y7'. Other Pit ffib hwp' L—J 0117"'r i `hC'. Ins{).
`iec.Ins Fee:
F-, ' Pltzrzi7 hr SP. T' t:: t
NOTE: This estimate does not include fees aue to otneruepartments (t. e.cturtrttng, .,,. —, . --l-
-
--'l
__,_Lf- -__.a _ L. tho vont inr addrt'1 info.
Ulstrlct, eta Lnese ees ure ouseu un. t o
FEE ITEMS (Fee Resolution 11-053 a.' 711/13)
FEE
-- --- -- -
QTY/FEE
-- -
MISC ITEMS
Plart CChecl, Fee:
A
PC Fee
Permit Fee:
$319.00
Suppl. Insp. Feer Reg. 0 OT
0,0hrs
$0.00
�'Ittrt'a fi. ii Jlfclt.;1: rc�c;
Pi'.rnfit Fee:
:
(.'C)t7sirtiefi n Tax:
PC,IL'LiF2E't'�l/�lili'Ii7ZYt4,? /'E'i('.S':
d'cles:
Strong Motion Fee: IBSEISMICR
$1.00
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
i II N
$321.00
$0.00 TOTAL'FEE:
v e
$321.00
Revised: 04/0112014
COMF<1!!NITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION - CUPERTINO
APPl/F---,r)
ceIn c.�
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� LATIA0 1
AfN
�IVED
MAYO 12014
SILICON VALLEY SOIL ENGINEERING
GEOTECHNICAL CONSULTANTS
uC71FILE
File No. SV1016T
May 6, 2014 S 12_ It -1
Bjurman General Engineering Corporation
3553 Haven Avenue, #7
Menlo Park, CA 94025
Attention: Mr. Phil Bjurman
Subject: Swimming Pool Removal
Existing Residence
10245 Scenic Boulevard
Cupertino, California
TESTING AND INSPECTION SERVICES DURING
THE BACKFILLING OPERATION OF THE
SWIMMING POOL REMOVAL
Dear Mr. Bjurman:
Pursuant to your request, we have performed testing and inspection services
during the backfilling operation for the swimming pool removal. The subject
site is the existing residence located at 10245 Scenic Boulevard in Cupertino,
California.
The existing swimming pool area was approximately 600 square feet with
depths ranging from 4 to 9 feet below existing ground elevation. First, the
entire pool was removed. Then, the excavated bottom was compacted. Next,
the excavated area was backfilled with import soil material to the existing
ground surface. The import soil material was moisture conditioned as necessary
and compacted in uniform 12 inch lifts to at least 90% relative maximum
density. The backfilling operation was performed by Bjurman General
Engineering Corporation from May 2 to May 5, 2014.
A total of 6 in-place field moisture/density tests were performed by our field
engineer using a nuclear gauge (CPN MC -1 DR). These tests showed values in
excess of 90% relative maximum density of the backfill material as determined
using the laboratory compaction test procedure ASTM D1 557-91. The results
of the field moisture/density tests are summarized in Table 1. Approximate
locations of these tests are shown on the Site Plan- Figure 1.
2391 ZANKER ROAD, SUITE 350 0 SAN JOSE, CALIFORNIA 95131 • (408) 324-1400 • F (408) 324-1404
.'
File No. SV1016T
May 6, 2014
As a result of our testing and inspection services, the contractor has performed
the backfilling operation accordingly.
If you have any questions or require additional information, please feel free to
contact our office at your convenience.
Very truly yours,
SILICON VALLEY SOIL ENGINEERING
M.
Sean Deivert '��
RCE
Project Manager 32296
Vien Vo, P.E.,,, C/VIS
SV1016T.BF/Copies: 3 to Bjurman General Engineering Corporation
2 SILICON VALLEY SOIL ENGINEERING
File No. SV1016T May 6, 2014
TABLE
SUMMARY OF FIELD MOISTURE/ DENSITY TEST RESULTS
Test
Date
Test
Moisture
Dry
Rel. Comp.
Soil Type
No.
2014
Location/
% Dry
Density
% of Max.
& Remark
108.4
91.1 B
Elevation
Weight
p.c.f.
93.3 B
6 itX6/F.L.
SWIMMING POOL BACKFILL
1 5/2 X1/4.L.
12.6
108.3
91.0 B
2 ItX2/41.
13.5
111.1
93.3 B
3 itX3/21.
15.9
110.5
92.9 B
4 5/5 X4/F.L.
14.6
108.4
91.1 B
5 itX5/F.L.
14.2
111.1
93.3 B
6 itX6/F.L.
13.1
108.2
91.0 B
NOTES:
21.
= SECOND LIFT
4.L.
= FOURTH LIFT
F.L.
= FINAL LIFT
B: Tan Brown Gravelly Sandy Silty CLAY
3 SILICON VALLEY SOIL ENGINEERING
ABANDONED SWIMMING POOL—\
X1 X6
X5
X2
X4
X3 /
d
V'
n
m
n
0
M
: D;
X
NOTE: X DENOTES APPROXIMATE FIELD TEST LOCATION
Silicon Valley Soil SITE PLAN File No.: SV1016T FIGURE
Engineering
Existing Residence
2391 Zanker Road, #350 Drawn by: M.N. 1
San Jose, CA 95131
(408) 324-1400 10245 Scenic Boulevard
Cupertino, California Scale: NOT TO SCALE May
2014
12
120
U
CL
milli
105 +
8
Silicon Valley Soil
Engineering
10 12 14 16
Moisture. Content (% of Dry Weight)
18
SAMPLE: B
DESCRIPTION: Tan Brown Gravelly Sandy Silty CLAY
LABORATORY TEST PROCEDURE: ASTM D1557-91
MAXIMUM DRY DENSITY: 119.0 p.c.f.
OPTIMUM MOISTURE CONTENT: 14.0%
2391 Zanker Road, # 350
San .Jose, CA 95131
(408) 324-1400
COMPACTION TEST B I File No.: SV1016T
Existing Residence
10245 Scenic Boulevard
Cupertino, California
5
Drawn by: M.H
Scale: NOT TO SCALE
20
FIGURE
2
May
2014