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15030086CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22432 CARNOUSTIE CT CONTRACTOR: DIG AND DEMO PERMIT NO: 15030086 OWNER'S NAME: SOMAYAR NANJUNDA AND GEETHA TRUSTE 231 MARKET PLACE DATE ISSUED: 03/13/2015 OWNER'S PHONE: SAN RAMON, CA 94583 PHONE NO: (877) 933-4448 JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL ❑ LICENSED CONTRACTOR'S DECLARATION SFDWL POOL REMOVAL 591 SQ FT License Class//t� C 21 Lic. # 6f,- S Date ' Contractor 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: $12000 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 35603029 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 180 DAYS FROM LAST CALLED INSPECTION. upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Issued by: Date `�/�' granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 918. Signature Date ``77 Signature RE-ROOFS: 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) 1, 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 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, Sections 25505, 25533, and 25534. ' Section 3700 of the Labor Code, for the performance of the work for which this p Owner or authorized agent: Date: 3'i5 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 APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408)777-3228 • FAX (408) 777-3333 • building a0cuper ino.org 1Sb36au SP PROJECT ADDRESS L Z u 3 -La r,"1 0 J�1 e, GT 1 I APN # nn (),gn /(] � "1 V OWNER NAME (�� a�'� � � �a S'p � a. � • I �f q PHONE jI A� Z �$� o/ 3 d E-MAIL STREET ADDRESS 2-71J31 CITY, STATE, ZIP q�D �'� FAX CONTACT NAME \ !� I Glrl o I G PHONE 9z5 \ p J 0 E-MAIL , r i STREET ADDRESS Z 3 P Ste 1'e CITY, STATE, ZIPo �j (�, r , FAX 13OWNER ❑ OWNER -BUILDER 11 OWNERAGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT 13 ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME 7 ` 7 _J LICENSE NUMB LICENSE TYPE BUS. LIC # COMPANYNAME\6iko E-MAIL ,,% 6WI ✓ham A FAX 1� / ,C0� STREET ADDRESS 2_ 1 I I _ k L y 2 u ( 7 ll CITY, STATE, ZIP D -/'/J n` [ j PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK / ILI of f � k I eb�i `� Co►�.c-.t`� ❑ SFD or Duplex • ❑ Multi -Family TYPE MATERIAL TYPE (CODE) AREA (SQ. FT.) VALUATION ($) USE OF POOL STRUCTURE: ❑ Commercial POOLISPA MATERIAL TYPE CODES: SPA V - VINYL -LINED F - FIBERGLASS DEMO 0r1 O GUNITE` TOTAL VALUATIONdMEMO P - PREFABRICATED - (`L. -©a7 By my signature below, I certify to each of the following: I am the property owner Nautharlao4egeffFo act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to build' g construct authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date — 1 ! �; x 1n. OFFICE ITS ANLY �y SUPPLEMENTAL ORNTATION REQUIRED'- Commercial or Multi -Family Buildings with Public Swimming Pools: un `❑ UIL�ING DEPT k — OVER; COUNTER Department of Environmental Health approval required. - r a ', �❑� � ®. ST W3�. e k �d (�k -.ter UBLIGWORK54DEPT' ��� ,mss-°' � E � � �' 'b x ,�'� -`f ® AR E �� ❑ N�'IRONMEiVTAL HEAITi , ' TAR]' SEWER'7)ISTRI�T p � y S n�r.�;. SwimPoolApp_2011.doc revised 03/16/11 CITY OF CUPERTINO r1T7-3 inCrTTAAir ♦ T%\il 1D7TT1 "INTO nrvrcTnN cl 1' L' L' A J" 1 —V— l lVit aADDRESS: FEE ID # POOLS ADDRESS:22432 carnoustie ct DATE: 03/13/2015 REVIEWED BY: Mendez BP#: 'VALUATION: $12,000 APN: Plarrn h.; :r11ec•h.r:l`lc c: *PERMIT TYPE: Demolition Permit PAN C HFCK 7 Ph,'; PRIMARY Swimming Pool, Res. 0.0 PENTAMATION 1 SFPOOLDEM PERMIT TYPE: i USE: Plafrtzh.� ticc•Jf.'1lcfc� 1�lurrrh. ' 1 c°1z.- l;lec Permit 14`ee: WORK sfdwl pool removal 591 sq ft Construction tic n KIX: SCOPE Nfech, Pl ar€ Check Aleck. fern if Fee: Ofher ,llech, [rasp. _iec'.a. I,tstz Fee: Plumb. Plcau Check Plumb. P� rmir l''ee: Either Plumb Ins.. p7ec. 111 an Check hie£'. permir Vee: Other Bleep Imp, Plumb. 11"p. Fee: I hlec. Insp. Fee: III.._./... L`.— C-- rl,atr,nt .Crhnni NOTE: This estimate does not incivae fees aue to orner uepartmellw i,,r.1,ul„•,•s, _ .��••� .. - _. _, ________ _ _ _.,_v_ a ,. L... ��s:.,,.,fo Tn,Itaet tho Dont for addn'Z info. District, etc . mese ees are oasea un -e rGLLIIIL,MI FEE ITEMS (Fee Resolution 11-053 Eff. 7111131 FEE ID # POOLS __-- ---- MISC ITEMS Plan (:.'heck f'ee: :5uppl—pC, / ee 1DEMOPRES 1 Plarrn h.; :r11ec•h.r:l`lc c: Permit Fee: $329.00 Suppl. Insp. Fee:Q Reg. 0 OT 0.0 hrs $0.00 Plafrtzh.� ticc•Jf.'1lcfc� 1�lurrrh. ' 1 c°1z.- l;lec Permit 14`ee: T=. Construction tic n KIX: r9.clininistrative Fee: HF ,Idvanced .Planrning Pees: Nfech, Pl ar€ Check Aleck. fern if Fee: Ofher ,llech, [rasp. _iec'.a. I,tstz Fee: Plumb. Plcau Check Plumb. P� rmir l''ee: Either Plumb Ins.. p7ec. 111 an Check hie£'. permir Vee: Other Bleep Imp, Plumb. 11"p. Fee: I hlec. Insp. Fee: III.._./... L`.— C-- rl,atr,nt .Crhnni NOTE: This estimate does not incivae fees aue to orner uepartmellw i,,r.1,ul„•,•s, _ .��••� .. - _. _, ________ _ _ _.,_v_ a ,. L... ��s:.,,.,fo Tn,Itaet tho Dont for addn'Z info. District, etc . mese ees are oasea un -e rGLLIIIL,MI FEE ITEMS (Fee Resolution 11-053 Eff. 7111131 I,• —••,..•— �.�•�–�-- FEE –.__ –. _ QTY/FEE __-- ---- MISC ITEMS Plan (:.'heck f'ee: :5uppl—pC, / ee Plarrn h.; :r11ec•h.r:l`lc c: Permit Fee: $329.00 Suppl. Insp. Fee:Q Reg. 0 OT 0.0 hrs $0.00 Plafrtzh.� ticc•Jf.'1lcfc� 1�lurrrh. ' 1 c°1z.- l;lec Permit 14`ee: T=. Construction tic n KIX: r9.clininistrative Fee: tf"ork Ivithoul Permit ,Idvanced .Planrning Pees: 1 r'catvl Doc umenlation 14'ees: Strong Motion Fee: 1BSEISMICR $1.56 Select an Administrative Item $0.00 ti -Lfi NPM $331.56 =ROI Bldg Stds Commission .Fee: 1BCBSC • ._ 31,5 Of ®R ITtMEOW - $1.00 $331 56 Revised: 02/14/2015 GIL G air°u5��e i I Eaves line o i �— 2. 0 HOUSE o i Line of wall 1i A a i I Propertv line 0 �c6 94.77 � N /FI OPVE GuDERTA N E T caul - ApPROVE® ions MUST be kept at the r,_ ecificat' o, ,?.::,,s and sA It is unlawful to MB" any or to deviate job site c�uconstruction. p ficial. clan s or aiterztions on sm a Bui.ding : oval from erefrom, �;,thout aAA- .ations S14 -L 140T T. ^ry atiis Alan ands�roval of the violation to bean prinance or State Law. i� �Idinc UPERmTIO ' rtmew REVIEVKI. ;= :-;. -;1L)E COMPLIANCF Reviewed By 0,5 � FIL D °nSulta� GeoEngineering Consultants (GEC) 4125 Blackford Avenue, Suite 145 San Jose, CA 95117 Phone: 925-321-5550 Project No. P15.0149 April 1, 2015 Dig & Demo Subject: Proposed Pool Demolition 22432 Carnoustie Ct., Cupertino, Ca GRADING REPORT Dear sirs: In accordance with your authorization, GEC has provided observation and testing services during pool backfill 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 equipment, concrete and rebars, pool slab, 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. The results of these tests are summarized on Table 1. Project No. P15.0149 22432 Carnoustie Ct., Cupertino, CA April 1, 2015 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 2. 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 P ESS ���qP coo No. C66379 C7 No. GE2792 J • Exp. 6130/2016 M G'FO VV IL F CF C'AIYF- Kamran Ghiassi, Ph.D., G. . Principal Geotechnical Engineer Attachment: Table I and Table 1I GEC. Page 2 TATE I Geo Engineering Consultants Client: Dig and Demo Date: March 31, 2015 Project: Pool Backfill Project No.: Project Location: 22432 Carnoustie Court Cupertino, CA Maximum Density/Optimum Moisture Determination Sample Material Description Max Dry Density Optimum Moisture #1 Reddish Brown Sandy Silty Clay W/Fine Gravel 126.7 10.3 Testing performed in accordance with ASTM D1557-07 B TABLE II Geo Engineering Consultants Client: Dig and Demo Date: March 31, 2015 Project: Pool Backfill Project No.: Project Location: 22432 Carnoustie Court Cupertino, CA Test Date Elevation #1 2015 114.9 #1 03/25 FG -5' #lA 03/25 FG -5' #2 03/25 FG -4' #2A 03/25 FG 4 #3 03/25 FG -3' #4 03/25 FG -3' #5 03/26 FG -2' #6 03/26 FG -2' #7 03/26 FG -1' #8 03/26 FG -1' Density Determination Test Location Pool Area Fill 9'N & 12'W of the S W Corner of House Retest of #1 YS & 21'W of the S W Corner of House Retest of #2 6'S & 12'W of the S W Corner of House 9'N & 15'W of the S W Corner of House YS & 9'W of the S W Corner of House 9'N & 12'W of the S W Corner of House 15'W & of the S W Corner of House 12'N & 9'W of the S W Corner of House Testing performed in accordance with ASTM D6938 -08a Moist. Dry Percent Cont. Dens. Comp. Curve 16.3 114.5 90 #1 15.6 114.9 91 #1 16.7 114.3 90 #1 15.2 116.4 92 #1 13.0 120.7 95 #1 14.7 113.6 90 #1 12.7 114.5 90 #1 12.3 116.2 92 #1 12.3 118.6 94 #1 11.0 117.3 93 #1