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15060150Larrabee & Associates, Inc. General Engineering Contractors & Consultants Lic. #525973 June 22, 2015 City of Cupertino Department of Planning, Building & Code Enforcement Re: Letter granting permission per agent(s) City of Cupertino To Whom It May Concern, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain a permit with the City of Cupertino: Vince Chirco Brian Larrabee Respectfully yours, Wal Larrabee Owner / President Larrabee & Associates, Inc. 3002 Scott Blvd Santa Clara, CA 95054 Office Phone 408 364 9000 Email: team@larrabeeandassociates.com Business Office 3002 Scott Blvd Santa Clara, CA 95054 (tel) 408.364.9000 (fax) 408.496. 1101 Business Mailing Address team@larrabeeandassociates.com I CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21673 CASTLETON ST CONTRACTOR: LARRABEE & PERMIT NO: 15060150 ASSOCIATES INC OWNER'S NAME: WILLIAM & JENNY WRIGHT 3002 SCOTT BLVD DATE ISSUED: 06/23/2015 OWNS PHONE: 4155086031 SANTA CLARA, CA 95054 PHONE NO: (408)364-9000 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL E] FOUNDATION REPAIR —7 Q 7 License Clas Lic. g cx / � J 9s� Contractor�2_3 I hereby affirm that I am licensed under the provisions f Chap r 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 Sq. Ft Floor Area: Valuation: $7000 performance of the work for which this permit is issued. 1 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 permit is issued. APN Number: 35618065.00 Occupancy Type: 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 DANCE 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 D . Y AST C INSPECTION. u indemnify P t P g judgments, a of and P g City e9 land mows oaccr etaf a grancosting of this permit Ald I said understands will ssue �""' Da e: with all non -point source gulation er t e Cupertino Municipal Code, ectio 9.18. �j /� RE-RO Signature Date All roofs shall be inspected or oofing 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 1, 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 Mu icipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(.) sh d 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 equi ent or ices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the ay rea Air lity Management District I performance of the work for which this permit is issued, will maintain compliance with the u rtino M Opal Code, Chapter 9.1 and _ 1 have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sectio 05,255 nd 25534. Section 3700 of the Labor Code, for the performance of the work for which this 71 i permit is issued. Owner or authorized agent: Date: 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 Compensation laws of California. If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10 10300 TORRE AVENUE - CUPERTINO, CA 95014-3265 CUPERTINO 1 (408) 777-3228 - FAX (408) 777-3333 - building &tJoerfino,ong ED NEW CONSTRUCTION [1 ADDITION OALTERATION /TI [] REVISION /DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 7 Z -77 APN # OWNERrttA-� OE -MAIL 3 -LIF -Loll STREET ADDRESS CITY, STATE, ZIP FAX 7-X�F"07 "--127, o /777 CONTACT NAME/ F-MAII S ADDRESS CITY, STTE, ZIP ❑ OWNER 13 OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR 1:1 CONTRACTOR AGENT OARCHITECT 0 ENGINEER 11 DEVELOPER 0 TENANT CONTRA A C LICENSENIUMBER LICENSE TY BUS. LIC # DESCRIPTION OF WORK/0 EXISTING USE PROPOSED USE CONSTR. TYPE I #STORIES USE TYPE I OCC. SQFT. VALUATION EXJSTG NEW FLOOR 7 ,2 CO FAX AREA I AREA I AREA S;WET DRES§,, I NET AREA CITY, STATE,ql SVA-77:�. 70 0 BATHROOM ARCHITECT/ENGINEER NAME OTHER LICENSE NUMBER BUS. LIC 0 COMPANY NAME REMODEL AREA E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK/0 EXISTING USE PROPOSED USE CONSTR. TYPE I #STORIES USE TYPE I OCC. SQFT. VALUATION EXJSTG NEW FLOOR DEMO TOTAL AREA I AREA I AREA I NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: LJDETACH � OATTACH 0 DWELLING UNITS IS A SECOND 1 11' OYES SECOND STORY OYES BEING ADDED? ONO AUDITION? ONO PRE_APPLICATION OYES IF YES, PROVIDE COPY OF IS THE BLDG4;4L YES TOTAL VALUATION: PLANNING APPL # ONO PLANNING APPROVAL LETTER EICHLER HOME? By my signature below, I certify to, each of the following! I am the property Owner Or at '�d' act on thsPreperty, A�Vefify 0 s behalf. I hae read this application and the information I have provid !� is correct. it is rate. I to comnly with all applicable local I have read the DescrimovVItl d Iv It ordinances and state laws relating to b ' di construction. l,"th?jize representatives of Cupertino to en e ab ntified prop for inspection purposes. Signature ofApplicant/A� e: Z' - SUPPLEMENTAL INFORMATION REQUIRED New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. —Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. — Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. BldgApp_201 I.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, ela). These ees are based on the prelimina information available and are only an estimates Contact the De t or addn 7 info, FEE ITEMS (Fee Resolution 11-053 Ef _ 7/1/13) 21673 CASTLETON ST DATE: 06/23/2015 REVIEWED BY: MELISSA lialADDRESS: APN: 356 18 065 BP#: / ig & ,_�6 *VALUATION: 1$7,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex Foundation Repair IFOUNDREPA PENTAMATION 1GENRE USE: 0.0 PERMIT TYPE: i WORK FOUNDATION REPAIR SCOPE $0.00 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, ela). These ees are based on the prelimina information available and are only an estimates Contact the De t or addn 7 info, FEE ITEMS (Fee Resolution 11-053 Ef _ 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 =# $859.00 Foundation Repair IFOUNDREPA Suppl. PC Fee: (F) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -0 Reg. © OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C<fFoJffK"ool lu,(; 2,Irn �irw -or i v 1, r"r_ 0 Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) C) Strong Motion Fee: IBSEISMICR $0.91 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 rB oTALS, $1.91 $859.00 TOTAL'FEE' I $860.91 Revised: 05/07/2015 In Addressa- SMOKE l CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408 777-3333 • building(cDcupertino.org # of Alarms Smoke: . C""y / n Monoxide: .- PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: Irl dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. I have read and agree to comply with the terms and conditions of this statement . r (,or Owner A��ent's tvame:)� ��— ego � Signalure........ .... .. Date: ............... . Contractor Name: � Signature .................................... ............................... Lic.# ...� �- ..�.:'w..Z.�?.... Dale: ................... Smoke and CO jorm.doc revised 03/18/14 2ril k`. CUPERTINO WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(akupertino.org Owner Frame �'-` ��'�"° Penr Address / y .. 3 C ><l 7777, Al BE Please refer to the attached California Civil Code Sections 1101.1 — 1101.8 which are part of this Certification form. 1. Is your real property a registered historical site? ❑ Yes Civil lode Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. a Owner Signature: Date: a;r �� 'L No Go to Question 2. 2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its plumbing, installation of water -conserving plumbing fixtures is not technically feasible? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Sign below and skip the rest of the form. O ignature: Date: J V NI- -X9 2-0� 9 r El No Go to Question 3. Is water service permanently disconnected for your building? ❑ Yes Civil C de ections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner i"gnature: Date: J UN 2 -el yr INo Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ No My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. �.�°Owner Signature: "IT Date: ,� �Jl�b N Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 110 1. 1 through 1101.8 apply. Refer to the attached. My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water -conserving plurnbing fixtures throughout the building. On or before January 1, 2017, all non-compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ My property is a multifamily residential real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water -conserving plutmbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water - conserving plurnbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). ❑ My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water -conserving plurnbing fixtures. SB407 2015. doc revised 02/04/15 On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). I/We, the owner(s) of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through. 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and that the water -conserving plumbing fixtures comply with the requirements as indicated in the table below. Owner's (or Owner Agent's) Signature: tDate: 0'12-i 1211 -_ Upon completing and signing this Certificate, please return it to the Building Division in order to final your permit. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB407 2015. doc revised 02/04/15 Non -Compliant Water -Conserving Plumbing Fixture PlumbingFixture (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type Water Usage 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 /Flow Rate 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 Single -Family Multi -Family Commercial Residential Residential Water Closets Exceed 1.6 Single flush toilets: 1.28 gallons/flush (Toilets) Gallons/flush Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite, average flush volume of two reduced flushes and one full flush Urinals Exceed 1.0 0.5 gallons/flush Gallons/flush Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of gallons per minute U.S. EPA WaterSense Specification for Showerheads (A hand-held shower is considered a showerhead.) For multiple showerheads serving one shower, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. Faucets — Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets 0.8 gallons per minute @ per minute @ 60 psi; 20 psi minimum 0.8 gallons per minute @ 20 psi In common and public use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute 60 psi Faucets — Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60 Kitchen per minute 60 psi @ 60 psi psi Faucets May temporarily increase May temporarily up to 2.2 gallons per increase up to 2.2 minute @ 60 psi, and must gallons per minute @ default to maximum 60 psi, and must 1.8 gallons per minute @ default to maximum 60 psi 1.8 gallons per minute Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are may be used to achieve unavailable, aerators or reduction. other means may be used to achieve reduction. 1. 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Specific Fracture Site Dimeric, Total Length: Varies Width: Existing Heigth: Varies Notes: - All work is a voluntary foundation systems - Concrete to O..t 0 11, 28 day., typ. - T-24 not rcq,,Irc�� Ali a..., - Slid-- Set -XP ESR -2508 Deteriorate (if opplia.1 Horizontal Exte HN, 12' dowel typ, (set—is epoxy)- ,,— (N) anchor colt (if opictic.late) (n) #5 rrbar lo 4 # (n" ) rea r ,e " '- dowels dowels (set-xp epoxy) I m.—d.H1 — ------------ 2-L3" .6 3" demolished area ----------- ------- < /A .,cry 12" on '6 Ll < 4 Sto-w-11 Q <1 ,A < < <1 (7,Typ. Horizontal Rebar Det. Side view Not to scale fD (N) 5/8' x 10' Author bolts w/ galvanized a h ' x 3" x 1/4" or Simpson UFPl0 washes" �'eirofitnehor plates per manufactures (n) rabor (#4 vertical dowels) to be doweled -,o into existing concrete a minimum of 4" So. detail 2 iv every 12" with set-xp epoxy. Top of Min- 8" vertical dowel to intersect horizontal rebar -suale, Sea detail 2 -3'ml— 1"3",.h . i,;UPERTINO JUN 2 -()R CU,)E CCAMPUANGE ,7 (a) Footing (E) Condition Typ. Horizontal Fracture Renovation Det. Section View Net to —la �/ Section View Net to seek, LARRABEE S ASSOCIATES, INC, '11.(: a LA,- i7 0/1 103 MITI— ,uLC,: N f,5 �iAT: 06/22/:5 'jdI�l2,iF 2