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14110082CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10371 RIVERCREST CT I CONTRACTOR: LOPEZ CONSTRUCTION PERMIT NO: 14110082 OWNER'S NAME: LOUISECHANDRAN JOEANAND AND I DATE ISSUED: 04/28/2015 LOUISCH OWNER'S PHONE: 4087055484 1 . 1 PHONE NO: CI LICENSED CONTRACTOR'S DECLARATION License Class _ Lic.# l �_ 73 _ Contractor Date I hereby affirm t at 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 erfiormance of the work for which this permit is issued. ave 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. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. 1 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -pm t source regulations per the Cupertino Municipal Code, Sectio 9.18. i „ J , i Date ❑ OWNER - BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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. 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 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 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 forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the 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. Signature Date r r— f— BUILDING PERMIT INFO: BLDG ELECT PLUMB I— r MECH RESIDENTIAL COMMERCIAL .JOB DESCRIPTION: 1006 SQ FT ADDITION TO FRONT AND REAR OF SFDWL, REMODEL 670 SQ FT THROUGH OUT; PANEL UPGRADE 200 AMP; FURNACE. Sq. Ft Floor Area: Valuation: $200000 APN Number: 32637008.00 1 Occupancy Type: I PERMIT EXPIRES IF WITHIN 180 A 180 DAY TARTED PISSUANCE OR ;D INSPECTION. Dater RE-ROOFS- All roofs sh a 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino MUme' al Code, Chapter 9.12 and the health & Safety Code, Sect' 255 5,255 3 , 25534. Owner or authorized agent. Date. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building(akupertino.orr ❑ NEW CONSTRUCTION X) ADDITION ❑ ALTERATION / TI ❑ REVISION /DEFERRED c- ORDINAL PERMIT # PROJECT ADDRESS rC737/ `/�✓eY ' p f / ` ( /( Yy (/ APN # 3,11-37- O OR OWNER NAME .T N u Is - Cfi►�N RBI PHONE o� - O - E -MAIL q4ep_� 2I+ .I 76D,y STREET ADDRESS /0,f7/ y�� ", CITY, STATE, ZIP C,4 v J V�Ev��TA V FAX CONTACT NAME � / � ,,J1 PHONE STREET ADDRESS fi 9w d CITY, STATE, ZIP 11 G G .4 ?Jy FAX ❑ OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT /ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER -7 LICENSE TYPE BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCMTECT/ENGINEER NAME / LICENSE NUMBER BUS. LIC # COMPANY NAME E -MAIL cagrg FAX STREET ADDRESS _ / `O /V� CITY, S ATE> ZIP / PHONE( /W \ + O t ��h v /s ^ I / DESCRIPTION OF WORK 4e," a �X U0 j-. y, �' G� / 1 /' !7 0 �d 1004 » � wn L .-IUPV MSTING USE PROPOSED USE CONSTR, TYPE }� ?-3 ' - ` I # STORIES USE TYPE OCC. SQ.Fr. VALUATION ($) EXISTG AREA .23f V1 NEW FLOOR / AREA 0 ,P6 DEMO AREA TOTAL NET AREA 33 a Add I«DQP BATHROOM REMODEL AREA KITCHEN REMODEL AREA 3" OTHER REMODEL AREA �i _� I / �G O r (� PORCH ��&AAAEEEA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREAS DETACH 7-r , ' n [$ATTACH — # DWELLING UNITS IS A SECOND UNIT ❑ YES SECOND STORY []YES BEING ADDED? ❑NO ADDITION? []NO PRE- APPLICATION IDYES IF YES, PROVIDE COPY OF PLANNING APPL# ONO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES PICHLER HOME? ❑ No RECEIVE TOTAL. VALUATTION,: IIv By my signature below, I certify to each of the following: I am the property owner or authorized gent to act on operty owner's behalf. 1 have read this application and the information I have provided is correct. I have read the Description of Work tLve accurate. I agree to comply with all applicable local ordinances and state laws relating to buildin construction. I authorize representatives of Cupertino to enter the above - identified property for inspection purposes. Signature of Apphcant/Agent Date- // /✓ SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER- THE - COUNTER BUILDING PLAN REVIEW _ 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. ❑ EXPRESS PL 1ANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 11 STANDARD IC WORKS _ Form if any Hazardous Materials are being used as part of this project. ❑ LARGE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. MAJOR ❑ ENVIRONMENTAL HEALTH BldgApp 2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10371 Rivercrest ct TYPE OF CONSTR. DATE: 11/13/2014 REVIEWED BY: Mendez - APN: BP #: 6 S�P_ *VALUATION: 1$200,000 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition IR3INSP PRIMARY SFD or Duplex USE: 2nd 'nit? OTC. Yes No 0 Yes ® No PENTAMATION 1 R3SFDADD PERMIT TYPE: WORK 1006 sq ft addition to front and rear of sfdwl remodel 670 sq ft through out' panel upgrade 200 am SCOPE furnace. 0.0 hrs $0.00 1 # Mechanical $143.00 IMFR = <l00 Furnace, Forced -Air OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R -3 (Custom) II- B,111- B,IV,V -B 1,006 $2,674.63 IR3PLNCK $1,739.91 IR3INSP $0.00 PME Plan Check: $0.00 200 1 amps $48.00 Electrical 1BELEC2oo Services Permit Fee: $1,739.91 Suppl. Insp. Fee:O Reg. Q OT 0.0 hrs $0.00 1 # Mechanical $143.00 IMFR = <l00 Furnace, Forced -Air PME Unit Fee: $0.00 PME Permit Fee: $96.00 TOTALS: 1,006 $2,674.63 F-1 $1,739.91 MECH, HOURLY 0 Yes G No PLUMB, HOURLY Q Yes (2) No ELEC, HOURLY Q Yes Q No Mech. Plan Check 0.0 hrs $0.00 Elec. Plan Check 0.0 1 hrs $0.00 Mech. Permit Fee: IMPERMIT - Elec. Permit Fee: IEPERMIT Other Mech. Insp. 0 .0 hrs $48.00 Other Elec. Insp. 0.0 hrs $48.00 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Deptfor addn'l info. FEE ITEMS (fee Resolution 11 -053 E .71,131 FEE QTY /FEE MISC ITEMS Plan Check ,Fee: $2,674.63 = s.£ $575.00 Remodel, Other IREMRESOTH Suppl. PC Fee: Q Reg. Q OTI 0.0 hrs $0.00 PME Plan Check: $0.00 200 1 amps $48.00 Electrical 1BELEC2oo Services Permit Fee: $1,739.91 Suppl. Insp. Fee:O Reg. Q OT 0.0 hrs $0.00 1 # Mechanical $143.00 IMFR = <l00 Furnace, Forced -Air PME Unit Fee: $0.00 PME Permit Fee: $96.00 F-1 0 G Work Without Permit? 0 Yes Q) No $0.00 Advanced Planning Fee: IPLLONGR $140.84 Select a Non - Residential Building or Structure G) 0 i Travel Documentation Fee: ITRAVDOC $48.00 Strom Motion Fee: IBSF,ISMICR $26.00 Select an Administrative Item Bid& Stds Commission Fee: IBCBSC $8.00 SUBTOTALS: $4,733.38 $766.00 TOTAL FEE: $5,499.38 Revised: 10/01/2014 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014 -3255 Telephone: 408 - 777 -3228 Fax: 408-777-3333 JOB ADDRESS: 2 PERMIT # 14 �- OWNER'S NAME: e�, I/"PHONE # D - GENERAL CONTRACTOR: S Qty BUSINESS LICENSE # ADDRESS: _ CITY /ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date /0/1-4/5 Ow r / r Signature ate >2 _e� 0 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical ( 'fti P Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing �� ✓� v2� Septic Tank Sheet Metal Sheet Rock Tile! /0/1-4/5 Ow r / r Signature ate >2 _e� 0 f` X, �' • 1 COMMUNITY DE=VELOPMENT DEPARTMENT ® BUILDING DIVISION Al BERT SALVADOR P.E. C B.O. RUJI DING OFFICIAL. _0RRE AVENUE, CUPI -PI INO :A CUPERTINQ (4081 777-2228 FAX (408) 777 ,',333 ",,,.�i'u� SITE ADDRESS 10$71 Rivercrest Ave. Cupertino APN BP# Owner....D.0 -1lf. Jq oW.(A .... ipu�....... 0....^ A! r \ ............................. Contractor .... l pee.- ........opl� UUr o.... .............................. ....... .... r .o Address - 1�...1`.4.a& 5r.0 A�� ................................ I.............. Address.... ?....c11 .. r!`J ILA............... . ............................... /....lo Ci /St.l v � �Y7�W ................ ty zip... i'�Cl ..�........ Phone..................... p .............. i.............. Ci /St..� VIOV.. ....... Zi /'S.44 P v ty i................. p.................. hone ................. . Applicant. ........ �.." a...... ..... ........................... Ste�e'� d Engineer /Architect.............. Yu Jar- Gh en ........ ............................... Address...Z•6.... " ..........6.................. � Address..40. 660.. Robin.. Street . ............................... .......... city/ st ........ 61 4r!• ho ................Zip........7 ......Phone. aZ'1981.. City/St...- Fremont. ................... Zip ............... Phone.51.Q68749 PROJECT DESCRIPTION: Addition and Remodel 0 This "STATEMENT OF SPECIAL INSPECTIONS" is submitted in fulfillment of the requirements of CBC Sections, nand 1705. This form is structured after and used by permission p l r ol _ � a NC) mode statement of Special Inspections. Also, includedwi h his form is the following: ❑ "LIST OF SPECIAL INSPECTION AGENCIES (page 2). A list of testing agencies and other special iNIP1111110ors that will be retained to conduct the tests and inspections for this project ❑ "SCHEDULE OF SPECIAL INSPECTION" (page 3 — 6). The Schedule of Special Inspections summ e Special ' Inspections and tests required. Special Inspectors will refer to the approved plans and specifications ailed special inspection requirements. Any additional tests and inspections required by the approved plans and stctions shall also be performed. Special Inspections and Testing will be performed in accordance with the approved plans and specifications, thi ffed ant and CBC Sections 1704, 1705, 1706, 1707, and 1708. Interim reports will be submitted to the Building Official and the Re Design Professional in Responsible Charge in accordance with CBC Section 1704.1.2. A Final Report of Special Inspections documenting required Special Inspections, testing and correction of any di ncies noted in the inspections shall be submitted prior to issuance of a Certificate of Use and Occupancy (Section 1704.1.2). T i I Report will document: • Required special inspections. • Correction of discrepancies noted in inspections. The Owner recognizes his or her obligation to ensure that the construction complies with the approved permit documents and to implement this program of special inspections. In partial fulfillment of these obligations, the Owner will retain and directly pay for the Special Inspections as required in CBC Section 1704.1. This plan has been developed with the understanding that the Building Official will: • Review and approve the qualifications of the Special Inspectors who will perform the inspections. • Monitor special inspection activities on the job site to assure that the Special Inspectors are qualified and are performing their duties as called for in this Statement of Special Inspection. • Review submitted inspection reports. • Perform inspections as required by the local building code. I have read and agree to comply with the terms and conditions of this statement Prepared By: Project Engineer ❑ Architect SE 2762 01/26/15 Design Professional in Charge Si nature ... . .. ...... . # ......... Date:.Registered Owner Name: / MbN /Cg N o. L Owner's Authorization Si nature . a ..................................... ............................... Date: Inspection Agency / Inspector Name: i 2 lch�?� i natu ................................. Lie. #.....G? /' f^......... .. Date: ..... ........ Building Official or desig e: Signature..................................................................................... ............................... Date:.......................... Sf�eciinc�s /�ectionH'orrn 2012.41ocr•evised 09 00 12 Al LIST OF SPECIAL INSPECTION AGENCIES APPROVAL OF SPECIAL INSPECTORS: Each special inspection agency, testing facility, and special inspector shall be recognized by the Building Official prior to performing any duties. Special Inspection agency's listed on this form must be pre- approved and listed on Cupertino's approved Special Inspector's list. Special inspectors shall cant' approved identification when performing the functions of a special inspector. Identification cards shall follow the criteria set by the GolifloT r,,ja Q 0 L f,_J f Y eS�v ;ono h s po i� ;tic ti i a i `� . � . No personnel changes shall be made without first obtaining the approval of the Building Official. Any unauthorized personnel changes may result in a "Stop Work Order" and possible permit revocation; To be pre - approved by the City of Cupertino, refer to the SPECIAL INSPECTION CRITERIA handout. Please allow two weeks to complete the application process. I ne touowlna are the testlna ana soecial inspection aaencles tnat will De retained to conduct tests ana Inspection on this 1. Special Inspection (except for Firm ................................................... ............ .... .. Addr ............................................................. ............................ geotechnical) city ..................... ............................... ...... ............................... State .......................Zi Telephone....... ............................... Fax............. ............................... Email.......................... ............................... 2. Material Testing Firm ............................................................. ........ Addr ................................. .............. ....................... ................... City........................................................................... ............................... State .......................Zip ...................... Telephone........ ............................... Fax............. ............................... Email.......................... ............................... 3, Geotechnical Inspections Firm ........................................................... .......... Addr......................................................................................... City........................................................................... ............................... State .......................Zip ...................... Telephone....... ............................... Fax............. ............................... Email.......................... ............................... 4. Other: Firm ................ ........................................ ......... .... Addr ........................................... ........ ...................................... City........................................................................... ............................... State .......................Zip ...................... Telephone....... ............................... Fax............. ............................... Email.......................... ............................... 'All agencies specified on this form must be pre- approved and listed on the City of Cupertino's Approved Special Inspector's List SEISMIC REQUIREMENTS (Section 1705.3.6) Description of seismic force- resisting system and designated seismic systems subject to special inspections as per Section 1705.3: Plywood shear wall - inspect nailing and tie -down The extent of the seismic - force - resisting system is defined in more detail in the construction documents. WIND REQURR MENTS Section 1705.4.1 Description of main wind- force - resisting system and designated wind resisting components subject to special inspections in accordance with Section 1705.4.2: The extent of the main wind- force - resisting system and wind resisting components is defined in more detail in the construction documents. S1)eciaJn.s1)ection1,6rm 2012.doc• remised 09 06 12 SCHEDULE OF SPECIAL INSPECTION SITE APN BP# ADDRESS PROJECT DESCRIPTION: Notation Used in Table: Column headers: C Indicates continuous inspection is required. P Indicates periodic inspections are required. The notes and/or contract documents should clarify. Box entries: X Is placed in the appropriate column to denote either "C" continuous or "P" periodic inspections. -- Denotes an activity that is either a one -time activity or one whose frequency is defined in some other manner. Additional detail regarding inspections and tests are provided in the project specifications or notes on the drawings. VERIFICATION AND INSPECTION � CJ P REFERENCED STANDARD IBC REFERENCE i INSPECTION OF FABRICATORS 1. ❑ Inspect fabricator's fabrication and quality control �_ I 1704.3 procedures. L I INSPECTION OF STEEL 1. Material verification of high- strength bolts, nuts and washers. • Identification marking to conform to ASTM stds AISC 360, specified in the approved construction documents. __ X Section A3.3 and applicable ASTM material standards • Inspect fabricator's fabrication and quality control -- X procedures. 2. Inspection of high- strength bolting: • Snug -tight joints. -- X • Pretensioned and slip - critical joints using turn -of -nut with matchmarking, twist -off bolt or direct tension -- X AISC 360, indicator methods of installation. Section M2.5 1704.3.3 • Pretensioned and slip - critical joints using turn-of -nut without matchmarking or calibrated wrench methods X — of installation. 3. Material verification of structural steel and cold- formed steel deck. • For structural steel, identification markings to conform X AISC 360, to AISC 360. Section M2.5 • For other steel, identification markings to conform to Applicable ASTM ASTM standards specified in the approved -- X material standards construction documents. • Manufacturer's certified test reports. -- X .S1?eciahtgvc1icmhorm 2012.ducrewsed 09 06 12 VERIFICATION AND INSPECTION C p REFERENCED STANDARD IBC REFERENCE 4. Material verification of weld filler materials: ❑ Identification marking to conform to AWS specification in the approved construction documents. – X AISC 360, Section A3.5 and applicable AWS A5 documents -- ❑ Manufacturer's certificate of compliance required. -- X — -- 5. Inspection of welding: a. Structural steel and cold- formed steel deck: • Complete and partial joint penetration groove welds. X -- AWS D1.1 1704.3.1 ❑ Multipass fillet welds. X • Single -pass fillet welds > 5/16" X — • Plug and slot welds. X -- ❑ Single -pass fillet welds <= 5/16" -- X ❑ Floor and roof deck welds. - -- X AWS D1.3 b. Reinforcing steel: ❑ Verification of weldability of reinforcing steel other than ASTM A 706. X AWS D1.4 ACI 318: Section 3.5.2 ❑ Reinforcing steel resisting flexural and axial forces in intermediate and special moment frames, and boundary elements of special structural walls of concrete and shear reinforcement. X — • Shear reinforcement. X • Other reinforcing steel. -- I X 6. Inspection of steel frame joints details for compliance: ❑ Details such as bracing and stiffening. - -- X -- 1704.3.2 ❑ Member locations. -- X ❑ Application of joint details at each connection. -- X VERIFICATION AND INSPECTION C p REFERENCED STANDARD IBC REFERENCE INSPECTION OF WELDING 1. ❑ Welded studs when used for structural diaphragms. -- X -- 1704.3 2. ❑ Welding of cold- formed steel framing members. — X 3. ❑ Welding of stairs and railing systems. -- X S��eciulf�specliof�Fofm 2012.doc �erisrci U) 06 12 VERIFICATION AND INSPECTION C p REFERENCED STANDARD IBC REFERENCE INSPECTION OF CONCRETE 1. ❑ Inspection of reinforcing steel, including prestressing tendons and placement. ___ X ACI 318: 3.5, 7.1 -7.7 1913.4 2. ❑ Inspection of reinforcing steel welding in accordance with Table 1704.3 Item 5b. AWS D1.4 ACI 318: 3.5.2 3. ❑ Inspection of bolts to be installed in concrete prior to and during placement of concrete where allowable loads have been increased or where strength design is used. X - ACI 318: 8.1.3, 21.2.8 1911.5, 1912.1 4. ❑ Inspection of anchors installed in hardened concrete. - X ACI 318: 1912.1 5. ❑ Verifying use of required design mix. 6. ❑ At time fresh concrete is sampled to fabricate specimens for strength tests, perform slump and air content tests and determine the temperature of the concrete. X X - ACI 318: ASTM C 172 ASTM C 31 ACI 318: 5.6, 5.8 1904.2.2,1913.2, 1913.3 1913.10 7. ❑ Inspection of concrete and shotcrete placement for proper application techniques. X - ACI 318: 5.9, 5.10 1913.6, 1913.7, 1913.8 8. ❑ Inspection for maintenance of specified curing temperature and techniques. X ACI 318: 5.11 -5.13 1913.9 9. Inspection of prestressed concrete: • Application of prestressing forces. X -- ACI 318:18.20 • Grouting of bonded prestressing tendons in the seismic force- resisting system. X - ACI 318:18.18.4 10. ❑ Erection of precast concrete members. - X ACI 318: Ch. 16 -- 11. ❑ Verification of in -situ concrete strength, prior to stressing of tendons in posttensioned concrete and prior to removal of shores and forms from beams and structural slabs. X ACI 318: 6.2 -- 12. ❑ Inspect formwork for shape, location, and dimensions of the concrete member being formed. X ACI 318: 6.6.1 13. ❑ Bolts Installed in Existing Masonry or Concrete • Direct tension testing of existing anchors. -- X See ICC ES Reports form special inspection requirements for proprietary products • Direct tension testing of new bolts. - X • Torque testing of new bolts. __ X • Prequalification test for bolts and other types of anchors. -- X 14. ❑ Other: .Sp ciahispeclionForm _2012.doc remised 09 06 12 )?)ecialnspeclionForm _2012.docrew.sed 09 06 12 REFERENCE FOR CRITERIA VERIFICATION AND INSPECTION C P IBC TMS 402 /ACI TMS 402 /ACI SECTION 530 /ASCE 5 530 1ASCE 6 INSPECTION OF LEVEL 1 MASONRY 1. ❑ Compliance with required inspection provisions of the construction documents and the approved — X — — Art. 1.5 submittals shall be verified. 2. ❑ Verification of f m and f'AAc prior to construction — X -- — Art. 1.413 except where specifically exempted by this code. 3. ❑ Verification of slump flow and VSI as delivered to X — -- — Art. 1.513.1.b.3 the site for self consolidating grout. 4. As masonry construction begins, the following shall be verified to ensure compliance: • Proportions of site - prepared mortar. — X -- — Art. 2.6A • Construction of mortar joints. -- X -- -- Art.3.313 • Location of reinforcement, connectors, X — — Art. 3.4, 3.6A prestressing tendons, and anchorages. • Prestressing technique. -- X -- -- Art. 3.613 • Grade and size of prestressing tendons and — X -- — Art. 2.413, 2.4H anchorages. 5. During construction the inspection program shall verify: • Size a:nd location of structural elements. - -- X — -- Art. 3.3F • Type, size, and location of anchors, including Sec. 1.2.2(e), other details of anchorage of masonry to -- X -- 1.16.1 _ – structural members, frames or other construction. • Specified size, grade, and type of reinforcement, anchor bolts, prestressing tendons and -- X -- Sec. 1.15 Art. 2.4, 3.4 anchorages. • Welding of reinforcing bars. X -- -- -- ❑ Preparation, construction and protection of masonry during cold weather (temperature below X Sec. 2104.3, Art. 1.8C, 1.8D 40 degrees F) or hot weather (temperature above 2104.4 90 degrees F). ❑ Application and measurement of prestressing X -- -- — Art. 3.6B force. 6. Prior to grouting the following shall be verified to ensure compliance: ❑ Grout space is clean. -- X -- -- Art. 3.2D • Placement of reinforcement and connectors and — X _– Sec. 1.3 Art. 3.4 prestressing tendons and anchorages. • Proportions of site - prepared grout and — X __ — Art. 2.66 prestressing grout for bonded tendons. ❑ Construction of mortarjoints. -- X -- -- Art. 3.36 7. Grout placement: • Grout placement shall be verified ensure X -- — — Art. 3.5 compliance. • Observe grouting of prestressing bonded X -- — — Art 3.6C tendons. )?)ecialnspeclionForm _2012.docrew.sed 09 06 12 .Speciubispec ionForm 2012.doc remised 09 06 12 REFERENCE FOR CRITERIA VERIFICATION AND INSPECTION C P IBC TMS 402 /ACI TMS 402 /ACI SECTION 630 /ASCE 6 630 /ASCE 6 8. ❑ Preparation of any required grout specimens, Sec. mortar specimens, and /or prisms shall be — X 2105.2.2, -- Art. 1.4 observed. 2105.3 INSPECTION OF LEVEL 2 MASONRY 1. ❑ Compliance with required inspection provisions of the construction documents and the approved — X — — Art. 1.5 submittals. 2. ❑ Verification of f m and f',Ac prior to construction and for every 5,000 square feet during — X — -- Art. 1.413 construction. 3. Cl Verification of proportions of materials in premixed or preblended mortar and grout as — X — — Art. 1.513 delivered to the site. 4. ❑ Verification of slump flow and VSI as delivered to X __ __ __ Art. 1.513.1.b.3 the site for self consolidating rout. 5. The following shall be verified to ensure compliance: • Proportions of site - prepared mortar, grout, and X — __ Art. 2.6A prestressing grout for bonded tendons. • Placement of masonry units and construction of — X -- - -- Art. 3.3B mortar joints. • Placement of reinforcement, connectors and X — Sec. 1.15 Art. 3.4, 3.6A prestressing tendons and anchorages. • Grout space prior to grouting. X -- -- -- Art. 3.2D • Placement of grout. X -- — — Art. 3.5 • Placement of prestressing grout. X -- -- -- Art. 3.6C • Size and location of structural elements. -- X -- -- Art. 3.3F • Type, size, and location of anchors, including other details of anchorage of masonry to X - -- — Sec.1.2.2(e) -- structural members, frames and other construction. • Specified size, grade, and type of reinforcement, anchor bolts, prestressing tendons and -- X — Sec. 1.15 Art. 2.4, 3.4 anchorages. • Welding of reinforcing bars. X Sec. 2.1.9.7.2, _- 3.3.3.4 (b) • Preparation, construction, and protection of masonry during cold weather (temperature below _ X Sec. 2104.3, _ -- Art. 1.8C, 1.8D 40 degrees F) or hot weather (temperature above 2104.4 90 degrees F). • Application and measurement of prestressing X -- — -- Art. 3.613 force. 6. ❑ Preparation of any required grout specimens, Sec. mortar specimens, and /or prisms shall be X -- 2105.2.2, — Art. 1.4 observed. 2105.3 .Speciubispec ionForm 2012.doc remised 09 06 12 VERIFICATION AND INSPECTION C p REFERENCED JIBC STANDARD REFERENCE INSPECTION OF WOOD 1. ❑ Inspect prefabricated wood structural elements and assemblies in accordance with Section 1704.2. 1704.6 2. ❑ Inspect site built assemblies. -- — 3. Inspect high -load diaphragms: ❑ Verify grade and thickness of sheathing. — — ❑ Verify nominal size of framing members at adjoining panel edges. -- 1704.6.1 ❑ Verify nail or staple diameter and length, — — ❑ Verify number of fastener lines, -- — ❑ Verify spacing between fasteners in each line and at edge margins. 4. ❑ Metal - plate- connected wood trusses spanning 60 feet or greater: Verify temporary installation restraint/bracing and the permanent individual truss -- X — 1704.6.2 member bracing are installed in accordance with the approved truss submittal package. REQUIRED VERIFICATION AND INSPECTION OF SOIL 1. ❑ Verify materials below footings are adequate to -- X achieve the desired bearing capacity. 2. ❑ Verify excavations are extended to proper depth and -- X have reached proper material. 3. ❑ Perform classification and testing of compacted fill X materials. - -- Table 1704.7 4. ❑ Verify use of proper materials, densities and lift thicknesses during placement and compaction of X — compacted fill. 5. ❑ Prior to placement of compacted fill, observe subgrade -- X and verify that site has been prepared properly. REQUIRED VERIFICATION AND INSPECTION OF DEEP DRIVEN FOUNDATION ELEMENTS 1. ❑ Verify element materials, sizes and lengths comply X with the requirements. 2. ❑ Determine capacities of test elements and conduct X -- additional load tests, as required. 3. ❑ Observe driving operations and maintain complete X — and accurate records for each element. 4. ❑ Verify locations of piles and their plumbness, confirm type and size of hammer, record number of blows per — Table 1704.8 foot of penetration, determine required penetrations to X — achieve design capacity, record tip and butt elevations and document any damage to foundation element. 5. ❑ For steel elements, perform additional inspections in accordance with Section 1704.3. 6. ❑ For concrete elements and concrete filled elements, perform additional inspections in accordance with -- -- Section 1704.4. Specialnspec7iunh'orm 2012.doc revised 09 00 12 VERIFICATION AND INSPECTION C p REFERENCED IBC STANDARD REFERENCE 7. ❑ For specialty piles, perform additional inspections as determined by the registered design professional in -- -- — Table 1704.8 responsible charge. REQUIRED VERIFICATION AND INSPECTION OF CAST -IN -PLACE DEEP FOUNDATION ELEMENTS 1 ❑ Observe drilling operations and maintain complete and X — accurate records for each element. 2. ❑ Verify placement locations and plumbness, confirm element diameters, bell diameters (if applicable), lengths, embedment into bedrock (if applicable), and X — — Table 1704.9 adequate end - bearing strata capacity. Record concrete or grout volumes. 3. ❑ For concrete elements, perform additional inspections in accordance with Section 1704.4. T HELICAL PILE FOUNDATIONS 1. ❑ Record installation equipment used, pile dimensions, X — -- 1704.10 tip elevations, final depth, final installation torque. SPRAYED FIRE - RESISTANT MATERIALS Physical and visual tests 1. Condition of substrates. ❑ Inspect surface for accordance with the approved fire - resistance design and the approved manufacturer's -- -- written instructions. ❑ Verify minimum ambient temperature before and after -- X application. -- 1704.12.1 ❑ Verify ventilation of area during and after application. -- X 2. ❑ Measure average thickness per AS -rM E605 and -- -- Section 1704.12.4. 3. ❑ Verify density of material for conformance with the approved fire- resistant design and ASTM E605. (Ref. -- -- Section 1704.12.5) 4. ❑ Test cohesive /adhesive bond strength per Section 1704.12.6. 5. ❑ Condition of finished application. MISCELLANEOUS 1. Mastic and Intumescent Fire - Resistant Coating. -- -- -- 1704.13 2. Exterior Insulation and Finish Systems (EIFS). Water - resistive barrier coating when installed over a sheathing - -- -- - -- 1704.14 substrate. 3. Special Cases — -- -- 1704.15 4. Smoke Control System — -- -- 1704.16 5. Seismic Resistance ❑ Suspended ceiling systems and their anchorage. — -- -- 1705.3 [4.3] S �eciufrisheclioril orn� 2012.doc revised 09 00 12 VERIFICATION AND INSPECTION C p REFERENCED I IBC STANDARD IREFERENCE 6. Wind Resistance • Roof cladding and roof framing connections. — -- -- ❑ Wall connections to roof and floor diaphragms and framing. -- • Roof and floor diaphragm systems, including collectors, drag struts and boundary elements. • Vertical wind - force - resisting systems, including braced frames, moment frames, and shear walls. • Wind-force-resisting system connections to the foundation. • Fabrication and installation of systems or components required to meet the impact resistance requirements -- -- of Section 1609.1.2. SPECIAL INSPECTION FOR WIND REQUIREMENTS 1. Structural Wood • Inspect field gluing operations of elements of the main X — wind - force - resisting system. -- 1706.2 • Inspect nailing, bolting, anchoring, and other fastening of components within the main windforce- resisting – X system, including wood shear walls, wood diaphragms, drag struts, braces and hold- downs. 2. Cold- Formed Steel Framing • Welding of elements of the main wind - force - resisting _– X system. • Inspection of screw attachments, bolting, anchoring, and other fastening of components within the main -- 1706.3 wind - force- resisting system including shear walls, -- X braces, diaphragms, collectors (drag struts) and hold - downs. 3. Wind-resisting components ❑ Roof cladding. -- X -- 1706.4 ❑ Wall cladding. - -- X SPECIAL INSPECTIONS FOR SEISMIC RESISTANCE 1. ❑ Special inspection for welding in accordance with the X — 1707.2 quality assurance plan requirements of AISC 341. 2. Structural Wood ❑ Inspect field gluing operations of elements of the X _- seismic-force-resisting system. Inspect nailing, bolting, anchoring, and other fastening of components within the seismic - force - resisting 1707.3 system, including wood shear walls, wood -- X diaphragms, drag struts, braces, shear panels and hold - downs. 3. Cold- Formed steel light -frame construction ❑ Welding of elements of the seismic - force - resisting X 1707.4 system. .SpeciubispeclionForm 2012.doc revised 09 06 12 ❑ Inspection of screw attachments, bolting, anchoring, and other fastening of components within the seismic- _– X force - resisting system including shear walls, braces, diaphragms, collectors (drag struts) and hold- downs. 4. Storage racks and access floors ❑ Anchorage of storvge racks 8 feet or greater in height — X 1707.5 and access floors. 5. Architectural components • Inspect erection and fastening of exterior cladding weighing more than 5 psf and higher than 30 feet -- X above grade or walking surface. • Inspect erection and fastening of veneer weighing more than 5 psf.and higher than 30 feet above grade -- X or walking surface. -- 1707.6 • Inspect erection and fastening of all exterior non- bearing walls higher than 30 feet above grade or -- X walking surface. • Inspect erection and fastening of all interior non- bearing walls weighing more than 15 psf and higher -- X than 30 feet above grade or walking surface. 6. Mechanical and Electrical Components ❑ Inspect anchorage of electrical equipment for _– X emergency or stand -by power systems. ❑ Inspect anchorage of non - emergency electrical _– X equipment. ❑ Inspect installation of piping systems and associated mechanical units carrying flammable, combustible, or -- X -- 1707.7 highly toxic contents. ❑ Inspect installation of HVAC ductwork that contains _– X hazardous materials. ❑ Inspect installation of vibration isolation systems -- X where required by Section 1707.7. 7. ❑ Verify that the equipment label and anchorage or mounting conforms to the certificate of compliance _ -- __ ___ 1707.8 when mechanical and electrical equipment must be seismically qualified. 8. ❑ Seismic isolation system: Inspection of isolation X - -- 1707.9 system per ASCE 7 – Section 17.2.4.8 9. ❑ Obtain mill certificates for reinforcing steel, verify compliance with approved construction documents, -- -- — 1708.2 and verify steel supplied corresponds to certificate. 10. ❑ Structural Steel: Invoke the QAP Quality Assurance - -- 1708.3 requirements in AISC 341. 11. ❑ Obtain certificate that equipment has been seismically 1708.4 qualified. 12. ❑ Obtain system tests as required by ASCE 7 Section 1708.5 17.8. Sj�ecrulrispecuont orrr� 2012.doc revised 09 00 12 ' r COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING; DIVISION ALBERT SALVADOR P E C B.0 BUILDING OFFICIAL. CURERTlNO 10300 TORRE AVENUE • C JPE.RTINO CA 950114 -325 (408) 77-1-3223 - FAX (408) 777 -3333 ' J", a ' 11 a The following list of Special Inspection Agencies and their special inspectors are approved by the City of Cupertino to provide specific inspection in their respective field until the expiration date listed. Agency Name, Address and expiration date Special Inspectors Special Inspection Field RC PC SM SW HB FP s w CG Achievement Engineering Corp. 434 Camille Cir. #13 San Jose, CA 95134 Tel: (800) 653 -1397 Fax: (408) 852 -0331 Expires: 07/22/2015 Firouz'aei, Arash X X X X Hooshdar, Sina X X X X Khodadadi, Mohammad X Safaian, Farshad Applied Materials & Engineering, Inc. 980 41 st Street Oakland, CA 94608 Tel: (510) 420 -8190 Fax: (510) 420 -8186 Expires: 12/19/2014 Email : ? Aaron Hardy X X X Anthony Klarich X X X X X Armen Ta'irian, P.E. X Bryan Jackson X X David Jackson X X X X X Diego Bertolino X X X Harold Walrath X X X X Ken Malone X X Michael Knowles X X X X Oswaldo Dominguez X X X X Sean Guches X X X Bagg Engineers 847 West Maude Ave. Sunnyvale, CA 94085 -2911 Tel: (650) 852 -9133 Fax: (650) 852 -9138 Expires 7116/2015 ,V Brown, Christian X X X X X Cole, Michael Hepper, John X X X Knudsen, Steven J. McManus, Alvin X X X Norris, David L. X X X X O'Driscoll, Alan Salceda, Francisco Sciortino, Brandon Smith, Louis Steinbrueck, Bryan Thai, Minh Umeki, Takashi RC = Reinforced Concrete SW = steel a welding s = sous PC = Pre- stressed/Post- tensioned Concrete HB = High - Strength Bolding W = Wood SM = Structural Masonry I FP = Spray - Applied Fireproofing CG = CalGreen Code S��ecinllrrs /�ectionLisl.doc rewsed 02 01 14 Agency Name, Address and expiration date Secial Insectors pp Special Inspection Field RC PC SM SW HB FP S w Cc Biggs Cardosa Associates, Inc. 865 The Alameda San Jose, CA 95126 Tel: (408) 296 -5515 Fax: (408) 296 -8114 Expires: 7/11/2014 ql ww t)i scardosa porn Castro, Roberto Chan, David X X Ghorbani, Behrooz Lazzarini, Dan Rivas, Ricardo Rosales, Adolfo Rosellini, Daniel Sanchez, Adam To an, Claudiu X X Woole , Mark X X X X Yamane, Robert BSK Associates Engineers & Laboratories 324 Earhart Way Livermore, CA 94551 Tel: (925) 315 -3151 Fax: (925) 315 -3152 Expires: 9/06/2014 Auser, Jim X X X Bos ue, Jeff X X X Clary, Mike X X X X Evans, Keven X Minerales, Gilbert Ness, Dennis X X X Olsten, Ken X X Reeves, Ben Rodriguez, Tim X X X Schurman, Peter X Capex Engineering Inc. 571 Seville Place Fremont, CA 94539 Tel: (510) 668 -1815 Fax: (510) 490 -8690 Expires: 6/25/2014 Gary Hsu X X X X X Chow, Erwin 1105 Belmont Ave. Long Beach, CA 90804 Tel: (562) 449 -7491 Expires: 4/24/2014 Erwin Chow X RC = Reinforced Concrete SW = Steel & Welding S = Soils PC = Pre-stressed/Post tensioned Concrete HB = High - Strength Bolding W = Wood SM = Structural Masonry I FP = Spray - Applied Fireproofing CG = CalGreen Code S1)ecicilbispecliotiLisi.dloc revised 02 01 14 Agency Name, Address and expiration date Special Inspectors Special Inspection Field RC PC sM SW HB FP S w CG Consolidated Engineering Laboratories 2001 Crow Canyon Road, Suite 100 San Ramon, CA 94583 Tel: (925) 841 -7100 Fax: (925)'855 -7140 Expires: 6/25/2014 ty a 1! Ahmed, Badaruddin Alexander, David X X X Andersen, Calvin X X Bartlett, Dennis X X Bobrovitsk , Edward X X X Bolen, Michael X X X Brooks, Brendan X X X X X Brown, Ronald X X X X X Buchmiller, Kenn Coffin ham, Paul Currier, James X X Eschliman, Duaine Eschliman, Kevin Fuller, Mark X X Halloran, James X X X X X Harrington, Wayne X X Hassebrock, Scott X X X X X Healy, Michael X Heilmann, Mark X X X Horn yak, John X X X X Hyslop, John X X X X King, Phillip X X X X Kmitt, Stanley X X Liebold, Jeffrey X X X X X Lozano, Alfonso Art Ma, Steven X Marlik, William X X McCutcheon, Thurmond X X McKenzie, Quinten McLaughlin, Lori X X Miner, Dwight X X Murphy, Don X Pastora, Geor e X X X X Rodriguez, Sandra X X Si mon, Josephine Sisson, James X X X X Small, Michael X X Van Horn, Bradford X X X X Walters, Michael Zuemer, Robert I X X X RC = Reinforced Concrete SW = Steel & Welding S = Soils PC = Prestressed /Post- tensioned Concrete HB = High - Strength Bolding W = Wood SM =Structural Masonry FP = Spray - Applied Fire roofing CG = CalGreen Code ,Ij)ecialliisPeclionList.doe revised 02 01 14 Agency Name, Address and expiration date Special Inspectors Special Inspection Field RC PC SM SW HB FP s w CG Brian Arnold Edward Bindert Jeremy Brown James Brumley Jared Byers Richard Collin Robert Cortez Robert Criswell Mark Doman Tom Edwards Tim Farley Gary Fechner Mike Gaunt Ron Harr Neal Hoellwarth Richard Jones Rick Mann Construction Testing Services Kevin McCurdy 2174 Rheem Dr., Ste. A Kevin Meyers Pleasanton, CA 94588 Kevin Moore Tel: (925) 462 -5151 Fax: (925) 462 -5183 Craig Na le Expires: 6/26/2014 David Puskarich - William Radulovich Brian Ragan John Rink George Rockenstein Lany Rothey Erin Salazar Robert Schulze Donald Shirley Tom Shuster Larry Slater Daryl S ieker Gary Stapleton Matt Swope Travis Taylor Vinny Vinavong Shawn Vucenic John White Isidoro Za ien X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X RC = Reinforced Concrete SW = Steel & Welding S = Soils PC = Pre- stressed/Post- tensioned Concrete HB = High - Strength Bolding W = Wood SM = Structural Masonry FP = Spray- Applied Fireproofing CG = CalGreen Code VXcialhispecriorrLisr.doc revised 02 01 14 Agency Name, Address and expiration date Special Inspectors Special Inspection Field RC PC sM SW HB FP S W CG Earth Systems Pacific 446 S. Hillview Dr. Milpitas, CA 95035 Tel: (408) 934 -9302 Fax: (831) 637 -0510 Exp: 6/28/2014 George Barnett X X Jeff Bryan X X Norman En en X X X X Cal Hicks X X X X X Dennis Hurley X X rus Me'ia ENGEO Incorporated 2010 Crow Canyon Pl., Suite 250 San Ramon, CA 94583 Tel: (925) 866 -9000 Fax: (888) 279 -2698 Exp: 7/06/2014 rJ'ti,1J P Tim Benton Greg Hudson X Mike Huener ardt X X X X Kevin Lecce James "Chip" Moore X X X Rand Mues X Jonathan Parker X X X X Rich Rose X X X H P Inspection, Inc. 690 Sunol ST, Building H San Jose, CA 95126 Tel: (408) 288 -8460 Fax: (408) 271 -0902 Expires: 11/15/2014 Larry Castrence Tony Cotta X X Mark Cotter Chuck Pinkham X X X X David Pinkham X X X X P. Scott Pinkham X X X Gary Stafford X X X X X Jason Waugh X X X X X RC = Reinforced Concrete SW = Steel & Welding S = Soils PC = Pre- strOssed(Post- tensioned Concrete HB = High- Strength Bolding I.FP W = Wood SM = Structural Masonry = Spray - Applied Fireproofing CG = CalGreen Code Sj�ecicdbzs�ecliunl ist.cluc revised 02 01 14 Agency Name, Address and expiration date Special Inspectors Special Inspection Field RC PC SM SW HB FP S W CG Inspection Services, Inc. 1798 University Ave. Berkeley, CA 94703 Tel: (510) 900 -2100 Fax: (510) 900 -2101 Expires: 03/21/2015 tin ��r .ne! _._ - Alakbarov, Ha dar X Amos III, Jessie X Baccus, Garrett X X Baek, Byung Gi X X X X X X Barone, Judith X X X Celik, Can X X X X X X X Colby, Paul X X Ehrsam, Gary X Falk, Andrew X X X X Flynn, Chris X X X X X X Gaut, Tobin X X X X Llames, Fernando X X X X Lon, Rand "Roy" X X X X X X Patterson, Rodger X X Putman, Edward X X X X X Sandoval, Carlos X X X X X X Shebesta, Todd X Simonton, Cy-Leon X Solis, Winnie X X Stafford, William X Stark, Douglas X X X X Toschi, Patrick X X X X X Wheeler, Steven X X X X X Kleinfelder 2601 Barrington Court Hayward, CA 94545 Tel: (925) 484 -1700 Exp: 7/10/2014 Anderson, Tim X X X X X X Brewster, Steve X Burton, Nathan X X X Craig, Cliff X X X X X X Delabriandais, Gary X X X Eres, Mark X X X X X Foster, Stephen X X X X Hammon, Robert X X X X Johnson, Josh X Kesler, Timothy X Milla e, Leonard X X X X X Nicoletti, Johnathon X X Oandason, Jose X X X X X X Rommel, Daniel X X Saber, Sam X X X Swank, Phillip X X X RC = Reinforced Concrete S W = Steel & Welding S =Soils PC = Pre- stressed(Post- tensioned Concrete HB = High - Strength Bolding W = Wood SM =Structural Masonry FP = Spray-Applied Fireproofing CG = CalGreen Code S�xciallssl�ecdos /.ia7.di�c revised 02 01 14 Agency Name, Address and expiration date Special Inspectors Special Inspection Field RC PC sM SW HB FP s w CG Krazan &Associates, Inc. 6711 Sierra Court, Ste B Dublin, CA 94568 Tel: (925) 307 -1160 Fax: (925) 307 -1161 Exp: 2/6/201'4 wvaw.kra.1an.(:)rn James Allen X X X James Benefeito X X X Larry Borges X X I X I X Ron Chandler X Van DeMent X X Gregory Fernald Matthew Fernald Lewis Franklin X X X X X Ken Hafeli X X X Andy Morris X X X X Sidney Moss X X X X Matt Romero X Gregory Ruf MatriScope Engineering Laboratories, Inc. 4730 Contractors Common Livermore, CA 94551 Tel: (925) 606 -7700 Fax: (925) 606 -7702 Expires: 7/26/2014 D'Souza, Andrew Fannin, Dana X X X Ho elian, Joseph X X X X Keller, Don X X Kohls, Kristin Lake, Adam X X Mathis, Q. Shane X X X X X Nieser, Paul X Palmer, Scott Reese, Mark X Scoble, Kod Selvage, Kevin Shelton, James X X X X X X Sta ner, Jack X X X X X X Swartz, Judy Tadlock, K. Scott X X X X X X Tadlock, Robert X X X X X X Thomas, Chris X Varella, Joe RC = Reinforced Concrete SW = Steel & Welding S = Soils PC = Pre- stressed/Post- tensioned Concrete HB = High - Strength Bolding W= Wood SM =Structural Masonry FP = Spray - Applied Fireproofing CG = Ca/Green Code Sj�eclallnspecliorll.isr.doc rerised 02 0114 Agency Name, Address and expiration date Special Inspectors Special Inspection Field RC PC sM SW HB FP s W CG Neil O. Anderson & Associates, Inc. 902 Industrial Way Lodi, CA 95240 Tel: (209) 367 -3701 Fax: (209) 333 -8303 Expires: 2/1/2016 Allen, Eric Cozad, Mike X X X X X Dickey, David X Erickson, Rick Gray, Dave X X X X X X Hall, Rollin Johnson, Carl X X X X King, Ryan X Kort, Jason X X X X Landess, Frank X X X Lenehan, Gerry Me'orado, Aaron X Merrell, Ryan X Morgan, Daniel O as, George Oszut, Gregory X X X X Roberts, Jason Westfall, Kimmis X X X X X Whiting, John Williams, Roger X X X PacificinterWest Bldg Consultants, Inc. 1600 South Main St, Suite 380 Walnut Creek, CA 94596 Tel: (925) 939 -5500 Fax: (925) 939 -9561 Expires: 9/6/2013 Cope,Doug X PSI, Inc. 365 Victor Street, Ste. C Salinas, CA 93907 Tel: (831) 757 -3536 Fax: (831) 757 -6265 Expires: 1/10/2015 Albert George X X X X X Deborah White X Michael Winter X X William Monger X X X X X Brand Burfield X Ezekiel Robles X Stephen Ramos X Darwin Zackary X RC = Reinforced Concrete SW = Steel & Welding S = Soils PC = Pre -stressed /Post- tensioned Concrete HS = High - Strength Bolding W = Wood SM = Structural Masonry FP = Spray - Applied Fireproofing CG = Ca/Green Code She�iallfisi�ectionList.uoc revised 02 01 14 Agency Name, Address and expiration date Special Inspectors Special Inspection Field RC PC SM SW HB FP S W CG RMA Group of Northern California 6296 San Ignacio Ave., Suite A San Jose, CA 95119 Tel: (408) 3624920 Fax: (408) 362 -4926 Expires: 04/01/2012 ry +ti r �� tr c:rbn t r °r. Alley, Maurice X X Bosque, Jeff X X X Carr, Greg Cecconi, Joe X Chinn, Gordon X X X X Francis, Chris X X Geraghty, Rich X X X Gillespie, John X X X X X Gundersen, Al X X X Haff, Tiffany Hughes, Dottie X X X Sondrol, Jeff X X X X Stocke, Jacob X Swain, Pat X Tellesen, Mike X X Tonkovich, Bill X X X X Walters, Chris X X X X X X Zeiher, Adam X RC = Reinforced Concrete SW = Steel 8 Welding S = Soils PC = Pre- stressed/Post- tensioned Concrete HB = High - Strength Bolding W = Wood SM = Structural Masonry FP = Spray - Applied Fireproofing CG = Ca/Green Code Sj�ecrcrllrrsPecJlotrlle7.cloc revised 02 01 14 Agency Name, Address and expiration date Special Inspectors Special Inspection Field RC Pc sM SW HB FP s w Cc Smith -Emery Company Corporate Office: 781 E. Washington Blvd. Los Angeles, CA 90021 Testing Facilities: 1940 Oakdale Ave. P.O. Box 880550 San Francisco, CA 94124 Tel: (415) 642 -7326 Expires: 4/09/2015 Allder, Scott Brunett, John X X X Caraisco, Thomas X X X X X X Chuong, Jason X Contreras, Roberto X X X X X Cross, Len Cunningham, Jim Daniels, Jodie X X Daquinag, Bonafacio Docena, Bernard Drake, Barry X X Joakimson, Robert X X X X X X K lopson, Paul X X X Mazuk, Ray X McCarron, Liam X X X Merino, Salvador X X X X X Miranda, Allen Murphy, Mike Nadler, Joel X X X Nickerson, Scott X X X X Ross, Jason X X Serrano, Ramon Sherwood, Tony X X X X X X Starkey, Raymond Stevenson, Wylie Viramontes, Keith X X X Stevens, Ferrone & Bailey 1600 Willow Pass Court Concord, CA 94520 Tel: (925) 688 -1001 Fax: (925) 688 -1005 Expires: 8/09/2014 ' 1.1 = Babione, Martin X X X Conner, Scott X X X X X X Fletcher, Brett X X X X X X X Minor, Matt X X X Quinn, Tom X X X X Thielges, Jon Lj RC = Reinforced Concrete S W = Steel & Welding S =Soils PC = Pre- stressed/Post- tensioned Concrete HB = High - Strength Bolding I W= Wood SM =Structural Masonry FP = Spray - Applied Fireproofing CG = Ca/Green Code SjxciallrrslrecriunLisr.doc rewsed 02 01 14 Agency Name, Address and expiration date Special Inspectors Special Inspection Field RC Pc sM SW HB FP s w CG Terracon Consultants, Inc. 3140 Gold Camp Drive, Suite 170 Rancho Cordova, CA 95670 Tel: (916) 858 -1579 Fax: (916) 858 -8277 Expires: 7/17/2015 www.terraccn.com Houts, Walter X X X X X X Mears, Steven X X X X X X Testing Engineers, Inc. 2811 Teagarden Street San Leandro, CA 94577 Tel: (510) 835 -3142 Fax: (510) 834 -3777 Expires. 4/22/2015 Ardizonne, Mike X Dougherty, John X X X X Ganly, Jim Geraghty, Richard X X X X Grossman, Peter, P.E. X Gunderson, Al X X X X Hernandez, Frank X X X X X Mendosa, John X Muzika, Bruce X X Ronald, Seth X Souza, Jason X X Tellesen, Mike X X Thomas, Paul X X X X Watanabe, Dan X Williams, Brian X White, Walker X Yoka, John X X X Western Technologies, Inc. 3480 South Dodge Blvd. Tucson, AZ 85713 Tel: (520) 748 -2262 Expires: 8/29/2014 Tiedemann, Thomas X RC = Reinforced Concrete SW = Steel & Welding S = Soils PC = Prestressed/Post- tensioned Concrete HB = High - Strength Bolding W = Wood SM = Structural Masonry FP = Spray - Applied Fireproofing CG = CalGreen Code Speciallirspection] Ist.doc revised 02 01 14 r C7 C7 r LL cc O 0. *— U a N, O N LC) N 9 a) LL N r C�C G t rte. c6 0 C 7 U c6 U .N _T cd c Q v N C O G. f/1 N O C 0 i+ ca 7 U c6 U r i U C U) F w w U U Q/ a O a N x o N N L2 0 ai Y 0 0 00 Q/ L: Z O CLO v H m N rl N N O Lr) 0 fu v Ul c 0 a a K [t Ol Uf O Ln 0 u 0 v 0` Q (1) Y 'd0 > o ° r 61 y t�' 9 CO ` > co o Lq w a o a T 0 0 � of O E a d � d 0 C C. C? O. M c6 � o U O N w N V y. 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