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B-2017-0123 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-0123 10354 COLBY AVE CUPERTINO,CA 95014-2401(316 29 038) JACK MYERS CONSTRUCTION INC SAN JOSE,CA 95129 OWNER'S NAME: MCCHESNEY DOUGLAS GEORGE TRUSTEE DATE ISSUED:01/25/2017 OWNER'S PHONE:408-761-1185 PHONE NO:(408)761-1185 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic.#634066 Contractor JACK MYERS CONSTRUCTION INC Date 12/31/2018 X BLDG ELECT _PLUMB MECH X RESIDENTIAL COMMERCIAL 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. JOB DESCRIPTION: KITCHEN REMODEL-M.E.P.(157 SF);MASTER BATH AND BATH I hereby affirm under penalty of perjury one of the following two declarations: REMODEL(130 SF);8(N)WINDOWS(LIKE FOR LIKE);DEMO 1. I have and will maintain a certificate of consent to self-insure for Worker's FIREPLACE AND REPLACE WITH WALL Compensation,as provided for by Section 3700 of the Labor Code,for the riperformance of the work for which this permit is issued. REV#1-REMOVE WALLS BETWEEN KITCHEN AND LIVING I2.,(6-."-2/7 I have and will maintain Worker's Compensation Insurance,as provided for by ROOM;RELOCATE NON BEARING WALLS IN BATHROOM Section 3700 of the Labor Code,for the performance of the work for which this (MASTER AND BATH ROOM#2)-ISSUED 2/28/2017 permit is issued. Sq.Ft Floor Area: Valuation:$40000.00 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 316 29 038 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. ,Signature -c„ .��• / Date 2/28/2017 Issued by:ABBY AYENDE Date:01/25/2017 OWNER-BUILDER DECL RATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is i. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:2/28/2017 I hereby affirm under penalty of perjury one of the following three declarations: 1. I have and will maintain a Certificate of Consent to self-insure for Worker's ALL ROOF COVERINGS TO BE CLASS"A”OR BETTER Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous Worker's Compensation laws of California. If,after making this certificate of air contaminants as defined by the Bay Area Air Quality Management District I exemption,I become subject to the Worker's Compensation provisions of the will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and Labor Code,I must forthwith comply with such provisions or this permit shall the Health&Safety Cod , ec' s 25505,25533,and 5534. be deemed revoked. _Owner or authorized agent: -4A APPLICANT CERTIFICATION Date:2/28/2017 I1 I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction len ing agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec. 097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. I understand my plans shall be used as public records. Signature Date 2/28/2017 Licensed Professional • -ao -- bun _ !,:: .,•,./ CONSTRUCTION- PERMIT .,PLICATION •• , ', -COMMUNITY DEVELOPMENT DEPARTMENT••BUILDING DIVISION Fay _=_�:., 10300 TORRE AVENUE•CUPERTINO CA 95014-3255 '_ : (408)777-3228• FAX(408)777-3333•bulldtnp(7a.cursertino.orq 4 1 CUPERTINO- tt. ®NEW CONSTRUCTION L._I ADDITION ❑ ALTERATION/II REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS * .. 1 ` A 1 APN 2.}Y AO OWNER NAME V G I PHONE i,J 6() 6.1 /( Il s_ EMAIL STREET ADDRESS / :3 LI f " ` r. CITY, STATE ZIP ` �+ r � FAX CONTACT NAME 1 / C' {�/ PHONE i t.�C ,ted S _ `I 0 31 16 rt.Cl 5/b./if t 4-ci e S! 4 s• @_ STREET ADDRESS !�LJ c 6 rd. CITY,STATE,ZIP X C/1 FA % d.. c, vvi © owN-ER El OWNER-BUILDER ❑ OWNER AGENT 3 CONTRACTOR ❑CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTRACTOR NAME :-1-7_4_� to I ��� IJCENSENUMBE �� �� LICENSE TYPE 78 BUS.LIC�:,�}1 3,�/j COMPANY NAME ^ . t i " E-MAIL _J F X j [. r� A ctC tIA.((t�,e(�..)CtS (-1 t- STREET ADDRESS j cry STATE,Z• PHONE h ARCHITECT/ENGINEERNAME -- 1 LICENSE NUMBER BUS.LIC; • COMPANY NAME II E-MAIL FAX • STREET ADDRESS CITY,STATE,ZIP PHONE -- -- DESCRIPTION OF WORK /2_1 - - i5----- y� C_ .------- 1--i .0(V i ,/.1)� l,� 12-At-i. -___1e..�A c�r " '�.. ,u £e c ,lam �'i' EXISTING USE • ` PROPOSED USE COiET'R.TYPE 1 S STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXIST•G NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑DETACH ❑ATTACH S DWELLLNG UNITS: IS A SECOND UNIT 0 YES SECOND STORY 0 YES RELNGADDED? 0N ADDITION? 0N PRE-APPLICATION 0 YES IF YES,PROVIDE COPY OF ISTHE BLDG AN CI YES - "� TOTAL VALUAT PI.Ah1iLMGAPPLR ONO PLAT*\I>`TGAPPROI'ALLETTER £]CHLERHOhtE? ©NO �_3� T� - -- _ --��'`;.;s•. -K4-- ,_,• By my sionature below,I certify to each of the following: I am the property owner or authorized agent to act of the pro erty 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 t uild'i:construction. I authorize representatives of Cupertino to enter the above ide ;fie tproperty for inspection purposes. Signature of Applicant/Agent:_ •t I �� Date: / SUPPLEMENTAL INFO* 4ATIDN REQUIRED :r r:.em _ _ :_ ,.--. '- xyYte,. _ risx ==: _ =c- = •==�:PLA1CHECK-T- T ? ± -ROUTINGSLIP-.s -<_ � = ' } ANRayMew SPD orMultifanTil dwellings: Applyfor demolition permit for rm.`OIERTIi=COLNTER;'t- -�r ]. tiILDkaPIA1� _ _ _ existing building(s). Demolition permit is required prior to issuance of building01, :, ; _-�;=:--" _,IV: . nFFkre_ __.4I1�,0 _ < .-__ • .: permit for new building. n-n, -- -;_ : .t]yPL�ti�I3GPIS\IE\Y=:'n- � �- =� TM :t�. - - .Commercial B7dgsProvide a completed Hazardous Materials Disclosure -sT.�- `-'-` wPUBLIC�3Rl.sy„ _ _ - _ form if any Hazardous Materials are being used as part of this project. � _ = - -=. _ -; _-- _ - -- - - -:_ _ FIRE6 , — i :_ Copy of Planning Approval Letter or Meeting with Planning prior to ' _ =:4. LJR'-J -``'= ' y "S4ITAR :SEWEDSBI = _submittal of Building Permit application, p = a; . : _ E; _ ; aitM fa _ . _=". .._. _ I20hAEtiTltE3L3i="i . BidgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0123 10354 COLBY AVE CUPERTINO, CA 95014-2401 (316 29 038) JACK MYERS CONSTRUCTION INC' SAN JOSE, CA 95129 OWNER'S NAME: MCCHESNEY DOUGLAS GEORGE TRUSTEE DATE ISSUED: 01/25/2017 OWNER'S PHONE: 408461-1185 PHONE NO: (408) 761-1185 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class 5 Lic. #634066 Contractor JACK MYERS CONSTRUCTION INC Date 12/31/2018 X BLDG _ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing — MECH X RESIDENTIAL —COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: KITCHEN REMODEL - M.E.P.(157 SF); MASTER BATH AND BATH I hereby affirm under penalty of perjury one of the following two declarations: REMODEL (130 SF); 8 (N) WINDOWS (LIKE FOR LIKE); DEMO i. I have and will maintain a certificate of consent to self-insure for Worker's FIREPLACE AND REPLACE WITH WALL Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. z , J 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. Sq. Ft Floor Area: Valuation: $40000.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 316 29 038 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non-point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 01/25/2017 Issued by: MELI Date: 01/25/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: Ali roofs shall be inspected prior to any roofing material being installed. If a roof is 1. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sec.7044, Business & Professions Cade) z. I, as owner of the property, am exclusively contracting with licensed Signature ofApplicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 01/25/2017 I hereby affirm under penalty of perjury one of the following three declarations: AL • ROOF COVERINGS TO BE CLASS "A" OR BETTER 1. 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. HAZARDOUS MATERIALS DISCLOSURE z. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(x) should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Secti ►s 25505, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent:; APPLICANT CERTIFICATION Date: 01/25/2017 " I certify that I have read this application and state that the above information is CONSTRUCTIONLEND correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section 9.18. 1 understand my plans shall be used as public records. Licensed SiSignature Date 01/25/2017 g Professional El NEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX ((408)777-3333 - buildinqRcupertino.org ADDITioN F\;l ALTPRATTOM/TT F-1 I)T7NrTQT NT/T`%Vr7UDDUn „ /� 3 BldgApp_201I.-doe revised 06121111 rld- PROJECT ADDRESS, j # kp OWNER NAME J Ir -1 PHONE E (.1 -. f/ E-MAI8 STREET ADDRESS CITY, STATE, ZIP FD 11 t) (2- SA, W 'I () �> e, (� C, q SY 2-7 IA - CONTACT NAME f? Q_ PHONE F—A C 1 C3 =3 (2_5 STREET ADDRESS ZIP ob 'I/ PIA- F1 OWNER [] OWNER -BUILDER 11 OWNER AGENT ❑ CONTRACTOR ONTRACTOR 'GENT ❑ ARCHITECT 1:1 ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMED–L/, (XU P LICENSE 3 LICENSE TYPE (3 -) - BUS. L1e# COMPANY NAME e K 14 C) G- /V FAX , (C- , C✓ - ST I STREET CA,,,t,&, 6�0�co CITY, STATE, ZIP 6Ak A-+_6C4,,,,C 50 7 0 PHONE ARCETIECTIENGI?,MERNAME11 SENUMB ER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK M7 A -±k,' 44- 2- -17dff. I Z87 EXISTING USE PROPOSED USE CONSTR. TYPE #sTOTs USE TYPE OCC. SQ.FT. VALUATION EXISTG AREA NEW FLOOR AREA I � DEMO 2�0TAL AREA 1 TO NETAREA BATHROOM ry REMODEL AREA ( KITCHEN REMODEL AREA 15-7 � OTHER REMODEL AREA PORCH AREA � DECK AREA TOTAL DECKNORCH AREA � GARAGE AREA: EIDETACH WTTACH # DWELLING UNITS: IS A SECOND uNrrI BEING ADDED? f -os SECONDITORY W1 ADDrrION? 0 PRE -APPLICATION 0 YES IF YES, PROVIDE COPY OF PLANNING APPL # F1 NO PLANNING APPROVAL LETTER IS THE BLDG ANES EICHLER HOME? 'fl.N. fTOTAL VALUATION: 4Y 0( , 6 0 0 By my signature below, I certify to each of the following: I am the property owner or authorized agent to 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 b mg o truCtiOn. I autho ize epresentatives of Cupertino to enter the above -identified for inspection purposes. Signature of Applicant/Age Date: zq /7 SUPPLEMENTAL INFORMATf)N REQUIRED PLAN CHECK TYPE ROUTING SLIP El OVER-THE-COUNTEREl BUILDING 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. El EXPRESS El PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure El STANDARD 13 PUBLIC WORKS To—nn if any Hazardous Materials are being used as part of this project. El LARGE El FIRE DEPT — Copy of Planning Approval Letter or Meeting with Planning prior to 1:1 MAJOR El SANITARY SEWER DISTRICT submittal of Building Permit application. .1 El ENVIRONMENTAL HEALTH BldgApp_201I.-doe revised 06121111 rld- Mr. Dave Voros Voros Construction MHU 1535 • AVENUE SUITE 200 Reference: Special Inspection for Epoxy Anchor Bolts Residential Remodel 10354 Colby Avenue, Cupertino, CA 95014 Redwood Engineering Job #1711 Mr. Voros, laffly�� February 28, 2017 At your request, a site visit was performed at the above-mentioned project on February 8, 2017 to observe installation of retrofit epoxy shearwall anchorage to existing concrete footings. The following items are noted: Engineer observed correct installation of all (3) required 5/8" diameter holdown anchors at new shearwalls bearing on existing foundation, as required on the structural drawings. Installation was in accordance with detail shown on approved plans, 2. Engineer observed and approves (2) new pad footing excavations and rebar ties at perimeter footing at front and side of structure. If you have any further questions or comments, please do not hesitate to contact me. Leonard Willis, PE Redwood Engineering CA PE #62076, exp. 9-30-2017 Mr. Dave Voros Voros Construction 1535 SEABRIGHT AVENUE SUITE00 SANTA CRUZ, CA • (831)426-8444 Reference: Framing Review Residential Remodel 10354 Colby Avenue, Cupertino, CA 95014 Redwood Engineering Job #1711 Mr. Voros, February 28, 2017 At your request, Redwood Engineering performed a site visit on February 2, 2017 to the above-mentioned jobsite. The purpose of this visit was to view completed structural framing, including connections and hardware components. At the time of the site visit, framing was found to be mostly complete; exterior and interior wall and beam supports are installed, shear panels nailed to framing, and connectors in place. Please note that not all aspects of construction were investigated, only those portions of work thought to be exemplary of general construction techniques. After review of the site conditions, discussion with site personnel, and examination of the approved structural drawings, Redwood Engineering finds that construction has progressed according to the intent of the structural plans. Prior to covering of interior and exterior nailing, the following items should be addressed: Framing Approved, no exceptions taken. Please note that on-site structural observation by Redwood Engineering is intended to assist construction personnel with compliance to the structural drawings; this service does not replace or supercede any inspections required by the local Building Official. If you have any further questions or comments, please do not hesitate to contact me. Leonard Willis, PE Redwood Engineering CA PE #62076, exp. 9-30-2017