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13030158-voidCITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21390 VAI AVE CONTRACTOR: LIGHTHOUSE PERMIT NO: 13030158 CONS'FRUC 1'10N OWNER'S NAME: BOLANDER RICHARD B AND PA,rRICI 1110 HACIENDA DATE, ISSUED: 03/28!2013 OWNER'S PHONE: 6502698950 CAMPBELL, CA 95008 PHONE NO: (408) 891-5312 ❑ LICENSED CONTRAC"TOR'S DECLARATION Class ic. 4 F 7 VL_)_u NFO: BLDG• ELECT PLUMB BUILDING FERMI"C iI..icense MECH R SIDENTIAL COMMERCIAL Contractor�l �' 1.-(/1' 7'� Date � �1 �- I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: CHANGE ORTION Oh ROOF FROM HIP1' 0 GABLI: 540 (commencing with Section 7000) of Division 3 of the Business & Professions SQl I Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following t -o declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Moor Area: aluation: $20000 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. APN No bcr 0 27.00 Occupancy "type: 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 IT EXPIR IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (W agree to save indemnify and keep harmless the City of Cupertino against li ilii s,judgmems, ITHIN 180 AYS OF PERMIT ISSUANCE OR costs, and expenses which may accrue against said City in c scque ce of the 1 0 DAYS F OM LAST CALLED INSPECTION. granting of this permit. Additionally, the/applicant underst cls and i11 comply with all non -point source regulations p the Cupertino M icipal C Section 9.18. issued by: �✓ G�1� Date: Signature e/ Da /7 OWNER -BUILDER DECLARATION /,,eby RE -ROOFS: shall be inspected prior to any roofing material being installed. fa rool'is I affirm that I am exempt from the Contractor's ,icense Law for ne of without first obtaining an inspection, I agree to remove all new materials for /Slipre, the following two reasons: n. I, as owner of the property, or my employees with wages as the ole co cnsation, will do the work, and the structure is not intended or offered for sale ec.7044, Signature of Applicant: Date: Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractor to construct the project (Sec.7044, Business & professions Code). ALL ROOF COVERINGS TO BE. CLASS "A" OR BET'l FR IIAZARDOUS DISCLOSURE, I hereby affirm under penalty of perjury one of the following three declarations: .MATERIALS I have and will maintain a Certificate of Consent to self -insure for Wkers I have read the hazardous materials requirements under Chapter 6.95 of the Compensation, as provided for by Section 3700 of the Labor Code. or the California Ilealth & Safety Code, Sections 25505, 25533, and 25534. L will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & I have and will maintain Worker's Compensation Insurance, a provided for by Safety Code, Section 25532(a) should I store or handle hazardous material. Section 3700 of the Labor Code, for the performance of the ork for which this Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. I maintain compliance with the Yupertino Municipal Code, Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued, I shall Health & Safety Code, See o s 25505, 25533, and 25534. not employ any person in any manner so as to become subject to the Worker's Compensation laws oPCalifornia. If, alter making this certificate of exemption, I Ow or at torize Date: become subject to the Worker's Compensation provisions of the Labor Code, I must __ -//_/CONSI•RIjCFlON forthwith comply with such provisions or this permit shall be deemed revoked. if LENDING AGENCY APPLICANT CERTIFICATION 1 hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued (Sec. 3097, Civ C.) correct. I agree to comply with all city and county ordinances and state laws relating bender's Name to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save Lender's Address__, indemnity and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the ARCLIITFC"I''S DECLARATION granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature _ Date CUPERTINO (�� a _,e� a CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinq(@cuoertino.orq ❑ NEW CONSTRUCTION ❑ ADDITION 0 ALTERATION / TI ❑ REVISION / DEFERRED / j9jD� :3ORIGINAL PERM/k PROJECT ADDRESS) APN N OWNER NAME PHONE MAIL STREET ADDRESS /� % a C/ CITY, STATE, ZIP J r��^� a FAX CONTACT NAMEL PHONE �1h I � P� STREET ADDRESS /J/ UL L �!ti>� �' CJTY, STT IP � FAX T�RA,{CTORAGENT CT ❑ ENGINEER 1:1 DEVELOPER El TENANT ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR 1:1 CONTRACTOR CONTRACTOR NAME LiCENSENUMBER y J NSE E n BUS. LIC N COMPANY NAME A� w y /, E MAIM FAX STREET ADDRESS CITY, STATE, ZIP �* J /U � PHONE z ARCHITECT/ENG[NEER NAME --k J& A � �f LICENSE NUMBER BUS. LIC k COMPANY NAME �t -MAIL FAX STREET ADDRESS ` / % CITY, ST P& P DESCRIPTION OF WORK ` EXISTA4G USE PROPOSED USE CONSTRF E # STORIES / USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITC ENOTHER REMODEL AREA REMODELAREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH E] ATTACH N DWELLING UNITS: IS A SECOND UNIT YES BEING ADDED? R' SECONDSTORY [I YES ADDITION? _81tQO PRE-APPLICATION�YES IF YES, PROVIDE OPY OF P LANNMG APPL p NO PLANNING APP VAL LETTER IS THE BLDG AN � YES EICHLER HOME? NO RECEIVED BY: / TOTAL VALUATION: �f ^ 6 By my signature below, I certify to eacK of the following: Yam the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I h e 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 relaf building I authorize representatives of Cupertino to enter the above-identi ed prope for inspection purposes. U ' "f �� u Signatureof ApplicanUAgen Date: TAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP OVER-THE-COUNTER BUILDING PLAN REVIEW New SFD dwellings: Apply for demolition permit for existing buildintion permit is required prior to issuance of building fing permit for new ❑ EXPRESS PLANNING PLAN REVIEW Commercivide a completed Hazardous Materials Disclosure ❑ STANDARD PUBLIC WORKS _ form ifany Haials are being used as part Of this project. ❑ LARGE ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp 2011.doc revised 06121111 CITY OF CUPERTINO MEN FEE ESTIMATOR - BUILDING DIVISION imADDRESS: 21390 Vai Ave DATE: 03/28/2013 REVIEWED BY: Se MISC ITEMS APN: BP#: "�'%/�5� *VALUATION: 90,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Additi PRIMARY SFD or Duplex USE: Vhrs PENTAM ION 1GENRES PERMIT/TYPE: WORK Chane portion of roof from hip to gable 540 sq ft). SCOPE li l' r (;; 11 J� Ph f" ht I � L1r'cla. I'I err f ��(wh a G wiz 1, c"', '`! ur�t� f'erurr� ! c'r� F:1,,'r oflwr arr rA io>l?. O1 / Plomm 7r r,. 0//wr° !r.T �Irh. ldrglr t'..>e: d"Irrru �irr .r�. a",lr frrsl 14e: NOTE: This estimate does not include fees due to other epartments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School Wvtrict_ etc ). Thrace fees are hnced an the nreliminary reformation available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS Fee Resolution 11-053 F . 7/1/12 FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? () Yes (F)o $0.00 1 hours Plan Check, Hourly $133.00 ISTPLNCK Suppl. PC Fee: Q Reg. Q OT 0.0 Vhrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? s Q No $0.00 Suppl. Insp. Fee -0 Reg. Q OT 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 �;r�rx,�'/e°i:r arc^rz le:t.t.c��r�rir:r.�r� ter rr 7�E: 0 0 Work Without Permit? Yes (F) No $0.00 Advanced Planning Fee: $0.00 ® hours Inspections $532.00 ISTINSP Inspection, Hourly (•,� 0 7'rav,'ll crroncr72ofiorl 1, CO"'. Strong Motion Fee: IBSEISMICR $2.00 Select an Administrative Item Bldg; Stds Commission Fee: IBCBSC $1.00 $3.00 $665.00 „' 'TUTA� SEE. $668.00 Revised: 01/01/2013 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21390 VAI AVE CONTRACTOR: LIGHTHOUSE PERMIT NO: 13030158 CONSTRUCTION OWNER'S NAME: BOLANDER RICHARD B AND PATRICI I l 10 HACIENDA DATE ISSUED: 03/28/2013 OWNER'S PHONE: 6502698950 CAMPBELL, CA 95008 PHONE NO: (408) 891-5312 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMME�RL El License Class �iJ Lic. # ?,•�'l2� CHANGE PORTION OF OF FRO TO GAB 540 SCREV # 1 - ADD 6 CANNED LIGHT FDCT RS, E NGHT, 2 DEDICATED Contractor �( Date CIRCUITS, (N) GAS LIN FRO E RTO°„FIREPLACE INSERT - ISSUED 5/14/2013 I hereby affirm that I am licensed under the provisions of Chapter 9�' (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's' Compensation, as provided for by Section 3700 of the Labor Code, for the S t door Area:/ Valuation: $20000 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided f r Section 3700 of the Labor Code, for the performance of the work for whi thi d J.PJNumjr�r: 36205027.00 Occupancy Type: permit is issued APPLICANT CERTIFICATION' I certify that 1 have read this application and state that the above informatio is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws ting WITHIN 180 DAYS OF PERMIT ISSUANCE 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,,Z 180 DAYS ALLED INSPECTION. indemnifyapplicant liabilities, judgments,oer s which osi,nxpenccegistaidCityincoanue ofomPIY W al awil Dab te: cnce granting of Admit >th with all non-po t source regulations per the Cupertino Municipal Code, Section 9.18. pa's ° RE -ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATON Y Signature of Applicant: Date: I hereby affirm that I am exempt from the Con actor's License Law for one of the following two reasons:m ALL ROOF COVERINGS TO BE CLASS "A” OR BETTER 1, as owner of the property, or my employees�th wages as their sole compensation, will do the work, and the structure is not iuKnded or offered for sale (Sec.7044, Business & Professions Code) 1, as owner of the property, am exclus� `°ely contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Bu ness & 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 penal f perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a ,ertificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provi d for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performanceof thew k for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will ma twin Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this s 25505, 25533, and 25534. the Health & Safety Code, S�09011141% rpermit 43 Owner or authorized agentIDate. is issued. !!! T,-%- — 1 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 Califomia. If, after making this certificate of exemption, 1 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 6�4:8vss^ s CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (40.88)) .777-3228 • FAX (4708) 777-3333 • building(o1cupertino.org TION I I AT)T)MON I I AT.TFRATTON/TT TA RF.VTRT0MVT)1ZFF.RRFT) rTRT(MiNAY. PFRMTT # PROJECT ADDRESS �..1 RMI APN # OWAi�ER �� r STREET ADDRESS CITY, STATE, ZIP FAX V VW Aye. CO CT DAME P OjjE &MAIL STREET ADDRESS CITY, STbbATE P FAX 10 92tlegbA Of 414 o ❑ OWNER .❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ONT OR)119/ ❑ ARCHITECT❑ ENGINEER 11 DEVELOPER El TENANT CO CTOR NAME LIC SE E�6_7) Z LI S TYPE BUS. L1C # ANY NAME E-Vt FAX STREET ADDRESS .. CITY, S' ATE, P >!o a xb PHONE CHITECT/ENGINEER NAM LIC N NUMB BUS. LTC # OMPANY NAME E- L FAX S gj�@RESS •, ,1 S ATE, ZIP PHONE / DESCRIP`1O OF',j'pRK d .WCAh t �� l r 't 'l.l11 C 1W (CLO 005 EXISTIN SEPROPOSFL SE 0704R TYPE #STORIES SQ.FT. USE TYPE OCC. VALUATION (5) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOMKITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA .PORCH AREADECK AREA TOTAL DECK/PO CH AREA GARAGE AREA: DETACH ATTACH ' 0DWELLING UNITS: ISASECOND LNrr 1 ❑YES SECOND STORY OYES ' BEING ADDED? ❑ NO ADDITION? ONO . PRE -APPLICATION ❑ YES IF YES, PROVIDE JtOPY OF. IS THE BLDG AN ❑ YES ], > � {� ,f �T1i`7 /n, j �' ''� 1� TO� VALUATION: PLANNING APPL # ❑NO PLANNING APPVIVALLETTER cc EICHLER HOME? ❑ NO lip. v �� By my signature below, I certify to ea c 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 hav rovided 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 ilding construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: AL INFORMATION QUIREDU 11, 1 A _.$PP,LEE n New $FD orMultidwellings: Apply for demolition permit for w t - existingbuilding(s) De olition permit is required prior to issuance of building permit for new building. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if Hazardous Materials being of this f t` any are used as part project. if Copy of Planning Approval Letter or Meeting with Planning prior to �F�� submittal of Building Permit application. � �A BldgApp_2O11.doc revised 06121/11 FM-0CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION 19 ADDRESS: 21390 Vai Ave DATE: 05/14/2013 REVIEWS Y: Sean Plan Check Fee: APN: BP#: 13030158 *VALUA ION• 000 ^PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: 1 hrs PENTAATION 1 REAP11 MPERMIT TYPE: wORK Revision #1: Install 6 can lights and 1 ceiling fan with dedicated ircuits: new 1/2" gas line for new SCOPE fireplace gas insert in master bedroom. Mech. Plan Check 0.0 hrs $0.00 Plumb. la 0.0 1 hrs $0.00 Elec. Plan Check0.0 hrs $0.00 Mech. Permit Fee: 11PE T l umb. Permit Fee: PPERMIT Elec. Permit Fee: IEPERMIT Other Mech. Insp. 0.0 hrs $ 5.00 Ot Pl b Insp. 0.0 s $45.00 Other Elec. Insp. 0.0 hrs $45.00 NOTE: This estimate does not include es due to qher Departments (il. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on thepreliminkry information atklahle and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS(Fee Resolution 11-053 7/11 FEE Z QTY/FEE MISC ITEMS Plan Check Fee: .00 = # $67.00 Electrical 1BREMFIXT Fixtures, Lighting Suppl. PC Fee: 0 Reg. (") OT 0,0 1 hrs $0.00 PME Plan Check: $0.00 1 # $67.00 Plumbing IPGASRES Piping, Gas <=4 Outlets Permit Fee: $0.00 Suppl. Insp. Fee -0 Reg, Q OT FO 0 hrs $0.00 0 # Mechanical $67.00 IBAPPLOT Other Appliance/Equip PME Unit Fee: $0.00 PME Permit Fee: $135.00 IC W 'P Administrative Fee: IADMIN $42.00 Q Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 A Travel Documentation Fee: ►v J0 Strong Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item 3 , Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $223.50 $201.00 TOTAL FEE: 1 $424.50 Revised: 04/29/2013 tmr CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building a(�cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TIREVISIO /DEFERRED ORIGINAL 955 PROJECT ADDRESS, E�.� L� OWNER NAME J PHONE_ -MA STREET ADDRESSCITY, STATE, ZI FAX O CONTACT NAMER I_ P �rT� STREET ADDRESSFAX CITY, SATE, Awa ) n ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR 1:1CO CTOR AG".�7' ❑ ARC CT41ER ❑ DEVELOPER ❑ TENANT CONTRA�yCTOR NAME �.(e C NUMBS X2~7 LICEN E BUS. LIC # COMPANY NAME E- L k1Q 6 VfROt, FAX STREET ADDRESS STATE, P NE � lilt)�- , 0-;� 0-i� M I1 a. ARCHITECT/ENGINEER NAME LICENSE NUMB i BUS. LIC k t COMPANY NAMEIL FAX STREET ADDRESS CITY, STATE ZIP PHONE DESC TION OF WORK �� ., W �� _ '�` 6�' 'roe o �a�sv i " 5 JwiTC tl Y' ^� t✓u" Sl n �5�1�� PCD S! i l� 'I (E�� ?5<il�� l r)°IZ [ �i$ o. EXISTING USE PROPOSED USE CONSTR TYPE N STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR D 0 TOTAL AREA AREA A NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL/EA REMODEL AREA PORCH AREA DECK ARE)B3 T AL DECK/PORCH AREA GARAGEAREA: DETACH ❑ ATTACH 4 DWELLING UNITS: ECONDUNrr ❑YES SECOND STORY ❑YES ADDED? ❑NO ADDITION? ❑NO PRF—APPLICATION ❑ YES YES, PROVIDE COPY OF IS THE BLDG AN ❑YES CF , , ALUATION: PLANNING ADPL M. ❑ NO PLANNING APPROVAL LETTER EICHLER HOME?/ ' , / u ✓/; ' By my signature Belo ; I certify to each of the following: I am the property owner or author' agen o act onrty owner's behalf. I have read this application and the information I have ovided 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 o, ` ilding construction. I thorize representatives of Cupertino to enter the abo /,de teed property for inspection purposes. . Signature of Applicant./Agent: Date: �� c2� SUPPLEMENTAL INFORMATIONUIRED Q �/ New SFD or Multifamily dwellings: Apply for demolition permit for OS'k'R T13E-COUNIER r � ,/ �� BUILDIl\6 PLAN REVIEWS rr✓,e, � Ir, existing building(s). Demolition permit is required prior to issuance of building rra/r///rcf 'o/ a�rypain/W,r r,,r rlrrvJJ JrFovyl,'a^ permit for new building. C1,I:�,P1tESS�j � ' ��, epr�/�l,/��,r ,ijP1fAI��tINc'PLA,tv�2Fy1f�/ r� Jap — Commercial Bldgs: Provide a completed Hazardous Materials Disclosure TAiVDARD/ f'i 'A �,1ITBLIC W(}RSCSN ;'/�r,iY r n form if any Hazardous Materials are being used as part of this project. ❑, Copy Planning Approval Letter Meeting with Planning to LARGFo}�,i r P� !I/, �� , i iy�/ i 'G�l��IftE37EkTli/,r�l�Jfal>i� ��i�'?p%el%/Yf ��l l _ of or Pffor submittal of Building Permit application. 1 CJ :,ENvrrzox�rENTAf:�ALTx � �: ,, BldgApp_201 Ldoe revised 06/21/11 CITY OF CUPERTINO rm--7 FEE ESTIMATOR - BUILDING DIVISION �/cb. I/, , <'I -r,. ck I I I f'hrrnl"'Y- - (11yel, ?,?r,r l l" , /, I I I I01•r,r. FYrnf (r2: -j,. /`1 /,,, r,/') ( /•.<,,/•: /,,, r l',, /�!Il ),,'( �/rt:fr h, p / cc' I /'lata,). /r�,p' / cc I i,[c( hex NOTE: This estimate does not include fees due other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School ni.ctrict. etc )_ These fees are hated nn the nre1jminam information available and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Elf ' 11/12) ADDRESS: 21390 VAI AVE DATE: 07/01/2013 REVIEWED BY: MELISSA APN: 362 05 027 BP#: `VALUATION: $0 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE:PERMIT Suppl. PC Fee: (F) Reg. 0 OTT0.0 PENTAMATION 1 R3SFDREM TYPE: WORK REV # 2 -WIDEN 1 E WINDOW & REPLACE 1 E WINDOW AND ADD BATHROOM REMODEL & SCOPE RECONFIGURATION TO (E) SCOPE OF WORK $0.00 �/cb. I/, , <'I -r,. ck I I I f'hrrnl"'Y- - (11yel, ?,?r,r l l" , /, I I I I01•r,r. FYrnf (r2: -j,. /`1 /,,, r,/') ( /•.<,,/•: /,,, r l',, /�!Il ),,'( �/rt:fr h, p / cc' I /'lata,). /r�,p' / cc I i,[c( hex NOTE: This estimate does not include fees due other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School ni.ctrict. etc )_ These fees are hated nn the nre1jminam information available and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Elf ' 11/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 141(f.1 s.£ $600.00 Remodel, Bath (<=300 sf) IREMRESBAT 26 Suppl. PC Fee: (F) Reg. 0 OTT0.0 hrs $0.00 PME Plan Check: $0.00 2 # $400.00 Window / Sliding Glass Door' / IWINREP Replacement 7 �� Permit Fee: $0.00 Suppl. Insp. Fee -(F) Reg. 0 OT0,0hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee:° $0.00 C `rtrZNHH tiv t '1'(J/PZ"til/,P/a/'!i (I ly ec' Work Without Permit? C) Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 i Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 ,. $0.00 $1,000.00 �'�Tf3�;FE: $1,000.00 Revised: 04/29/2013 �0yy CONTRACTOR / SUBCONTRACTOR LIST Building Department CityOf Cupertino I O3M Torre Avenue , CA 95014-3255 one: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: _�/ :3 rr d V i l PERMIT # OWNER'S NAME:if /l 14 PHONE # 2' 91— 53 GENERAL CONTRACTOR: Z, SINESS LIC SE # ADDRESS: CITY/ZIPCO *Our municipal code requires all businesses working in the city to have a NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) GENERAL CONTRACTOR AND ALL SUB,,CONTRA RS HAN F BUSINESS LICENSE. n I am not using any subcontractors: signature Please check applicable subcor Ir ctors and'complete the A Cupertino business license. ,L BE SCHEDULED UNTIL THE AINED A CITY OF CCUPERTINO Date information: Owner / Contractor Signature Date SUBCONTRACTOR BUSINESS N E BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation \1J Landscaping Lathing Masonry ' Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date (FN I 0 I CP rk� C -P 7N, ctltRt'rr►i �" 950tq 0-) � tLwn lz' o�tJar�ze, vias � t nc�fa�► m� tD oras c'ns�4'• ti� s�s�Qll V cyan • 1 c��s� � x�� 3� �hsial� l Ctcling� $ QUA 2APAIrattd. ci("4s f(b"l OL) Cttlin9nt �c�e) b*). 4 t4A lC ' lg� C> 330 Patricia Garcia From: Zackary Horsager [ezlighthouse@yahoo.com] Sent: Wednesday, May 27, 2015 4:52 PM To: Patricia Garcia Subject: permit * 13030158 y :`� 1 0 V Pat, we have been advised by the cslb to cancel the permit #13030158 for 21390 via, cupt. as of this date at 4;50 pm 5/27/2015 thank you Zackary Horsager Lighthouse Construction STRUCTURAL For or 2P90 Vai Ave. I Ofirtino, CA. 950 Date: 3/20/13 Br' ............ MAR 2 8 2013 1 1825 Yosentile Blvd. Alodcsto. CA, 95354 /'home: (800) 332-6035 l7a,a--(209) 5-14-8784 Project Date Description 21390 Vai Ave. Cupertino 3/20/13 Design Criteria Sheet Index: Roof Design 1 Post Footings 2 - 3 Ridge Beam 4 - 5 Hip Beam Design Criteria: Gravity Loads: Roof DL+LL = 21+20 = 4 Lateral Loads: Floor FDL+FLL = 75+50� 125 6" c Wall DL = 15psf 2"x6" woo framing Gyp. Boar & T-111 Misc. Wind: Zone C, Seismic Zone, D 1825 Yosemite Blvd. Modesto, CA. 95354 Phorze:800 332-6035 Fax:(209) 544-878-1 'T: Post Footings (TYP.) PAGE: I 0,�- e�� 4T: DESIGN BY: 0.: DATE: REVIEW BY: �Plain Concrete Foofina Deslan Based on ACI 318-08 INPUT DATA COLUMN WIDTH C, = 0 in COLUMN DEPTH C2 = 0 in BASE PLATE WIDTH b, = 5-5 in BASE PLATE DEPTH b2 = 3-5 In FOOTING CONCRETE STRENGTH fe, = 2.5 ksl REBAR YIELD STRESS fy = 60 ksi AXIAL DEAD LOAD Pa = i k AXIAL LIVE LOAD PU = 1 1 k LATERAL LOAD (O -WIND, 1 =SEISMIC) = I SeIsmicSD SEISMIC AXIAL LOAD PLAT = 6.5 k, SD SURCHARGE cis = 0 ksf SOIL WEIGHT WS = 0,11 kd FOOTING EMBEDMENT DEPTH Df = 2.00 ft FOOTING THICKNESS T = 24 In ALLOWABLE SOIL PRESSURE Oa = I ksf FOOTING WIDTH B = 2.5 ft FOOTING LENGTH L = 2.5 It THE FOOTING DESIGN IS ADEQUATE. ANALYSIS DESIGN LOADS (IBC SEC, 16053.2 8 ACI 318-08 SEC.9.2.1) CASE 1: DL + LL P = 3 k CASE 2: DL + LL + E / 1.4 P = 7 k CASE 3: 0.9 DL + E / 1.4 P = 6 k CHECK SOIL BEARING CAPACITY (ACI 318-08 SECA5.2.2) CASE CASE 0.42 ksf, 1.16 ksf, q MAX 4 kOa, where k = 1 for gravity loads, 413 DESIGN FOR FLEXURE (ACI 318-08 SEC.22.5.1) 3 00 ()o ft -kips where = 0.6 (ACI 318-08, con 9.3.5 modulusS elastic section dul section DESIGN SUMMARY FOOTING WIDTH FOOTING LENG rH F -O(," ING THIGKNESS = 2.27 F P %C1318-WSEC.22.5.4) qmAx BL 28.80 kips where = 0.6 (ACI 318-08. Section 9.3.5 -3.04 kip 3 ki V1,2L + *6 LL ;2 + .0 LL + 1.0 E 0 0 , 1 .9 + 1.0 E loads. 2880 Ina M n CK PUNCHING SHEAR (ACI 318-08 SEC.22.5.4) 201.10 kips OM,, = MIN (50J—'s, 0.850f CS} coon 9.3.5 ratio of long side to short side of concentrated load 2.06 ft -kips 2 [Satisfactory) B = 2,50 h L = 2.50 ft T = 24 Ifl PU = PU = In ca PU = < 0 V n Isatisfactory) 11.57 < 0 V n Isatisfactory) INPUT DATA & DESIGN SUMMARY MEMBER SIZE MEMBER SPAN UNIFORMLY DISTRIBUTED DEAD LOAD UNIFORMLY DISTRIBUTED LIVE LOAD CONCENTRATED DEAD LOADS (0 for no concentrated load) LIMIT OF LIVE LOAD LIMIT OF LONG-TERM PAGE: DESIGN BY: REVIEW BY: GLB 5 1/8 x 15 Glulam 24F-1.BE L = 20 ft WD = 180 lbs / ft WL = 189 lbs / ft PD, = 0 lbs L, = 0 It PD2 = 0 lbs L2 = 0 It d L = L / 360 Ca r => 0.41 inch dKu0,L=L/180 Wind/Earthquake Load Does member have continuous lateral support by top diaphragm ? (1= yes, 0= no) 1 Yes 920 Duration Factor, G, Condition 1 0.90 Dead Load 2 1.00 Occupancy Live Load 3 1.15 Snow Load 4 1.25 Construction Load 5 1.60 Wind/Earthquake Load 6 2.00 Impact Load Choice => 4 Constriction Load ANALYSIS DETERMINE REACTIONS, MOMENT, SHEAR wsMi wt = 18 lbs/ft Raft = 3.87 kips Vw., = 3.39 kips, at 15 Inch from left end RINE SECTION PROPERTIES& ALLOWABLE STRESSES b = 5.13 in E',In = N/A CHECK BENDING AND SHEAR CAPACITIES d = 15.00 in FbE = N/A 66 psi < F,' A = 76.9 int I = (.44 In' in, at 10.000 ft from left end, S„ = 192.2 in' Re = N/A , (NDS 3.5.2) 'E= N/A ksl F„ = 331 psi CD CM C) CI CF 1 1.25 1.0D 1.00 1.00 1.0 1.00 0 CHECK BENDING AND SHEAR CAPACITIES fb = MMax / S„ = 1209 psi < Fb - 2' fv' = 1.5 VMax /A = 66 psi < F,' CHECK DEFLECTIONS ksi Fb. = N/A A n+„l = 0.26 in, at 10.000 ft from left end, dlKcrD+ ,,,,xl = 0.68 in, at 10.000 It from left end Where K., = 1.50 , (NDS 3.5.2) GERMINE CAMBER AT 1.5 (DEAD + SELF WEIGHT) Id (r,sD. M2K) = 0.41 in, at 10.000 ft from left end THE BEAM IGN IS ADEQUATE. 2 Douglas Fir -Larch = 3.87 kips �JRfth, 119.37 ft -kips, at 10.00 ft from left end = E. = 1800 ksi Fb. = N/A 1 b = 2,400 psi F = FbE / Fb* = N/A v 265 psi Fe = 2,948 psi E' = 1,800 ksl F„ = 331 psi Cc C, 1.00 1.00 psi [Satisfactory] [Satisfactory) < dL = L / 360 [Satisfactory] < d K« o � L = L / 180 [Satisfactory] 3 0. CHECK THE BEAM CAPACITY WITH AXIAL LOAD AXIAL LOAD F = 8.1 kips ALLOWABLE COMPRESSIVE STRESS IS F.' = F. Co CP CF = 2081 psi Where F� = 1600 psi CO = 1.60 CF = 1.00 (Lumber only) Cp = (1+F) / 2c - [(1+F) / 2c]z - F / c]°-5 0.813 Fc' = Fc CO CF = 2560 psi LB = Ke L = 1.0 L = 240 in d = 15 in SF = slenderness ratio = 16.0 < 50 [Satisfies NDS 2005 Sec. 3.7.1 A] F, = 0.822 E'min / SF 2 = 2986 psi E'min = 930 ksi F = F�E / F,' = 1.166 C = 0.9 ACTUAL COMPRESSIVE STRESS IS f� = F / A = 105 psi < F,' [Satisfactory] ALLOWABLE FLEXURAL STRESS IS Fe = 3774 psi, [ for Co = 1.6 ] THE ACTUAL FLEXURAL STRESS IS fb = (M + Fe) / S = 1525 psi < Fb :CK COMBINED STRESS [NDS 2005 Sec. 3.9.21 (f. / F.' )Z + fb / [Fo (1 - f. / F.E)] = 0.422 t 'I LIT DATA & DESIGN SUMMARY ABER SIZE ABER SPAN FORMLY DISTRIBUTED DEAD LOAD FORMLY DISTRIBUTED LIVE LOAD VCENTRATED DEAD LOADS (0 for no concentrated load) LIMIT OF LIVE LOAD LIMIT OF LONG-TERM GLB 5 118 X 15 ;' Glulam 24F -1.8E L _ _.- 15 ft WD = 200 lbs 1 ft WL = 210 lbs 1 ft PD, = 0 lbs L,= 0 ft PD2 = 0 lbs PAGE: - 64, 5— DESIGN BY: REVIEW BY: La= 0 It AL = L f 360 Camber > 0.14 inch dx10+L = L 1 180 Does member have continuous lateral support by top diaphragm ? (1= yes, 0= no) 1 Yes Code Duration Factor, Cr, Condition 1 0.90 Dead Load 2 1.00 Occupancy Live Load 3 1.15 Snow Load 4 1.25 Construction Load 5 1.60 Wind/Earthquake Load 6 2.00 Impact Load Choice => 4 Construction Load 4LYSIS rERMINE REACTIONS, MOMENT, SHEAR ws.xwi = 18 lbs 1 ft RLeft = 3.21 kips VMS = 2.68 kips, at 15 Inch from left end rERMINE SECTION PROPERTIES& ALLOWABLE STRES S b = 5.13 In E'r„ ir, = NIA d = 15.00 in FbE = N/A A = 76.9 in' I = 1,441 in SX = 192.2 in RB = N/A 1,E = N/A THE BEAM DE IG IS ADEQUATE. 2 Douglas Fir -Larch tt 3.21 kips ft -kips, at 7.50 ft from left end E = E, = 1800 ksi Fb = N/A Fb = 2,400 psi F = FbE 1 Fe= NIA F 265 psi Fe= 3,000 psi E' — 1,800 ksi F„ = 331 psi CD CM C, Ci C, CF Cv Cc Cr 1.25 1.00 1.00 1.00 1.00 1.00 1,00 1.00 1.00 CHECK BENDING AND SHEAR CAPACITIES fb = MMsX 1 Sx = 752 psi < Fb = 3000 psi fv' = 1.5 VMax 1 A= 52 psi < F,, [Satisfactory] CHECK DEFLECTIONS A (L, Me) = 0.09 in, at 7.500 ft from left end, < d (Kr D + L. Mex) = 0.24 in, at 7.500 It from left end < Where Kir = 1.50 , (NDS 3.5.2) DETERMINE CAMBER AT 1.5 (DEAD + SELF WEIGHT) d(,SD,Mu) = 0.14 in, at 7.500 ft from left end [Satisfactory] AL = L f 360 [Satisfactory] d Ka D+ L= L 1 180 [Satisfactory] CHECK THE BEAM CAPACITY WITH AXIAL LOAD AXIAL LOAD F = 8.1 kips ALLOWABLE COMPRESSIVE STRESS IS F� = Fa Co Cp CF = 2369 psi Where F� = 1600 psi Cp = 1.60 CF = 1.00 (Lumber only) Cp = (1+F) / 2c - [(1+F) / 2c)Z - F / c]o.6 = F,' = F� Cp CF = 2560 psi Le = Ka L = 1.0 L = 180 in d - 15 in SF = slenderness ratio = 12.0 < FSE = 0.822 E'mi„ / SFZ = 5309 psi E'min = 930 ksi F = FSE / Fc* = 2.074 C = 0.9 ACTUAL COMPRESSIVE STRESS IS %, = F/ A = 105 psi t F� i ALLOWABLE FLEXURAL STRESS IS Fo = 3840 psi, [ for Co = 1.6 ] 0.925 50 [Satisfies NDS 2005 Sec. 3.7.1.4) [Satisfactory] ACTUAL FLEXURAL STRESS IS fb = (M + Fe) IS = 1068 psi < Fti [Satisfactory] CHECK COMBINED STRESS [NDS 2005 Sec. 3.9.2] (f. / F� )Z + fb / [Fti (1 - f. / F.E)] = 0.286 < 1 VAI AVENUE fu ..-- — — _ EDGE OF AC � w NI� z_ N 09' V W iG0.0G' _. `". _. -_"_— -- -— fLin 3 � � I (E) OAS NEXR (E) IOGA 1'0.3W ElEGT,— — (E) DRIVEWAY CE �i SUA& METER I I w. €wsnNc SINGLE STORY RESIDENCE I I T f �,,� t 5' DECK < oi DETACHED (E) GARAGE 01 � MAR 2E 2073 1 N 89` W�T law` PLOT PLAN SPECIAL NOTES TITLE 24 MANDATORY NOTES j z zxc xt¢aa cY Pte` iLdd i. 27990 VSA Ci Rbc G.91i91k � � ee 1 1 I � IT II `T GI C:) Q I I 1' 9� uw 11' Ir 11_ P#1A w I .:msf au xrufcipw u t +w .xss*x ' i .^ NIA ....x.fin...i...�7 1 f.rt f Y—"1—i'T1I 1 �«aoe� f saw zo ane z «aa ai � s e. , II o- <n� « o to ai .. 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MATCH (E) MSE B'x4`POBT®DLR CONNEGlION. 412' NOR WHFA£. 050815 580 0 r at .,SWW4§ BCI BA`.S. CAP k r Yx OF SIX TOM BLOC$ RESSMIN STAGiE.PED EASOC FACE TO MAIM EMSTNG 2 7_D• 12 Jam.( nr+epa 5u� � dunM Z'. �(E) ._. e^zir'nFaa Hoa wNF.R�occuRes - .ESSU E TREATED POST w/SIMPSON CB44 OR DIME TO 30` 50. X 24° DEEP CONC FOHNO./#4 BARS 12" O.C. EACH WAY WALL R3 EATEP� RSL ...CONNECTION _-._�. ....- - �...., ._ — KING POST /'�`'< FOOTING DETAIL f s axWn sz PLUMB DURING CONSTRUCTION .._... 8, 2. ALL CDTRNX,'ERS TO EXTEND TO (2) RAPIERS .,...��;, •_.• a,J� ax<,.. TO E° WAS M ORAE /re FALSE PARTS w/r PLY A1301E f a > � "x:«r i:mm..w. \ m c12 � v I" PAY oR 058 %CAaRRG r/w 0!£Wk I10G°EN CROSSSECTIGN{N}VAULTEDAREA /'a\ �' eiMeiaNWT]tbiNAPORCQVAI.ix LFO x'X1D" DfWT BLOGxINE# r"` •.' xTiNxE0.xAPTER FP"NA"Fx I `' s{. 3(b'=T'-e' V. • t OPi'x RAFTEHx�x4•Qa Yk t £Rfex Rtt ENNRAIRNI ua s xox•w-xn uvo.cV xaTAL N36TYe,} \ : tigry xbev} I i -W H — aeex 4e.ni l.ta z ---------------- 2AB CVT & 2C O.C. RAFifA5024°O.C. AST 7O. flEMAlli I'}„• ,/ " ema w N. w ",n .m S�w..•a.. - W E j BELOW Sam 5�°x15' 0.9 H qQq d 1 iW. SNEAIiWNG PER DETAIL 412 SallAR flCOM SAYM TO MAIM 4•x4• o AD CUi BEAM 0 M" WSiNG 0.G. tD NATGN {MISTING cx++ m 5 e Z 1 __________ ________ _ —�Rf-- _ _ } RAFTERS TORDGEDETAfl. _ W .- `\ } /;a 7- W aT.x �y FNi USE4B HIP w/m CUT-OOMN 14 CUT k S7ACKW RAFTERS 0 EM 0.C. /"An 0 Q}L GETTING RAST TO RExAiN ..I (N)UT CA. FRAME (N} BUC b E 1 1 Ix sN x' i j 4), 3L L � r- IB' GABLE W/ 2x4 (N) RIDGE BEAM OUTRI�iS 0 35. O.C. (E) FAEP4.ACE TTM BELOW ROOF PLAN ! 1 —^ ROOF UNE nr+epa 5u� � dunM u NOTES: 1. CONTRACTOR TO BRACE WAfLS. LEVEL AND w' axWn sz PLUMB DURING CONSTRUCTION .._... 2. ALL CDTRNX,'ERS TO EXTEND TO (2) RAPIERS .,...��;, •_.• a,J� ax<,.. MIN. 24• 3. ALL TAL RAFTERS TO BE CORTIDUOS , .,`.:• ,:. ........ "x:«r i:mm..w.