B-2017-1352CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1352
20348 CLAY ST CUPERTINO, CA 95014-4403 (369 38 030) LARRABEE &
ASSOCIATES INC
SANTA CLARA, CA
95054
OWNER'S NAME: MILLER MARTIN H AND CLAUDETTE T TRUSTEE
DATE ISSUED: 08/15/2017
OWNER'S PHONE: 408-805-1318 1 1 PHONE NO: (408) 364-9000
License Class A Lic. #525973
Contractor LARRABEE &ASSOCIATES INC Date 10/31/2017
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:
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
ormance of the work for which this permit is, issued.
have and will maintain Worker's Compensation Insurance, as provided for by
VSection 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. 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 peryje Cupertino Municipal Code, Section 9.18.
Date 8/15/2017
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
r. 1, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code).
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
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
z. 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.
3. 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 if
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 8/15/2017
BUILDING PERMIT INFO:
X BLDG —ELECT —PLUMB'
MECH X RESIDENTIAL COMMERCIAL
JOB DESCRIPTION:
FOUNDATION REPAIR (10 LF).
Sq. Ft Floor Area: Valuation: $7000.00
APN Number: Occupancy Type:
369 38 030
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: ABBY AYENDE
Date: 08/15/2017
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant:
Date: 8/15/2017
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 I
will maintain compliance with the Cupertino Municip ode, Chapter 9.12 and
the Health & Safety Code, Sectio 255055 3, and 25534.
r or authorized agent:
Date: 8 5/
CONSTRUG ON 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
5 -doi7 - 1359 -
CONSTRUCTION PERMIT APPLICATION
Is COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CU'PERTINO (408))1777-3228 • FAX (408) 777-3333 * building(a.cupertino.org
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IS A SECOND UNrr E] YES
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PLANNING APPL# []NO PLANNING APPROVAL LETTER
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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 coriect. 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 but ;ng construction. I authorize -representatives of Cupertino to enter the abov-idemsled property for inspection purposes.
Signature of Applicant/Agent: V— Date: ! ! /�
SUPPLEMENTAL INFORMATION REQUIRED
a�r.�» a PLA`N;�H�@��x�'E.� F, , a�
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_ New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is requited prior to issuance ofbuilding
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permit for new building.
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form if any Hazardous Materials are being used as part of this project.
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BldgApp 2011.doc revised 06/21/11
CUPERTINO
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(aDcupertino ora
PRIIIIT CANN(iT.BE"FINALEp IHS +CE2TIFiCATE" HAS BEEN
OlViPL 'I ID; .. FT R1V 7> TQ 1 BVI11,DiNG DI ION
PURPOSE
This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms
for compliance with 2016 CRC Section R314, 2016 CBC Sections 420 6 and 907.2.11.2 where no interior access
for inspections are required.
GENERAL INFORMATION
Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon
Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds
$1000 00, CRC Section R314 and CBC Sections 907.2.11.5 and 420 6 require that Smoke Alarms and/or Carbon
Monoxide Alarms be installed in the following locations:
AREA
SMOKE ALARM
CO ALARM
Outside of each separate sleeping area in the immediate vicinity of
the bedroom(s)
X
X
On every level of a dwelhng unit including basements
X
X
Within each sleeping room
X
Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that
do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with
CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal.
Power Supply In dwelling units with no commercial power supply, alarm(s) may be solely battery operated.
In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do
not result in the removal of wall and ceiling finishes or there is, no access by means of attic, basement or crawl
space. Refer to CRC Section R314 and CBC Sections 907.2.114 and 420 6.2. An electrical permit is required for
alarms which must be connected to the building wiring
As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been
installed in accordance with the manufacturer's instructions and in compliance with the California Building
and California Residential Codes. The alarms specified below have been tested and are operational, as of the
date signed below
Address .�. �� '� 1.5-7-- Permit No :�0� ,�� 1-2
Specify Number of Alarms: # Smoke Alarms. # Carbon Monoxide Detectors.
( have read and agree to comply with thatarm.c and r^nn�;t;�„� nFfh;o cf.f._nnf.
Owner (or Owner Agent's)
Signature
JName:
M D-itA
•-_7 ? Date:
Contractor Name:
Signature Lic.# Date:
Smoke and CO fonn.doe revised 12/15/16
N
Abby Ayende
08/15/17
08/15/17
B-2017-1352
Abby Ayende
Notes:
- All work is a voluntary foundation
systems renovation.
- Concrete to test #3000 @ 28 days, typ.
- T-24 not required
- All epoxy - Simpson Set-XP ESR-2508
Site Specific Fracture Site Dimensions:
Total Length: Varies
Width: Existing
Heigth: Varies
(n) rebar (#4 vertical dowels) to be doweled
into existing concrete a minimum of 4"
every
16" with set-xp epoxy. Top of
vertical dowel to intersect horizontal rebar
member
Existing mudsill
(N) 5/8" x 10" Anchor bolts w/ galvanized
washer / plate 3" x 3" x 1/4" or Simpson
UFP10 retrofit anchor plates per
manufactures guidelines. Installed 4' o.c.
and 1' within mudsill break.
Typ. Horizontal Fracture Renovation Det.
Exterior
(e) Footing
(e) Footing
Horizontal Fracture Location
Deteriorated Rebar
(if applicable)
(n)conc.
3"min.
2"-3"
Not to scale
(e) Stemwall
demolished area
See detail 2
Typ. Horizontal Rebar Det.
Not to scale
See detail 2
4"min.
every 16" oc
(E) Condition
Not to scale
Side View
Section View
Section View
3"min.
(n) #5 rebar
min. 12" dowel typ.
(set-xp epoxy)
Min 4" embedment
(N) anchor bolt w/ 3x3x1/4 plate
Crawlspace
Min. 8"
(n) #4 rebar
vertical dowels (set-xp epoxy)
2"-3"
(e) mudsill
Within 1
2" of exterior plywood
Within 1
2" of exterior plywood
Abby Ayende
08/15/17