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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 F-1 XM IT nnXTQT TT!`T' n.T 1 I I ATI 111111T 14 AI III AT7. 11 F� RRVT.QTnM I TIFFFRRFTI (ORTC:TMAI. PERMIT # PROJECT ADDRESS`/1 i ®4� ^ APN # ✓� �j C� �` �� OWNER NAME IA�sYo -. LG.�� O or, `/���� STREET ADDRE�SS�"(�CrrYSTAT�IP T ` " - FAX CONTACT NAME PHONE �,4,VOV;g—,0 m ECi STREET ADDRESS CITY,.STATE, ZIP -e-0 AX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER El, TENANT � CONTRACTOR NAME -� `6s LICENSE NUMBERLICENSE TYPE �J BUS. LIC # E-MAIL LJ -iF_ FAX COMPANY NAME STREET ADDRESS e� CITY, STATE, ZIP A� _ PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK��oJ/-� y� �% ®J���s� /O EXISTING USE PROPOSED USE CONSTR. TYPE #STORIES USE TYPE OCC. ' SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREATOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH # DWELLING UNITS: IS A SECOND UNrr E] YES SECOND STORY ❑ YES BEING ADDED? �N0 ADDITION? 'IVO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YESRECEIVEL?,�H ,, `' � , a �' �' �r TOTAL VALUATION: PLANNING APPL# []NO PLANNING APPROVAL LETTER EICHLER HOME? �NOmg 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� �at s, �. s,:. i R9 NG;,S'kIP a.$, � 1 r •, _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is requited prior to issuance ofbuilding k"' �A P OVER T#IV-COiJNTER �i BT7ILDIN(r PLAJVEVTEy1 permit for new building. P g EXPxEss ❑� rtAtvi�I�hPX artlrvlEw�� Hazardous Materials Disclosure❑ "� �❑ pT "ter _ Commercial Bldgs: Provide a completed STANDARb Otis r ;� form if any Hazardous Materials are being used as part of this project. ❑ri u� ���Ifi of Planning Approval Letter or Meeting with Planning prior to❑ Wo��,�� ° A pE��x _Copy submittal of Building Permit application. � � � �SANI'1�i�ItY 5EWR DiS�RYCT �a3..y� � wlt '�&�. i�?,��,"a ��� 0-0k tl❑x'�I���+1 ��l+il����Si'.+ 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