B-2017-1690 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1690
10475 BANDLEY DR CUPERTINO,CA 95014-1912(326 33 111) BARRON BUILDERS
INC
SANTA CLARA,CA
95054
OWNER'S NAME: DPT BANDLEY DRIVE LLC DATE ISSUED:09/29/2017
OWNER'S PHONE:650-906-9751 PHONE NO:(650)964-4493
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#916366
Contractor BARRON BUILDERS INC Date 07/31/2019 X BLDG _ELECT _PLUMB
MECH_RESIDENTIAL X 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:
APPLE-LAB 1 11;RELOCATE 2 CHAMBERS AND INSTALL 3(N)
I hereby affirm under penalty of perjury one of the following two declarations: CHAMBERS
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
Werformance of the work for which this permit is issued.
,r" 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
pe i 's issued. Sq.Ft Floor Area: Valuation:$35000:00
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 326 33 111 A(Tenant Improvements)
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 VVORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF;;PERMIT ISSUANCE OR
Additionally,the applicant u ..erstands and will comply with all non-point
source regulations per thy'upertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
(Signature .44 " 4 Date 9/29/2017 Issued by:Abby Ayende
Date:09/29/2017
� . ► -B __,;..r_i, !- --._ a '- -
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
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 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:9/29/2017 -
I hereby affirm under penalty of perjury one of the following three declarations: ALL 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(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
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of Califomia. If,after making this certificate of will maintain compliance with the Cupertino v- nicipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sectio 25505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall /
be deemed revoked. A caner or authorized agent: /tai
APPLICANT CERTIFICATION Date:9/29/2017 �I
I certify that I have read this application and state that the above information is CONSTRUC.r ON LENDING AGENCY
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. I understand my plans shall be used as public records.
Licensed
Signature Date 9/29/2017
Professional
CONSTRUCTION PERMIT APPLICATION
3V1 COMMUNITY DEVELOPMENT DEPARTMENT •• BUILDING DIVISION
( 10300 TORRE AVENUE •• CUPERTINO, CA 95014-3255 • , B
r St7ys%
, on- IGett
° •,„ s• (408) 777-3228 • building@cupertino.org PEMIT#B-
CUPERTINO REV E DEF#
❑ NEW CONSTRUCTION ❑ADDITION ❑ALTERATION&T.I. ❑MEP ❑RE-ROOF ❑SWIMMING POOL/SPA
PROJECT ADDRESS APN p "�
OWNER NAME PHONE E-MAIL
A-i°in4it' 6S )—%( Q75/ cA44 _6r1Q .e_ /via-0 .
STREET ADDRESS CITY, STATE,ZIP
CONTRACTOR NAME 0 OWNER-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE
Iow/ j Gaup--Iefs 9'/b36(o it
STREET ADDR CITY,STATE, ZIP
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E-MAIL PHONE j BUS.LIC b
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0 ARCHITECT 0 OWNER ❑OWNER AGEN CONTRACTOR AGENT ENGINEER 0 DEVELOPER 0 TENANT
CONTACT NAM , E-MAIL
0 1 11/1411 • vii QrUNI e- 19Ar2 ►J& o(aq . C rz-'n
STREET ADDRESS CITY,STATE,ZIP PHONE
a,1/.h . 414,441. i0 Gt..."eavioa ►ier.4— A ,rJCAT 9S7 j row '-'9491
DECRIPTON
A►.✓ A- 6/CC ) C FS 6 ers yr t- gl-(a) JW 14/
❑SINGLE-FAMILY/DUPLEX ' ❑MULTI-FAMILY 0 INDUSTRIAL ❑COMMERCIAL
EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES 4 TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION(5)
•
REMODEL REMODEL KITCHEN REMODEL OTHR J GARAGE ❑ATTACHED
BATHROOM SF SF SF SF ❑DETACHED
EXISING ❑YES EICHLER 0 YES SECOND STORY ADDITION OYES
FIRE SPRINKLERS 0 NO , . ❑ NO 0 NO
•
DWELLING SECOND DWELLING ,0 YES 0 ATTACHED DETACHED OTHER •
UNITS a UNIT ADDITON: ❑NO S F
POOLS' 0 FIBERGLASS ❑,VINYL-LINED 0 GUNITE 0 PREFABRICATED
POOL-SF SPA-SF • I SPA ATTACHED El YES 0 NO I TOTAL-SF REC DBY:
fl
TOTAL WON:
Commercial or Multi-Family Buildings.with Public Swimming Pools requires Department of Environmental Heath approval Q, 1i4 1 I,t, ivl&.q 35'
RE-RO OFI EXISTING'ROOF TYPE: D BUILT-UP ROOF❑ASPHALT SHINGLES WOOD SHAKES El WOOD SHINGLES V❑`TII E "OTHER(SPECIFY) •�Z7 (CC.••111JJJ"'CCC///
REMOVE/REPLACE❑NO IF:NO PLYWOOD ❑1/2" ❑3/8" PLYWOOD TYPE: PITCH: ROOF CLASS ,
YES !R OF LAYERS THICKNESS❑5/8" OTHER ❑OSB ❑CDX OTHER •12 A
PROPOSED ROOF TYPE:'❑BUILT-UP ROOF DASPHALT SHINGLES❑WOOD SHAKES❑WOOD SHINGLES 0 OTHER
*Provide a signed copy of fhe Cupertino's Tear-Off Policy SF ;of SQUARES
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? ave provided is correct. I have read the Description of Work and verify it is accurate. I agree
to comply with all applicable local ordinan3,7 and state laws relating to building construction. I authorize representatives of Cupertino to
enter the above-identified property fo in.-.ection pur•. - . I acknowledge and authorize all information contained on this application form
to be made available for public reco-y.
..1/.. —q-/—&4/
Signature of Applicant/Agent: / q� .._� Date:
SUPPLEMENTAL INFORMATION R
*New SFD/Second Dwelling Units/Mu1r ily Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction.
*Commercial Buildings: Provide a c.'pleted Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project.
*Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application.
*HOA-Provide a letter of approval from the Home Owner's Association
BldgApp_20/7.doc revised 08/01/17 .
/0 /
41111bk
TESTING ENGINEERS, INC. 1-7-
2811 Teagarden St. 510-835-3142 510-834-3777 fax
San Leandro,CA 94577 800-660-3142
'San Leandro • San Jose • Martinez _
INSPECTION REPORT Week Ending: 10/6/17
PROJECT#66164 TYPE OF INSPECTION.
Screw Anchors
PROJECT PLACE OF INSPECTION:
10475 Bartilley Drive fobsite
Apple BA05
Cupertino,CA
Permit#B-2017-1690
DATE 10/6/17
HOURS 4
INSPECTOR S Hughes
Reported to Albert Alvarez of Barron Builders at the jobsite as requested.
Inspected predrilled holes for proper diameter and depth. Observed the cleaning of holes and-witnessed the proper
insertion of four(4)3/8"diameter Hilti KH-EZ screw anchors,2-1/2"in length,embedded 2-1/8",and twelve(12)1/2"diameter
Hilti screw anchors,3-1/2"in length,embedded 3",all anchoring stacked chamber frame to slab.
The preceding work was,to the best of my knowledge,in compliance with approved job plans and specifications,including
revisions by engineer,and Drawing S-1,Detail 1,dated 9/29/17
Reviewe. gr'',1111111FP
Da e Chippero
Si-cial InSpection Division Manager
1cc: Barron Builders/M.Brum
City of Cupertino/Bldg.Inspection Dept.
The results presented in this report relate only to the item(s)tested/inspected and
may be reproduced only in its entirety unless written permission from TEl is obtained.
Page 1 of 1
TE
STING ENGINEERS, INC. It6 11)
. /
2811 Teagarden St. 510-835-3142 G r 510-8 -3777 fax
San Leandro,CA 94577 800-660-3142
9//9
San Leandro • San Jose • Martin-
INSPECTION REPORT
Week Ending: 10/6/17
PROJECT#66164 TYPE OF INSPECTION:
Screw Anchors
PROJECI: PLACE OF INSPECTION:
10475 Bandley Drive Jobsite
Apple BA05
._Cupertin),CA_ __
Permit#B-20174690
DATE 10/6/17
HOURS 4
INSPECTOR S.Hughes
Reported to Albert Alvarez of Barron Builders at the jobsite as requested.
Inspected predrilled holes for proper diameter and depth. Observed the cleaning of holes and witnessed the proper
insertion of four(4)3/s"diameter Hili KH-EZ screw anchors,2-1/z"in length,embedded 2-1/s";and twelve(12)1/2"diameter
Hilti KH-EZ screw anchors,3-1h"in length,embedded 3",all anchoring stacked chamber frame to slab.
The preceding work was,to the best of my knowledge,in compliance with approved job plans and specifications,including
revisions by engineer,and Drawing S-1,Detail 1,dated 9/29/17.
Reviewe. .
dr
Dav'd Chippero
S -cial Inspection Division Manager
1cc: Barron Builders M.Brum -
CEIVED
City of Cupertino/Bldg.Inspection Dept.
OCT 1 7 2017
BY
__)&_„/7
The results presented in this report relate only to the item(s)tested/inspected and
may be reproduced only in its entirety unless written permission from TEI is obtained.
Page 1 of 1
Quality Assurance Services
Materials Consulting
TESTING ENGINEERS, INC. Since 1954
October 11, 2017 ° �F IJ
/0 a�
City of Cupertino TEI Project' 66164
Building Inspection Department Permit No. B-20 690
10300 Tone Avenue
Cupertino, California 95014
-FIhTAI;REPORT —_
Project: 10475 Bandley Drive
Apple BAO5
Cupertino, California
Gentlemen:
In accordance with Section 1705 of the California Building Code,we have provided special inspection of:
Installation of screw anchors in existing concrete.
These inspections were performed by personnel under the general supervision of a Registered Civil Engineer in
the State of California. Based upon our inspections performed and our substantiating reports,the inspected work
requiring special inspection was,to the best of our knowledge, in conformance with the approved plans and
specifications,the applicable workmanship provisions of this Code, and any changes by the Engineer of Record.
Details of our work on this project are ••...ned in our testing and inspection reports that were submitted during
the-progress-o-f-construction. — ___—._ _
44i t t - Arlo t r$
TESTING ENGINEERS,Iih. ti �, �'Yfi
34132
Terry L. Egland,P.E. ECEAVE
CE##34132,Exp. 6/30/17' �I ,�"'
OF CA
r --- 0 C T -1 2017
cc: Barron Builders/M. Brum
_Am)
BY
Corporate Office—2811 Teagarden Street—San Leandro,California 94577—(510)835-3142—FAX(510)834-3777
www.Testing-Engineers.com
AIMIllihk Quality Assurance Services
Im
-terials Consultino TESTING ENGINEERS, INC
aism .lliwr /0- )-7 i) Since 1954
•
prat- t,
L-------1 if I !
a' Liz,
October 11,2017 t....,,,
City of Cupertino TEl Project No. 66164
,
Building Inspection Department Permit No. B-20174690
10300 Terre Avenue
Cupertino, California 95014
Subject: FINAL REPORT
Project: 10475 Bandley Drive
Apple BAO5
Cupertino, California
Gentlemen:
In accordance with Section 1705 of the California Building Code,we have provided special inspection of:
_ Installation of screw anchors in existing concrete.
These inspections were performed by personnel under the general supervision of a Registered Civil Engineer in
the State of California.Based upon our inspections performed and our substantiating reports,the inspected work
requiring special inspection was,to the best of our knowledge,in conformance with the approved plans and
specifications,the applicable workmanship provisions of this Code, and any changes by the Engineer of Record.
Details of our work on this project are 0, .'tied in our testing and inspection reports that were submitted during
the progress of construction.
,4, ipo•-e, ii.„„,
TESTING ENGINEERS /4
AliCI4 ! , 34132 1
/ , .,4 Afit,, *,
Terry L.Egland,P.E. ', 49, on, \,%..._
CE#34132,Exp. 6/30/17
,.....-..
-_
cc: Barron Builders/M. Brum
Corporate Office-2811 Teagarden Street-San Leandro,California 94577-(510)835-3142-FAX(510)834-3777
www.Testing-Engineers.com