02070125 (3) BUILDING DIVISION v PERMIT 'I:CON'RACTOR,INF,ORMATION--l?
'f:.4�5tH1'q'Yi:(.1�,T`Z"'A.'f'it'V 4.11.9Ls'Gh't kflY.n:.-s4.E'C'r'4
BUILDING ADDRESS: ""1207012510385 MANN DR ABLE SEPTIC •
OVUM MAYNARD E 520 REED ST. APPLICATI6N gIjfIY2002
PHONE: U / L
�'
(408) 377-9990 SANITARY NO, CONTROL NO.
ARCHITECLFNGMEER: BUILDING PERMIT INFO
BLDG ELECr PLUMB MECH
S CNvi i LICENSED CONTRACTOR'S DECLARATIONS
;Z Ihereby aRrmthat IamGansedunder pmWsionso(Chapter9lrommeming INSTALL SEWER/�E.Y7"S�p K
y y with SauonIDW)of Divivon3of Oa Business and Profe.a.m Codgand.,license
-S is in full force and effecs.
Og License Clasx Lic.g
3 u.U Date Com,ea.,
.u.O ARCHITECT'S DECLARATION
: 1 understand an,plans shall be used as public records
i
i i ce O Licensed Professional
• =ff OWNER-BUILDERfrom
die RATION
I hereby afErm that 11. ,Bump from d r Convector's e:Any c Law for the $3690 F z following assn..(cation ID construct,
Business and Professions Code:Any cso or county Y 3 6 9 0
SFC which requires n permit 1.re cores the alit improve,demolish,or repair sty swment
pdono its umence,alurequires the septicum for such permiuo Rleasigncdunemem aL.Cn]]�.7� �nnn�
thst hall licensed pannim to the pvlsions of the Convectors Licenu Law(Chapter 9 ,32.666 GfJ1'a`Qa Valuation
(ccm%Fcing with Section 70W)of Division 3 of the Business and Probl000m Code)
orthat be is exempt thciefmm and�the basis for the alleged alemptiori.Any violation '
"OfSectlan 70315 by any applicant for o permit subjects the applicant m a civil penttl
.afoot mae than five hundred dollars(S500). 104PNFZMH & Occupancy Type
01.as owner Of the Property,or my employee:with wages as their sole compensation, 202 - UNDERFLOOR P UMBING
'will;A Use work and the structure is not intended or offered for sale IS.,.7044, TUB & Det
Business and Professions Code:The Contractor's License Law does not apply to m 3 0 2 - O ctions
owner of prapany Who builds a improves thereon,and who does such work himself H
or Nrough his own employees,provided that such improvements are,not intended or
offered for sale.IL however,the building or improvement is sold within one year of 502 - FINAL PLUMBING .ENERGY"' ,
completion,the owner-builder will have the burden of proving that he did not build or 506 - GAS TEST
ve for purpose of sale.).
I;;us Owha of the �° —' —' 507 - FINAL PLUMBING---
_.
P Perry,am Business
a contracting with licensed contractors m
Licenses the prolan(Sec.]04q Business end ProfessionsCade:)or The Comramfa
License Law don not apply man owner with
property who Wilds se improves thereon,
.::. -snd who e.Lnum for such projects wiN a contncmr(s)licensed pursuant m the
. .: Convanoh Lic<nu Law. .. - ....... ... ... _.._.. .._ . "'"--......
❑Ili rut n Sc &PCfathisressoa
t WO KER'SC PENSAlI� D? RATION
1 - Ihereby affirm under Penalty ofxiddrdr,one ofthe fallowing declarations: V ^
I haveaM will maintain a Certificate of Cousin,to self-insure fa Worker's V�
.Ompmation, as provided for by Section 3700 of the IsWr Code. for the
'rfomunce of the work for which this permit is issued.
❑1 have and will mainaho Workeri Compensation Insurance,u requited by Section
3700 of the Labor Code,for the Performance of the wmk'for which this permit ja
issued.My Worse,Compemadon Insurance carrier aM Policy number art:'
.. ... . ,...�..... .our v
Cam i.'.:.: :•;S Policy No.: .. .. t•o 's... .
-..C:E..R.:T.F»'CA�-OF FROM WORKERS'
COMPENSATION INSURANCE C. •. .. •' . '. `.,
MI 00) ..
or to zkstion ottd noel o completed i(the permit is fa one hundred do0an
less.)
'.1«nifY that in the perfoimasoe of the wo[k for wh'M this pcovdi u timed,l ,, -. .- ^ _..... .. .. ... .. .. ... .... ._ ..
dull tai emPlo any
0qct tip a(4oJac ubta the Wmkni
NCompewi u0�Li Ca
' .a✓i�� . .
N �p1�CpNT:lf,gf¢r mekhng Nis CemtOcere of Exemption.you should -
Z beta bjecuo the Workds Compensation pmvim.m.of the Labor Coda you must
00 forthwith comply with such provisions or this permit shall be domed revoked.
r, " "CoNS em is 4 c0N LENDING AGENCY
1 hereby which that them ss e comvucton luno og agency far the performance
a' 0 ofjb<il'workfr .. thispermit is issued(Sec l0)],Civ.C) '
I, . LcndcrI Address �, aws
V-� I«ssfy that 1 have read Nis application and sum that the above information is '//v\' ,/y'--
fa. t correct I agree to comply with JI city u d county ordinances and state laws relating
Q to Wilding cansuuction.and hereby authorize represematives of this city to enter upon
y W the above-mentioned pmKny for inspection purposes.,
i[.•i,La (we)"¢gree m save.indemnify and keep harmless City of Cupertino against ^� '
%' liabilities,judgments,fosse and expenses which may in any way accrue agunst said a'•�
U.� Cary in conseyucnce of the yrantia fthis permit
SOPLICANT ND STA WLCOMrl."TTHA 'NON. INT Issued by:
7 Z Date
am fAFDlicattdemo,' .. '• ... .Date Re-roofs
- H' RDOU9 MATERIALS DISCLOS
Will•die applicant er faire built ing oLcvpani v&e M handle hevNoihs mated) Type of Roof -
as defined by the Cupeniao Municipal,Cods,Chapter 9.13,and On Health and Safety ..
Code,Section 25532(a)?
CYC' All roofs.shall.be inspected prior to any roofing material being.installed. _
Will the applicant or share,building Occupant use equipment or,devices whim If a roof is installed without first obtainingaft inspection,I agree'to remove
emit hawdousw cantvninams as defined by the Bry Arca Air Quality Management P
Darrict] all new materials for inspection. Applicant understands and will comply with
j 13 V° all non-point source regulations.
1 heve'rtad she bazatdoos materials requirements under'Chapter 6.95 of the
itthI ismi4 HeJth d Safety Code.Sections 25505,25533 and 25534.1 undarsutk that
if e Wilding does nes cmreadY have-tenant.that it is my ruponsiladity tort the
oecupbm of Ne rcquirtmenu w 'ch must be met prior to Wu oce of a Certifscare of
Z Signature of Applicant Date
oraothorigent Da All roof coverings to be Class "B"or better
OFFICE .. .
P.O. Box 24819
• San JoseAof , CA 95154
.fLAE
(408) 377-9990
"SERVING ALL NORTHERN CALIFORNIA"
JULY 15, 2002 PROPOSAL/CONTRACT
�/�y�� AC 02-135
LLS
ADDRESS: 8038UZZ5 MANN DR.
offiCk
OOP tj H� (408) 725-1634
CITY/ZIP: CUPERTINO, CA 95014 (�J llJl �f U
SITE: SAME FL2
INSTALLATION OF SANITARY SEWER:SCOPE OF WORK AS FOLLOWS:
1. INSTALL ONE SANITARY BUILDING SEWER.
2. LATERAL TO BE EXISTING 4" STUBBED INTO OR AT PROPERTY LINE.
3. INSTALL TRENCH BEDDING AND COVER. (AS NEEDED)
4. INSTALLATION OF 80'LINAEL FEET OF 4" ABS SCHEDULE 40 PIPE, TO BE USED AS
BUILDING SEWER.
• 5. ONE BUILDING SEWER CLEANOUT AT 2' FROM FOUNDATION.
6. INSTALL CLEANOUT AT PROPERTY LINE W/ BOX TO GRADE.
7. COMPACT ALL TRENCHES. (METHOD OF CCWACTION TO BE MECHANICAL)
8. INSTALL BACKFLOW PREVENTION DEVICE. (IF REQUIRED)
9. ROUGH GRADE ALL SOIL IN AT SITE. (REPLACE SOIL IN TRENCHLINE)
10. OFF HAUL SPOILS RELATED TO SEWER INSTALL ONLY (EXPORT OF SPOILS) .
11. CO—ORDINATE WITH THE CITY/COUNTY INSPECTOR.
12. INSTALL TRACER WIRE ON NEWLY INSTALLED SEWER.
13. ABANDON ONE 1500 HUNDRED GALLON SEPTIC TANK. (AS PER CITY OF CUPTINO)
APPRC - 95
IN ACC OOAGE WITH E CITI 01
DOES AN RDINANC"
TOTAL COST PER ABOVE SCOPE: $ 3690.40 CSP ��-
DAT
SIGNED specifications MUS1
This an bat all times and fl is un
SEE PAGE TWO FOR ACCEPTANCE OF PROPOSAL AND WARRAN h kept on the W
TYia , .I,C7N changes or alteration`.
on same without written
tte of Permission
rm ssi on from
the scampi Dept.,
this plan and specifications
The stamping
SHALL NOT be held to Permit or to be an
rovisions
n Of
'if f any
approval
Oid nraoceoor StateyLaw.
on
•
SEPTIC•SEWER•STORM• WATER• UTILITY TRENCHING• DEMOLITION• GRADING• PAVING
SEPTIC SYSTEMS• DESIGNED• INSTALLED• REPAIRED•PUMPED•INSPECTED
UPGRADED• REAL ESTATE WORK• HILLSIDE EXPERTS• FULL SEPTIC TANK SERVICE
ABLE SEPTIC ffff& CopV AC-02-135
PAGE 2
WARRANTY IS AS STATED:
5 YEAR ON ALL MATERIALS AND LABOR
STARTING FRCAI DATE OF COMPLETION OF PROJECT W
WARRANTY EXCLUDES: JUL 2 2 2002 _
ALL TREE ROOTS AND EARTHQUAKES
ALL STANDARD STOPAGES By _
WARRANTY IS VOIDED IF ANY OTHER THAN ABLE PERFORMS WORK. ABLE TO REPAIR ANY/ALL
WARRANTY WORK OR WARRANTY IS IMMEDIATELY TERMINATED.
THIS BID EXCLUDES THE FOLLOWING:
• ALL ENGINEERING. ALL PERMITS. REPAIR OF ANY UXMARXED LINES (GAS, WATER,
TELEPHONE, CABLE, ELECTRIC, ETC) . ALL CONCRETE REPLACEMENT. ALL ASPHALT
REPLACEMENT. SOIL'S ENGINEERING/SOIL'S TESTING. BOND'S OR CD'S.
ANY ALTERATIONS OR DEVIATIONS FROM THIS PROPOSAL, INVOLVING EXTRA MATERIAL'S OR
LABOR WILL BE EXECUTED ONLY ON WRITTEN ORDER AND WILL BECOME AN EXTRA CHARGE
OVER THE ABOVE COST OF PROPOSAL.
10$,�DOWN��R 40.$�PROGRESS�PAYb43JT;:,:BALANC,E„ PAYABLE�UPON .COI�LETIONx"OFyPRA7ECT.,,����,.
ACCEPTANCE OF PROPOSAL
THE CONTRACT/PROPOSAL IS ACCEPTED, PAY1,1ENT WILL BE MADE AS OUTLINED.
CUSTOMER SIGNATURE: DATE:
CONTRACTOR'S SIGNATURE: < < i DATE: 4 1 ' OZ
•
;�t,'- ,y"
l
]PERMIT P-1 g 6.7 1
• CUPERTINO SANITARY DISTRICT
Santa Clara County
20065 Stevens Creek Boulevard, Building C
Cupertino, California 95014
Telephone 408-253-7071
`
CONNECTION PERMIT Offl'E CDPV
Date t APN: Book�)2 47 Paage4riParcel n7
ROS/PM/Tract No. 647 ' Lot No. AX
Property Owner:
Mailing Address: — ---
r-Im1: -TINO CA 61Q) -IM
rJUL
�.2002(UWe),being 7t�he AofwflAner(s)(owner's agent),hereby make applicati+on for connection of the at: �
1 A,N1 KI RE I y6 C(,(Y�ITI V G consisting of the following Type of Buildings:
Residential: Single Family Dwelling; Multi Family Dwelling_; No. Units_
Commercial ; Industrial ; Other No. Units
•Do hereby request a permit to connect the sewer system of the Cupertino Sanitary District.
IN CONSIDERATION OF THE GRANTING THIS PERMIT, THE OWNER AGREES:
1.To comply with all existing Ordinances, Rules and Regulations of the Cupertino Sanitary District as now or hereafter amended.
2.To maintain the House Sewer(that portion of the sewer within private property)which includes a serviceable cleanout to grade
and accessible located within five feet(5')of the point of connection with the Lateral Sewer(that portion of the sewer in the
street right-of-way of District easement. r '
3.To acquire a Plumbing Permit from the 0,1 1 of 0(,i ffif,11 hl 0 , Building Department and obtain the required
Building Department inspections and approval prior to use.
4.To expose and inspect for serviceability the Lateral Sewer prior to starting construction of the House Sewer.
5.That this permit does not constitute a request for the issuance of an encroachment permit for sewer construction in the
street/public right-of-way of the agency having jurisdiction thereover.
6.To connect to sewer within one(1)calendar year from the date of issuance of this permit.
7.To call UNDERGROUND SERVICE ALERT(USA) 1-800-227-2600,at least 48 (tours prior to starting construction.
8.SPECIAL PERMIT CONDITIONS:
i
A BACKFLOW PROTECTIVE DEVICE shall be installed to protect the above property by the owner. Type of'device
and installation shall comply with the Plumbing Code Requirements of the jurisdiction shown in 3 above.
Fees:
Screr Service Charges to June 30,71(1"1?7 J
No. Units z$I N month x_�no. months $ Z r% (310/0)
Backflow Protection Device Inspection Fee (/r r (31020)
Connection Permit Fee: l rr % (31020)
• Additional Connection Fees ( )
Total:
Considerations and Considerations of this Sanitary Sewer Connection Permit with attached Exhibits, are hereby agreed to
and acknowledged by the undersigned Owner(or Owner's Agent). Failure to comply may result in termination of permit.
Acknowledgement: : f Yates"
Owner's Agent:
• (If Signing for Owner Please Print Your Name)
Receipt of it acknowledged and permit granted.
MARK THOMAS & CO.,INC., district Manager-Engineer
By ..
Revised 5/00 NOTE: See Details on other side of this permit
X14 Ca" . ,
TYPICAL CLEANOUT FOR LATERAL SEWER
Distance from Property Line
to be as close as practicable,
a' not to exceed five(5) feet.
c
J
`u Removable Cleanout Plug
o.
0
a Finish Grade
A
Wye for Riser
Sewer Cleanout Box with Lid to be accessible
and maintained by property owner. .
Short length Riser Pipe
Adaptor coupling 1/6 Bend
FLOW m-
Loteral Sewer House Sewer
LaterGl Sewer slope House Sewer slope
determined by District determined by building deportment
—CLEANOUT TO BE SAME SIZE AS LATERAL SEWER—
Notes: •
1. Distance from the property line not to exceed five(5')feet.
2. Property Line Cleanout, Lateral Sewer Cleanout,to be same size as Lateral.
3. The maintenance of the Lateral Sewer Cleanout is the responsibility of the Property Owner.
4. House sewer minimum slope determined by local Building Department plumbing code requirements of the
agency having jurisdiction thereover.
TYPICAL BACKFLOW PROTECTIVE
DEVICE INSTALLATION
TYPICAL BACKWATER VALVE TYPICAL KELLY VALVE INSTALLATIONS
INSTALLATION Jar.aicaanal Rutdcnan.
Accepted By All Jurivaicnone
FIGURE I FIGURE 2 FIGURE 3
In.talled Below Grade IMlmm B.Ae Grade IW.11.4 Above Grade
Shawn Ise...n St...I Right-0-Way and Building Shawn At prop.",Line CManout She..Adlaum To Building
Reauir.. Regular Mulnlenance i Red.".Minimum Mainl.nance Reguire.Minimum M.m enanae
Valve To Be Removable Vale should Be Removable •
r VALVE ACCESS BOX
¢ eIlhy Vented Covo FINISH FLOOR
o L vel f FINISH FLOOR
KELLY VALVE
I
Im.h Grade
VALVE ACCESS BOX
LLY VALVE vuE
rFIW,h Grade Fini.h Grade �
BACKWATER m
VALVE
FLOW A FLOW EI—
� FLOW Al
Notes: •
1. The Backflow protective device to be located on site in the house sewer.
2. The type, location and installation of the Backflow Protective Device shall comply with the local Building
Department plumbing code requirements of the agency having jurisdiction thereover.
3. Device to be accessible and maintained by the Property Owner.
4. If a Kelly Valve Is installed at Property Line, it is to be readily removable for Lateral Sewer Maintenance.
OTPERTINO SANITARY DISTRIO
20065,Stevens Creek Blvd.,Bldg. C DER:
Cupertino,California 95014 CHH: _
(408)253-7071 CV: _
File:
"ON-SITE REQUIREMENTS-OVER THE COUNTER REV_ W"Z� Z
Date: I"�n10
File: CuS P
Building Dept-Cupertino
Community Development Department-Building City0 Cupertino COP
10300 Torre Ave. 1Uv(
Cupertino,CA 95014-3202-
L � Re: Subject: � [r/�r.�l
JUL 2 2 2002 i ,IName:. IJl JA 11,LLQ
JAddress: IO� 5 V/IV Dove
APN: :V-6-4-5-07-7
Control/Plan Ck No:
Permit No:
ce0WT�OK WIT Vo FL 16571 D'
The Cupertino Sanitary District has reviewed the plans for the subject project: Vii,
❑ No additional conditions/requirements by the District.
❑ Sanitary sewer is available and the existing building is connected to sanitary sewer,see conditions/requirements listed
below. � J
• Sanitary sewer is(/V[)available, see conditions/requirements listed below.
❑ Sanitary sewer is not provided by the District,please contact the City of Sunnyvale.
The folio Conditions/Requirements are made:
Install new Property Line cleanout or locate and raise to grade an existing property line cleanout. Cleanout . shall
be the same diameter as the street portion of the service lateral(Minimum gravity lateral is 4"diameter). Videotape
inspection of the existing Cleanout, Point of Connection and Street Lateral is required,Please Do Not Inspect any
onsite construction until this is cleared in writing by the District, Owner to call District 48 hours prior to video
inspection to schedule a District Inspector.
I&KF-O W
❑ >�ege Pump is required,unless Civil Engineer certifies that the lowest finished floor with plumbing is at least one
(1')foot ab6ve the rim of the next upstream manhole prior to issuing a Cupertino Sanitary District Connection
Permit.
❑ Cupertino Sanitary District Fees or Permits are required for the subject improvements please do not
issue any building permits.
❑ Plans shall be reviewed by the Industrial Waste Division of the San Jose/Santa Clara Water Pollution Control Plant,
Phone 945-3000 for questions and to schedule an plan appointment. Please Do Not Issue permits until pretreatment
recommendations have been forwarded to you by the District.
❑ Verify existence and serviceability of an existing backflow protective device.
❑ Break areas authorized minor electrical appliances only.(No commercial disposal or commercial dishwasher
installations.)
• ❑ Other. .............................:............................................................................................................................................
Storm water from surface or roof drains,other general surface runoff water or condensate from any residential HVAC equipment shall not
be discharged to the sanitary sewer.
NOTE: Contact CuSD for "OFF-SITE REQUIREMENTS"
III i� � „ , � h�, ��
i" NIA SANITARY DISIITRITF wfi
NN D
YU�PE ail N R, ... � ,
r r ..IVE ,BENEFIT ZONE.
County Records: Property Owner:
Tract& Lot No. APN Number: 326 45-027 BOARD
Permit Number:OJ ,A, fnent,S
Permitnup DATE: Jun 30, 1991
Permit Date: Ill l, ��IIU
u
SSCharge: $0.00 BENEFITZONE Payment: $0.00 $0.00
Construction Date: Jun 30, 1991 PAID in FULL
Construction Cost:: $4,152.23Construction Escalation Rate:
.....................................
Days Calculated:: 0 Current CONSTRUCTION COST: I; $4;162:23
............................... j
............................ ...... tI J U, lU1 IF,
ACRE Fee Rate: ....._. $1, ...0 00. ACRE Fees Paid:' $0.0 0 0 : j
.....................................
PARCEL ACREAGE: 0.2610 RATE PER ACRE: $1,040.00 i ' JUL 2 2 2002 U
ACREAGE FEE: I $271.44
Current Construction Cost&Acreage Fee:
SIGNUP DATE LOAN INTEREST RATE:; 8.50%
....................................
.. .. .. . 0
....................................
To End of Tax Year::. Jun 30, 1991 INITIAL PAYMENT: ;
• Fiscal Year Begins:;....Jul.1,.1991..,, Days Calculated:::................0............. .` PREPAY INTEREST
....................................
INTEREST Through: 6130/1991 $0 00
............
STARTING BALANCE without Interest thru: Jun 30, 1991 $4,423.67
CURRENT BALANCE as of: Jul 22, 2002
j q CLOSE ACCOUNT
q
,DATE." FINAL PAYMENT:
Closing Difference: $0.00 ENDING BALANCE: F==1
First Year Payment includes the interest thru: 6/30/1991 $0.00 + $376.01 $376.01
TEN YEARSCH...E..DULE.
TAXROLL YEAR Beginning Annual Payment Ending Extra Annual
July 1 - June 30 Balance Interest Principal Balance Payment Payment
1991 1 1992 4,423.67 376.01 298.19 4,125.48 0.00 674.20
1992 2 1993 4,125.48 350.67 323.54 3,801.95 0.00 674.20
1993 3 1994 3,801.95 323.17 351.04 3,450.91 0.00 674.20
1994 4 1995 3,450.91 293.33 380.87 3,070.03 0.00 674.20
1995 5 1998 1 3,070.03 260.95 413.25 1 2,656.79 0.00 674.20
1996 6 1997 2,656.79 225.83 448.37 2,208.41 0.00 674.20
1997 7 1998 2,208.41 187.72 486.49 1,721.93 0.00 674.20 ='
1998 8 1999 1,721.93 146.36 527.84 1,194.09 0.00 674.20
1999 9 2000 1,194.09 101.50 572.70 621.38 0.00 674.20
• 2000 10 2001 621.38 52.82 621.38 0.00 0.00 674.20
Totals: 2,318.34 4,423.67 0.00 6,742.01
TOTAL AMOUNT PAID at TERM: $6,742.01
Note: Total Amount includes (Inter t, Principal & Ext r Payments)
32845027.XLS /� ' 7/22/2002
gea:
CITY OF CUPERTIN U Z 07 o � v�
g -1jjgjRE E/ SEWERS/ MAIN SAVICE
CUPEkTINO PERMIT APPLICATION FORM
• APN# O Date:
p 7—Z2 -d 2
Building Address:
03 SS ivy 4�t//t/ o e
Owner's Name: Phone #:
/634-
Contractor: License#:
Contact: Phone #:
cE Gi EizT 377—Q997>
Applicant/Contractor:
Building Permit Info:
Bldg Elect Plumb Mech
Job Description:
Residential: i✓sTi9LL SEs Commercial:
Sq.Ft. Floor Area: ` G /S .Ft.:
.Architect/Engineer: c4t. Valuation:
Type of Construction: Occupancy G oup:
Qty. if
Applicable Fee ID Fee Description Fee Group
PPERMTTFEE Plumbing Permit Issue PLUMBING
BPREPIPE Re i e of Fixtures PLUMBING
BPFIXTURE Pblg Fixture PLUMBING
BPWSVCS Main Water Service PLUMBING
BPSEWER Sewers PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BUSLIC Business License BUILIDNG