NO PERMIT NUMBER (2) cITV OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRHSS'. PERMIT INO.
C
DWNERSNIW868 NORTHSHORE SO AI'I'11CAT1000801100
'NE: A'ITKEN/HARTSANTIARYM/15% i01HNO
5 os S/aZ O
o�>. ARCHITECIOENGINEER: !+ / yG� BUILDING PERMIT INFO
o 0 1..../1 d�7/1 /A J ' BLuc ELECI pLOMB NIECH
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FONj LICENSED CONI'RAMOR'S DECLARAHON Job Description
1 hcmby'arfrm that I am licensed ander provisions ofchapter 9(commencing
wink Smtion]tllXll ofDlvision3nfthc Rusinmsand rro/m/asi�on's�cute.. dmr L=en¢= -
< eafall,lace anJ eRl.=,. Q
:'x6 I.iccnsc Class (/ Lic,a_ mw
y'ca
O ),ua Commctor y�^•�j�.
ARCHI'I'I'.Cl'S DECLARNNON INT REMODEL
t=O 1 unJcmanJ my plans shall he uwA us public rccuNs e D
WYE.
i S p It LicenmJ I'rnfeeeiunnl l
X w OWNER-HUILp]iRDECLARATION
�PJt;- p � ZDO
I hemby at'tinn than 1 am cac,npl fold the Contmetor's License law for the
i hdbwing n u.(Sell ion 7031.5,limine,and Pontic, „Code,Any oily i unty '
i a which reclaims a permit In,ou,nael,.[,a,improve.demolish,or repair any structure
prior, t uninec.alk.reduice,I ppl a t for such parrinit tofl 'gn J statement
deal n Il '.can,t a piociaonsol(lieContractors 1 chapmr9 Sy. Ft. Floor Area valuation
Ittmtmcnungwi,h Sttuon]0101t,,D v'nion7of the Bu. , and lr f_. ,Coca)
nem
or that he is ept,herafrnm and the basis for the alleged eumption.Any violation
ul Section 703 1 s by any appficall lira permit.Oijc,,,th=upPliann m a civil pommy
nfnmmmemanfile hundred delta, led)(l). APN Number 0ccWk1H1bT4vpe
❑Ln r of n he Properly. my onpluyca if,wago,an lhch=,ol.coa...manin I.
wn=
well re the work,and the Cod,
The i,not intended en a Law far suet Isuc, to 4.
an
owner
of and Profession,Code:The lo—Ocor:,,and law m,c,nm apply m an - 31638037. quired Inspections
m' his own
Who baud,ar Improv,,most
such,mal wed Jrx:v such winkhi nded or
m through his own mwe at,es. building
Thal such nis
are non can ,,Or
,nonfiction,
for sale, rr-I a the building e I improvement of is mil within ane yuan of
iamnmeoa,ata awn=r-I,nildcr will have me na,ntn or pawing nnnt he did nm n„'i1i1”` 1.01 — FOUNDATION
mprove for Psmase arswe). 102 — PIERS
Cl f a,owner of the prapeny.on,cacl¢,oely=ommcdnq wllh lieco,ed cono."I'm in
, ,met he pmlec,(See 770,14,Tisane,,and Pon......I,Ced,)The Caamwmr, 103 — UFE R
License Law arcs not apply man nwncr of p obey x hit build,or improve,themm.
..I who canned,to,sae,p,q�eens widt n cumra=t„roe lieenw�d parmant m he 1.04 — REBAR
C31'am`e`xemp�`unde s«. .B S P Chm this mason 105 — ANCHOR BOLTS
Owner Dale 106 — SEWER R• WATER
WORKER'S COMPENSATION DECLARATION - 202 — UNDERFLOOR PLUMBING
I hereby affirm and,,penal,v of peUmy ane or']in decla,aron,: 203 — UNDERFLOOR MECHANICAL
base and will mnoten a Certificate of Consent to tell-insure for Worker. X04 — UNDERFLOOR FRAME
C...npemaarn,, a, provid,d for by Section 1700 of the Lnhnr Cad, for the r—
perrarmancenonewm),to,wNchdo,perm.isi...ad. 205 — UNDERFLOOR INSULATION
❑Ilanecmwill nmmminWa,keraCampensanianIasamnca,a,refined brSection 301 — ROUGH PLUMBING
3700 of the LMa Cale,far the pe,foawnce of the work fill which This Permit is
Issued.M�y Wjak�•',Cant on msureace carer and Policy number art: 302 — TUB & OR SHOWER
cmer:SL/a raL=rNa.JOg,7 'C70 303 — ROUGH MECHANICAL
CERrIFIC\I'IONOI'EFEMPIIONFROMWO RIiRS'
COMPENSAHONINSURANCE 304 — ROUGH ELECTRICAL
ani,.eeeanneedinnrocamplcedam=pem,aisrmanensndrtddau... 305 — FRAME
ISllxq or Ic,x.)
I candy hat in the wribrombee ill the work for which this farm,is issued.I 30E -HOEDOWNS
-,hall nal nnph,y n Iin..a.--in any mamtm as n,m none snbes,n,,he W..ka" 307 — • INSULATION
Comarmain on Law,of Caliramia.Dole
APpfa,u 308 — SHEETROCK
NO]'ICE'IO APPIJCAN'U If,m@r making this Ceaifnda of 11crop ...i,you should
become subject w,be WorAcrs Compensation pravisiansof the laror Coale.you muss 309 — EXTERIOR LATH
O form ith simply with such provision,or this Permit shall Ise deemed revalued. 310 — INTERIOR LATH
Z' rn CONSTRUCTION LENDING AGENCY
hereby amrm,bmthere isacomtil,mionfnainsasencyfor the performance 311 — SCRATCH COAT
aI he ware for which ads paaail is issm'd(See.3097.G..C)
?vI Leader
e ei'sAd
313 — ROOF NAIL
zldress
501 — FINAL ELECTRICAL ENERGY
I certify it)Indcrtad dr, and co ntty aIle Incmedrone of is 502 — FINAL PLUMBING ENERGY
E. correct.I agree m comply with all city and county oNinances and.acre lows melding
d�buill cnmo-namn.,m,[herthy 0uthrrize representatives of this city to enter ugtn 3 —
Y a. Int,ro(yGanem;,,am am,s�ndemify orpoll, 50.., FINAL MECHANICAL ENERGY
a N'elasmcrosavc.mdunnifyection nmmle>.theCi or Cupninnuyainn 504 — FINAL BUILDING ENERCr V—�
m liabilities,adgnica,,cows mad expenses which,,nay in airy way.accoac against said (
v z aw
inesraama dillopermf. 505 — FINAL ELECTRICAL
g�TANOS AND WILL COMPLY W�ALL IN-PO�d Issued by: — Date
mom T
-,t m^_— /Data Re-roofs 507 — FINAL PLUMBING
'/.ARDOUS MAIER1ALS DISCLOSURE
Will theaprlicamarmmrehaddingocap:mtcomorhamLenaa dammceriel Type ofRoof508 — FINAL MECHANICAL
m defibed be the C.Pcnino Municipal Code.Chap¢r 9.12.and the Haohh and Safety
Cada.oefl n255321arr oN 9 — F NAL GRADE
yes All roofs shajg�ns e �pppfftr t t r rL naterial being installed.
w,uthe applicant ar❑.n.mbuilding a«,,Pamuse egwp,nenlardevices which IfaroofisinII€d�itTo6t�i n h{7Ne action, Iagreetoremove
nh hu'mNou,air nm,nminums as JelinaJ by the Bay Arcu Air U,ralLy Mandgcntcu, 1fTtlpl .PHM! lis DTIC, py,lace all new mates Olins ECTtl7tl-A'p IC 1111((1111.."I1331`drIDY and will comply with
ore, 0 N all non-point source regulations.
I have read the hmaWon,memrials rtyuirtmemun
a der Chapter 6.95 or,he
California Hedllh&Sufar,Calc,Sections 25505,25533 and 25534.I undersand the
it lie haddingdnm nun narcndy have u,endnn,,hu,d in my rcya,„sihlli,y ,,nm Hy be
occupant of the Niturnmms which muss R Anel poor m issuance of a Cenilicate of
G` y' Signature of Applicant Date
, ��' —od All roof coverings to be Class `B” or better
mari
f
a„(cost sen, udtt
O OVA of 0-0
G,rpur.i,e OI(ias DC1
• Mamria415 Fo•child riveobotorics 4 Hith Office
4IS'Pairchild Urivc �HanSar Way
m,,.mn,ln Vie,,,,C,,hr,,rnl„ 941M32'1(, DYNAMIC CONSULTANTS INC. Wmsmivina,call(omla 95076-2432
Telephone. (650) 967-6982 Telephone: (831) 724-2234
Facsimile: ((,50) 967.6955 Testing&Inspection Ser Vices Facsimile (831) 724-9166
December 22, 2000/gn
LAB NO.: 54127 DCI No.: 6581-MOI
Permit No.: Pending
REPORT TO: Kevin Aitken &Judy Hart
10868 Northshore Square
Cupertino, California 95014
PROTECT: AITKEN / HART RESIDENCE ADDITIONS
10868 Northshore Square, Cupertino, CA
SERVICE: PLACEMENT INSPECTION
MATERIAL: Concrete
*iUPPLIER: All American Concrete
12/18/00 -- 2.00 Hrs. S.T. -- Insp.: John Dougherty
Inspected placement of 10 cubic yards of concrete in two (2) piers with connecting grade beam at
front of garage and two (2) piers at rear of garage. Cast four (4) cylinders. Concrete has been placed
in accordance with approved plans (Code Enforcement Agency's stamp of review and approval for
use is present) and specifications.
Respectfully submitted,
• DYNAMIC CONSULTANTS, INC.
1c: J D Designs, Inc./Jennifer Davis t ! r , �✓� s ? w "
n '
lc: Kihlthau, Inc./Timothy Kihlthau
Ic: C M T Construction/Chuck Mannina Clifford N.Craig, P.E.
1c: Bldg. Insp. Dept., City Of Cupertino, CA Senior Engineer
.... Y r.>.''i•' .....- �, _7x.:W >Ah:.:.'r�-• �� v Vii,.^•,.,vJ� .,...:tiew7 ric.n"Sry y.Y o"'_i_" S "
Co tor,, Office,
blah11161chrmi I Labomtores ennch Office
4 L5 pairhdd Dri.a NHan IV.y
1.,n0'm,.C.,ummL, 1,4041-2210 DYNAMIC CONSULTANTS, INC. sa` s 4.2
Telephone. lVaTelephojie: (831) •,-2234 4
t 1^>J,•,^.--o•1P2 Telephone: 9111 X24.2'_24
Testing& Inspection Services p ,� I , IN,1 -v n1
COMPRESSION TEST REPORT
December 26, 2000/8-days
Report to: DCI No.: 6581-M01
Kevin Aitken & Judy Hart
10868 Northshore Square Permit No.: Pending
Cupertino, California 95014
Project: AITKEN / HART RESIDENCE ADDITIONS
10868 Northshore Square, Cupertino, CA.
Sampling Location: Pier in rear of garage closest to front porch
Material: Concrete Cylinders Date Cast (ASTM C31): 12/18/00 Slump,in. (ASTM C143): 2-3/4
Supplier: Central Concrete Date Received: 12/19/00 Mix Temp.,°F (ASTM C1064): 71
Mix Design: 6001903 Sampled By (ASTM C172): Others Ambient Temp.,°F: 56
Cement Factor,sk/cy: 6 Truck NoJLoad No.: 71 1 - Air Content,% (ASTM C173/C231):
Max.Size Aggr.,in.:. 3/8 peagravel Tag No.: 3539.40 Fresh Unit Wt.,pcf (ASTM C138):
Admixture(s): water reducer
•n Strength,psi: 2,500 @ 28 days
Compression Test Data (ASTM C39)
Nominal Compressive
Specimen Client's Date Age, Dimensions, Area, Ultimate Load. Strength, Tested
No. ID Tested days in sq.in. lbs. psi Fracture
7370 A 12/26/00 8 6 x 12 28.26 90,200 3,190 Normal JB
7370 a 1/15/01 28 6x12 28.26
7370 C 1/15/01 28 6x12 28.26
7370 D HOLD 6 x 12 28.26
I
r All samples designated HOLD will be kept 14 days after the 2
day test and thereafter discarded untess instructed otherwis-
Any samples held beyond these 14 days are subject to storag
fees. Sampling information provided by others; therefor(
referenced procedures cannot be verified by DCI.
Respectfully submitted,
DYNAMIC CONSULTANTS, INC.
r
DDesigns, Inc/Jennifer Davis
tc Kihlthau, Inc. / Timothy Kihlthau DZL i
lc C T M Construction/Chuck Mennanning Y
1c CityofCupertino Laborat r Su erv'sor
Dependability . . . . Credibility . . . . Integrity Its the foundation of quality assurance for your project. At DCI,we built it into our name