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1402015609 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19800 VALLCO PKWY CONTRACTOR: CUPERTINO PROPERTY PERMIT NO: 14020156 DEVELOP LLC OWNER'S NAME: CUPERTINO PROPERTY DEVELOP LLC 19620 STEVENS CREEK BLVD DATE ISSUED: 06/06/2014 OWNER'S PHONE: 4083431088 CUPERTINO, CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ROSEBOWL - T.I TO BUILD OUT SHELL FOR (N) LEASING License Class Lie. # OFFICE (1,007 S.F) INCLUDE M.E.P.'S Contractor Date 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 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 Sq. Ft Floor Area: Valuation: $120000 performance of the work for which this permit is issued. 1 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 APN Number: 31620108.19800 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that l have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 D T ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 Dd1ol L LED INSPEC ION. 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 c sued by: Date: with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signature Date 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. OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, 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) as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE nstruct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous 1 have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 28533, jnid 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner / Dater permit is issued. or authorized agent: !� 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, 1 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, 1 must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source .e LiVations per the Cupertino Municipal Code, Section Licensed Professional 9.18. orf ` Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingna.cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ® ALTERATION V171 ❑ REVISION / DEFERRED ORIGINAL PERMIT # i PROJECT RESS APN# n�� 19 60 -(AN.LV fAtle-WA' l//S 6cv OWNER NAME GLit'F..%r1(40 P'-OI'OWTY DeVeurme T u- C PHONEE-MAIL +09-343. 10 88 N IA. STREET ADDRESS l9�Zo STI;VeW1 CRE0c p6U/G ?oo CITY, STATE, ZIP G1tt'irFLTINot CA 95014 FAX 40$•3+3. 1050 CONTACT NAME MAWL BhTT1Sri N1 PHONE (050• �3f�•32Z(� E-MAIL MOATiiST(NI & (Leif PevrowrmerjT STREET ADDRESS Orou STrtieNs t�� 13WD -s"ryoo CITY, STATE, ZIP 0ul'eizrime, C-49rvoI1 FAX 40$. ,_13.1089 OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER 0 TENANT CONTRACTOR NAME,a LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECTIENGINEER NAME a, LICENSE NUMBER I, r7 `Z BUS. LIC # MICKOVOL- STANTVN G ( COMPANY NAME E-MAIL FAX 4rANYON f4I2CH1TE-YS MS'('ANTON STANTVNA"41TECMRE. CD STREET ADDRESS 55 Pb FFA" STC Scm CITY, STATE, ZIP SAN F1Ar1 c.l Sce, Ck- 9'31 �� PHO1141,;. �15. BGS,• 9 bvo DESCRIPTION OF WORK -rWANT MP OU100%AT &p tX ISTllvG S4em S1J1ALC-. -V-Jh v f 000 "NSTAPCr (N) wPU4 FOR PUTLIMI—b L,0ASING Or-F-I[G , NI✓C.ESSA.MT1- Wom EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA �� / BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AL DECK/PORCH AREA GARAGE AREA: DETACH 7.EED? ❑ ATTACH #DWELLING UNITS:D UNIT ❑ YES SECOND STORY ❑ YES ❑ NO ADDITION? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YESRt;GEIVII3 TOT TION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO� TH) By my Signature below, I certify to each of the following: I am the property owner, or authorized agent d act on the property owner's behalf. I have read this application and the information I have providedis rrect. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relatin building c n ption. I aathorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature ofApplicant/All V✓ Date: SUPPLEMENTAL INFORMATION REQUIRED AN°CHI CI{ �� _ SLIP RI ?'PE , 1"'(5UTIII New SFD or Multifamily dwellings: Apply for demolition permit for ' `� ... ._ s' _ existing building(s). Demolition permit is required prior to issuance of building ERT>»eotli ad 1 Buu�>rIc gi AlY ztEvl`E1 �t: permit for new building. C1 EXPHES "i ;E hLA(VvEW aPA`NNtNG P6LIC _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD Woji� Brio form if any Hazardous Materials are being used as part of this project. NG x� _ n 11 _Copy of Planning Approval Letter or Meeting with Planning prior to _III, ❑ submittal of Building Permit application. MAJOX2$A�ILTARAn EV*tR'D�ISTRIGT BldgApp_2011.doc revised 06121111 CO .F CITY OF CUPERTINO Fm' -N, FEE ESTIMATOR - BUILDING DIVISION Y ADDRESS: 19800 VALLCO PKWY DATE: 02/27/2014 REVIEWED BY: MELISSA PC FEE ID APN: 316 20 108 BP#: 14020156 'VALUATION: 1$120,000 'PERMIT TYPE: Building Permit PLAN CHECKTYPE: Tenant Improvement PRIMARY USE: Commercial Building IMTIPLNCK PENTAMATION PERMIT TYPE: I M I A WORK - T.I. BUILD OLIT SHELL FOR N LEASING OFFICE (1,007 S.F. SCOPE �ROSEBOWL OCCUPANCY TYPE: TYPE OF G, _ S. , - FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID M (Tenant Improvements) -A,I-B 4 1,007 - IMTIPLNCK $1,615.16 IMTIINSP Klee. Insp..Fee: $1,615.16 Suppl. Insp. Fee:D Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consiruc:tion Tax:J7_ zl dtninistrati ve .Fee: Q G) Work Without Permit? 0 Yes (j) No $0.00 TOTALS: 1,007 jj4, 1 rave.1 Docionentarion Fees: $1,615.16 Strom Motion Fee: 1BSEISMICO MECH, HOURLY 0 Yes O No : PLUMB, HOURLY Q Yes Q No E'LEC, HOURLY Q Yes Q No ttec:h. Flan Check FYuwb, Plan C'hec'k Elec..Plan C;hr:ek Xtech. Permit Fee: Phimb. Pemit Fee: F'lec. Peranir fire: Other• Aferh. Insp. Other Plumb Insp. OTher Elee. Insp, 14,,ch, Insp. Fee: Plumb. Insp. Fee: Klee. Insp..Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Elf' 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $4,275.24 Select a Mise Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. Q OT 0.0 ht's $0.00 PME Plan Check: $0.00 Permit Fee: $1,615.16 Suppl. Insp. Fee:D Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consiruc:tion Tax:J7_ zl dtninistrati ve .Fee: Q G) Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential E) Building or Structure 0 1 rave.1 Docionentarion Fees: Strom Motion Fee: 1BSEISMICO $25.20 Select an Administrative Item B1dp, Stds Commission Fee: IBCBSC $5.00 SUBTOTALS: 1 $5,920.60 $0.00 TOTAL F suL, s5,920.61? Revised `�.01��/201e4 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION u ADDRESS: 19800 VALLCO PKWY DATE: 02/26/2014 REVIEWED BY: MENDEZ PC FEE ID APN: BP#: `VALUATION: 1$120,000 xPERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: IMTIPLNCK PENTAMATION 1M TI PERMIT TYPE: WORK COMM. T.I TO BUILD OUT SPACE FOR LEASING OFFICE SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.L PC FEES PC FEE ID BP FEES BP FEE ID M (Tenant Improvements) II-B,III-B,IV,V-B 1,007 $2,850.16 IMTIPLNCK $1,076.80 IMTHNSP Flee. Insp. Fee: PME Plan Check: $0.00 Permit Fee: $1,076.80 Suppl. Insp. Fee -.(D Reg, 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 1,007 $2,850.16 J $1,076.80 MECH, HOURLY 0 Yes G No PLUMB, HOURLY Q Yes ,, D No, ELEC, HOURLY Q Yes Q No Meeh. Plan Check Phonb, Plari 0ieck Flec. Plan Check tllec;h. Permit F'ee.. Plumb. Pei -Mil Fee; Flee. Persil Fee: Orher dlech. Insp. Other Plumb Insp. Other Elec. Insp. Li 1jec _ 111sp. &e: Phimb. heap. Fee: Flee. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the Preliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Ej. 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,850.16 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: 0 Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,076.80 Suppl. Insp. Fee -.(D Reg, 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax:TT ,Idininistrative .Fee: Q Work Without Permit? 0 Yes (•) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) i T rcmel Documentation Fees Strong Motion Fee: IBSEISMICO $25.20 Select an Administrative Item Bldg- Stds Commission .Fee: IBCBSC $5.00 SUBTOTALS: $3,957.16 $0.00 � TOTAL FEE: 1 $3,957.16 Revised: 01/15/2014 TEMPORARY CERTIFICATE OF OCCUPANCY FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • build ing(ailcupertino.org APN BP #: 14otio 15b DATE: (• IT - 15 PROJECT VALUATION: $ /50i SITE ADDRESS: 19 "0 YA Lt -C-0 f°kw OWNER'S NAME: PHONE #: 40S . 3 43 • l0 88 &gPkIz-rlNo VEVF_L0I0MWN-T FAX#: MAILING ADDRESS (if different from site address): 19(020 Ckk 13LVp C,4 C.501 (- CONTRACTOR: PHONE #: -r I M &T C'�_-r FAX #: CONTACT: PHONE #: 4 08 • 4(0 0. $$SA - 1,ZAN SLATT�1z• FAX #: TEMPORARY CERTIFICATE OF OCCUPANCY INFORMATION BOND TYPE: ❑ SURETY BONDT(FIBOND: MOUNT (1% VALUATION V (BLDBONDS] CODE CHECK ❑ CASH BOND 5K min -10K max Sy(X% EDITION: TCO EXPIRATION FEE: $2$6.00/1710 TOTAL FEE: $ [1TEMPOCC] DATE (6 MONTHS MAX): i-7) �_. USE TYPE OF CONSTR FLOOR AREA OCC LOAD LEVEL COMMENT I-1�J►SIJWG O�I�I CL � L00 Date:....�....Z..� ..1— APPROVED El APPROVED WITH CONDITIONS- o s is❑APPROVED _ ' ' APPROVED WITH CONDITIONS" Signature:........... ....................... Date:...2 Other: Signature:....... Date:-.��.".%S ❑ APPROVED APPROVED WITH CONDITIONS* OTHER DEPARTMEN(/AGENCY APPROVALS: V,0 ceWc %k kew-Lvik. �Q `k oCcc eI Panning �� APPROVED ` * APPROVED WITH CONDITIONS Signature: ......... ... ....... ............................ Date: ....2. ..20.. ire Si nature: Signature: Date:....�....Z..� ..1— APPROVED El APPROVED WITH CONDITIONS- o s is❑APPROVED _ ' ' APPROVED WITH CONDITIONS" Signature:........... ....................... Date:...2 Other: Signature:....... Date:-.��.".%S ❑ APPROVED APPROVED WITH CONDITIONS* 1CONDITIONS OF COMPLETION - Attach a letter signed by the contractor and owner of the property tating the list of items required to be completed for each individual Department before final occupancy can be granted. Include approximate completion dates for each item. The undersigned covenant and agree as a condition to the approval of the above request for temporary occupancy to have the building or buildings complete and in compliance with all building codes, ordinances and regulations and ready for inspection prior to the expiration date specified. If this Temporary Certificate of Occupancy expires, the total amount of the bond may be forfeited and the non-compliance may result in an enforc ent action. Owner Contractor ..................... Date:.. ....... :�.. Date: ...................... This temporary certificate ens res that all fire protection and life safety systems have been completed, inspected, successfully tested and approved for the specific are of a building specified above to provide a reasonable degree of safety to the occupants from fire and similar emergencies. Building Official: ...... ......................................Print:......................................................................... Dat :..... /S, ........... DEPARTMENT ACTION: After d termination, copies to: 1) applicant, 2) permit file .. iWTempOccForm 2011 doc revised 717114 yr/ -an %too 2075'(, JMM Mechanical FILZ 1657 Shenandoah Avenue Milpitas, CA 95035 AIR BALANCE REPORT PROJECT: Rosebowl Leasing Office ADDRESS: 19700 Vallco Parkway ste 180 Cupertino, CA 95014 DATE: February 17, 2015 Date lRoom Volume Velocity Comment Supply/Return 2/17/15 Return F 102 F 324 F-Exh 2/17/15 Return F 120 F 382 I Exh 2/17/15 Return F 650 F1128 [-1 Exh 2/17/15 Media room F 132 F 420 F-1 Sup 2/17/15 1 Hallway F 156 496 F Sup 2/17/15 Managers office -93F-297F-Sup 2/17/15 Break room114 364 Sup 2/17/15 Entry 191 F 609 4 supply Sup Total Supply F 686+520 Total Exhaust 1 872 STATEMENT OF SPECIAL INSPECTIONS, 2013 CBC COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C,B.O., BUILDING OFFICIAL CUfrERTI N4 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 - buildinafdicuaerlino.org ADDRESS 15900' VA t•t-Cv t-ILW Y Ap 3l fvrLD/0�• g 9t oo BP# 14 020150 Owner ... A�u P—Y:!149...I......kkG� .......... Contractor...... rHf�� .�...r.1..M6MT..»� .. Address... (t Lo SztiV NS...»Cl�jc Bf�Yv.f?2o°..,.. Address»+ 69....QVI�A1... PVt.....»ttvrr„ 5 .�5 10 g6�..2iilo Cit /St, ��q' X.iM! .a..CA.......... Zl � f! l!t...........Ph n ... . v�8.... Y P•• aut�tTi.i r�„ Y t�kr t.'g 04 Clty/St.. !�! .R., Zip, ci�..� .xr.....phone.. Applicant ... tIVAKf ...ft !S;fINI ... ................... Engineer/Archilecl..... Stanton Arahl(cc(uro ........................... Address A 9 ! „S Tc Ve�is „ ct „„ w n zoo Address....... 555• de HaroStreet, Suite 3 0 D ............................. CiIy1SI.c;Ui;+ r{�o; C,y.............. Zip ..�hoki........... Phone ..................... Clly/SI... SanFrancisco ....... ......... Zip..94107... Phone.4158659600 PROJECT DESCRIPTION: THE WORK INCLUDES THE MODIFICATION OF THE EXISTING BUILDING TO ACCOMMODATE A RETAIL LEASING OFFICE. THE WORK WILL ONLY OCCUR AT THE GRADE LEVEL, . This "STATEMENT OF SPECIAL INSPECTIONS" is submitted in fulfillment of the requirements of CBC Sections 1704. and 1705. This form is structured after and used by permission from the Structural Engineer Association of Northem California's (SEAONC) mode statement of Special Inspections. Also, Included with this form Is the following.- LIST ollowing:LIST OF SPECIAL INSPECTION AGENCIES (page 2), A list of testing agencies and other special, inspectors that will be retained to conduct the tests and inspections for this project ❑ "SCHEDULE OF SPECIAL INSPECTION" (page 3 - 6). The Schedule of Special Inspections summarizes the Special Inspections and tests required. Special Inspectors will refer to the approved plans and specifications for detailed special Inspection requirements. Any additional tests and Inspections required by the approved plans and specifications shall also be performed. Special Inspections and Testing will be performed in accordance with the approved plans and specifications, this statement and CBC Sections 1704,1705, 1706, 1707, and 1708. Interim reports will be submitted to the Building Official and the Registered Design Professional In Responsible Charge in accordance with CBC Section 1704.1.2, "• A Final Report of Special Inspections documenting required Special Inspections, testing and correction of any discre-pa cie' fto�, ri the inspections shall be submitted prior to issuance of a Certificate of Use and Occupancy (Section 1704,1.2). The In aWiII document; • Required special inspections, • Correction of discrepancies noted 1n Inspections, The Owner recognizes,',his or her obligation to ensure that the construction complies with the 1,p o 0 , currents and to Implement this program of special inspections. In partial fulfillment of these obligations, th t7w �I al ,and;directly pay for the Special Inspections as required In CBC Section 1704.1.`" �' . This plan has been developed with the understanding that the Building Official will: • Review and approve the qualifications of the Special Inspectors who will perform a inspdctions, • Monitor special inspection activities on the job site to assure that the Special Inspedl6rs are qualified and are performing their .duties as called for In this Statement of Special Inspection. • Review submitted Inspection reports. • Perform inspections as required by the local building code. ��tt 1 have read and aarse to co t�h.the terms add tions of this statement Prepared By. - - - Project 0 Engineer ®Architect Registered Design Professional In ChaMe SI nature tic,# .... C-115ti2., Date: Owner Name: Owner's Authorization SI nature .. Date: Inspection All t Inspector Name; v SI nature . c. Date:.,.. Building Moral or designee: 7�� k\O�A 2,. l.. / Signature........ ..MAY. . Date: & .B fpecfalnspecrionForm 1011,docrevlsed04/06112 LIST OF SPECIAL INSPECTION AGENCIES APPROVAL OF SPECIAL INSPECTORS: Each special inspection agency, testing facility, and special inspector shall be recognized by the Building Official prior to performing any duties. Special Inspection agency's listed on this form must be pre -approved and listed on Cupertino's approved Special Inspector's list. Special inspectors shall carry approved identification when performing the functions of a special inspector. Identification cards shall follow the criteria set by the California Council of Testing and Inspection Agencies. No personnel changes shall be made without first obtaining the approval of the Building Official. Any unauthorized personnel changes may result in a "Stop Work Order' and possible permit revocation. To be pre- approved by the City of Cupertino, refer to the SPECIAL INSPECTION CRITERIA handout. Please allow two weeks to complete the application process. The following are the testing and special inspection agencies that will be retained to conduct tests and inspection on this project: EXPERTISE FIRM i INSPECTOR INFORMATION 1. Special Inspection (except for Firm....! ' Oil 17ATKp �hl6- Addr..SQ Z1.... .......... . G w...��%d^t s M fn0 geotechnical) fel. Cit 0.14... � P.0..r....Cf�.... Vf o;,f� Telephone..�.1..r......�:s........ ...... Fax ............................................ . State ...!�k .............Zi Email......................................................... � ..... 2. Material Testing Firm.....................................................................Addr......................................................................................... City.......................................................................................................... Ptate .......................Zip ...................... Telephone.......................................Fax............................................ Email......................................................... 3. Geotechnical Inspections Firm.....................................................................Addr......................................................................................... City.......................................................................................................... State .......................Zip ...................... Telephone...................................... Fax ............................................ Email......................................................... 4. Other: Firm.....................................................................Addr......................................................................................... City.......................................................................................................... State .......................Zip ...................... Telephone...................................... Fax ............................................. Email......................................................... *All agencies specified on this form must be pre -approved and listed on the City of Cupertino's Approved Special Inspector's List. SEISMIC REQUIREMENTS (Section 1705.3.6) Description of seismic -force -resisting system and designated seismic systems subject to special inspections as per Section 1705.3: The extent of the seismic -force -resisting system is defined in more detail in the construction documents. WIND REQUIREMENTS Section 1705.4.1 Description of main wind -force -resisting system and designated wind resisting components subject to special inspections in accordance with Section 1705.4.2: The extent of the main wind -force -resisting system and wind resisting components is defined in more detail in the construction documents. SpecialnspectionForm_2012.doe revised 09/06/12 SCHEDULE OF SPECIAL INSPECTION SITE ADDRESS ('JSDD VA- -LQ() rlc-WY APN�I6 10$ � (�SOo B 1402 015 (� PROJECT DESCRIPTION: LE:A W & O FI=i M -r-ENANT ZM 10 RcyV;_:)" 1E(rT Notation Used in Table: Column headers: C Indicates continuous inspection is required. P Indicates periodic inspections are required. The notes and/or contract documents should clarify. Box entries: X Is placed in the appropriate column to denote either "C" continuous or "P" periodic inspections. --- Denotes an activity that is either a one-time activity or one whose frequency is defined in some other manner. Additional detail regarding inspections and tests are provided in the project specifications or notes on the drawings. VERIFICATION AND INSPECTIONC p REFERENCED IBC REFERENCE STANDARD INSPECTION OF FABRICATORS 1. ❑ Inspect fabricator's fabrication and quality control 1704.3 procedures. INSPECTION OF STEEL 1. Material verification of high-strength bolts, nuts and washers. ❑ Identification marking to conform to ASTM stds AISC 360, specified in the approved construction documents. --- X Section A3.3 and applicable ASTM. material standards ❑ Inspect fabricator's fabrication and quality control procedures. 2. Inspection of high-strength bolting: ❑ Snug -tight joints. --- X ❑ Pretensioned and slip -critical joints using turn -of -nut with matchmarking, twist -off bolt or direct tension --- X AISC 360, indicator methods of installation. 1704.3.3 Section M2.5 ❑ Pretensioned and slip -critical joints using turn -of -nut without matchmarking or calibrated wrench methods X --- of installation. 3. Material verification of structural steel and cold -formed steel deck. ❑ For structural steel, identification markings to conform AISC 360, to AISC 360. X Section M2.5 ❑ For other steel, identification markings to conform to Applicable ASTM ASTM standards specified in the approved --- X material standards construction documents. ❑ Manufacturer's certified test reports. --- X SpecialnspectionForm_2012.doc revised 09106112 VERIFICATION AND INSPECTIONC C p REFERENCED STANDARD IBC REFERENCE 4. Material verification of weld filler materials: ❑ Identification marking to conform to AWS specification in the approved construction documents. --- X AISC 360, Section A3.5 and applicable AWS A5 documents - ❑ Manufacturer's certificate of compliance required. --- X --- --- 5. Inspection of welding: a. Structural steel and cold -formed steel deck: ❑ Complete and partial joint penetration groove welds. X --- AWS D1.1 1704.3.1 ❑ Multipass fillet welds. X --- ❑ Single -pass fillet welds > 5/16" X --- ❑ Plug and slot welds. X --- ❑ Single -pass fillet welds <= 5/16" --- X ❑ Floor and roof deck welds. --- X AWS DU b. Reinforcing steel: ❑ Verification of weldability of reinforcing steel other than ASTM A 706. - X AWS D1.4 ACI 318: Section 3.5.2 - ❑ Reinforcing steel resisting flexural and axial forces in intermediate and special moment frames, and boundary elements of special structural walls of concrete and shear reinforcement. X --- ❑ Shear reinforcement. X --- ❑ Other reinforcing steel. --- X 6. Inspection of steel frame joints details for compliance: ❑ Details such as bracing and stiffening. --- X --- 1704.3.2 ❑ Member locations. --- X ❑ Application of joint details at each connection. --- X VERIFICATION AND INSPECTION C p REFERENCED STANDARD IBC REFERENCE INSPECTION OF WELDING 1. ❑ Welded studs when used for structural diaphragms. --- X --- 1704.3 2. ❑ Welding of cold -formed steel framing members. --- X 3. ❑ Welding of stairs and railing systems. --- X SpecialnspectionForm 2012. doe revised 09/06/12 VERIFICATION AND INSPECTIONC p REFERENCED IBC STANDARD REFERENCE INSPECTION OF CONCRETE 1. ❑ Inspection of reinforcing steel, including prestressing --- X ACI 318: 3.5; 7.1-7.7 1913.4 tendons and placement. 2. ❑ Inspection of reinforcing steel welding in accordance AWS D1.4 ACI 318: with Table 1704.3 Item 5b. _ _ 3.5.2 3. ❑ Inspection of bolts to be installed in concrete prior to and during placement of concrete where allowable X -- ACI 318: 8.1.3, 1911.5, 1912.1 loads have been increased or where strength design 21.2.8 is used. 4. ❑ Inspection of anchors installed in hardened concrete. --- X ACI 318: 1912.1 5. ❑ Verifying use of required design mix. 1904.2.2,1913.2, --- X ACI 318: 1913.3 6. ❑ At time fresh concrete is sampled to fabricate ASTM C 172 specimens for strength tests, perform slump and air X --- ASTM C 31 1913.10 content tests and determine the temperature of the concrete. ACI 318: 5.6, 5.8 7. ❑ Inspection of concrete and shotcrete placement for X --- ACI 318: 5.9, 5.10 1913.6, 1913.7, proper application techniques. 1913.8 8. ❑ Inspection for maintenance of specified curing --- X ACI 318: 5.11-5.13 1913.9 temperature and techniques. 9. Inspection of prestressed concrete: ❑ Application of prestressing forces. X --- ACI 318: 18.20 ❑ Grouting of bonded prestressing tendons in the X --- ACI 318: 18.18.4 seismic force -resisting system. 10. ❑ Erection of precast concrete members. --- X ACI 318: Ch. 16 --- 11. ❑ Verification of in-situ concrete strength, prior to stressing of tendons in posttensioned concrete and --- X ACI 318: 6.2 --- prior to removal of shores and forms from beams and structural slabs. 12. ❑ Inspect formwork for shape, location, and dimensions --- X ACI 318: 6.6.1 --- of the concrete member being formed. 13. M Bolts Installed in Existing Masonry or Concrete ❑ Direct tension testing of existing anchors. --- X See ICC ES Reports form special inspection requirements for proprietary products ® Direct tension testing of new bolts. --- X ❑ Torque testing of new bolts. --- X ❑ Prequalification test for bolts and other types of anchors. - X 14. '�T, Other: jGt "�pS ` 5i SpecialnspectionForm 2012.doc revised 09/06/12 SpecialnspectionForm 2012.doc revised 09/06/12 REFERENCE FOR CRITERIA VERIFICATION AND INSPECTION C P IBC TMS 402/ACI TMS 402/ACI SECTION I 530IASCE 5 530/ASCE 6 INSPECTION OF LEVEL 1 MASONRY 1. ❑ Compliance with required inspection provisions of the construction documents and the approved --- X --- --- Art. 1.5 submittals shall be verified. 2. ❑ Verification of f'n, and fanc prior to construction --- X --- --- Art. 1.413 except where specifically exempted by this code. 3. ❑ Verification of slump flow and VSI as delivered to X --- --- --- Art. 1.513.1.b.3the site for self consolidating grout. 4. As masonry construction begins, the following shall be verified to ensure compliance: ❑ Proportions of site -prepared mortar. --- X --- --- Art. 2.6A ❑ Construction of mortar joints. --- X --- --- Art.3.3B ❑ Location of reinforcement, connectors, _ _ X --- --- Art. 3.4, 3.6A prestressing tendons, and anchorages. ❑ Prestressing technique. --- X --- --- Art. 3.613 ❑ Grade and size of prestressing tendons and X --- --- Art. 2.413, 2AH anchorages. 5. During construction the inspection program shall verify: ❑ Size and location of structural elements. --- X --- --- Art. 3.31F ❑ Type, size, and location of anchors, including Sec Sec . 1.2.2(e), other details of anchorage of masonry to --- X --- 1.16.1 _ structural members, frames or other construction. Q Specified size, grade, and type of reinforcement, anchor bolts, prestressing tendons and --- X --- Sec. 1.15 Art. 2.4, 3.4 anchorages. ❑ Welding of reinforcing bars. X --- --- El Preparation, construction and protection of masonry during cold weather (temperature below ___ X Sec. 2104.3, ___ Art. 1.8C, 1.8D 40 degrees F) or hot weather (temperature above 2104.4 90 degrees F). ❑ Application and measurement of prestressing X --- --- --- Art. 3.613 force. 6. Prior to grouting the following shall be verified to ensure compliance: ❑ Grout space is clean. --- X --- --- Art. 3.2D ❑ Placement of reinforcement and connectors and ___ X --- Sec. 1.3 Art. 3.4 prestressing tendons and anchorages. ❑ Proportions of site -prepared grout and __- X --- --- Art. 2.613 prestressing grout for bonded tendons. ❑ Construction of mortarjoints. --- X --- --- Art. 3.3B 7. Grout placement: ❑ Grout placement shall be verified ensure X ___ --- -__ Art. 3.5 compliance. ❑ Observe grouting of prestressing bonded X --- --- --- Art 3.6C tendons. SpecialnspectionForm 2012.doc revised 09/06/12 SpecialnspectionForm 2012.doc revised 09/06/12 REFERENCE FOR CRITERIA VERIFICATION AND INSPECTION C P IBC TMS 402/ACI TMS 402/ACI SECTION 530/ASCE 5 530/ASCE 6 8. ❑ Preparation of any required grout specimens, Sec. mortar specimens, and/or prisms shall be --- X 2105.2.2, --- Art. 1.4 observed.. 2105.3 INSPECTION OF LEVEL 2 MASONRY 1. ❑ Compliance with required inspection provisions ' of the construction documents and the approved --- X --- --- Art. 1.5 submittals. 2. .❑ Verification of fm and fna,c prior to construction and for every 5,000 square feet during --- X --- --- Art. 1.413 construction. 3. ❑ Verification of proportions of materials in premixed or preblended mortar and grout as --- X --- --- Art. 1.513 delivered to the site. 4. ❑ Verification of slump flow and VSI as delivered to X --- --- --- Art. 1.5B.1.b.3 the site for self consolidating rout. 5. The following shall be verified to ensure compliance: ❑ Proportions of site -prepared mortar, grout, and --- X --- --- Art. 2.6A prestressing grout for bonded tendons. ❑ Placement of masonry units and construction of --- X --- --- Art. 3.313 mortar joints. ❑ Placement of reinforcement, connectors and --- X --- Sec. 1.15 Art. 3.4, 3.6A prestressing tendons and anchorages. ❑ Grout space prior to grouting. X --- --- --- Art. 3.2D ❑ Placement of grout. X --- --- --- Art. 3.5 ❑ Placement of prestressing grout. X --- --- --- Art. 3.6C ❑ Size and location of structural elements. --- X --- --- Art. 3.3F ❑ Type, size, and location of anchors, including other details of anchorage of masonry to X --- --- Sec.1.22(e) structural members, frames and other construction. ❑ Specified size, grade, and type of reinforcement, anchor bolts, prestressing tendons and --- X --- Sec. 1.15 Art. 2.4, 3.4 anchorages. ❑ Welding of reinforcing bars. X --- --- Sec. 2.1.9.7.2, --- 3.3.3.4 (b) ❑ Preparation, construction, and protection of masonry during cold weather (temperature below ___ X Sec. 2104.3, --- Art. 1.8C, 1.8D 40 degrees F) or hot weather (temperature above 2104.4 90 degrees F). ❑ Application and measurement of prestressing X --- --- --- Art. 3.613 force. 6. ❑ Preparation of any required grout specimens, Sec. mortar specimens, and/or prisms shall be X --- 2105.2.2, --- Art. 1.4 observed. 2105.3 SpecialnspectionForm 2012.doc revised 09/06/12 VERIFICATION AND INSPECTIONC p REFERENCED STANDARD IBC REFERENCE INSPECTION OF WOOD 1. ❑ Inspect prefabricated wood structural elements and assemblies in accordance with Section 1704.2. --- 1704.6 2. ❑ Inspect site built assemblies. --- --- 3. Inspect high -load diaphragms: ❑ Verify grade and thickness of sheathing. --- --- ❑ Verify nominal size of framing members at adjoining panel edges. --- 1704.6.1 ❑ Verify nail or staple diameter and length, --- --- ❑ Verify number of fastener lines, --- 1:1 Verify spacing between fasteners in each line and at edge margins. 4. ❑ Metal -plate -connected wood trusses spanning 60 feet or greater: Verify temporary installation restraint/bracing and the permanent individual truss --- X --- 1704.6.2 member bracing are installed in accordance with the approved truss submittal package. REQUIRED VERIFICATION AND INSPECTION OF SOIL 1. ❑ Verify materials below footings are adequate to achieve the desired bearing capacity. -__ X 2. ❑ Verify excavations are extended to proper depth and have reached proper material. X 3. ❑ Perform classification and testing of compacted fill materials. X --- Table 1704.7 4. ❑ Verify use of proper materials, densities and lift thicknesses during placement and compaction of X --- compacted fill. 5. ❑ Prior to placement of compacted fill, observe subgrade and verify that site has been prepared properly. X REQUIRED VERIFICATION AND INSPECTION OF DEEP DRIVEN FOUNDATION ELEMENTS 1. ❑ Verify element materials, sizes and lengths comply X with the requirements. 2. ❑ Determine capacities of test elements and conduct X additional load tests, as required. 3. ❑ Observe driving operations and maintain complete X and accurate records for each element. 4. ❑ Verify locations of piles and their plumbness, confirm type and size of hammer, record number of blows per --- Table 1704.8 foot of penetration, determine required penetrations to X --- achieve design capacity, record tip and butt elevations and document any damage to foundation element. 5. ❑ For steel elements, perform additional inspections in accordance with Section 1704.3. 6. ❑ For concrete elements and concrete filled elements, perform additional inspections in accordance with --- --- Section 1704.4. SpecialnspectionForm 2012.doc revised 09/06/12 VERIFICATION AND INSPECTION C p REFERENCED IBC STANDARD REFERENCE 7. ❑ For specialty piles, perform additional inspections as determined by the registered design professional in --- --- --- Table 1704.8 responsible charge. REQUIRED VERIFICATION AND INSPECTION OF CAST -IN-PLACE DEEP FOUNDATION ELEMENTS 1 ❑ Observe drilling operations and maintain complete and X accurate records for each element. 2. ❑ Verify placement locations and plumbness, confirm element diameters, bell diameters (if applicable), lengths, embedment into bedrock (if applicable), and X --- --- Table 1704.9 adequate end -bearing strata capacity. Record concrete or grout volumes. 3. ❑ For concrete elements, perform additional inspections in accordance with Section 1704.4. HELICAL PILE FOUNDATIONS 1. ❑ Record installation equipment used, pile dimensions, X --- --- 1704.10 tip elevations, final depth, final installation torque. SPRAYED FIRE-RESISTANT MATERIALS Physical and visual tests 1. Condition of substrates. ❑ Inspect surface for accordance with the approved fire - resistance design and the approved manufacturer's --- --- written instructions. ❑ Verify minimum ambient temperature before and after X application. ❑ Verify ventilation of area during and after application. --- X 2. ❑ Measure average thickness per ASTM E605 and Section 1704.12.4. --- --- --- 1704.12.1 3. ❑ Verify density of material for conformance with the approved fire-resistant design and ASTM E605. (Ref. --- --- Section 1704.12.5) 4. ❑ Test cohesive/adhesive bond strength per Section 1.704.12.6. 5. ❑ Condition of finished application. MISCELLANEOUS 1. Mastic and Intumescent Fire -Resistant Coating. --- --- --- 1704.13 2. Exterior Insulation and Finish Systems (EIFS). Water - resistive barrier coating when installed over a sheathing --- --- --- 1704.14 substrate. 3. Special Cases --- --- --- 1704.15 4. Smoke Control System --- --- --- 1704.16 5. Seismic Resistance ® Suspended ceiling systems and their anchorage. --- --- --- 1705.3 [4.3] SpecialnspectionForm 2012.doc revised 09/06/12 VERIFICATION AND INSPECTIONC p REFERENCED IBC STANDARD REFERENCE 6. Wind Resistance ❑ Roof cladding and roof framing connections. --- --- --- ❑ Wall connections to roof and floor diaphragms and framing. ❑ Roof and floor diaphragm systems, including collectors, drag struts and boundary elements. ❑ Vertical wind -force -resisting systems, including braced frames, moment frames, and shear walls. ❑ Wind -force -resisting system connections to the foundation. ❑ Fabrication and installation of systems or components required to meet the impact resistance requirements --- -_- --- of Section 1609.1.2. SPECIAL INSPECTION FOR WIND REQUIREMENTS 1. Structural Wood ❑ Inspect field gluing operations of elements of the main X wind -force -resisting system. _-- 1706.2 ❑ Inspect nailing, bolting, anchoring, and other fastening of components within the main windforce-resisting X system, including wood shear.walls, wood diaphragms, drag struts, braces and hold-downs. 2. Cold -Formed Steel Framing ❑ Welding of elements of the main wind -force -resisting system. X ❑ Inspection of screw attachments, bolting, anchoring, and other fastening of components within the main --- 1706.3 wind -force -resisting system including shear walls, --- X braces, diaphragms, collectors (drag struts) and hold- downs. 3. Wind -resisting components ❑ Roof cladding. --- X --- 1706.4 ❑ Wall cladding. --- X SPECIAL INSPECTIONS FOR SEISMIC RESISTANCE 1. ❑ Special inspection for welding in accordance with the TX 1707.2 quality assurance plan requirements of AISC 341. 2. Structural Wood ❑ Inspect field gluing operations of elements of the X seismic -force -resisting system. ❑ Inspect nailing, bolting; anchoring, and other fastening of components within the seismic -force -resisting 1707.3 system, including wood shear walls, wood --- X diaphragms, drag struts, braces, shear panels and hold-downs. 3. Cold -Formed steel light -frame construction ❑ Welding of elements of the seismic -force -resisting X 1707.4 system. SpecialnspectionForm 2012.doc revised 09106112 ❑ Inspection of screw attachments, bolting, anchoring, and other fastening of components within the seismic- X force -resisting system including shear walls, braces, - diaphragms, collectors (drag struts) and hold-downs. 4. Storage racks and access floors ❑ Anchorage of storage racks 8 feet or greater in height X 1707.5 and access floors. 5. Architectural components ❑ Inspect erection and fastening of exterior cladding weighing more than 5 psf and higher than 30 feet --- X above grade or walking surface. ❑ Inspect erection and fastening of veneer weighing more than 5 psf.and higher than 30 feet above grade --- X or walking surface. --- 1707.6 ❑ Inspect erection and fastening of all exterior non- bearing walls higher than 30 feet above grade or --- X walking surface. ❑ 'Inspect erection and fastening of all interior non- bearing walls weighing more than 15 psf and higher --- X than 30 feet above grade or walking surface. 6. Mechanical and Electrical Components 0 Inspect anchorage of electrical equipment for X emergency or stand-by power systems. ❑ Inspect anchorage of non -emergency electrical X equipment. -_- ❑ Inspect installation of piping systems and associated mechanical units carrying flammable, combustible, or --- X --- 1707.7 highly toxic contents. ❑ Inspect installation of HVAC ductwork that contains X hazardous materials. -- ❑ Inspect installation of vibration isolation systems where required by Section 1707.7. _-- X 7. ❑ Verify that the equipment label and anchorage or mounting conforms to the certificate of compliance 1707.8 when mechanical and electrical equipment must be ___ ___ _-_ seismically qualified. 8. ❑ Seismic isolation system: Inspection of isolation --- X --- 1707.9 system per ASCE 7 — Section 17.2.4.8 9. ❑ Obtain mill certificates for reinforcing steel, verify compliance with approved construction documents, --- --- --- 1708.2 and verify steel supplied corresponds to certificate. 10. ❑ Structural Steel: Invoke the QAP Quality Assurance requirements in AISC 341. __- 1708.3 11. ❑ Obtain certificate that equipment has been seismically 1708.4 qualified. --- 12. ❑ Obtain system tests as required by ASCE 7 Section--- 17.8. --- --_ 1708.5 SpecialnspectionForm 2012.doc revised 09/06/12 CUPERTIKO RECOGNIZED SPECIAL INSPECTION AGENCY LIST COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building aacupertino.org The following list of Special Inspection Agencies and their special inspectors are approved by the City of Cupertino to provide specific inspection in their respective field until the expiration date listed. Agency Name, Address and expiration date Special Inspectors RC PC Special Inspection Field SM SW 1113 FP S W CG Achievement Engineering Corp. 434 Camille Cir. #13 San Jose, CA 95134 Tel: (800) 653-1397 Fax: (408) 852-0331 Expires: 07/22/2015 Firouz'aei, Arash FP = S ra -Alied Fireproof CG = Ca/Green Code X X X X Hooshdar, Sina X X X X Khodadadi, Mohammad X Safaian, Farshad Applied Materials 8 Engineering, Inc. 980 41 s' Street Oakland, CA 94608 Tel: (510) 420-8190 Fax: (510) 420-8186 Expires: 12/19/2014 Email: infoaa.ammateng.com Aaron Hardy X X X AnthonyKlarich X X X X X Armen Ta'irian, P. E. X Bryan Jackson X X David Jackson X X X X X Diego Bertolino X X X Harold Walrath X X X X Ken Maloney X X Michael Knowles X X X X Oswaldo Dominguez X X X X Sean Guches X X X Bagg Engineers 847 West Maude Ave. Sunnyvale, CA 94085-2911 Tel: (650) 852-9133 Fax: (650) 852-9138 Expires: 7/16/2015 www.baggengineers.com Brown, Christian X X X X X Cole, Michael Hepper, John X X X Knudsen Steven J. McManus, Alvin X X X Norris, David L. X X X X O'Driscoll, Alan Salceda, Francisco Sciortino, Brandon Smith, Louis Steinbrueck, Bryan Thai, Minh Umeki, Takashi RC = Reinforced Concrete SW= Steel & Welding S =Soils PC = Pre-stressed/Post-tensioned Concrete HB = High -Strength Bolding W= Wood SM =Structural Masonry FP = S ra -Alied Fireproof CG = Ca/Green Code SpeciallnspectionList.doc revised 02/01/14 C Agency Name, Address and expiration date Secial Insectors pp RCTPC PC = Pre-stressed(Post-tensioned Concrete Special Inspection Field SM SW HB FP S W CG Biggs Cardosa Associates, Inc. 865 The Alameda San Jose, CA 95126 Tel: (408) 296-5515 Fax: (408) 296-8114 Expires: 7/11/2014 www.biaascardosa.com Castro, Roberto FP = Spray -Applied Fire roofin CG = Ca/Green Code Chan, David X X Ghorbani, Behrooz Lazzarini, Dan Rivas, Ricardo Rosales, Adolfo Rosellini, Daniel Sanchez, Adam To an, Claudiu X X Wooley, Mark X X X X Yamane, Robert BSK Associates Engineers & Laboratories 324 Earhart Way Livermore, CA 94551 Tel: (925) 315-3151 Fax: (925) 315-3152 Expires: 9/06/2014 www.bskassociates.com Auser, Jim X X X Bos ue, Jeff X X X Clary, Mike X X X X Evans, Keven X Minerales, Gilbert Ness, Dennis X X X Olsten, Ken X X Reeves, Ben Rodriguez, Tim X X X Schurman, Peter X Capex Engineering Inc. 571 Seville Place Fremont, CA 94539 Tel: (510) 668-1815 Fax: (510) 490-8690 Expires: 6/25/2014 Gary Hsu X X X X X Chow, Erwin 1105 Belmont Ave. Long Beach, CA 90804 Tel: (562) 449-7491 Expires: 4/24/2014 Erwin Chow X RC = Reinforced Concrete SW= Steel & Welding S = Soils PC = Pre-stressed(Post-tensioned Concrete HB = High -Strength Bolding W= Wood SM = Structural Masonry FP = Spray -Applied Fire roofin CG = Ca/Green Code SpeciallnspectionList.doc revised 02/01/14 Agency Name, Address and expiration date Special Inspectors RC PC Special Inspection Field SM SW HB FP S W CG Consolidated Engineering Laboratories 2001 Crow Canyon Road, Suite 100 i San Ramon, CA 94583 Tel: (925) 341-7100 Fax: (925) 855-7140 Expires: 6/25/2014 www.ce-labs.com Ahmed, Badaruddin FP = Spray -Applied Fireproofing CG = CalGreen Code Alexander, David X X X Andersen, Calvin X X Bartlett, Dennis X X Bobrovitsk , Edward X X X Bolen, Michael X X X Brooks, Brendan X X X X X Brown, Ronald X X X X X Buchmiller, Kenn Cottingham, Paul Currier, James X X Eschliman, Duaine Eschliman, Kevin Fuller, Mark X X Halloran, James X X X X X Harrington, Wayne X X Hassebrock, Scott X X X X X Healy, Michael X Heilmann, Mark X X X Horn ak, John X X X X Hyslop, John X X X X King, Phillip X X X X Kmitt, S-tanley X X Liebold, Jeffrey X X X X X Lozano, Alfonso Art Ma, Steven X Marlik, William X X McCutcheon, Thurmond X X McKenzie, Quinten McLaughlin, Lori X X Miner, Dwight X X Murphy, Don X Pastora, George X X X X Rodriguez, Sandra X X Si mon, Josephine Sisson, James X X X X Small, Michael. X X Van Horn, Bradford X X X X Walters, Michael Zuerner, Robert X X X RC = Reinforced Concrete SW = Steel & Welding S =Soils PC = Pre-stressed/Post-tensioned Concrete HB = High -Strength Bolding W= Wood SM = Structural Mason FP = Spray -Applied Fireproofing CG = CalGreen Code SpeciallnspectionList.doc revised 02101114 Agency Name, Address and expiration date Special Inspectors RC PC Special Inspection Field SM SW HB FP S w CG Construction Testing Services 2174 Rheem Dr., Ste. A Pleasanton, CA 94588 Tel: (925) 462-5151 Fax: (925) 462-5183 Expires: 6/26/2014 www.cts-1.com Brian Arnold X X X Edward Bindert X X X X X Jeremy Brown X X X James Brumley X Jared Byers X X Richard Collin X X X Robert Cortez X X X X X Robert Criswell X X X Mark Dornan X X X X Tom Edwards X X X X X Tim Farley X X X X X X Gary Fechner X X X Mike Gaunt X Ron Harr X X X X Neal Hoellwarth X Richard Jones X X X X Rick Mann X X Kevin McCurdyX X Kevin Meyers X Kevin Moore X X Craig Nagle David Puskarich X X X X William Radulovich Brian Ragan X X X X X John Rink X George Rockenstein X X Larry Rothey X Erin Salazar X X Robert Schulze X Donald ShirleyX X I X Tom Shuster X X X X X Larry Slater X Daryl Spieker X X Gary Stapleton X X X Matt Swope X X Travis Taylor X X Vinny Vinavong X Shawn Vucenic X John White X X X X X Isidoro Za ien X X X RC = Reinforced Concrete SW = Steel & Welding S =Soils PC = Pre-stressed/Post tensioned Concrete HB = High -Strength Bolding W= Wood SM = Structural Masonry FP = Spray:Applied Fireproofing CG = Cal Green Code SpeciallnspectionList.doc revised 02/01/14 Agency Name, Address and expiration date Secial Insectors pp RC Pc Special Inspection Field SM sw HB FP S W CG Earth Systems Pacific 446 S. Hillview Dr. Milpitas, CA 95035 Tel: (408) 934-9302 Fax: (831) 637-0510 Exp: 6/28/2014 www.earthsystems.com George Barnett FP = Spray -Applied Fire roofin X X Jeff Bryan X X Norman Engen X X X X Cal Hicks X X X X X Dennis Hurley X X rus Melia ENGEO Incorporated 2010 Crow Canyon PI., Suite 250 San Ramon, CA 94583 Tel: (925) 866-9000 Fax: (888) 279-2698 Exp: 7/06/2014 www.engeo.com Tim Benton Greg Hudson X Mike Huener ardt X X X X Kevin Lecce James "Chip" Moore X X X Randy Mues X Jonathan Parker X X X X Rich Rose X X X H P Inspection, Inc. 690 Sunol ST, Building H San Jose, CA 95126 Tel: (408) 288-8460 Fax: (408) 271-0902 Expires: 11/15/2014 Larry Castrence Tony Cotta X X Mark Cotter Chuck.Pinkham X X X X David Pinkham X X X X P. Scott Pinkham X X X Stafford X X X X X -Gary Jason Waugh X X X X X RC = Reinforced Concrete SW = Steel & Welding S =Soils PC = Pre-stressed/Post-tensioned Concrete HB = High -Strength Bolding W= Wood SM = Structural Masonry FP = Spray -Applied Fire roofin CG = CalGreen Code SpeciallnspectionList.doc revised 02/01/14 Agency Name, Address and expiration date Special Inspectors RC Pc Special Inspection Field SM sw HB FP S W CG Inspection Services, Inc. 1798 University Ave. Berkeley, CA 94703 Tel: (510) 900-2100 Fax: (510) 900-2101 Expires: 03/21/2015 www.inspectionservices.net Alakbarov, Ha dar CG = Ca/Green Code X Amos 111, Jessie X Baccus, Garrett X X Baek, Byunq Gi X X X X X X Barone, Judith X X X Celik, Can X X X X X X X Paul X X —Colby, Ehrsam, Gary X Falk, Andrew X X X X Flynn, Chris X X X X X X Gaut, Tobin X X X X Llames, Fernando X X X X Lon, Rand "Roy" X X X X X X Patterson, Rodger X X Putman, Edward X X X X X Sandoval, Carlos X X X X X X Shebesta, Todd X Simonton, Cy -Leon X Solis, Winnie X X Stafford, William X Stark, Douglas X X X X Toschi, Patrick X X X X X Wheeler, Steven X X X X X Kleinfelder 2601 Barrington Court Hayward, CA 94545 Tel: (925) 484-1700 Exp: 7/10/2014 www.kleinfelder.com Anderson, Tim X X X X X X Brewster, Steve X Burton, Nathan X X X Cliff X X X X X X —Craig, Delabriandais, Gary X X X Eres, Mark X X X X X Foster, Stephen X X X X Hammon, Robert X X X X Johnson, Josh X Kesler, Timothy X Mi11a e, Leonard X X X X X Nicoletti, Johnathon X X Oandason, Jose X X X X X X Rommel, Daniel X X Saber, Sam X X X Swank, Phillip X X X RC = Reinforced Concrete SW = Steel & Welding S =Soils PC = Pre-stressed(Post-tensioned Concrete HB = High -Strength Bolding W= Wood SM = Structural Masonry FP = Spray -Applied Fire rootin CG = Ca/Green Code SpeciallnspectionList.doc revised 02/01/14 Agency Name, Address and expiration date Special Inspectors RC Pc Special Inspection Field SM sw HB FP s w CG Krazan & Associates, Inc. 6711 Sierra Court, Ste B Dublin, CA 94568 Tel: (925) 307-1160 Fax: (925) 307-1161 Exp: 2/6/2014 www.krazan.com James Allen X X X James Benefeito X X X Larry Borges X X X X Ron Chandler X Van DeMent X X Greqory Fernald Matthew Fernald Lewis Franklin X X X X X Ken Hafeli X X X Andy Morris X X X X Sidney Moss X X X X Matt Romero X Gregory Ruf MatriScope Engineering Laboratories, Inc. 4730 Contractors Common Livermore, CA 94551 Tel: (925) 606-7700 Fax: (925) 606-7702 Expires: 7/26/2014 www.matriscope.com D'Souza, Andrew Fannin, Dana X X X Ho elian, Joseph X X X X Keller, Don X X Kohls, Kristin Lake, Adam X X Mathis, Q. Shane X X X X X Nieser, Paul X Palmer, Scott Reese, Mark X Scoble, Kod Selvage, Kevin Shelton, James X X X X X X Sta ner, Jack X X X X X X Swartz, Jud Tadlock, K. Scott X X X X X X Tadlock, Robert X X I X X I X X Thomas, Chris X Varella, Joe RC = Reinforced Concrete SW = Steel & Welding S =Soils PC = Pre-stressed/Post-tensioned Concrete HB = High -Strength Bolding W= Wood SM = Structural Masonry FP = Spray -Applied Fire roofin CG = Cal Green Code SpeciallnspectionList.doc revised 02/01/14 Agency Name, Address and expiration date Secial Insectors pp RC PC Special Inspection Field SM SW HB FP S W CG Neil O. Anderson & Associates, Inc. 902 Industrial Way Lodi, CA 95240 Tel: (209) 367-3701 Fax: (209) 333-8303 Expires: 2/1/2016 www.noanderson.com Allen, Eric FP = Spray -Applied Fire roofin CG = Cal Green Code Cozad, Mike X X X X. X Dickey, David X Erickson, Rick Dave X X X X X X -Gray, Hall, Rollin Johnson, Carl X X X X King, Ryan X Kort, Jason X X X X Landess, Frank X X X Lenehan, Gerry Me'orado, Aaron X Merrell, Ryan X Daniel -Morgan, O as, George Oszut, Gregory X X X X Roberts, Jason Westfall, Kimmis X X X X X Whiting, John Williams, Roger X X X PacificlnterWest Bldg Consultants, Inc. 1600 South Main St, Suite 380 Walnut Creek, CA 94596 Tel: (925) 939-5500 Fax: (925) 939-9561 Expires: 9/6/2013 WWW. 2CifiCinterwest.com Cope,Douq X PSI, Inc. 365 Victor Street, Ste. C Salinas, CA 93907 Tel: (831) 757-3536 Fax: (831) 757-6265 Expires: 1/10/2015 www.psiusa.com Albert George X X X X X Deborah White X Michael Winter X X William Monger X X X X X Brand Burfield X Ezekiel Robles X Ramos X -Stephen Darwin Zackary X RC = Reinforced Concrete SW = Steel & Welding S = Soils PC = Prestressed/Post-tensioned Concrete HS = High -Strength Bolding W= Wood SM =Structural Masonry FP = Spray -Applied Fire roofin CG = Cal Green Code SpeciallnspectionList.doc revised 02101114 Agency Name, Address and expiration date Special Inspectors RC PC Special Inspection Field SM SW HB FP S w CG RMA Group of Northern California 6296 San Ignacio Ave., Suite A San Jose, CA 95119 Tel: (408) 362-4920 Fax: (408) 362-4926 Expires: 04/01/2012 www.rmacomr)anies.com Alley, Maurice X CG = CalGreen Code X Bosque, Jeff X X X Carr, Greg Cecconi, Joe X Chinn, Gordon X X X X Francis, Chris X X Geraghty, Rich X X X Gillespie, John X X X X X Gundersen, Al X X X Haff, Tiffany Hughes, Dottie X X X Sondrol,. Jeff X X X X Stocke, Jacob X Swain, Pat X Tellesen, Mike X X Tonkovich, Bill X X X X Walters, Chris X X X X X X Zeiher, Adam X RC = Reinforced Concrete SW =Steel & Welding S =Soils PC = Pre-stressed/Post-tensioned Concrete HB = High -Strength Bolding W= Wood SM = Structural Masonry FP = Spray -Applied Fire roofin CG = CalGreen Code SpeciallnspectionList.doc revised 02/01/14 1 Agency Name, Address and expiration date Special Inspectors S =Soils PC = Pre-stressed/Post-tensioned Concrete Special Inspection Field RC Pc SM sw HB FP S W CG Smith -Emery Company Corporate Office: 781 E. Washington Blvd. Los Angeles, CA 90021 Testing Facilities: 1940 Oakdale Ave. P.O. Box 880550 San Francisco, CA 94124 Tel: (415) 642-7326 Expires: 4/09/2015 www.smithemervsf.com Allder, Scott CG = Ca/Green Code Brunett, John X X X Caraisco, Thomas X X X X X X Chuong, Jason X Contreras, Roberto X X X X X Cross, Len Cunningham, Jim Daniels, Jodie X X Daquinag, Bonafacio Docena, Bernard Drake, Barry X X Joakimson, Robert X X X X X X K lopson, Paul X X X Mazuk, Ray X McCarron, Liam X X X Merino, Salvador X X X X X Miranda, Allen Murphy, Mike Nadler, Joel X X X Nickerson, Scott X X X X Ross, Jason X X Serrano, Ramon Sherwood, Tony X X X X X X Starkey, Raymond Stevenson, Wylie Viramontes, Keith X X X Stevens, Ferrone & Bailey 1600 Willow Pass Court Concord, CA 94520 Tel: (925) 688-1001 Fax: (925) 688-1005 Expires: 8/09/2014 www.sfandb.com Babione, Martin X X X Conner, Scott X X X X X X Fletcher, Brett X X X X X X X Minor, Matt X X X Quinn, Tom X X X X Thielges, Jon RC = Reinforced Concrete SW = Steel & Welding S =Soils PC = Pre-stressed/Post-tensioned Concrete HB = High -Strength Bolding W= Wood SM = Structural Masonty FP = Spray -Applied Fire roofin CG = Ca/Green Code SpeciallnspectionList.doc revised 02/01/14 Agency Name, Address and expiration date Secial Ins ppectors RC PC Special Inspection Field SM SW HB FP S W CG Terracon Consultants, Inc. 3140 Gold Camp Drive, Suite 170 Rancho Cordova, CA 95670 Tel: (916) 858-1579 Fax: (916) 858-8277 Expires: 7/17/2015 www.terracon.com Houts, Walter X X X X X X Mears, Steven X X X X X X Testing Engineers, Inc. 2811 Teagarden Street San Leandro, CA 94577 Tel: (510) 835-3142 Fax: (510) 834-3777 Expires: 4/22/2015 testing-engineers.com Ardizonne, Mike X Dougherty,John X X X X Ganly, Jim Geraghty, Richard X X X X Grossman, Peter, P.E. X Gunderson, Al X X X X Hernandez, Frank X X X X X Mendosa, John X Muzika, Bruce X X Ronald, Seth X Souza, Jason X X Tellesen, Mike X X Thomas, Paul X X X X Watanabe, Dan X Williams, Brian X White, Walker X Yoka, John X X X Western Technologies, Inc. 3480 South Dodge Blvd. Tucson, AZ 85713 Tel: (520) 748-2262 Expires: 8/29/2014 www.wt-us.com Tiedemann, Thomas X RC = Reinforced Concrete SW= Steel & Welding S =Soils PC = Pre-stressed/Post-tensioned Concrete HB = High -Strength Bolding W= Wood SM = Structural Masonry FP = Snrav-ADOlied Firearoofina CG = Ca/Green Code SpeciailnspectionList.doc revised 02/01/14