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13513 POST THIS CARD NEAR FRONT OF BUILDING PFRNNT NUn19ER CITY OF CUPERTINO INSPECTION DIVISION 13513 JOB INSPECTION RECORD PERMIT EXPIRATION JOBADDRESS 10605 N WOLFE ROAD UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER MARRIOTT CORPORATIONSONTRACTOR MASON COMPANY IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM FOUNDATION LASTCALLED INSPECTION. UFER PERMIT VALIDATION PREGUNITE . T( ®, eeL c !A� POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED I�UC I A "� a�.l._ U U UNDERGROUND /SLAB A PLUMBING Of C�ppo ELECTRICAL Clr• SuANc DAT BLDG. ELECT_ PLG. MECH. MECHANICAL It, ryL DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION siFT. PLUMBING _ - J MECHANICAL PERMIT TO ELECTRICAL �p+/• 1LI FRAMING V!/1/ M(�✓Fs O STORIES TV PE CONSTR. INSULATION {T75 OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 50 FL GI OOII AREA TOTAL ACREAGE ROOF DIAPHRAGM BUILDING USE NES IND CON P9 Olner APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED El 1:1 ❑ El El nSS:1 SPAR CEL NO. ROUGH PLUMBING TRACT NO. PARCEL NO GAS TEST MECHANICAL ELECTRICAL FINALS DATE INSP. ACC.DATE ncc.PaE No. FRAMING SAN #• ZONING ENG.SITE NO. INSULATION PLUMBING -j-opf wzr— GAS FIFE SPRINK ENERGY TZE MECHANICAL —_ X.-ov 'w Y ❑ No v ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING _Af )00 FLOOD ZONE A.L.U.C, LATH—INTERIOR ELECTRICAL -Z- LATH—EXTERIOR FIRE DEPT. v❑ rv❑ v ❑ N❑ SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING DOL. s -2 BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE / <. OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ~w ONE WORKING DAY BEFORE REQUIRED INSPECTION. �PLUMBING O PLEASE GIVE JOB ADDRESS WHEN PHONING. Z MECHANICAL — SEE PERMIT FOR EXPIRATION DATE — CONST.TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY �0 LD1 NG PROJECT I DENTI FICATION PERMIT NUMBER BoHjss APPLICATION & PERMIT 13513 Q S 1 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S 1 PLAN CHECK VALIDATION NAME TV, ELECTRIC PERMIT FEE ,O O PHONE �S CONTRACTORS UTLETS-SWITCHES-RECEP 10.00/1.00 NPME QIc.No. LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S APPLIANCES 4.00 ADDRESS /11/�r 1C I� plsoNE - PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20.00 ENGINEER PLAN CHECK FEE P.C.NO. on LIC,NO, SIGNS TRANS. 3.00 ARCH.OR ENG' SPECIAL CIRCUIT , 5.00 I�AIDL IDATION ADDRESS bI • zIP EMP.METER OR PO E'INS. (' t �y20.00 r, 'r^ AEMOTORS S F N� ADDRDDRESSSS - SERVICE CHANGE 20.00 fs (17 w 02 LICENSED CONTRACTORS DECLARATION a�f a U u 1 hereby affirm that I am licensed under provisions of Chapter 9 E�LZ7 -- ooL� ISSUANCE DATE H <w (commencing with Section 7000)of Division 3 of the Business and SLOG. ELECT. PLG. MECH. I- m z Professions Code, F ease is in full for ft{c yNli z 0 m- Licens Class_ A Lic.Number J ❑ ❑ ❑ ❑ N �/' Dalel.�-Y-�-Com rector ¢ 2 w e OWNER-BUILDER DECLARATION BUILDINGRM PERMIT a 0 e. MISC.- REFER TO ORD INFORMATION w 3 w_ I hereby affirm that I am exempt from the Contractor's License VALUATION $/FT. FLLas Oa Law for the following reason.(Sec.703 I.S.Businessand Professions PERMIT ISSUANCE 10.00 .Q oZ0 600 Code:Any city or county which requires permit to construct,alter, ¢¢40 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIG NO. ELEC. at O u requires the applicant for such permit to file a signed Statement that TOTAL PERMIT TO 11 .p whe is licensed pursuant to the provisions of the Contractor's License r i i Law(Chapter 9(commencing with Section 7000)of Division 3 of the yp (,IJI r1.v /N I i ao Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE U d4 L' ¢ H the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. e 3 � of noimorelicant for a five permit subjects dollars the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 �U/v/� ❑ L as owner of the properly,or my employees with wages as BACK F LOW PROTECT.DEVICE 4.00 DCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 Code:The Contractor's License Law docs not apply to an owner of Property who hui dS or improves Thereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT FLOOR AREA TOTALACREAGE himself or through his own employees,provided that such improve- GAS-EA -SYSTEM6.00 memS are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion, the owner- GAS-EA.SYSTEM-OV,ERI,yTW ) 2A0 BuuO Nn uSE builder will have the burden of proving that he did not build or im- RES IND CON PB Omer prove for purpose of sale.). INDUSTRIAL WASTE INTER. .30.00 ❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044, Business LAWN SPRINKLE Sp 1C,1NQ�(V!B. 6.00 ASSESSORS PARCEL NO. and Professions Code,The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS'-`OV ER 5(EA.) 1.00 contracts for such projects with a contractors)licensed pursuant to SEWER-SANITARY-STORM !( ft 0.00 TRACT NO. PARCEL NO. the Contractor's License Law. ❑ lam exempt under Sec.-.B4P.C.for this WATER HEATERW/VrNT 6.00 reason Owner Dam WATER SYSTEM 5.00 ACC.DATE ACG FILE NO. WORK Ii RS'COMPF:NSA1'ION DECLARATION WATER TREATING EQUIP. 5.00 I hereby all'um that I have it certificate ofaI t to'elf-it or a certificate of Workers'Compensation lasumace,or a certified ZONING ENG.SITE N0. copy theregpI(y 3800,Lab.C.).( _-. l\�./,�, ,1 Q Policy NO.{S.d't-Company-`7_v1k�- ].CL i Q ❑ Cerlifed Copy¢herebyfurnished. FIRE SPRINK ENERGY T 24 Z Z ❑ Certified copy is filed with the city inspection division. MISC.- REFER TO ORD. Y ❑ N❑ Y ❑ NE] APPlieant PERMIT ISSUANCE 10.00 O FLOOD ZONE A.L.u.c. cc - CERTIFICATE 01'FXEMPf10N FROM WORKERS' LU >_ COMPi NSA'I'ION INSURANCE PLG.CONTR. LIC.NO. PLO. y[:] N E] Y ❑ NF](This section need not be completed it the permit is to,one TOTAL Z hundred duller.is 100)or lest U 0 I certify that in the performance of We work fur which this per- QTY. MECHANICAL PERMIT FEEULi P: FEE SUMMARY mit is issued,I shall not employ any person in any manner so as to p'„bay 00 become subject to the Workers'Compensation Laws of California. BUILDING J� Date Applicant ALTER OR ADD TO MECH. 5.00 } NOTICE,TO APPLICANT: If,after making this Certificate of Ex- f- ? emption,you should become subject to the Workers Compensation APPLIANCE 1�r elU t l 5.00 PLAN CHECK provisions of tile Labor Code, you must forthwith comply with FEE U such provisions or this permit Shall he deemed revoked. AIR HANDLING UNI (TO 10)X)0C.FiMi1ln4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVFR;I ,000C: .M.) 6.00 SEISMIC FEE -COL 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.T HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender,Name HEATING UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC ro Lender's Address I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct.I agree to comply with all city and countyPLUMBING ordinances and stale laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 /Q '�' CONST.TAX may in any way accrue,against said City in emasequmce of the granting ofit pe nit. MECH.CONT. LIC.NO. MECH. TOTAL oZ`S TOTAL Signature of Applicant/Contractor Date OFFICE COPY --�