14524 POST THIS CARD NEAR FRONT OF BUILDING
PERMIT NUMB eR
CITY OF CUPERTINO 14524
INSPECTION DIVISION
JOB INSPECTION RECORD �.
* PERMIT EXPIRATION
J08 ADDRESS 10605 N. Wolfe Road UNIT# _LOT#
PERMIT EXPIRES IF WORK
OWNER Courtyard CONTRACTOR Federal Sign IS NOT STARTED WITHIN
INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU.
_ ANCE OR 180 DAYS FROM
FOUNDATION NOTE: LASTCALLED INSPECTION. .
LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION
CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED` / ✓
UNDERGROUND /SLAB
PLUMBING
ELECTRICAL ISSUANCE,DATE.
MECHANICAL _ RLD'�, nLECT PEO. NI❑ 13
�L9
00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED DING PERMIT
C4,,�'"ItUFORMATION
WOOD FLOOR VALUATION S/F T.
PLUMBING ✓ :It "
MECHANICAL f S
_ PENM1III TO
ELECTRICAL /
-SI.Cry,
FRAMING
STORIES TYPE CONSTN
INSULATION
OCC GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
50 FT FLOOH PPEP iOiPL ACREPGF
ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID
BUILDING use
ROOF SHEATHING - Res IND CON Pe ou..,
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ El E) ❑
ASSESSORS PARCEL NO
ROUGH SAN.N.
PLUMBING ELECT.ENERGY '
TRACT NO. PARCEL NO
TUBS&SHOWER PAN PLUMBING ENERGY
MECHANICAL MECH.ENERGY
ACC DATE ACC.FILE NO
ELECTRICAL BUILDING ENERGY
FRAMING ELECT.FINAL TEST zONING ENG SITE NO.
INSULATION - PLUMBING
GAS TEST GAS -
FIRE SPRINK ENERGY T`2<
MECHANICAL Y ❑ Nr v ❑ IN
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING
aooD zone nLuc.
EXTERIOR SHEAR ELECTRICAL RELEASE
INTERIOR SHEAR FIRE DEPT. vL N❑
SHEETROCK GRADE " FEE SUMMARY
EXTERIOR LATH BUILDING BUILDING �•� _
INTERIOR LATH TEMPORARY APPROVALS '
SCRATCH COAT ELECTRIC PLAN CHECK .1
FEE
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE .
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ,
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
fLONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
0� PLEASE GIVE JOB ADDRESS WHEN PHONING.
ZMECHANICAL
— SEE PERMIT FOR EXPIRATION DATE —
IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE _
CALLING FOR FINAL INSPECTION. TOTAL �?
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BLI LDING PROJECT I DENTI FICATION .PERMIT NUMBER ,
BUILDING APPLICATION & PERMIT
ADORE ss _ _ /' /
/µJ/5✓ //('/ ��` BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
14524
OWNER 5 PLAN CHECK VALIDATION
NAM/' CITY. ELECTRIC PERMIT'+ ' FEE
�/� PHONE 1
CONTRACTORS UTLETS-SWITCHES-RECEP 10.00/1.00
NAM /,�
L �17; , No. Z/7�gD LIGHTING FIXTURES 10.00/1.00
f-ONTRALTOREy/S) APPLIANCES-RESIDENTIAL 4.00
AODIR s
SPHONE PANELS 10.00 DATE OF APPLICATION
cHITzcT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO.
OR
ENGINEER
uc.No. SIGNS TRANS. 3.00
ADDRESS alae. SPECIALCIRCUIT 5,08 PERMIT VALIDATION
ZIP TEMP.METER OR POLE INS. 20.00
APPucANrs /02 ,...Syn/ /C,/fEG
AOOMOTORS SEE FEE SCH.
R
owCQ/eQ SERVICE CHANGE 20.00
49
uoH+O O LICENSED CONTRACTORS DECLARATION ?,
Q U u I hereby affirm [hat I am licensed under pm,mimis rel Chapter 9 ISSUANCE DATE
z w (coinmincing with Section 7000)of Division 3 of the Business and
BLDG. EL PLG- MECH.
H H z ProfessionS COdi d .e is in full for •and,41 1 M ❑ ❑
z o R,- License Class - Lia Number u
o z H w Date_/_. Contract �_q1_
a ,s �� l// � (%""-' BUILDING PERMIT
M w ¢ OWN[R-BUILDER D:CLARATION INFORMATION
o a " REFER TO ORD
w ; H I hereby offinn that 1 am exempt from [hc Contractor's License MISC--
a_ Law URIhefollowingroaso, Sec.7031.5.Business and Professions PERMIT ISSUANCE 10.00 VALUATION __4
� /FT
a_
� - Code:Any city or county which requires a permit to construct.alter, y7��o
R ¢<,O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. y �)
O R requires the applicant for such permit to File a signed statement that TOTAL _zA PERMIT TO
' w m u he is licensed pursuant to the provisions of the Contractor's License
Hza
Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe SSG-✓
E i o Business and Professions Code)or that he is exempt therefrom andCITY. PLUMBING PERMIT FEE
m H o the basis for Bre alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
La A3: � by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00
of not more than five hundred dollars(S5000:
❑ 1,as owner of the property,or my aeployees with wages as BACK FLOW PROTECT.DEVICE 4.00
their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS
intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00
Code:The Contractor's License Law does not apply to an owner of
property who builds of improves thereon,and who does such work FIXTURES-PER TRAP 5.00 So.FT.FLOOR AREA TOTAL ACREAGE
toren elf re through his own employees,provided that such improve-
ment,
mprovr
mLms are Out throngintended or n emrM fees,provided
that such
he building GAS-EA.SYSTEM-1 WC.4 OUTLETS 6.00
nprovemen[ is sold within one year of completion, the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00
builder will have the burden of rovin that he diJ not build or ins- BUILDING USE
p g RES IND CON PB Other
prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00
El 1,as owner of the property.am exclusively contracting with
licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO.
and Pmfessior,Code:The Contractor's License Law docs not apply
to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00
contracts for such projects with a contrUCIORs)licensed pursuant to
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO, PARCEL NO.
❑ I am exempt under Sec. .B.&I'.C.for this WATER HEATER W/VENT 6.00
reason
Owner Date WATER SYSTEM 5.00 ' ACC.DATE ACC.FILE NO.
WORK FRS'COMPENSATION DFCLARAI'1ON WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate of consent to self-insure. ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance,or a certified
copy thereof(Sec.3800,Leb.CJ.
Policy No. Company
0 O Certified copy is hr yfurnishrdf FIRE SPRINK ENERGY T24
Z Z _.f1�� Cert if tpy I A wit H, cly inspection division.
O lsnicant _ � MISC.- REFER TO ORD. Y❑ N� v � N❑
Fw 7 PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U,C.
Lu Cf!RI'I PIC'ATIi Oh SArI EXEMPTION RAN WORKERS'
EL 0 need Out
be completed
INSURANCE PLG.CONTR, LIG NO. PLG, Y0 NEJ Y � N❑
4. O 1"Phis section need not bi comple[cJ if the Diane( is for ane TOTAL
0 Z hundred dollars($100)or leu.)
U O 1 certify that in the peHo mance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY
LL I- mit is issued,I shall not employ any person in any manner so as to
Ow become subject m the Workers'Ctou,notion Laws of California. BUILDING VV
Dae' Applicant ALTER OR ADD TO MECH. 5.00LO
} ran NOTICE TO APPLICANT: If.after making this Certificate of Ex
F ? Sorption,you Should become subject to the Workers Compensation APPLIANCE 5.00 PLAN CHECK ^�'
provisions of the Labor Code, you must forthwith comply with FEE 3a
U such provisions or this permit shall be demned revoked AIR HANDLING UNIT(TO 10,000C.F.M.) 4.00
CONSTRuc TION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE
I 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. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM
30'J7,CiYC.I.
Lender's Name - HEATINGUNIT(OV ER 100,000 B.T.U.)9.50 (
Lender's AddressELECTRIC aZoV
I certify that Ihave read this application and state that the above VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to comply with all city and county BOILER-COMP(3 H.P,or 100,000 B.T.U,) 6.00 PLUMBING
ordinances and state laws relating to building consOuction, and
hereby ..III...I, representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL y
above-mentioned property for inspection purposes, 1
(We) agree to save, Indemnify and keep 11mriless the City of MISC.- REFER TO ORD.
Cupertino a rest liabilities,judgments, costs and expenses which CONST.TAX
may in an ay accme a ins( said City in consequence of the PERMIT ISSUANCE 10.00
MECH.CONT. LIC.NO. MECH.
OTA` TOTAL Q�f�a
ignature of pplof r�ontramor� (�--�-
OFFICE COPY A