15356 POST THIS CARD NEAR FRONT OF BUILDING
�.• P'� PERMIT NUMBER
CITY OF CUPERTINO 15356
INSPECTION DIVISION
JOB INSPECTION RECORD
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' 'PERMIT EXPIRATION '
JOB ADDRESS 10123 North Wolfe Road UNIT# _LOT#
PERMIT EXPIRES IF WORK
OWNER Sports Stuff CONTRACTOR - IS NOT STARTED WITHIN
INSPECTION DATE INSPECTOR INSPECTION RECORD 180 Days OF PERMIT Issu
FOUNDATION NOTEANCE OR,180 DAYS FROM
R
' UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION.
TO COMPLY WITH THE APPROVED PLANS AND CIN OF, PERMIT VALIDATION
PREGUNITE, - CUPERTINO STANDARDS.
GARAGESLABS-
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /-SLAB h
7/1 p
' PLUMBING , ' •A '
ELECTRICAL ISSUANCE ' TEi '-
MECHANICAL - SLUG. eLecr PLG.-y MECH
a ❑ ❑ ❑ .
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT
WOOD FLOOR INFORMATION
VALUATION $/FT.
PLUMBING '
MECHANICAL
ELECTRICAL
FRAMING p '
STORIES TYPE CONSTR.
INSULATION
DEC GROUP RES UNITS
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED
. ROOF NOTE:NO FINAL INSP,SHALL BE MADE BEFORE SD.ET.FLOOR AREA TOTAL ACREAGE
DIAPHRAGM THE CONSTRUCTION TAX IS PAID '
' BUILDING USE
ROOF SHEATHING - RES IND CON PB om•
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP.
ASSESSORS PARCEL NO
ROUGH SAN.#
PLUMBING ELECT.ENERGY - -
TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT NO. PARCEL NO
MECHANICAL MECH'ENERGY
ELECTRICAL , o-(Oj BUILDINGENERGY ADD:DATE ACC.FILE No
FRAMING ELECT.FINAL TEST ZONING ENc.SITE No.
INSULATION PLUMBING
GAS TEST GAS
MECHANICAL EIRE SPRINK ENERGY T 2
COVER NO WORK UNTIL ABUVE HAS BEEN SIGNED HEATING Y [] No ° ❑ N(_]
EXTERIOR SHEAR
ELECTRICAL RELEASE aooD zorvE A.LUc.
INTERIOR SHEAR - FIRE DEPT. - v N� v N❑
SHEETROCK —,n - GRADE - FEE SUMMARY
EXTERIOR LATH BUILDING
INTERIOR LATH- TEMPORARY APPROVALS BUILDING J I
SCRATCH COAT • ELECTRIC PLAN CHECK
' GAS FEE
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED,BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, EMECHANICAL
IC
Nfxt:', o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. G
PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z
' SEE PERMIT FOR EXPIRATION DATE —
IMPORTANT! TAx
r- ePLEASE READ REVERSE SIDE BEFORE ' ° yCALLING FOR FINAL INSPECTION. AL J r
OFFICE COPY
APPLIC�gNT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
._a
BUI LDI NG PROJECT I DENTI FICATION - -PERMIT NUMBER
6UILOINO� 1� APPLICATION & PERMIT
AGGRESS _ 1 �r'1/{�
10 2 I1J LI✓`i�/ BUILDING -ELECTRICAL-PLUMBING-MECHANICAL I V V 5 6
OWNER'S f1�, PLAN CHECK VA ATION
E QTY. ELECTRIC PERMIT FEE
3 j
�" _ PHGNE255lo� _
IanweRnca'ofls - - OUTLETS SWITCHES-RECEP 10.00/1.00 '
LIC-NO. LIGHTING FIXTURES 10.00/1.00
O.ONTRACTOR
ESS r�'Y- r�+ '-T APPLIANCES-RESIDENTIAL - 4.00 '
O T /
PHONR PANELS 10.00 DATE OF APPLICATION ,
ARCrrTEC �
GR blryY�•1 PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P,QiNO.
ENGINEER
SIGNS TRANS. 3.00
ARCH.OR E PERMIT VALIDATION
A Ess - 1) SPECIALCIRCUIT 5.00
S V -' zIP �) EMP.METER OR POLE INS. 20.00
A o ICANT'S - MOTORS
Z r SEE FEE SCH.
Z
°
SERVICE CHANGE - 20.00 s. N Kiri
0 o LICENSED CONTRACTORS DECLARATION
a u. 1 hereby affirm that I am licensed under provisions of Chapter 9 'A,
z i :. ISSUANCE GATE
Hi Q (Commencing with Section 7000)of Division 3 of the Business and - BLDG. ELECT. ALG. ,MECH.
rn Professions Code,and my license is in full force and effect.
H w .❑ ❑ ❑
License Class Lie.Number _
O w Date Comracmr
Q y'1
a a w a OWNER-BUILDER DECLARATION BUILDING PERMIT
w- 0 a ° INFORMATION .
; . I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD
Hu0¢ Law for the following reason.(See 703 1.5,Businessand Professions VALUATION $/FT.
v,w PERMIT ISSUANCE 10.00 - ~
Code:Any city or county which requires permit to construct,alter,
SC Q
Q 2O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTH. - LIC.NO. - -E LEC.
a_ O u requites the applicant for such permit to file a signed statement that TOTAL PERMIT T
w$ he is licensed pursuant to the provisions of the Contractor's License - gip-/t
HiQLow(Chapter 9(commencing with Section 7000)of Division 3 offlicTc�sCC 7s�jC� t'
i o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE '
a H$ the basis for the alleged exemption.Any violation of$ection 7031.5 STORIES, TYPE CONSTR.
a.
by'any applicant fora permit subjects the applicant toacivil penalty ALTER-DRAIN -WATER IEA.) 5.00
of not more than five hundred dollars(8500).):
❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC: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,AREA,CON D. 5.00
Code:The Contractor's License Law does not apply to an owner of
property who builds or improves thereon,and who does such work F IXTUR ES-PER TRAP S.00 S0.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees,provided that Such improve-
• ' ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1INC.4'OUTLETS 6.00 -
or improvement is sold within one year of completion,the owner
builder will have the burden of proving that he did not build or im- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE
p for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND ' CON -PB I Omer JI
R4, I,as owner of the property,am exclusively contracting with ❑ .❑ 1:1 1:1 ❑
licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 VB800 ASSESSORS PARCEL NO.
and Professions Code:The Contractor's License Law does not apply V.B. .
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 contractors)licensed pursuant to -
theContractor'sLicenseLaw. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT No. PARCEL No.
❑ la xe t tundcr5 ,B.&P.C.lorthis WATER HEATER W/VENT 6.00 �I
reason 1
Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
ORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 ..
.. I hereby affirm that I have a certificate of consunt to self-insure, ZONING ENG.SITE NO.
, '
or a certificate of Workers'Compensation Insurance,or a certified I
copy thereof(See.3800,Lab.C.). - -
Policy No. Company• - ,
' 0 ❑ Certified copy is_hereby furnished. FIRE$PRINK ENERGY T-24
Z Z ❑ Certified copy is filed with the city inspectiot, division. - ❑ ❑. ❑ ❑
O Applicant _ _ MISC.- REFER TO ORD. v N v N
CC w C17RTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10,00 • FLOOD ZONE. A.L.U.C.
ION
W > (This section need not heTcoompleted INSURANCE thepermit is for one PLG.CONT0.
❑ if LIC.NO: PLC
TOTAL _ Y❑' N❑- Y F1 N[_1Z hundred dollars($100)or less.)
ar
V O 1 certify that in the performance of the work lot which this per, QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL 1- not is issued,I shall not employ any person in arty manner so as to
Ow become subject to the Workers'Compensation Laws of California. BUILDING
a Uatc Applicant - ALTER OR ADD TO MECH. 5.00 Q�
} m NOTICE TO APPLICANT: If,after making this Certificate of Ex-
F ? emption,you should become subject to the Workers'Compensation APPLIANCE - 5.00 PLAN CHECK
provisions of the Labor Code, you,Most forthwith comply with FEE -
V such provisions or this permit shall be deemed revoked. AIR,HANDLING UNIT(TO 1QODOCF.M.) .'4.00 ',
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.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 lire work for which this permit is issued(Sec. MICROFILM
3097,Civ.C.). HEATING UNIT(TO 100,000B.T.U.) -8.00
Lender's Name HEATING UNIT(OVER 100,000 B.T.U.19.50
Lender's Address ELECTRIC
1 comity that Lhave 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 PLUMBING
ordinances and state 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 tire
above-mentioned property for inspection purposes. BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL
'
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
upertino against,liab'hies,judgments, costs and expenses which PERMIT ISSUANCE 10,00 CONST.•'TAX
may in n ay a ru age said ity in consequence of the
ra0tin of thi pe it MECH.CONT. LIC.N0. MECH. '•j
�y// `/ TOTAL /F-
IY Si nat re o / / e, TOTAL
V_ g pp t/Con'ac m Det
OFFICE COPY
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