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15240 POST THIS CARD NEAR:FRONT OF BUILDING PERMIT NUMBER CITY.-OF CUPERTINO 15240 _ 'INSPECTION DIVISION JOB INSPECTION RECORD - t• PERMIT EXPIRATION + 1 JOB ADDRESS •914 Liberty. Court UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER Larry Dick - CONTRACTOR - IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMITASSU- FOUNDATIONANCE OR 180 DAYS FROM NOTE:. - - LASTCALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED ' TO COMPLY WITH THE APPROVED PLANS AND CIN OF PERMIT VALIDATION PREGUNITE CUPERTINO STANDARDS. - GARAGE SLABS - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED LINDERGROUND1SLAB -' PLUMBING ELECTRICAL PNS ISSUANCE DATE ` MECHANICAL - >G ELECT : ..PLGMECH. ❑ 0 ❑ ❑ ' DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED -. p�,,,(�� BUILDING PERMIT WOOD FLOOR t - pjN Y7 INFORMATION VALUATION • `y5/F T. PLUMBING �� - � - - � �� - • a J MECHANICAL - FFR91T To ELECTRICAL - FRAMING ,.._�+ STORIES TY_PE.CONSTR. ' INSULATION - OCC GROUP RES UNITS '— PLACE NO SU BFLOOR UNTIL ABOVE HAS BEEN SIGNED ` - $O.FT,FLOOR AREA TOTPI-ACREAGE ? ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM - THE CONSTRUCTIONTAXIS PAID ',:� _ - BUILDING USE ROOF SHEATHING RES IND CON PR om.r r APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS .DATE INSP. ❑ ❑ - 0 ❑ ❑ ASSESSDRS'PARCELNO. ''ROUGH SAN.A PLUMBING ELECT.ENERGY - TUBS&SHOWER PAN - PLUMBING ENERGY - - TRACT NO. PARCEL No MECHANICAL MECH.ENERGY ACC,DATE - ACC FILE NO, ELECTRICAL BUILDING ENERGY FRAMING - ELECT.FINAL TEST ' INSULATION PLUMBING ZONING ENG.SITE No • . GAS'T.EST GAS MECHANICAL FIRE SPRINK ENERGY T 24 Y N Y .:N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING � EXTERIOR SHEAR ELECTRICAL RELEASE FLOODZONE , A.LA c. INTERIOR SHEAR , - FIRE DEPT. Y E] N� Y ❑ NE] Ex SHEETROCK -� - GRADE FEE SUMMARY EXTERIOR LATH r__21AS BUILDING BUILDING INTERIOR-LATH - - TEMPORARY APPROVALS 74h SCRATCH COAT - ELECTRIC PLAN CHECK FEE _ GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - .SEISMIC FEE �} OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDINGINSPECTOR. MICROFILM 1 ARRANGE FOR INSPECTION BY PHONING 252-4505,• ELECTRIC F_ ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING - !u 1 O� PLEASE GIVE JOB ADDRESS WHEN PHONING.. - z t. MECHANICAL ' +' •✓ - SEE PERMIT FOR EXPIRATION DATE - ' -IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE ° CALLINGTOTAL.FOR FINAL INSPECTION. - OFFICE COPY l9v ,Ip 1)4 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY BU LDING PROJECT I DENTI FICATION - -.PERMIT NUMBER RUILOINGAPPLICATION & PERMIT 15240 Woos Ess I-/I L( I eY"fy BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S A PLAN CHECK VALIDATION NAME �,.• a,..k TY. :ELECTRIC PERMIT FEE Mr +Mr Drs LAV' RE SA 90 CONTRACTOR'S - / - _ NAME UTLETS-SWITCHES-RECEP 10.00/1.00 N"S&4 •4 yhLOMRGL l v IKc G3;0-1'3�. LIc.NO. (Q LIGHTING FIXTURES 10.00/1,00 CONTRACTORS LoS Gk PPLIANCES-RESIDENTIAL 4.00 ADDRESS I 31 } • 4R^�fA C0.Vz .PHON;5'r}-°°OS PANELS 10.00 DATE OF APPLICATION ORRcmTECT - PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.INO. ENGINEER V• /Md I— .l�/r rte- sea No. SIGNS TRANS. • 3.00 Woo ESS ena. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP ITEMP.METER OR POLE INS. 20.00 APPLICANTS ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 - >F woo LICENSED.CONTRACTORS DECLARATION, a i u' I hereby affirm that 1 am licensed under provisions of Chapter 9 ' MSSUANCE DATE 4 a (commencing with Section 7000)of Division 3 of the Business andV�k BLDG. ELECT. PLG. MECH. H " Professions Code, d_m license is in full force of ct. ❑ ❑ License ass LIC.Numher Date Contractor - ¢ y2, BUILDING PERMIT pp``��fI le M 4 OWNER-BUILDER DECLARATION y1W o a ° MISC.— REFER TO ORD INFORMATION w g;w y I hereby affirm that I am exempt from the Contractor's License VALUATION $/FT. F m m j Law for the following reason.(Sec.703 1.5,Businessland Professions PERMIT ISSUANCE Fo.00 d �� p�p��,s Code:Any city or county which requiresa permit to construct,alter, ®V o ac a,¢ improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. /''eD - wO u requires the applicant for such permit to file a signed statement that TOTAL,O?U PERMIT Tppp��TTT m he is licensed pursuant to the provisions of the Contractor's License / rid Law(Chapter 9(commencing with Section 7000)of neision 3 of the 4 a Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE ¢ o by basis for the alleged exemption.Any violation ultoarSection 7031.5 -STORIES TYPE CONSTR. n;m by any applicant fore permit subjects the applicant ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars($500)J: ' ❑ I,as owner of the property,or my employees 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 1 Code:The Contractor's License Law does not apply to an owner of - property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 0 50,FT.FLOOR AREA TOTAL ACREAGE , himself or through his own employees,provided that such improve. me nts are not intended or offered for sale.If,however,elle building .GAS-EA.SYSTEM-,l1NC.4OUTLETS or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.1 2.00 BUILDING USE / builder will have the burden of proving that he did not build or int prove for purpose of sale.). - RES IND CON PS Other U I,as owner ol'the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 ❑ 0 ❑ 0 ❑ licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V:B. 6.00 ASSESSORS PARCEL N0. 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-OVER 5(EA.) .1.00 contracts for such projects with u contractod s)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.&P.C.for this WATER HEATER W/VENT 6.00 • - reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC,FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self-insure, ZONING or a certificate of Workers Compensation Insurance,or a certified ENG.SITE NO. :ip copy thercoi(Sec.380_o �fhfllc pu)ND . Policy No191A}L7 Co1APany O ❑ Certified copy ishereby furnished. FIRESPRINK ENERGY T-24 Z Z Applicant - V N V W Certified copy is filed will, the city inspection division. MISC.- -REFER TO ORD. O N LU Fm CERTIFICATE OF TION PERMIT ISSUANCE - /�'~ FLOOD ZONE A.L.U.C. EFROM WOWORKERS'W > COMPENSATION OMPENSAATIOTIO N dittheINSURANCE PLG.CONTR. LIF NO. PLG. / ' YE] N� YQ N❑ � Z (This section need not be completed if the permit is for one TOTAL Imoulmd dollars(S 100)or less.) ) O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY 'U. P mit is issued,I shall not employ any person in any manner so as to Ll become subject to the Workers'Compensation Laws of California. O Qom_ i BUILDING Dmc Applicant ALTER OR ADD TO MECH. 3;00 } N NOTICE.TO APPLICANT: If, it,,making this Certificate of fix- F ? emption,you should become subject to the Workers'Comptaxation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F.M.)- 4.00 �— CONSTRUCTIONLENDINGAGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE % 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. HEATING UNIT IT0100,000 B.T.U.)• 8.001MICROFILM 3097,Civ.CJ. �9 Lender's Name HEATING UNIT(OVER 100,000 B-T.U.)9.50 ELECTRIC esoCs�J! Lender's Add,", _ I cerify laid l 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 county PLUMBING ordinances and state laws relating to budding construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 r hereby authorize representatives of this city to ender upon the BOILER-COMP lover 100,000 BTU)SEE FEE SCH. - ,MECHANICAL uv- above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep Imnnless dile City of Misc.- REFER TO ORD. upertino a islities,judgments, costs and expenses which .CONST.TAX ay in y against said City in consequence of the PERMIT ISSUANCE /a a go MECH.CONT. LIC.NO. MECH. �c - as f) TOTAL /0^ TOTAL �94� I eo pIicant/Contractor D to OFFICE COPY