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51241.2 I 4� a 10216 _I Camberley Lane Lot No. 121 No. Street 1.89 CITY OF CUPERTINO APPLICATION FOR BUILDING PERMIT Sanitary No. 8918 BF File No, 51,241.2 Date 1/10/74 19 Application is hereby made for a permit to Construct (502-B) a 2 story, T yon 5 I J to be occupied only a.c Single Family Dwelling (Townhouse) in accordance with Plot Plan, Plans and Specification filed herewith„ Estimated Value of Improvements $ 27,000 FEES ph 00 Plan Check $ Owr,ar Deane Projects Inc. Address 617 Veterans Blvd. RWC Contr. Address Phone 364-2990 State License B-1 256178 255-2575 Approved James H. Sisk/h APPLICATION FOR ELECTRICAL PERMIT Date 19 FEES Contr, Address Phone State License Approved APPLICATION FOR PLUMBING & GAS PERMIT Data 19 GAS FEE $ PLUMBING FEE $ Contr. Address Phone State License Approved APPLICATION FOR APPLIANCE PERMIT Data 19 FEE$ Contr. Address Phone State License Approved Applicants agree not to violate any of the Workman's Cnmpensation Laws of the State of California PD-1 RECORD OF INSPECTION APPROVALS BUILDING DATE I PECTO MISC/I PAD FINAL FOUNDATION a• UNDERFLOOR FRAME 0' LATH 8 PLASTER GRADING FINAL FINAL BLDG. O ELECTRICAL DATE G IN OR MISC. UNDERGROUND ROUGH `—1 ROUGH WIRING ' FINISHED WIRING k'3 FIXTURES MOTORS— FINAL OTORS FINAL PLUMBING, GAS & APPLIANCE DATE INSPECTOR ,�^ MSC.. BACK FLOW REQ. /-5/V SANITARY0 ftl iSL UNDERGRO '7 ww— PARTIAL ROUGH ROUGH COMPLETE MAIN DRAIN— FINAL RAIN FINAL PLBG. FINAL GAS ova _7 FINAL APPLIANCE DATE INSPECTOR '� MISC. MISC MISC MISC G � m w m � 4 A O m 1 n m n o O G °J- 2[1 ZD G)>Fo z m N O m� 0 ~ 0 3 m 00 A T� Z Z m �\ O 0-- z N 0 ROUTE SLIP Isle No . Date Locat'_o i /— ✓fie -,tip �.� (J Sa^ e c t � _rotes A^Droved —® �• Date Ir_sgec�;or m N s b N n a` t T q-e•,4 � n z - a e � V O m 0 o c o a c w � w \ 7T o N n CA 0 � � k A n t 'ro 2 V F n M I li i m n . \ / � } � � \ 4- � m � ��/ ( �[ § & . Q4 I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S COMPENSATION LAWS OF THE STATE OF CALIFORNIA. { � / ( ( \ { / { � / ! \ { 0 \ \ ) � s ; 4 [ _ � � 7 10 / § { k ( ® � 3 \ \ t \ � q § f \ . / 6 ] f \ [/ § ; > ! / > � m0 | | El ; f � ! ° 70 • / ' a Fr \ ' r § « ® ( 0 , & k k | § _ .0m ) ( i ( 2 . imf , § \ \ ; . / k /\ ( cn ' &�» 3C4 } � , ,20 a' z / \ ) « ; W ! ¥ ; # \ ° / OD Ln n / %{ oZ R � & z; ° | E ƒ 2 [ ^ , j � / 2 } \ ; ! ■ (§ . § 0CL § ! ; ! & , ma SL k m Q / } ! I� } i ƒ/ § d : ! \ 2 F /i\§ \/ \ m $ - ` � 82 � & 2`66 t l � mk B > \ . ( /� ®o p : ( o ' z la t © / \ 2 ~ � /\ / T m Q _ CL } } ( � — ! PLAN 502 ITEM NEW RPL FEES Number of Outlets _ 7 Number of Switches �O Number of Receptacles �• Number of Fixtures 0.5" } Ranges or Ovens K.W. 00 Size of Main Service 0 U Number of Meters Number of Panels • 0 Signs•Transformers Dryers Motors: H.P.Phase H.P.Phase H.P. Phase Power Poles Misc. Permit Fee •• D harges Total Fees ULA to s � a p 9C O 0 All, CL D m F J a 33 -a f o a A Fv Fr ti 5< o D 9f os" s OE Fr n N < a 6 6 o f R N , ^ Z y m OOoTO . S TD i Q r m m a� m Z 3 "- m � � 0 y J o O m o ^� dao D 0 3 3 0 0 b^ T Ta O JC ] J ry N Q Z m D Z p a o ^ O N ^ N J o =D P m p IF Soz_ FIXTURES NUMBER MAIN DRAIN Units Fees Units Fees Water Heater /,$"p Size Water Closet ,] Material Bath Tub / To Curb Shower / I� p To Prop.Line Lavatories To Existing Kitchen Sink / .SO Not Conn. Dish Washer Waste Disposal Wash Tray STORM DRAINAGE Washing Machine ,SV Size Water Softener Material Bar Sink To Moi n Drain Comb.Sink&Tray To Curb _Dental Unit Drinking Fountain Floor Drain WATER SYSTEM Hopper Size Restaurant Sink Material t Sand Trap TOTAL FEES Urinal Fixture Fee Area Drain Main Drain Fee S'�00 Water Leader Storm Drain Fee Sprinkler System Water Sys.Fee „{p Relief Value Gas Fee Vac Breaker Skimmer Filter Pool Sweeper Permit Fae �.,p0 Total „{p Total Fee 6,S"O T m s 9C O � � � ° 3'e•. O O O � n � Ao � a m m P5 N — O O. S r ~ ° m z a N z m y 0 y 9 N < v n as of aT Z -a 0 n'o a 1 o m a t0 ,•°..0, D y m NKo m STC a m D Z. 02 m �.� n O T m y •�. n O m , 0 3 Q> � n 0 � n m � O m V Z Z o v N• 4, o � � ". opo APPLIANCE UNITS FEES 1)FORCED AIR OR GRAVITY FURN.TO AND INCLUDING 100,000 B.T.U.b- 2)FORCED AIR OR GRAVITY FURN.OVER 100,000 B.T.U:S 31 FLOOR FURNACE 4)5 IDED,REL,WALL,FLOOR HEATER 5)INSTALLATION OF APPL.VENT 6)REPAIR OF,ALTERATION OF,OR ADDITION TO HEATING APPL.,REFRIG.VNI1,AB50RP.UNIT, COMFORT HEATING,COOLING,ABSORP.,OR EVAP. COOLING SYSTEM 71 BOILER OR COMP.TO 4-HP.ABSORP. SYSTEM TO 100,001 B.T.U:S B)BOILER OR COMP.TO 16-HP.ABSORP.SYSTEM 100,000 TO 500,001 B.T.U.'S 9)BOILER OR COMP.TO 15-HP.10 31-HP.AB ORP. SYSTEM 500,000 TO 1,000,001 B.T.U.'S 10)BOILER OR COMP.30HP.TO 51-HP,ABSORP. SYSTEM 1,000,001 TO 1,750,001 B.T.U.'S 11)AIR HANDLER 10,000 CU.FT. 12)AIR HANDLER OVER 10,000 CU.FT. _ 13)EVAP.COOLER PORTABLE 14)VENT.FAN CON.TO SINGLE DUCT 15)VENT.SYSTEM NOT A PART OF HEATING OR AIR CONDITIONING 16)MOOD-MECHANICAL EXHAUST 17)DOMESTIC INCINERATOR IB)COM.OR INDUST.INCINERATOR 19)EQUIPMENT NOT COVERED BY THE ABOVE PERMIT FEE TOTAL FEE