NO PERMIT NUMBERC2 )-3
No.
Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Date 3 a x196-7—
Application
6-7—Application is hereby made for a permit to
a
to be occupied only as
Lot No. 3Si
File No. S /D
Sanitary
story, Type
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimoted Value of Improvements $
FEES p - Plan Check E$ G
Owner Address
Contr. Address
Phone 1 State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
196 FEES
Address
State License
Q-
Approved
-
APPLICATION FOR PLUMBING & GAS PERMIT
196 GAS FEE $ —
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Dare 1% FEES
ti
Contr; Address
Phone State License
.. �'. Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
L
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Data
UNDERFLOOR
Date
FRA MF
Date
LATH 8 PLASTER
Do to
ew. i
Date
ELECTRICAL
Inspector
Inspector
Inspector
Inspector
Inspector
SERVICE SIZE
TERIAL
OUTLETS
TOTAL FIXTURES
FEE
SWITCHES
Date
RECEPTACLES
Inspector
ROUGH WIRING
FIXTURES
Date
H.P. CHARGE
Date
PERMIT FEE
FINISH WIRING
TOTAL FEES
Data
Inspect"
ELECTRICAL
Inspector
Inspector
Inspector
Inspector
Inspector
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM
SERVICE SIZE
TERIAL
UNDERGROUND
TOTAL FIXTURES
FEE
UNDERGROUND
Date
REGISTERS
Inspector
ROUGH WIRING
BLOWER FURNACES
Date
Inspector
Date
Inspector
FINISH WIRING
MISC
Data
Inspect"
Date
Inspector
FIXTURES
Date
Inspector
Date
PERMIT FEE
Inspector
Motors
Date
Inspector
Date
Inspector
FINAL
Date
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM
SIZE
TERIAL
TYPE OF APPLIANCE
TOTAL FIXTURES
FEE
UNDERGROUND
FIXTURE FEE
REGISTERS
PARTIAL ROUGH
BLOWER FURNACES
Date
Inspector
MAIN DRAIN FEE
ROUGH COMPLETE
MISC
Data
Inspect"
STORM DRAIN FEE
MAIN DRAIN
MISC
Date
Inspector
WATER SYSTEM FEE
PERMIT FEE
GAS PIPING
FLOOR FURNACE
Date
Inspector
GAS PIPING FEE
FINAL
Date
Inspector
PERMIT FEE
MISC
Date
Inspect"
TOTAL FEE -
MISC
Date Inspect"
APPLIANCE
TYPE OF APPLIANCE
UNITS
FEE
TYPE OF APPLIANCE
UNITS
FEE
CIRCULATING HEATERS
REGISTERS
BLOWER FURNACES
COMBUSTION VENT
SUSPENDED UNIT
MISC
GAS RANGE -
MISC
GAS DRYER
PERMIT FEE
FLOOR FURNACE
TOTAL FEE
INSPECTED
Do to Ins pector
OFFICE COPY
ELECTRIC SERVICE NOTICE
BUILDING ,INSPECTOR'S OFFICE
CITY OF CLJPERTIN
/ ,...................�
Yo ......... .................1 1967
You are hereby uthorized to con el l e ice fo
' Owner'or Tenant .... ................................l.............
At....................................................7........'.............................................................
No. of Wires ...... .............. Size of Wires ....�..v...... ,Size of Switch's O6.14..
Motor Load ...........1...........
... Voltage ................................ 'Phase ..................................
HeatingLoad .....'................... K. W..........i........................ Voltage ................................
No. of -Meters .......... ........
Light ............... 11o..New Service ................ Reconnect ..............
Heat ................. 220........a.,,,..Move....Service............No. of Add. Meter............Power............... ........... love Meter..............
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I AGREE I WILL NOT VIOLATE ANY OF THE V'ORnMEN S
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I AGREEi,!,,WILL
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Type of Appliance
Units Fees II
Remarks (Check ✓;
New Replace Relocate
Gas Ranges I 11
Wall Heaters
Gas Plates
Circulating Heaters
1 __
Blower Furnaces I l .0011
X
Gas Fired Boilers I
1 1
Warming Ovens 11
1
Percolators 1
-
Griddles 1
I
Steam Tables
Gravity Furnaces 1
IIS- 1
—r
Suspended Unit 1
i _
Floor 'Furnace
Miscellaneous
(NAME. TYPE) I
Iall
Fee
15 Outlets $j -r_ Vr�ntWa
M12
a Htr. VeiKit.
Vont
_L
pp lance -ees I I
I I I
Inspected and Approved................................................................
DATE INSPECTOR
1,
A►•
GAS SERVICE NOTICE oerse;'
COPY'
BUILDING INSPECTOR'S OFFICE:
CITY OF CUPERTIN r�
_..........,.��.���........._.................... 196.l.
You are hereby authorized to connect the GAS
Owner or Tenant
At
No. of Meters .......
for
New Service .........._....
Reconnect ........ ... ---- ..... ....
Move Service .
No. of Add. Meters .............. Move Meter ...... ...... ....... --
P U
_.PLU BIN G INSPECTOR
Bldg. Dep -"---t.
Office Copy
BUILDING .INSPECTOR'S OFFICE
CITY OF CUPERTINO
Sewer Connection Sanitary Permit No.
&0 1 "Plumbing Final Plumbing Permit No -,l
� Lot No.
{G ..................
Owner or Tenant
At
Tract...............
Date Connected ...............
Date Final ---------------------------
ill 141�7664M
............. 19(
............................
. ... .......... ...................
INSPECTOR
CERTIFICATE -OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
w^ ,�r�
Date ..... aJ F.... " .... 4.,.-„ 19.6 ... Buildin Permit No.✓! !�.`..
The Building Located at �.�-Y�"�"
.�.� iced'
Ownedby ........! n>kG......f wcs...t.......... :.<.............................................................
Has Been (Completed)
Por Use As:........ l
....._.........-•'-.................-'-......................................
4.
..............................._........ _......-...............
BUILDING INSPECTOR
102 12/66 -IM ,' .
n
JL
ROUTE SLIP
File No. S / DOl Z—
Date Out
Date In
Location 6 2� 3 G
Notes
Approved' q'%ZQ '67
Date
Inspector
To
You are hereby
Owner or Tenant''..
At ......Z`:�
No. of Wires ....�.?.
V . N OFFICE COPY
ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTIN
196. 7 s96.7
...... Size of Wires ._ .. +..... Size of Switch -PQJ` ..
MotorLoad .......................... Voltage ... ............... ....._._--- Phase .......................... ._.-
HeatingLoad ........................ K.W...... .................... .------- Voltage .--- ... ... I ......
._.... .
Light....... 1 U.. f New Service'. Keconnect.................
No. of Meters......:.. 1.........
Heat ................. 220....,�� ree ire ..... ...... Move Service..........
No. of Add. Meters............ 1
Power ............... - se.._j.. .... Move Meter..............
ELECTRICAL INSP2LTON`