FILE 51167.1 Lot Nal Z
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. ���IL � I
c Sonita ry No. "" �7p
�J
Date 7 42
7 196 _.L_
Application is hereby made for a permit to
i
a eZ story, Ty v.f_ r V
to he occupied only as
in accordant ith Plot Plan, Plans aSpacification filed her
Estimated
C� Value 'of Improvements s C;2 . lid O Owe
FEES Plan Check $ qq �I--
Owner Address .Q.y;/ s ,& 0
Contr. Address
Phone o r-7 State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Data9-T 2°-- 196 FEE$ , 3 SS
Contr. ,�alV-'Ls-'J Address
Phone 7'�"(' -S�`1'/ State License F�'Z �
Approved v�" .��
APPLICATION FOR PLUMBING & GAS PERMIT �� 00
Date _ 196 GAS FEE $
/ / PLUMBING FEE
Contr. Yee,-.J(/�t/t/ ' Address
Phone S- a ; Z 3 -- State License
Approved
APPLICATION FOR APPLIANCE PERMIT S�
Date �d 196 FEES
i
Cantr. l/.C.+"//^ i�.C.-r-c,/�/�`t'Z.'-� Address
p
Phone -� 7 rState License e 2 G �L
/ s
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the �
State of California
RECORD OF INSPECTION APPROVALS
BUILDING
FOUNDATION
UNDERFLOOR
D - Da 0, Inspe p
J G
ota In• ecf
FRAME _
at _6
LATH PLASTER
D top c o
FINAL �
Date Ins as ctor
ELEgTRICAL
,OUTLETSMr'�" SEL 51
0211
SWITCHES UNDE NO 0
o� Ina ecf or
RECEPTACLES ROUGH WIRING
Date, Inspe
FIXTURES FINISH WIRING 6
DQtq 6,) sector
H.P. CHARGE FIXTURES L6
De•- _ Impactor
PERMIT FEE ors
TOTAL FEES FINAL
2-D -f7 nspac -
Date Inspector
PLUMBING a GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date ns
MAIN DRAIN FEE ROUGH COMPLETE
Do fA
STORM DRAIN FEE MAIN DRAIN + —
D e
WATER SYSTEM FEE \ GAS PIPINa'�2 15p
Data
GAS PIPING FEE FINAL
DateSpector
PERMIT FEE MISC
ata nspec for
TOTAL FEE MISC
Data Inspector
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 Ld
FLOOR FURNACE ' TOTAL FEE
INSPECTED
DatenS pector
1
1.
ROUTE SLIP
File No.
• Date Out
Date In —6
Location
Subject
Notes
App rovedl
Date Inspector
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY 0y17 CUPERTINO i// ��rr
The BuildingLocated / 19fo 7 R. Buildin Permit No.�; / R..71
Owned by ...... ..-.a.:+SAIt!;x::.......... ......:..:...:.........�i^'�. �V_�.. ---
(Completed) /
Has Been (AY w�d} For Use As: ...... p.It...............................:... .. ....
..........................: ..:.:..:.............. .. ...............1............. .. .. .............--... -- .........
v
........::................. ........................................ ..........:....:..........................................................
BUILDING 114SPECTOR
102 ,12/66-1M r
GAS SERVICE NOTICE OFFICE
BUILDING INSPECTOR'S OFFICE COPY
/ CITY OF CUPERTINO
1 ..... .............. 196. 7
To
You are hereby authorized to. connect the GAS service for
�G..x
Owner or Tenant ...: . -... . .
................................................
At ........ .. �. .... ��, .................... ...... .........................
New Service .�.....:.......
No. of Meters .: ..........:.. Reconnect ..::....:... .
Move Service :......................
No, of Add. Meters .............. i Move Meter .................7.......
................ ...... .. .. . .........
PLUMBING INSPECTOR
+ Bldg. Dept.
Office Copy
BUILDING ;INSPECTOR'S _OFFICE
} CITY OF CUPERTINO
❑ SewW Connection Sanitary Permit No. &.t!�.Of.........
&/P P' al Plumbing Permit No&//b/x/-.
Lot No. ./W/.................
Owner of',Tenant ----------- .. .... .......
At ..J- . . . . ......G... .
'...............'
.........................
Tract ............ . .. ..>°e. . . ................?:......... �-..................-............-.........
a
DatConnected D - .......................:.............
Date al ................... . ..;/1
19�G.7
PLUMBING INSPECTOR
111^ 12/66-1M ,"!'
ELECTRIC-SERVICE NOTICE' qFFICE COPY
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
/W.-.7%.........0.14.... ........... 196.17.
To,
You are hereby thor' d to nect electrical service for
Owner or Tenant .....
At. .....IMP.......
No. of Wires .....15.............. Size of Wires -,
Size of Switch,/.O ............
Motor Load .......................... Voltage ................................ Phase ............. ....................
HeatingLoad ........................ K. W.........I............. .... ....... Voltage ..............................
No; of Meters..... h Reconnect:....:...........:Lig, ..... Them Wire..'.'....:.'..: Move Service.........._
No:of Add. Mete1.::::,:�,::: Heat..
Power.............. Phase.. ......i.. Move Meter.........._..
.................. ............................... ......-------- -- -
?,.a; BLECT CAL.I.NSPECTOR
ROUTE SLIP
File No.
Date Out y 7
Date In
Location _$Z
—
No't e s 97, C --
Approved�'7 Z
Date Inspector
��✓/`// ��.�il!/�.S'/ �L�W LOT NO.'�.1�
NO. ST EE 1131 4,4
—
waPPLic�AT?Ell, FOR BUILDING PERMIT
s ° Y
OF CUPF.RTINO
Y 4
U. fSEP 6 1967 Sanitary No.
w Uare (L{l0 .�1� 19612 Permit No. ��¢9
LL
CATYlicP is rAF a ®ra permit too n ✓JUT
a
i N a story,Type '�Illll Building
aW
w to be occupied only asQylzl zi///�-til,U in accordance with
o o plans, Specifications and Plot-Plan filed herewith. PI Ck Fee
"; Estimated Value of Improvements,g�'�d/D Fee S A�OO
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* Z all other laws applicable to the construction, loraaiun, and use of buildings within rhe City of
d 0 Cupertino will be complied with.
�
3
_ m Owner — Address
rc a Bye i/c -- Address
_U Phone. el'--llle9 Approved
State LICenS ?I
BUILDING INSPP.CTOa 1/