NO PERMIT NUMBER Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. ,. 1671
Sanitary No. T,/
Date �O 196
A plication is hereby made for a permit to
a story, Ty s z J
to be, occupied only,as
in'accordantVwith plot plan, plans au4f Specification filed herew
pEstimated Value of Improvements $ eZ(0f Od 0 tYo
FEE$ t? ( va Plan Check $
OwnerAddress a I-
Contr, Address
Phone P257-/// co State License 'J-/ 79�
Approved
qg�/ APPLICATION FOR ELECTRICAL PERMIT
Data �/ 196 7 FEE$ Pd 6a
Contr. 6cia"C""j Address 9a-5-144,
a
Phone 73(G - d � State License /2],,�
Approved F
uAPPLICATION FOR PLUMBING & GAS PERMIT
Date //� 196 GAS FEE $
�,/J� PLUMBING FEE $ .,_3
-ontr, VG-�-.J �L Address.-,/�2 .? Y 1��-.'_7,.�f✓
Phone State License 6S 7 d
Approved
APPLICATION FOR APPLIANCE PERMIIJ
)a to f 1 196 T FEE$ /�,py.'�y S'
:ontr, Address 1'jd /✓ '�'."�"'----�
'hone State License 1/
Approved
Ipplicant,s agree not to violate any of the
Vorkman's Compensation haws of the
"tate of California
RECORD OF INSPECTION APPROVALS
FOUNDATION J BUILDING e
D e n paetor
UNDERFLOOR
0 a� , Inspector
FRAME
Dote n pector
LAT & PLASTER d'
y-Poe
ector—
FINAL C
Data Ins as c tar
ELECTRICAL
,OUTLETS SERVICE SIZ
SWITCHES UNDERGROUND
` �/ Inspector
RECEPTACLES ROUGH WIRING lQ 9�
1 I eta Inspector
FIXTURES FINISH WIRING _—
ate ns pactar
H.P. CHARGE FIXTURES v
DataInspector
PERMIT FEE Motors
1 2 - a1e b Inspector
TOTAL FEES FINAL r
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH 6
aten r
MAIN DRAIN FEE ROUGH COMPLETE/0-
DA d or
STORM DRAIN FEE MAIN DRAIN
Data I or
WATER SYSTEM FEE GASP G :S
Dote p r
GAS PIPING FEE FINAL - 7
Date Inspector
PERMIT FEE MISC
Date Inspector
TOTAL FEE MISC
Date Inspector
A
TYPE OF APPLIANCE UNITS EE TYPE OF APPLIANCE UNITS FEE
CIRCULATING NEATE RS REGISTERS
BLOWER FURNACES COMBUSTION VENT
SUSPENDED UNIT MISC
GAS RANGE MISC
GAS DRYER PERMIT FEE
FLOOR FURNACE LTOTAL FEE
INSPECTED
Date Inspector
OT NO.-
NO. STREP�T'
� ` �APPLIC TION FOR BUILDING PERMIT �io9 a
= a
CITY OF CUPERTINO
T C l
Y ,
o a Sanitary No.
U F X67 ` ,�196� Permit No.
u:ue �SF«
0
4 w Application i(s�hlereebx madefora permit to
i In a C!T Or s�dFyrTY �I't1 /e� Building
at(�be occupied only as Jii�� r in accordance with
0 o Plans, Specifications and Plot-Plan/filed herewith. PI Ck Fee
"; Estimated Value of Improvements, S.- Fee
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J Z all other laws applicable to the construction, location, and use of buildings within the City of
d O Cupertino will be complied with.
3Q
Owner Address
w Z lam'
Address J?M'� lylyz
Phone
a u PhApproved
11 State Licens BUILDING INSPP.CrOR
K
`ROUTE MIP
File No .
Date Out >a-z�-67
Date In
Location
Notes
Approved /Z- 2m'67
Date Inspector
!i
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY OF }CUPERTINO
Date ........ 1� . '.-.1-......�. .... .................... 19 : Build' g Permit No.��1d I
J ...
The Building.Located at ' ..:........1X..... .--............. .............- -..--... ...-.......f.-....--...
Owned by -..11?.t :......................_ ..--..........1.,A :�`�g..�
Has Been (Completed) For Use As: ....-�f.- !4n
.......................................................................... ........................... .......................... .......
... ........................................................................... .....................................................
............. ..................:........-.............:........... '
BUILDING'INSPECTOR-•' .
102 12/66.1M
OFFICE COPY
(\ ELECTRIC SERVICE NOTICE
Ct BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
S ..........................1;:v::.-. ......... 19E;E..
To (� l
You are hereby autNotvfe to-con p electrical service for
Owner or enant ""r -toc J t_
At .......................... .b...... w aL]L ...: . ._:.......,.......
` No. of Wires .�.............. Size of Wires�:.� ,........ Size of Switc4 .i,;).Q./"(:...
MotorLoad .......................... Voltage ................................ Phase ..................................
HeatingLoad......................... K. WW.. .................................. Voltage .........................:......'
{ .... Light..✓......... 110./New Service.. ............ Kemnnect...............
...
No. of Meters.......`.......
Heat................ 220.... ... Three 24
e.............. Move Service..:.........
No. of Add. Meters............ /
Power............... 24............. Move Meter..............
BLaC'riuCAL INSP CTOa .
GAS SERVICE NOTICE OFFICE
COPY
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
..... ... . ..../C:;:?
... ................... 196......
TO
You are hereby authorized to connect the GAS service for
Owner or Tenant ....*Z . ..... ........... ......
At .. ......
ssal . ..........................
New Service ...........
No. of Meters ............... Reconnect .............................
Move Service .......................
No. of Add. Meters ..... Move Meter ...................
...................
PLUMBING INSPECTOR
Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
❑ Sewer Connection Sanitary Permit No:
[],_*flu r mbing Final Plumbing Permit No
Lot No. ........a---------------
Owner or ----
--
Tenant ----
-------- ----
- -- ------- ---------------
At
Tract ........
------------- ----------------------------------------- ................
DateConnected ----------------------/ .......................................................
DateFinal ........................ ......................................................... 19.6Z
..................
PLUMBING INSPECTOR
111 12/66-IM-,
ROUTE SLIP
File No. _ /� 7,
Date Out
Date In -S'— 7 _
LGcaticn �� S�
Y
Subiec,.t �
Notes
Approved if S—d 7
Date Inspector