51167 T . .
��s r Lot No..240'
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. 116
/w Sanitary No. ✓ yd 3
Dote 196
Application is hereby made for a permit to
C--*� a story, T pe �-
to be occupied only as
r
in accords with Plot Plan, Phan. d Specification filed 61.im.
Estimated Value of Improvements s 584, odd°-tl
FEE$ �.'j Sb Plan Check $ '�a• 7�
Owner 9!SIZ Address 2
C ontr. Address
Phone 2? 7���� t7 State License 1,12791
Approved -�
APPLICATION FOR ELECTRICAL PERMIT
oZ3 v
Date /� 196 FEEs G
Contr. Address 9'2 5-
Phone 7.;,; State License 512- cle�L L
Approved `
/
APPLICATION FOR PLUMBING & GAS PERMIT
Date � L 196 '7 GAS FEE $
PLUMBING FEE $ 02,S
Contr. Address /1- 3 u L lb'""
/ T
Phone —2-3 i.3 State License/ i � 79
Approved - v��`-�/•� <-�'l
Date 1%PLICATION FOR FEE�IANCE�ERMST
Cont,, ``t' 16� , Address �/-'3(3
Phone •L_/ 1 - n T/(� State License
Approved _
Applicants agree not to violate any of the
Workman's Compensation Laws of the i
State of California
t
d i
RECORD OF INSPECTION APPROVALS
�O _ 7 BUILDINd
FOUNDATION
D pector .
UNDERFLOOR
D_ate Ins pe
FRAME _ 6
e 6 Ins ctor
,�rD
LATH 8 PLASTER ))" _
e / ctor
FINAL lD
Date & Insoector
ELECTRICAL
,OUTLETS
SERVICE SIZ
SWITCHE UNDERGROUND
i T 1
RECEPTACLES ROUGH WIRING $' 7 (4:o-1 Inspector
ata Inspector
FIXTURES FINISH WIRING
H.P. CHARGE FIXTURES LAS
a Spector O
Date Inspector
PERMIT FEE Motors
11o_te Ins actor
TOTAL FEES FINAL ����
Date InspecNor
Z PLUMBING & GAS
MAN ORA N SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUG —
Date for
MAIN DRAIN FEE ROUGH COMPLETE
STORM DRAIN FEE MAIN DRAIN — 9
ate r
WATER SYSTEM FEE GAS PIPING
pq� n etor
GAS PIPING FEE FINAL -26 —67
ata� tor
PERMIT FEE r r o "
Dote Inspector
TOTAL FEE MISC
Date 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
FLOOR FURNACE TOTAL FEE
INSPECTED
Do to Inspector
TEMPORARY! G,�AS SERVICE
DATE: .......�/.' .� / �?... _ ...............
Fee:
W 1 s<
......
OW
d NER: :;V r! ...' ' """""""""""'............................. ..
O
LOT: . �:�+f7 -._ ._- . ...............................................................
CRT-
REASON:
REASON: . ...... ---e..._ . ........
.........
The undersigned agrees to be responsible for the gas service at the above location,
until the building is ready for occupancy, and is released by the Building Department,
City of Cupertino.
Phonec .....J...... .. ....................
........
,. L ..........
INSPECTOR TENANT OR OWNER
117 1/63-500
ROUTE SLIP
a
File No. �/ I
Date Out 9
Date In _ q—fj -4
Location
Subjeat
Notes
Approved 3�6
Date Insp:cto`
OFFICE C Y ril
ELECTRIC $ERYICE -NOTICE
C . BUILDING •INSPEC"fOR'S OFFICE
CITY OF CUPERTINO
To
You are hereby auth 'zed to ct e ectrical service for
Owner or Tenant ........ . .. ........ . .. . .. ....
At vll_
n
No. of Wires .......�..__----- Size of Wires Size of Switch
Motor Load ._....................... Voltage .................._............ Phase .............................
Heating Load ........................rK. W. ..... ............................ Voltage ...............................
.
Light................ I10......_.... New
S rvicr_.............. connect....._......_.
No. of Meters.......�............�
Heat................. _0............ Thr, Wire.... ....... ...
No. of Add. Meters............
Power........ ..... Thr az_e... ..........filove Meter..............
......... ................
- ELECTRICAL INSPECTOR
iROUTEi SLIP
File No :
Date Out /
/ Date In , T—
Location
Subject , � (
Notes
I
Approved_9�/Z
Date Inspector