NO PERMIT NUMBERLot No.
No. Street y
APPLICATION FOR BUILDING PERMIT j
CITY OF CUPERTINO �j
File No. SI`1
Sanitary No. K/9Idle�
Date 3 3 196 7� .
Application is hereby made for a permit to
a / story, Ty v
to be occupied only as 041
in accordanlf with plot Plan, Plans 407pecification filed herewitO
Estimated Value of Improvements
FEE$ &7 "M �
Owner � �i/%�
or
Contr.
$ .Z.i
Plan Check $
Address er�
Address
Phone State License /47 7
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 3 196—% FEES .ZO S�
Contr. Y'V Address 9-7,�
s
Phone ^7 3 G J oZ � State License
Approved L'-
APPLICATION FOR PLUMBING & GAS PERMIT
Date 3 / G 196 Z GAS FEE E
PLUMBING FEE $
Contr. t/` 44e 3
Phone t22 9' 1 23 A-3
Address
State Lic
Approved
APPLICATION FOR APPLIAI
Date �3y^ v 1% FEES /''fo
Contr._ 1/ p "ct— Address 13
Phone �,`—� 9� ^"" State License �oZ(o
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the -
State of California
RECORD OF INSPECTION APPROVALS,
/
FOUNDATION -e% BUILT
UNDERFLOOR
FRAME
LMea
ATH PLASTER
FINAL /i ��a!
Date ins oe cto,
ELECTRICAL
,OUTLETS /i
SWITCHES -1-
RECEPTACLES(
Y
/3
FIXTURES
J
H.P. CHARGE-
PEWMIT FEE
TOTAL FEES
ti
UNDERGROUND
V SI
�3�
�
ctor
ROUGH WIRING
�'D
e
1 Spector
FINISH WIRING
Pit
pector
FIXTURES-
All:
Date
Inspector
Motors
-
-
I spa ttor
FINAL
Dote Inspector
PLUMBING & GAS
MAIN DRAIN
SIZE
MATERIAL
STORM DRAIN
SIZE
MATERIAL
WATER SYSTEM SIZE
ITERIAL
TOTAL FIXTURES
a3
UNDERGROUND
FIXTURE FEE
PARTIAL ROUG �?'
MAIN DRAIN FEE
�O�
Date
ROUGH COMPLETES ----:-?-
n
STORM DRAIN FEE
MAIN DRAIN
or
WATER SYSTEM FEE
S '♦!
Date
GAS PIPING -9
l/Inectyr
GAS PIPING FEE
/
to
FINAL
� ct'r
PERMIT FEE
p% A
Dote
MISC
Inspector
TOTAL FEE
Date
MISC
-Inspector
Dote Inspector
APPLIANCE
TYPE OF APPLIANCE
UNITS
FEE
TYPE OF APPLIANCE
UNITS
FEE
CIRCULATING HEATERS
REGISTERS
BLOWER FURNACES
o2 `r-"
'COMBUSTION VENT
SUSPENDED UNIT
MISC�'¢'�
�ry
GAS RANGE --
MISC
GAS DRYER
PERMIT FEE
j2i-
INSPECTED
Date Ins pa ctor
NO STREET LOT NO
;,.C'IT�f'"O l9VPIFd1INp -CITY OF CUPERTINO
APPLICATION FOR PLUMBING PERMIT
Date .''rv_
�r
Application is hereby made to the City of Cupertino
Pipes and/or` fixtures listed on the reverse side hereof,
'.;and/or fixturesin accordance with the provisions of th
e
StateLicensew Approved to C�e✓s
Plumbing Inspector
j; I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
0
FIXTURES
NUMBER
MAIN DRAIN
-
Units
Fees
- -
Uriits ,
Fees
Water Heater
Size
j
Water Closes
Material
Both Tub #
To Curb
Shower
To Prop. Line
Lavatories
To Existing
Kitchen Sink
JJpt Conn.
"
Dish Washer
-
Waste Disposal 1
{
Wash Troy {
"}-.
STORMDRAINAGE
Washing Machine
-
Size
-
t
- Water Softener - _f
f
Material -
Bar Sink
To Main Drain
Comb. Sink 8 Tray
- -
To Curb
Dental Unit
Drinking'Fountain
Floor Drain
- - WATER SYSTEM -
Hopper - "
-Size
Restaurant Sink
Material
Sand Trap
TOTAL FEES" "
Urinal -
'}-
.Fixture Fee
Area Drain
Main Drain Fee-`-'
_ Water Leader,_ �-
-
Storm .Drain "Fee
- -
.SprinklerSystem'
_ /
1, _ Water Sys."Fee
Relief Value
-Gas Fee' -
"Vac Breaker
-
Skimmer
--
Filter
- 'Pool Sweeper
- -
Permit Fee
-
Total
Total Fee
G v -
1 % lz� l /, iG /.W' I OT NO.
/ NO. STREET
N Q
w Z
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y O
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APPLICATION FOX BUILDING PERMIT
,sy� II CITY OF CUPF.RTINO
Sanitary No. 7
Uat�c ^ 196�. "Permit No. d2e�� 7-
Application is hereby made for a permits to�f�f '
a(`I'G'1ll�l�glr�����!/ Building
to be occupied only as Loul�C <<or..`-CsZ&12a� in accordance wits
Plans, Specifications and Plot -Plan hied herewith. PI Ck Fee
Estimated Value of Improvements, $ 000 �O Fee $
It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws applicable to the construction, location, and use of buildings within the City of
Cupertino will be complied with.
Owner e�2 �fl9tlG
Phone s;h' Ille
State License S/ l
Address �o>. Ate'r1 D '
Address /
ApprovedG
BUILDING INSPECTOR
21591 Columbus Ave.
No. STREET — LOT No. 13 Plan flog
�.P�PL:I:CATION. FOR 'ELECTRICAL PERMIT
" jCITY OF CUPERTINO
NAR 6 1967 ?.:.
Date 3-3 19§7 Permit No.
MY OF CUPERTINO Ffe SZO-0
Application is hereby made to the City of Cupertino for a permit to install electrical
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
wiring and/or.fixtures_in accordance with the.provisions-of the -Electrical Code of the
City of Cupertino, and all other aws applicable thereto.
Use of Premises
1-fam. res.
Owner nit?-rrana Address
K G. WANDERER
By SE5 HiFE ; „ass _ Address
SUNNYVAE2�13dML.QADA9f�W Approve
Phone: PHONE 79u-5421
State License 12422
WSPECrou
I✓
NEW_
RPL FEES
Size Service Conduit ----------------------
Number of Outlets--..--------- -- 15 --
.---...------..---
Size Service Wires .... ---------------------
Number of, Switches...-____--- ----------
---- ---
__...._----
----------
Size Service Switch ------------------------
Size
Number of Receptacles-..-....--- - 5-,l -
-------
----
Size Sub Feed Conduit ------------------
Number of Fixtures-....._...._..-- --....... 2
-- -------
------
Size Sub Feed Wires --- - ---------------
Ranges ---- ------- KW-------------
Number of Circuits ----------- .......
Oven KW. ----------
----------
---
Number of Meters_..._------ ----------Signs----------
Transformers...----- ----------
----------
---------__.
Misc------- Misc ---------
Dryers .... / --- ---- ------- --- ---------- ----------
----------
-- -----------
Motors ----
P base -------------- Permit
Fee
$t.00
Motors-------------------- HP --------------------
Phase ------------------ -
Motors-------------------- HP ------ - ------------
Phase ----------- -------- H P Charge ----------------
---
TOTAL FEES
3D
Zia
RECORD
OF INSPECTION APPROVALS
RoughWiring--------------- ----------------------------
Fixtures ------------- -------- --------------
----------- -
04TI INSPECTOR
1.11.,T..
Finish Wiring ........ ....... ............
... ... �.ATE ......... ........
--------- ---
-------------------
DATE INSPECTOR DATE
INSPECTOR
totorS
Final........... .......... ........
-------------------
DATE
INSPECTOR
NO. STREET LOT NO.
APPLICATION 'FOR 'ELECTRICAL PERMIT
_l) CITY OF CUPERTINO
�'9S7 G7
Date , 19A_ Permit No, �� 7
nr-V P— i�l tnrj T i Fee S
Application;is hereby'made to the City of Cupertino for a permit to install electrical
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
wiring and/or fixtures in accordan(e with the provisions of the Electrical Code of the
City of Cupertino, and all other laws applicable thereto.
Use of Premises I
Owner I.T - Address
By e � _ Address C�
CONTRACTOR, AGENT
A pprov
Phone ELECMCAL M,
State License-
Size Service Conduit ------------------ ----
Number of Outlets ------------------
---------
.------.-
------ .---
Size Service Wires -------------------------
Number of Switches------------- --
---------
----------
------------
Size Service Switch ------------------------
Number of Receptacles----.-.-.---
- ------
----------
-------------
Size Sub Feed Conduit ------------------
Number of Fixtures.----------------
----------
----------
.--_-.-------
Size Sub Feed Wires --- - --------- .....
Ranges ---------------- KW--------------
----- --
----------
-------------
Number of Circuits-----------------
Oven .------------ KW------------
--------
---------
---------...-
Number of Meters -----------------------
Signs ....... ... Transformers_.----
----.-..-..--------
--------.---.
Motors .................... HP --------------------
Phase -----------------.-
Permit Fee $1.00
Motors-----------
-------- HP -------------------
Phase ------------------
Motors --------------------
HP ------------
----- Phase ----------
--------- H P Charge -..------------
TOTALFEES
RECORD OF INSPECTION APPROVALS
RoughWiring
..... ----------- 1----------------------------
Fixtures --------------------- --------------------
DATE
ItS[[CTOt
DATE IKSr[CTOt
Finish Wiring
..------- ------ I -------
--- --0- -totorS
----" -- '---........ --._------'---
DEre
�tsr[crot
D�rE �x[r[crotnal
------------------------......------'-'--`---
DSTE ItSrECTOt
wQ
u z
STREET
�� ✓ / LOT NO.
\O. STR EEi
� rAPFPLI ATIIONY
FOR PLUMBING PERMIT
OF CUPERTINO
Sanitary No.
1962 Permit No
n'-^sr dkl , h P FeeS Cz c5�a
Apphcahonj �s her tb 2he City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed onthe reverse side hereof, and agrees to install said prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises
Owne
By `
CON 'RACTOR, AGENT
State License_ �I
Approved
PLUMBING INSPECTOR
—_—
a
UNITS
FEES
UNITS
FEES
Water Heate
J'
Size
_
Water Closets
�..,
Y,—e
Material
Bath Tubs
r
-C.
To Cur
Showers
/
,gl
To Prop. Line
Lavatories
1,
• le
To Existing
Kitdren Si
ish WashersWaste
Dsposals
TraysDRAINAGE
Water SoftenersBar
A
EC.rb[,,
SinksainCom
. Sink s TraysDental
Units_Drin
iug FountainsMoor
DrainsSTEM
_
Size
Hoppers
Restaurant Sinks
Material
Sane raps
TOTAL FEL'S
Urines
Fixture Fee
/
rca rains
Main Drarn F
St-C
�Uater leaders
o of rain, ee-
„5'e
Sprinkl,r V:dves
Water Sys. Fee
SZ�
Permit Fee
a—('
TOTAL
155 /
ii TOTAL FEE
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final
a
2Z
d�
Ro
Z LL
3a
W W
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LL F
oa
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3`
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I.F W
O
-u
21591 I Cojumbus Ave. 13'
LOT NO.
NO. STREET
APPLICATION FOR APPLIANCE PERMIT
CITY OF CUPERTINO
y� f
Date N"';'+p :>•� la=:% - 196— Permit No.
Fee $C. 10.2'0
T V Application is khereby made to the City of Cupertino for a permit to
install, gas aupli ttR1 as listed on the reverse side hereof, and agrees to
install said appliances in accordance with the provisions of the Plumbing
Code of the City of Cupertino, and all other laws applicable thereto.
Use of Premises Residence
Own
By130 S. Gilman Ave. - FR 8-093,
Phon tSdi4iR '@!;'�Fbrnio
Mate License—
icens STATE CONTRACTOR'S
LICE S #
Address D 0 ?nX 500 c �.r
Approved
PLUMBING INSPECTOR V
Type of Appliance
Units Fees I
Remarks (Check ✓,
New Replace Relonte
Gas Ranges
CUall Heaters
Gas Plaies
��
Circulating Heaters
:Blower Furnaces
0,3
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
Miscellaneous
(NAME, TYPO
To
•
I
I
pp.ance •ees
I
I I OA-S
11
1_
Inspected and Approved.................................................................
DATE. INSPECTOR
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Date .......jG' . ........................ 10�7. ` Building Permit No.10��P,
The Building Located at��
Owned by .......: .:E-. .. ' `. f er.`diY%:.t..........................................................
om lete_d
Has Been (Altered) -Vor Use As:....._:;.\`o"''�c;-'.6..::.................................
BUILDINU INSFEC1"UR
102 12166-1M
Bldg. Dept
Office Copy
BUILDINGANSPECTOR'S OFFICE
CITY OF CUPERTINO
Sewer Connection Sanitary Permit No . ....... . 7--2.� ......... .
Plumbing Final Plumbing Permit No. .....
Lot No. —./IX ..................
1j Z-
Owner or Tenant ----- C044
At
Tract............ .......................... ......................
DateConnected ................................ ............................................ 1 f-�:7
DateFinal .................................... 4 ..................................................... ig.v'7.
r- ------------ ( - - -- -- -- ------------ —* ........ * ........
PLUMBING INSPECTOR
111 7/63-1M
(�3 GAS SERVICE NOTICE OFFICE
ll COPY,
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
./ ............................... I 96..J
To
You are hereby authorized to connect the GAS service for
Owner or Tenant ..... ... .el��t��' C?s2s._...r....................
New Service ..............
No. of Meters ..... ./............ Reconnect _..................._.......
Move Service .......... ..............
No. of Add. Meters ....... Move Meter ...................
lalz....... _.......... _...
PLBING INSPECTOR
OFFICE COPY
ELECTRIC
BUILDING
(C)TY
SERVICE NOTICE
INSPECTOR'S OFFICE
OF — C . U P I E . R . T . I . N . 0 --- t96-1
are hereby anth ri ed o con, ice for
11 ec, e"-5c
Owner or Tenant ............
At..........
No. of Wires ..... Z ............. Size of Wires ... Size of Switch ft,.04
Motor Load ........................... Voltage .........._.................._Phase ...... ............ ... -- -
HeatingLoad ........................ K. W . ......... ............ .......... . Voltage ..............................
No. of Meters ........... I ........ g t .... I 10 .... *e!.' New Service ..... ooe'.7� Reconnect .............
Heat ......... - ..... 220..... Three of Add. Meters............ r ... OK ... .. Move Service ..........
hree
Power ............... it
is ........ ..... Move Meter..............
ELECTRICAL INSPE OR
ROUTE SLIP
File No. �5-116 :,-7 _
Date Out 7:3 1
Date In
Location P
Subject.
d
Notes
Approved' -/ZG
Date
Inspector
..RCUTE SLIP
File No. 7
Date Out%
Date In.
Location. i.
Subject,
Notes
Approved
Date Inspector