NO PERMIT NUMBER ^n ice:
.21682 I COLUMBUS AVE. Lot No. 21
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. 51167
Sanitary No. 484o.
Data Seot . 8 196 6
Application is hereby made for a permit to
Construct a 2 story, Type 5 1 J
to be occupied only as Single Family Dwelling
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements' $ 28,000.00
FEES 85.5o Plan Check $
o.,nar Ditz-Crane Address Box 509 , S. J.
Contr. Address
Phone 257-1110 State License 151791
297-9544 Approved W• D. Benevich/h
APPLICATION FOR ELECTRICAL PERMIT
Data ( J)1961° FEES
Cont,. Address
Phone 7.3 State License
Approved / "-"" -•-�/
APPLICATION FOR PLUMBING & GAS PERMIT
Date 91 f� 196 6 GAS FEE $
PLUMBING FEE $
Contr. `'P'y^1 "'""e✓ Address z v
Phone a y S — 2- 32- 3 State License
Approved Z
1 1 APELICATION FOR APPLIANCE
Date
P MIT ��
Cant% 0.'�4L Address /3-0 � ^"�—•+� �-•��
Phone / j 11/ State License
Approved
Applicants agree not to violate any of the `
Workman's Compensation Laws of the
State of California
cI
RECORD OF INSCT�N APPROVALS'
6 BUILDI
FOUNDATION
Spector
UNDERFLOOR L f•
FRAME
/O��pDa}ei/ ns pe ctor
/ 'G(•
Date
Spector
LATH PLASTER B
nspecror
FINAL
Do to I ns oe ctor
ELECTRICAL
OUTLETS /
SERVICE SIZ
SWITCHES 2,2 UNDERGROUND
D t ter
RECEPTACLES/ ROUGH WIRING
1A Dat Inspector
FIXTURES FINISH WIRING 0 /
a 2 Datl Inspector
H.P. CHA GE VW. FIXTURES • y
/ ^ - Date Inspector
PECT FEE -�eMotors
Ci )S Spector
TOTAL FEES T FINAL —(DIE
Dote Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH !f
Data for
MAIN DRAIN FEE ROUGH COMPLET 0—
Dgfq trot
STORM DRAIN FEE MAIN DRAIN — �G
D ty I r
WATER SYSTEM FEE /J` GAS PIPING (o
Date r
GAS PIPING FEE - FINAL41
— —
Date, Inspector
PERMIT FEE �� MISC
Date Inspector
TOTAL FEE �c � M_ISC
Dote Inspector
APPLIANCE
TYPE OF APPLIANCE UNITS FEE TYPE OF APPLIANCE UNITS FEE
CIRCULATING HEATERS REGISTERS
BLOWER FURNACES COMBUSTION VENT cw
SUSPENDED UNIT MISC
GAS RANGE "`- MISC
GAS DRYER - PERMIT FEE of
FLOOR FURNACE TOT F E
INSPECTED %2 — c
- - Date 1 Inspector
RDUTE T.StI P
File No.
Date Out y f
Date In
Location
subject
Notes
Approved �lA.
Date Inspector
ROUTE SLIP
File No. drll� 7 4
Date Outc�
�/�( Date In
Locutciiom� U
Subject
Notes 1
Approved ����
r Date Inspector
^� I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN S -a
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.\
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CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Date ... ..:::.......:_ ..................... 19..4-.4.... - Building Permit No. ......................
The Building Located .......... :: . a • +i %✓ �.�_
Owned by ....... d . l a1 "
Com"leted �i..
Haz Been For Use As: ............. �.__............... 1.......
(Altered) ................................
1
.............................................................................:...................................................................
I
..:....................................................................................:....:....................................................
BUILDING INSPECTOR
102 1/63.500
GAS SERVICE NOTICE of ici:
COPY
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
................... 1964�—
To
You are hereby authorized to connect the GAS service for
Owner or Tenant
At .CV16;AV .........
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
F-1 Sewer Connection Sanitary Permit No. ....y ..............
Plumbing Final Plumbing Permit No.J--/Z47
qq�ZG 7..._.....
/ Lot No.pc.�......................
Owner or Tenant ....&" j. .L�7et .. .. ................................................'-
�At --'� --�-"- -- .. .................---........................
Tract ..........J/./..L. ............................................---...................../.../.... '
Date Connected .................................�...���........................................ .... 19Gv//. .._.
01
DateFinal ................................. .:v : ...-.............................................
...............
III 7/63-1M PLUMBING INSPECTOR
_ u,
' 01,ka COPY
ELECTRIC SERVICE NOTICE
Z BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
............ 196......
To
You are hereby at o iz to nnect electrical service for
Owner or Tenant ....................... ................ ..................
At ...........�.......< <oo.Z....................................... ^' ` :.........................................
No, of Wires ........................ Size of Wires-.......L...... Size of Switch'
Motor Load .......................... Voltage ................................ Phase ..................................
HeatingLoad ........................ K. W. .................................. Voltage ................................
Light..../.. 110..0 New Service. ... Reconnect..................
' .No. of Meters......A...........1
No,of Add. Meters............1 Heat...._...... I20........ Th it ............. Move Service............
(Power.......... .. hr a .............. Mo Meter..............
......... ......................... .......... ...... ............. ............
SLI CAL IN 0C ro
ROUTE SLIP
File No . 51 6
Date Out j
Date In
Location �21
Subjeat
Notes
Approved tZ Z7Z(lp6 _
' Date Insp � for