1100 qLor No.
NO w � 'F.T �I ' N FOR BUILDING PERMIT
M ' ITY OF CUPERTINO
��Eg ss _, 195_ � m
Perit No. I bU
Application is hereby made for a perm
CtLl« PGP � - 'k� t m20 Building
at I O L S o Q
to be occupied only as--. kt i
in accordance with Plans, Specificatio and Plot-Plan filed herewith.
c�0
Estimated Value of Improvements,$ 00Pec
v
[ 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 mplied with.
E Owner ��%/ ..P.�J --eJAddressl O Vc(
BY Address
¢. CONTRACTOR, AGP.NT
�g Phone X I— �1/ 3 Approve c
BUILDING INSPECTOR
RECORD O;r INSPECTION APPROVALS
FOUNDATION
DATE INSPECTOR
FRAME
DATE INSPECTOR
t
LATH and PLASTER
c� DATE llNSPIICTOR
FINAL BLDG. x � tv/
DATE INSPECTOR
f
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE INSPECTOR
I, the undersiiled do herby certify-that I am
the owner amd occ'up1,nt of the single family dwelling at
for which I am making
application todo Cq��peeJ¢work as a home owner.
Iisc certify that I will not, hire any non-licensed
CAFiC N i Qtr contr ,actcr, but will do this work myself.
4"=
OD1E 1�Ut%.B SIGiL41URE
NO. JtREET LOT NO.
APPLICANO ELECTRICAL PERMIT
rtF
PERTINO
DateB 211981 I Permit No.
Fee $a 7
Applicati f)'iTyerotna PJWOCupertino 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
V City of Cupertino, and all other laws applicable thereto.
y Use of Premises
c
a Owner XAV 7 Address
By �ti� Address
c NT8Acr gr B� Approved
Phopc: .... I \ ELEC[RI L INSPECrox
Z_Z�
NEW RPL FEES
Size Service Conduit..........-_---------Number of Outlets.....-..
----- 00
--
Size Service Wires.............._..........Number of Switches..... ..
----------- ........ - --------------
Size Service Switch..-.._-----------------Number of Receptacle. . .. ---------- -------- - --------------
Size Sub Feed Conduit..................Number of Fixtures.................. .......... .......... ..........
Size Sub Feed Wires.---...............Ranges................ KW----.....---- ---------- ---------- ---- .........
Number of Circuits--- --....... Oven .............. KW...------- -- ---------- ---------- --------------
Number of Meters........................Signs---------- Transformers...----- ---------- ---------- --------------
Misc------------------------------------------------Dryers -------- --- - --------**------Revm—it -F*,c--e-*
Motors---------/......... HP.......I---------. Ph
Motors.................... HP-------------------- Phase-- --------------- *... r7
Motors.................... HP------ ----------- Phase-------------------- H P Charge....------------
TOTAL FEES
RECORD OF INSPECTION APPROVALS
RoughWiring................ ---------------------------- Fixtures ..................... --------- --------- -----
Finish Wiring .......AT_....D .t ........I-N-51....-_.....
-E-C-T-0-R.....Ifotors .........77�--------
PAYS INSPECTOR Final A----------
:PAT% I.S'.CTOR