FILE 51107.1 (2)1"
No.
C,,GS
Street
Lot No.
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No: tZZ-Zzt
Sanitary Noes; �Q /.r
Data a' 196
to be occupied only as
is hereby made for a permit to . .
a story,pe v +
in accordan jl,with Plot Plan, Plansod Specification filed
Estimated Value of\Improvements s c,2 a 00d a B`
r'00 eo
FEES Plan Check $ }t I
OZ
Owner C040 #bvdress
Contr. / Address 9 p
Phone d.i-3 — o /o `J'� State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Dote 196 ^'
FEE$ / '?
T
Contr. C–c���.c.c /
i
j– C �e– 4i`. i g—'C
Addrecc a'1 7j -
Phone
S�
State License gf/
Approved V
APPLICATION FOR PLUMBING
& GAS PERMIT
Date 4=�L 196
GAS FEE $
PLUMBING FEE $ , / J
D
Contr.L
Address
Phone .2S3 Ty
State License /14-5 4/
�—
Approved
APPLI ATION FOR APPLIANCE ERMIT�p p
Date 1916
FEEE$
Contr.' �� /'-'
'1{ddresa LL
Phone s47 A 7 Z/
State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
ns pector
K
Inspector
Date ` Inspector
PLUMBING & GAS
MAIN DRAIN
SERVICE SIZ
UNDERGROUND
,OUTLETS o2s
Y
.57
RECORD OF INSPECTION
3
'�
r
J f
RECEPTACLES
/APPROVALS
BUILDING
S°
FOUNDATION
b
S
d
H.P. CHARGE
Z
ctor
UNDERFLOOR
�/
(•
o -o
TOTAL FEES
to
ns pe ctor
FRAME
CP
D o
FIXTURE FEE
specter
&A& PLASTER
-
PERMIT FEE
v�-
FLOOR FURNACE
Inspector
Data
FINAL
MAIN DRAIN FEE
ROUGH COMPLET
Do to
Insoectar
or
ELECTRICAL
ns pector
K
Inspector
Date ` Inspector
PLUMBING & GAS
MAIN DRAIN
SERVICE SIZ
UNDERGROUND
,OUTLETS o2s
Y
.57
SWITCHES 36
3
'�
r
J f
RECEPTACLES
S
S°
FIXTURES Q
2
S
d
H.P. CHARGE
Z
s
yS
PE MIT FEE
�
o -o
TOTAL FEES
%
ns pector
K
Inspector
Date ` Inspector
PLUMBING & GAS
MAIN DRAIN
SERVICE SIZ
UNDERGROUND
I MATERIAL
UNITS
ROUGH WIRING
�- .Dale p
`� ��^D
STORM DRAIN
FINISH WIRING
7 "
FIXTURES
-
Motors
Date
IATERIAL
FINAL
�% r
�b
TOTAL FIXTURES
ns pector
K
Inspector
Date ` Inspector
PLUMBING & GAS
MAIN DRAIN
I SIZE
I
I MATERIAL
UNITS
FEE
CIRCULATING HEATERS
STORM DRAIN
I SIZE
I 1.91m6TERIAL
BLOWER FURNACES
WATER SYSTEM SIZE
COMBUSTION VENT
IATERIAL
SUSPENDED UNIT.
TOTAL FIXTURES
(o`
UNDERGROUND
GAS RANGE
- /
FIXTURE FEE
GAS DRYER
PARTIAL ROUGH
6
PERMIT FEE
v�-
FLOOR FURNACE
Dote
TOTAL FEE
MAIN DRAIN FEE
ROUGH COMPLET
a e
or
STORM DRAIN FEE
MAIN DRAIN
a�°lc
D tor
-
Wln.p.,t.r
WATER SYSTEM FEE
GAS G J
Data
GAS PIPING FEE
X5-0
� FINAL
�a-
Date
Inspector
PERMIT FEE
MISC
ate
Inspector
TOTAL FEE
MISC
APPLIANCE
TYPE OF APPLIANCE
UNITS
FEE
TYPE OF APPLIANCE
UNITS
FEE
CIRCULATING HEATERS
REGISTERS
BLOWER FURNACES
COMBUSTION VENT
SUSPENDED UNIT.
MISC ' d�
GAS RANGE
MISC
GAS DRYER
PERMIT FEE
v�-
FLOOR FURNACE
TOTAL FEE
� ��
INSPECTED
Date Inspector
SAA
z
W
IL
W
.0
U
Q
0
0
OWN
ARY GAS
.....
l SERVICE
........t......l..................... ... .
.....
CITY OMUPERTAW' -4�4 -- ----- .........................
.... . ...... ................
LOT: ......
REASON:
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. Phone
............. 5.;/,. ..
. ...... .. ...........
INSPECTOR cf,-qENANT OR OWNER
117 1/63.500
OFFICE COPY
ELECTRIC SERVICE NOME
BIZIDING, 'INSPECTOR'S OFFICE
OF CUPERTINO
. ... . ...... 196.6
YOU care herebyoriz t connect ele-M—Zit'. rice for
or
Owner or Tenant — . .... -,(.
ev
At 2.zz - e.............
No. of Wires ...... Z ......... — Size of W Size of. Switch
Motor Load .......................... Voltage ... ................. ....... Phase - ............. ...... ..
Heating Load ........................ K. W . .....
No. of Meters..................
No. of Add. Hlat.� ..... ��: 220 ...... .✓. -.
Power ...............
........... Voltage ........__---
No.
...-...----
Service....(/ . Reconnect..
ELECTRICAL
........ Move Service..........
........ Move Meter ... ..... —
TEMPORARY ELECTRICAL SERVICE
DATP: .......7._..-a ,.-. .�............... Pee: .........................
gam.... . ...........
.�l J
ciTy 0 Yak
s
The undersigned agrees to be responsiblc1
untile building is ready for occupancy,
City jVf (jupertino.
qly� 116 1/63.500
1. ce --aecK u.`� '
)he electrical servic it the above location,
id is released by the�uildijag Department,
OR OWNER
ROUTE SLIP
File NoD 7,
Date Out S
//Date In,
Loration�p aK✓ ycJ �.�-<�r//�
Subject
Notes
Approved ¢ -Gb
Date
Inspector