NO PERMIT NUMBER 10028 I Dove Oak Ct . Lot No. 40
No. Street 41645
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No. 738j -
6/15/71 File No. 51231 . 1
Data 196
Application is hereby made for a permit to
con Stri Int a 'P story, Type
to be occupied only as Single Family Dwelling
in accordance with Plot Plan, Plans and Specification filed herewith.
Estimated Value of Improvements $ 25,000
FEES -- 78 .00 Plan Check $
ovrnar _ Shapell Industries Address 3000 Scott Blvd . S. C .
Contr. Address
247-3801 169863
Phone State License
��252-3831 Approved W. D. Benevich/h
/i L��7 >/
APPLICATION FOR ELECTRICAL PERMIT
Data 1 196!_.{ FEES Z6
Cantr. Address
Phone • State Lica
QSkr
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date " 196 -7/ GAS FEE $ (/�0J
PLUMBING FEE $ ,{Z
Contr. ed Address r/
Phone State License, s
Approved
y, APPLICATION FOR APPLIANCE P RMIT/
Dote / ?/ 196_2 FECES//
Cant ' I
S7/—�6 o S' 1 //D6.z_d' - JC
Phone - State License -
ss S
Y Approved lldi)� • —�/
Applicants agree not to violate any of the
Workman's Compensation Laws of thee,
State of California
RECORD OF INSPECTION APPROVALS A'•
BUILDING
DATE INSPECTOR MISC.
PAD FINAL 7
FOUNDATION
UNDERFLOOR '
FRAME Z 6�
LATH & PLASTER
GRADING FINAL I
FINAL BLDG. r'
ELECTRICAL
D.A INf
MISC.
UNDERGROUND ROUGH-
ROUGH WIRING 1• Y
FINISHED WIRING ' •
FIXTURES 1 MOTORS FINAL
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO.
SANITARY NO.
UNDERGROI-/- /
PARTIAL R ,
ROUGH COMMAIN DRAINFINAL PLBFINAL GASFINAL APP
Y : i
DATE INSPECTOR MISC.
MISC •�
MISC
MISC
OFFICE COPY
CITY OF CUPERTINO
ELECTRIC SERVICE NOTICE
............... . 72,o
To
You are hereby aut(Norized to connect ellecrpgal se?vce or.,
Owner or Tenant ......:—.................
At
No. of Wires ........................ Size of Wires ...................... Size of Switch
Motor Load .............. ........... Voltage ....:........ .............. Ph-ase ..................................
HeatingLoad ........................ K. W. ....... .................... Voltage ................................
Light......: 110......<G.. New Ser,ice...... Heconnect.........
No. of Meters.......(............
Heat.......--..... 220....... ........
No. of Add. Meters............
Power........... h. Phase.. ....... Nfmr Meter.......
ZLECTMAI INSPECTI).
i
30 Bldg. Dept.
Office Copy
CITY OF CUPERTINO
SEWER-PLUMBING NOTICE
%Z Sewer Connection Sanitary Permit No- -----.."T.:3..gq.......
Plumbing Final Plumbing Permit No. SL3...3.1..�....
Lot No. .....13..n................
Owner or Tenant ...
....
At
............................................................
Tract ...........................................
DateConnected ...... ..:.. �:...�.�-....._............. ........_...-................. 19............
DateFinal ......._ ........t..7..@. .................................................................. 19............
..., ... .................
PLUMBING INSPECTOR
Q C3a GAS SERVICENOTICE °o 't
N
o� BUILDING INSPECTOR'S OFFICE
ff
CITY OF CUPERTINO
...................... ... ., t,M
To
You are hereby autl rued to connect the GAS service for
Owner or Tenant ....
: -Ag ...... .. ........�Q...............I........................... _ ........._.
-At .../0 1�..... ............ ........ _........ ..............
/ New Service .....0--' ..: ..
No. of Meters ........./.......... Reconnect ..............................
Move Service ...... ................
No. of Add. Meters .............. Move Meter ..........................
............................04... � ".... ..................
PLUMBING INSPECTOR
ROUTE SLIP
File No .
Date - -7
Location �ar�ysr�
XO< 3�
Subject
Notes
Approved -
Date Ih4,ectbr
ROUTE SLIP
File No .
Daa7t^efAA
LocationIds
Al,&94,S
Subject
Notes
Approved - �
Date spec or
i
o e �n�c violate
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ITEM NEW RPL FEES
Number of Outlets
Number of Switches
Number of Receptacles O
Number of Fixtures
Iterates or Ovens K W. '0�
Size of Main Service �oc� �-�
Number of Meters
Number of Panels O'C1
Signs-Transformers
Dryers
Motors:
H.P.Phase
H.P.Phase
Power Poles
Permit Fee 2.00
H.P.Charges
Tot ees d,9O
, __ , .3 NOT mm. ANY OF THE WORKMEN'S
a.___ LAWS _ THE STATE « CALIFORNIA.
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APPLIANCE UNITS FEES
as I op
Gas Oven
Wall Furnace
Gravity Furn.
Forced Air Furn.
Gas Fired Boilers
Wunuing Ovens
Susp Units
Dwelling Kit./Bath L40�
Independ Vent System
Com., Indust .Inst.Kit.
Hood &Vent System
Forced Air Under 4000 CFM
Forced Air Over 4000 CFM
Ind Ventilation System
(without Comfort Cool 1
Forced Air. Mech.each Power
a tv�loff" �1 1-7
No of Air Outlets - 's �-•
Stacks for Metal Fireplaces U
Smoke Stacks Mise. Equip,
Under 15' h1 iRh
Oyer 15'lligl
Coin fort Cooling
Comp.of 20 1-I I'or less
&absorp.units with input
of 500.000 BTU or less
Comp,over 20 HI'& Under 50 HP
&Absor) units with input
of 500,001 &Under 1,000,000 _
4TotJF1,e
Total �q. �j
, _e will not violate any athe __e
Compensation laws a the_,ate_y
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