511673Lot No.
no. Street
APPLICATION FOR BUILDING PERMIT l•
CITY OF CUPERTINO (� ?
File No. I�,, -7
Sanitary No. &01d 'Qp
Date"1'02 7ZG 196
Application is hereby made for a permit to T
4� a / story, Type
to be occupied only as S. Ir. R.
in accordance with Plot Plan, Pians and Specification filed herewith„
Estimated Value of Improvements
FEES n �•SO
Ow r.e r
Contr. _��(� z VGAF/►�
Phone
$
..14, 000.
Plan Check $
Address pp - /QJ��
Address 'IJ F (J[.s K Cu. AJL
State License / 7/
Approved ,WILLL4M D. E4aNkvlroii
APPLICATION FOR ELECTRICAL PERMIT
Dote 196
Contr. &&W�_
Phone 7 �G - ro/
FEES
Addres,
State L
Approve
APPLICATION FOR PLUMBING &GAS E�rcmi i
Date 2-22/l - 196 GAS FEE $
n
PLUMBING
,, FEE $ -2
Contr. _ //fir /"4 _ Lt9• Address 423e W. 9
Phone — _2 32 3 State License % plod 7 %
Approved VVILLI�uvl U. bENEVI _M
APP ATION FOR APPLIANCE PERMIT n �f
Date 1% FEESARA C/
- �e[•acs /_ y��.t
C ontr. �•'� Address AM I.n xsssfi
Phone ;State License .-,L.5 .2
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Approved td
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State -of California
SERVICE SIZE
UNDERGROUND
SIZE
FEE
RECORD OF INSPECTION
APPROVALS
TOTAL FIXTURES
SWITCHES
BUILDING
b
FOUNDATION
(mob O
2-20-61
/
Dote
—t/, b!
Ins or
UNDERFLOOR
c7
v
Dae ,6 —
In"pector
FRAME
Inspector
FIXTURES
Date
Ins pec o
LATH PLASTER
Date—
Inspector
UateA t!
1-7_
Ins tar
FINAL
D
_
ate
Insoactar
Inspector
ELECTRICAL
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SERVICE SIZE
UNDERGROUND
SIZE
FEE
,OUTLETS
te/
TOTAL FIXTURES
SWITCHES
ROUGH WIRING
b
RECEPTACLES
2-20-61
FIXTURES
FIXTURE FEE
Inspector
H.P. CHARGE
PERMIT FEE
Date
at
TOTAL FEES
Inspector
FIXTURES
SERVICE SIZE
UNDERGROUND
SIZE
FEE
TERIAL
te/
TOTAL FIXTURES
Inspect �O
ROUGH WIRING
b
REGISTERS
2-20-61
_ I �at.
FIXTURE FEE
Inspector
FINISH WIRING
SUSPENDED UNIT
Date
at
MAIN DRAIN FEE
Inspector
FIXTURES
MISC
Date—
t
Inspector
Motors
--�
PERMIT FEE
D
t'
ate
TOTAL FEE
Inspector
FINAL
�"^�
ata
for
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM
SIZE
FEE
TERIAL
UNITS
TOTAL FIXTURES
CIRCULATING HEATERS -
UNDERGROUND
REGISTERS
2-20-61
n
L^^
FIXTURE FEE
PARTIAL ROUGH
SUSPENDED UNIT
Date
w
MAIN DRAIN FEE
ROUGH COMPLET
GAS RANGE
MISC
I or
STORM DRAIN FEE
GAS DRYER
MAIN DRAIN
PERMIT FEE
D
for
WATER SYSTEM FEE
TOTAL FEE
GAS PIPING j
ata
for
GAS PIPING FEE
FINAL
Date
Inspector
PERMIT FEE
MISC
Date
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
GAS RANGE
MISC
GAS DRYER
PERMIT FEE
FLOV FURNACE
TOTAL FEE
Ins pe c tor
CERTIFICATE' OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Date ...... ... ........................... MO.. -..... Building Permit No.
,'../�.�..., .........................
The Building Located at
i .... i.L.. �....iC'..................
Owned by '...
.....�.;-A- �`...h...
:............
Has Been (Comp ted)
(owter* For Use As: ...............................................---------•-------....-----_..
=b W
................--........................... .......................................
.......................................................
u�.... t'
BUILDING INSPECTOR
102 12/66 -IM
OFFICE COPY
ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICF
CITY OF CUPERTINO,
........ 19
To You are hereby autho iz d t... .....
meet rical service for
.. . .
Owner or Tartar
At
No. of Wires ......... Z . .... Size of re Size of -.Switch
Motor Load .......................... Voltage . ............. .......... Phase — ........... _.. ..........
Heating Load ........................ K. W, . — - . ............ . Voltage ....................
No. of Meter*s.-. Service. Reconnect.....:....._..,..
No. of Add. Meterj.!�-�:: Hear . ................ 220......._::. Wire...... Move Service...........
Power... ............ ec� Ph e.... Move Meter..............
. ..... ....
C L INSPECTOR
FLE &L
GAS SERVICE NOTICE 01411C:
BUILDING INSPECTOR'S OFFICE COPNI
CITY OF CUPERTIIN)Ve
To
You are hereby authorized to connect the GAS service for
0
C-'7. 4!��
Owner or T..'44 Tenant ....... . ...... ............... ........
At
New Ser-vice
..............
No. of Meters ..../Reconnect .................. ...........
Move Service .... ...... ............
No, of Add. Meters .............. More Meter .......................
PLUMBING INSPECTOR
Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO J
❑ Sewer Connection Sanitary Permit No.
QyPlumbing Final Plumbing Permit No.&-Z&r r..•2...
6 --3 Lot No..CJ90-------------------
Owner or Tenant ...... `� .ri i,%/.'^�u�.-"--------...--"-'--'------ ....................
..................................... ..................................................................................
Tract ............... �' �9 %�_._vv'E ' .o
ri{
//
DateConnected ............................. !.-�.--...................._............................
Date Final ................................... 19.7.---
.N
X, PLUMBING INSPECTOR
111 12/66-1M
10915 Dryden Ave.
NO. STRRIa LOT NO. 10
Plan 1120
APPLICATION EOR EL"EWRI,CAL PERMIT -
c ; o.
CITY Or C. PBR&N
Dale JAN 24 1969 ' ,�1N''� �>%, N�`"
Application is hereby made to the City"1f 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 laws applicable thereto.
Use of, Premises
Owner D i tz-Crane
B Y H. G. WANDERER
raut�RM°J.^.�Ti RL�LI�TORN[A
Phone: PHONE 736.8421
State License. 12422
Address Santa Clara
Address _
Approved
ELECTRICAL INSPECTOR
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I AGREE
WILL NOT VIOLATE ANY OF THE WORKMEN'S
TION LAWS OF THE STAT OF
m O a
CALIF.
ES
Water
Valves
RECORD OF INSPECTION
Underground Rough... _
Partial Rough..
Rough, Complete..
Main Drain
Final...
?�Aq G/S Z" I 'C "d��µ
/ LOT NO.
at9 �.. tF Ill
w - APPLICATION FOR BUILDING PERMIT -
r °t 1968 CITY OF CUPERTINO
° a pEC Sanitary No. G C �$
SU _
W LL
Date 1962 Permit No. S // 6 —2,2-
° ri is hervb1 t
0,
�A='1�Applicahon is hereby made for a permit'to
a a story, Type �Z/ 'j Building
a
to be occupied only as z ze in accordance with
o o Plans, Specifications and Plot -Plan filed herewith. PI Ck Fee
>0
o a Estimated Value of Improvements, $ ep 0 0 Fee $ AO. SO
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* Zall other laws applicable to the construction, location, and use of buildings within the City of
j o Cupertino will be complied with.
3�
aN Owner Address
WZ
rc a By AddressTZ
CRANE
`V Phone �5"�—///v APPr v 2 5 DE LA CRUZ�BLV /
�� State License /S / % �/� o
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ADDITIONAL PERMIT FEES
BUILDING PROJECT 1 DENTI FICATION
VALUATION
BUILDING
o Cs oo
09).5- V, u�
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1'Q(' S�LO t.Jtiq vaoRE ZSS—OZ97
FEE SUMMARY
BUILDING
CO EMuc*oaB
NE
LIc. No
PLAN CHECK
FEE
coNTBACTOas
eooaeu
PHONE
SEISMIC FEE
QTY. ELECTRIC PERMIT
FEE
S UTLETS-SWITCHES -RECEP
0
ELECTRIC
Oa
LIGHTING FIXTURES
PLUMBING
APPLIANCES RESIDENTIAL
PANELS PAIR
MECHANICAL
SIGNS
TOTAL
SIGNSTRANS,Jjr E.A
SPECIAL CIR
EMP. METER OR POno
MOTORS SEE FEE SCH.
PERMIT VALIDATION
x `-4""`-�1l/
&/_d/If
' ISSUANCE DATE
SERVICE CHANGE
TOTAL
QTY. PLUMBING PERMIT
FEE
BLDG,
ELECT.
vLc.
❑
MEOH.
ALTER DRAIN SI VENT -WATER IEA.)
BACK FLOW PROTECT. DEVICE
Clr� X Z2`lam
E/I,N>'/,j'
h
DRAWS -FLOOR, ROOF, AREACOND.
ES
PER
FIXTU
STEM -IAP
GAS-EA.SVSTEM-11NC.4OUTLETS
GAS - E
GAS - EA. SYSTEM - OVER 4(EA.)
INDUSTRIAL WASTE INTER.
LAWN SPRINKLERS -1INC 5 V.B.
LAWN SPRINKLERS - OVER 5(EA.)
SEWER -SANITARY -STORM EA. 200ft/
WATER HEATER WNENT
WATER SYSTEM
WATER TREATING EOUIP.
TOTAL
QTY MECHANICAL PERMIT FEE
ALTER OR ADD TO MECH.
APPLIANCE
AIR HANDLING UNIT ITO 1010001—F. M-)
AIR HANDLING UNIT (OVER 10=1C. F,M.I
EXHAUST HOOD (WITH DUCT)
HEATING UNIT (TO 10),000 B.T.U.)
HEATING UNIT (OVER 100,000 B.T.U.)
VENTILATION FAN (SINGLE)
BOILER -CONY (3 H.P. or 100,000 B.T.U.)
BOILER COMP 10-1100.000 BTUI SEE FEE SCH.
TOTAL
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APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
PROJECT IDENTIFICATION
-
PERMIT NUMBER
BUILDING
BUILDING - ELECTRICAL -PLUMBING -MECHANICAL
9 2 4 6
BUILDINGAPPLICATION&PERMIT
Afo��`I S by, 4 ,J L c
CwrIEns J
NAME p
S+iOwM IJ1 ET S ZSS'OZ97
PHDNE
QTY. ELECTRIC PERMIT FEE
PLAN CHECK VALIDATION
CON
NAMEnncTons
UTLETS-SWITCHES-RECEP 10.00/1.00
I.T. NO.
LIGHTING FIXTURES 10.00/1.00
CONTRACTORS ss T
PPLIANCES- RESIDENTIAL 4.00
PANELS 10.DO
PHONE
DATE OF APPLICATION
ARCHITECT
ENGINEER
LIC. ND.
PANELS (OVER 200 AMP) 20.00
PLC. AN CHECK FEE . NO.
ISIGNS TRANS. 3.00
ADDRESS ERG.
SPECIALCIRCUIT 5.00
PERMIT VALIDATION
EMP. METER OR POLE INS. 20.00
ZIP
AooPLass
�' MOTORS SEE FEE SCH.
SERVICE CHANGE 20,00/�/`s/
�/a
LICENSED CONTRACTORS DECLARATION
PAPID
TEMP. POLE 30,00
I hereby alfml that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 ofthe Business and
Professions Code, and my license is in full force and effect
Class Lie Number
-
J U -
ISSUANCE DATE
BLDG. ELECT. PLG. MECH.
11 F-1 F-1License
City of Cupertino
Dat` Contractor
BUILDINGPERMIT
OWNER -BUILDER DECLARATION
1 hereby affirm that I am. exempt from the Contractor's License
Law for the following reason. (See 7031.5, Businasand Professions
Code: Any city or county which req uires a �rrnit to construct, alter,
MISC. - REFER TO ORD
PERMIT ISSUANCE�0
VALUATION
$/FT.
ELEC. CONTE, LIC. NO,
ELEC. �-q
TOTAL
improve, demolish. or repair any structure, prior to its Lowrance, also
rectums the applicant for such NORTH to file a signed statement that
he is liceowd pursuant to the provisions of the Contractor's License
Law (Chapler9(commencing with Suction 70001of DivismR3 ofthe
PERMIT TO
7
Business and Professions Code) or that he is exempt therefrom and
QTY. PLUMBING PERMIT FEE
the basis for the alleged exemption. Any violation of Section 7031.5
byany applicant fora permit subjects the am toacivil penalty
o n [mora five hundred dollars (S500),):
STORIES
TYPE CONBTR.
ALTER -DRAIN St VENT -WATER (EA.) 5.00
ownhaner
1, as owner of the property, or my employes with
a,em
then sole compensation, will do the work, and the structurem is s not caul
BACK FLOW PROTECT. DEVICE 4.00
OCC. GROUP
REB. UNITS
DRAINS -FLOOR, ROOF, AREA, COND. 5.00
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors Licerlw Lew docs not apply to an owner of
FIXTURES - PER TRAP 5.00
GAS-EA.SYSTEM-11NC.40UTLETS 6.00
property who builds or improves thereon, and who docs such work
himself or through his own employees, provided that such improve-
menisarcnotintendedoroffered for sale. If, however, the building
BO. FT. FLOOR AREA
TOTAL ACREAGE
or improvement is sold within one year of completion, the owner
builder will have the burden of proving that hnt-
e did not build or i
- . -..
GAS EASYSTEM OVER 4 (EA) 200
BUILDING USE
prove for purpose of sale.).
❑ I, a owner of the property, am exclusively contracting with
REB IND CON PB Oram
El El El El F-1
INDUSTRIAL WASTE INTER. 30.00
licensed contractors to construct the project (See. ]044, Business
and Professions Code: The Contractor's License Low does not apply
LAWN SPRINKLERS - 1 INC 5 V.B. 6.00
ASSESSORS PARCEL NO.
LAWN SPRINKLERS - OVER 5 (EA.) 1.00
to an owner of property who builds or improves thereon, and who
contracts for such projects with a contmctods) licensed pursuant to
the Contractor's License Law.
❑ Ian e t rS• ,B.& C. -r
reason k9
SEWER -SANITARY -STORM EA. 20011/10.00
TRACT NO.
'
PARCEL NO.
'NATER HEATER ADVENT -6.00
Owner ate
WATER SYSTEM 5.00
ACC. DATE
ACC. FILE NO.
WORKS RS'COMIT SATION DF.CL%RA
WATER TREATING EQUIP. 5.00
1 hereby affirm that I have a certificate of consent to self -insure.
ZONING I
ENG. SITE NO.
or a certificate of Workers' Compenvtioa Insurance, or a certified
copy thereof (Sec. 3800, Lab.C.).
Policy Nn. Company
MISC. - REFER TO ORD.
❑ Certified copy is hereby furnished.
❑ Certified copy is Bled with the city inspection division.
FIRE SPRINK
Y N�
ENERGY T 2
V NE]
CERTIFICA7'1 S OF 1 XEMPTION ('ROM WORKERS
COMPENSATION INSURANCE:
(This section need not be completed if the permit is for one
PERMIT ISSUANCE 10.00
FLOOD ZONE
Y � NE]
A.L.U.C.
V [:] N�
PLG. CONTE. LIC. NO.
TPLG
OTAL
hundred dollars IS 100) or Icss.)
I cenity that in the performune, of the work 1" which Nis per-
mit is issued, 1 shall not employ any ,person in any manner w as to
QTY. MECHANICAL PERMIT FEE
FEE SUMMARY
become subject to the Workeri Compensation Laws of Calitornia.
ALTER OR ADD TO MECH. 5.00
Date- Applicant
NOTICE. TO APPLICANT: if, after making this Certificate of Ex-
BUILDING
,
APPLIANCE 5.00
AIR HANDLING UNIT (TO 10D30C.F.M,) 4.00
PLAN CHECK
FEE
emption, you should become subject to the Workers' Compensation
provisions of the Labor Code, you must forthwith comply with
such provisions or this permit shall be deemed revoked.
AIR HANDLING UNIT(OVER 10,000GFM.) 6.00
SEISMIC FEE
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for
I EXHAUST HOOD (WITH DUCT) 5.00
the 3097,, Civ.0 once of the work for which this permit is issued (Sec.
Lender's Name
MICROFILM
HEATING UNIT (TO 100,000 B.T.U.) 8.00
Lender's Address
HEATI NG UN IT (OV ER 100,000 B.T.U.) 9.50
ELECTRIC
13, (�
I certify that 1 have read this application and state that the above
VENTILATION FAN (SINGLE) 4.00
information is correct. I agree to comply with all city and county
ordinances and state laws relating to building construction, and
utho
hereby arire representatives of the city to enter upon the
above-mentioned led property for inspection purposes.
PLUMBING
BOILER -COMP (3 H.P. or 100,000 B.T.U.) 6.00
BOILER -COMP (Ovar 100,000 BTU)SEE FEE SCH.
MECHANICAL
(We) agree to save, indcnmify and keep harndes the City of
Cupertino against liabilities, judgments, costs and expenses which
ay agmmt Said City in
ma��"" m any14""",
LMECH.
MISC. - REFER TO ORD.
PERMIT ISSUANCE 10.00
CONST. TAX
g(aD�f per
CONT. LIG NO.
MECH.
1C M7 -.TOTAL
TOTAL
pliDam
OFFICE COPY