NO PERMIT NUMBER &.G.IC/GC..,� •/ ... Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
File No.
Date ' d 196 T
Application is hereby made for a permit to
o sto Typc
to be occupied only as i
in ac ordance with Plot Plan, plan and Specification filed_herewith,
Estimated Value of Improvements $
FEE$ •J' S-0 Plan Check $
'Owner _ Address
Contr. I/ Address
Phone ��.� 7 X 5e- State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Cont,. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
xDate 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Data 196 FEE$
Contr. Address
Phone State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the ' -
State. of California
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
PAD FINAL
FOUNDATION
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL
FINAL BLDG.
ELECTRICAL
DATE INSPECTOR MISC.
UNDERGROUND ROUGH
ROUGH WIRING
FINISHED WIRING
FIXTURES
MOTORS
FINAL
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO.
SANITARY NO.
UNDERGROUND ROUGH-
PART AL
OUGHPARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE S 3O�7C
DATE INSPECTOR MISC.
MISC
MISC
MISC
I� f
CITY OF CUPERTINO
10300'Torre Ave. .
CORRECTION, -NOTICE
Department
Job Located at
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You are hereby notified that, no more work shall be
done until the above violations are.corrected. When
corrections have been made, call the inspector.
252-4505 Date:' - --------------
City Telephone Inspector:
LOT NO.
NO. P.T'
R PLUMBING PERMIT
. T CUPERTINO
Y o (OCT 20 1969 Sanitary No.
R g / , 1961 Permit No r
0 a Uate if.� /n
3 ULLCITY' Of CUPERTINO Pee $3•s'a
0 Application is hereby made to the City of Cupertino for a permit to install plumbing,
'oa pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
> 4 and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
WCupertino, and all other laws applicable thereto.
a
Use of Premises
00
zJ Cwner G LQ m he r f Address /0154 CIL FS CV
z By / Address
n CONTRACTOR, AGENT
3 �
— 0 Phone
W Z _
WW
a
State LicenseApprovcd-/ Io
PLUMBING INSPECTOR
Ell §
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1 O I Slo G/6T G&7i w u 4612 • LOT NO S/
NO. STREET
CITY OF CUPERTINO (VAL i62�
CAP. (l �
Q.. APP (CATION FOR BUILDING PERMIT FEE 3
Z(—Y fi7 Citi Ll 10 �i'W
w Z b Building Per.No.
f K Dote � ,�Ma 19
j 1 Sanita Per.
Y
0.
3`v pplication hereby made for
0 permit to �e-o', N.. U d"f� t�
T- 61 a A sLbry, Type— Structure
u- - to be occupied only as in accordance with
a
'z y Plans,Specifications and Plot-Plan filed herewith.
a w
r Estimated Value of Improvements,$ 1.200
PI Ck Fee$
O O It is hereby agreed that the requirements of the awe
.n Cupertino Building and Zoning Ordinances and all Fee$ 1-2 —
0 a other laws applicable to the construction,location,and
z — use of buildings within the City of Cupertino will be Total Fee$
zz complied with.
3N �a 3ueNS Inl5b EAST sT�I �r'S
W z S O,WNE PHONE
QBDDE.RESS
CONTR.OR AGENT ADD
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PHONE STATE LICENSEBUILDING INZ17 TOR
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