51074 10 / I 7 AU C/9 ,h' l�C Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No. �-
File No. J707 D
Date 196
Application is hereby made for a permit to - -
a story, Type
to be occupied only as
in ac cordane ith plot V11
plans and Specification filed herewith„
�Es-tiimated Value of Improvements $
FEES _ r.J �Q Plan Check $
Owner )(X -rte'... , Address
Address
Phone State License
Approved �� O -c-1C��✓/
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
Conir. Address
Phone State License
Approved ... -
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
i
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
MOT ORS-
FINAL-
PLUMBING,
RSFINALPLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REQ.
SANITARY NO.
UNDERGROUND ROUGH '
PARTIAL ROUGH 42f )1�76 lift
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG. 4
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
MISC
10181 Finch Ave.
NO. SfT ' " - LOT NO.
CITY OF CUPERTINO .50
APPLICATION FOR BUILDING PERMIT
SANITARY NO.
FILE NO. 51,074
DATE 9/5/74 19_
Application is hereby mode for a permit to
r.nnatrunt. Tnt Prinr Part a 1 story,type 5 L Hr.
to be occupied only as H-2 Church
in accordance with plot plan,plans and specification filed herewith.
ESTIMATED VALUE OF IMPROVEMENTS $ 2,000
FEE$ 20.00 PLAN CHECK$ 13.00
.OWNER Bethel Lutheran ADDRESS
PHONE 252-8500
CONTR. ADDRESS
PHONE STATE LICENSE
APPROVED James H. Sisk/h
BUILDING INSPECTION RECORD
DATE INSPECTOR DATE INSPECTOR
FOUNDATION FLOOR STEEL
PRE-GUNITE FRAME Z
BOND BEAMS LATH
WALLBOARDS-INT.8 EXT.
FIREWALLS
MEMBRANE LANDSCAPING
F.M.O. INSPECTION
FINAL BLDG.
UNDER-FLOOR
TI E DO W NS -MISC-
DIAPHRAMS
0OHC BUSINESS FORMS INC..Lr
ELECTRICAL INSPECTION RECORD
RESIDENTIAL DATE INSPECTOR COMMERCIAL DATE INSPECTOR
UNDERGROUND ROUGH UNDERGROUND ROUGH
ROUGH WIRING ROUGH WIRING �•
FINISH WIRING FINISH WIRING
FIXTURES INTERIOR FIXTURES
MOTORS EXTERIOR FIXTURES
FINAL MOTORS
FINAL
MISCELLANEOUS INSPECTIONS
PLUMBING INSPECTION RECORD HEATING&A/C INSPECTION RECORD
DATE INSPECTOR DATE I INSPECTOR
BACK FLOW REQUIRED UNDERFLOOR S.M.
BACK FLOW INSTALLED DUCTS&INSULATION
UNDERGROUND ROUGH FLUES&COMB.AIR
PARTIAL ROUGH CONDENSATE DRAINS
ROUGH COMPLETE FINAL APPLIANCE
ROOF DRAIN&LEADERS
MAIN DRAIN
FINAL GAS
FINAL PLUMBING
MISCELLANEOUS
W
LL
6
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LOT NO. /
NO. ET •
• CITY OFCUPERTINO
tSAPAJG.,ATION FOR ELECTRICAL PERMIT
Sa
Permit No. /'57 L) 7
Data ,99 19-- Fee
Application is is her made to the City of 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 Work To Be
Promises p ('Performed -
owns
r Pel e( LuTtievan Vpddress
Phone 1 252-8500
BY X Or1UV2h 0K- Address
Contractor,Agent
Phone
State License Approved
ctric s to
I AGREE 1 WILL NOT VIOLATE ANY OF THE WOR N'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
m c.
_Llf/G LOT NO. OJr
NO. STRE ,t »
CITY OF CUPERTINO C VAS"
dv
F) a QAgPL ATION FOR BUILDING PERMITding Per. FEE
BuilNo.
Dafe F!1^FCLYr� ,19
$ O I Sanitary Per.No.
3 u ! plication is reb; node for o.permit to--412"12A/407:
= u_ atory, 7pe Structure
XO /�
O r to be occu -a only asa ���� in accordance with
a
Z Plans,Specifications and Plot-Plan filed herewith.
4 .
X Estimated Value of Improvements,$02 Q+P—O
PI Ck Fee$
OO It is hereby agreed that the requirements of the
> 3Cupertino Building and Zoning Ordinances and all Fee $
other laws applicable to the construction,location,and d
O a Total Fee$
Z use of buildings within the City of Cupertino will be
Z complied with.
3 ° x 252-ys-00 lol?l
w Z !!�OWNER PHONE ADDRESS
UOnayan Lr�.
Q FO CONTR.OR AGENT R
t V
PHONE STATE LICENSE 9��4DING INSPECTOR
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