2160 (:9;, 0/00 I k 04411S •'W• LOT NO. —3/ _
rT
W ® APL O 6 1t BUILDING PERMIT
C
CUPFRTINO'FEs A96B
° J Sanitary No. 1:3 6153
3u
Uate_g�-.. Permit No._
° VI ' FRfc�
o Application is'hereby ma a or a permit to
a
V) story,Type s' `DDa Building
W I to be occupied only as xky 04
0 o in accordance with Plans, Specifications and Plot-Plan filed herewith.
3 Estimated Value of unprovements;$`,�f 0t70 '- Fee$__A QO
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J i all other laws applicable to the construction, location, and use.of buildings within the Cit of -
2 o Cupertino will be complied with. y
3 a J7/71— CR'4W'r
_ m Owner .__ Addreas_;m /✓ Lifl'!. d"rT.
w By err--t Address '' 1
hone-2Z5 -
Approved f
State Licens �S/7 �`�"� HUI ING INSPECTOR
Jo 0 o c o 0 o C
Q �
U V U V U V V V
Yl W W W
6 �• 1 6 6 S C
W
CL
N
LL � o � c � o ; c � o � c •� c � c
W F \�
m
.a Q w ra
w ip
L�
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS zTHE STATE OF CALIFORNIA. �
§ \
—
.
}(0
In
?§ z
0, g �
® >
{ /� \z� « 0 1 ;
\/ S�
% . \� ■
.�
FIXTURES l BER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heater Size ,/
Water Closets Materia!
Bath Tubs / To Curb
Showers J To Prop. Li e
Lavatories To Existing –
Kitchen Sinks / Not Conn.
Dash Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE,
Washing Machines / Size
Water Softeners Material _
Bar Sinks To Main Drain
Comb. Sink w Trays - To Curb
Dental Units
Drinking Fountains
Moor Drains WATER SYSTEM —
Hoppers Size
Restaurant Sinks Material
San Traps T TAL FEES
Urinals Fixture Fee .fop
Area Drains Main Drain Fee .p6
Water Leaders Storm Drain Fee.', '
Sprinkler V01Vcs Water Sys. Fee .�
Permit Fee "
TOTAL 11 TOTAL FEE
RECORD OF INSPECTION
Underground Rough_.
.Partial Rough..
.Rough Complete..
\lain rain
3
Final...
State License 12422
S
O
n `,n 0., �.,tro bob 2 00
C ro w w �1 0
'D N rt O O a� T
3� I - m ,e
m n � 1 0 2 m 0
D
fy m
CD Y" j' N �C VlW m N
Q
m
Zy� A w Q, a � W v
CD
n E `"
T w
� rt H f1 I y r
a a a Hb z
M
O H n
O O 7 o n z
9 O
m
m �, ° w z 0
w
" m
P ... w
N
CD CL
a T \ O _
rt w � Vl
m
� = w
.-
� . : � : \ ` � \ } \ �; \ � \
z
vA
: U-ii
\ . ' ' ( \ : /
F-I
10
0
0 0
CL,
\�
to
;?l @40n ;
} ) } » 2 ij
\ : \ | ` ; »
\ \ \ \ % 12
0 0
i7l
N
)k)\z z C4 44
tr
4
A >
a az Tu', '.lb wr hY �f' aJ' .�5`h+�.C{tlry{moi,!' Y f�'1.
til,
^:tc. . .
t �
�C t ti
t
0
t�
» ;
:k ) n .
/ 2
\ : `
9 ƒ o
} y on
\ � \ \ m y I » 9�.
o
� � \ \ � \ � . .
j §
02 Ln
o 0
. ; 1 � � � � � j , ewm
\ . \ � 8 0 Z
� \ 7
. FL
� ) m
n § �
\ z § } z
IN,
m
, g � .
% &S'} T;THE WORKMEN'S
OF CALIFORNIA.
0 ".1 _
® ~
} ) �\
v
Ilk� 0 � t
/ 0/\ `
AO
� �/
� { \ ~ ,
/ z z
� ) ` n -
�
) 2
%EIV\
` , 2� ��10 ` o ®
` \ ` ( JJ0 ƒ
■ _
_ ( 0 ■ §
/
1 ��� \ /
. a. /«
_ S+ .' S
r. ::F3�'
Remarks"'(Check ✓T
Type of Appliance Units Fees II New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters `
Blower Furnaces 6d
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables "
Gravity,Furnaces
Suspended Unit
Floor Furnace
Miscellaneous
NAME TYPE)
/ aN
. +it
HOUSE GAS PIPING
Number of Outlets Size of Main
Gas Piping Fees
Tested and Approved ............... ......
DATE
State, «tee
't1 C7 Q qL^ O w W
O O n w
^ 7 n
W ^
o. \tel
5 w _ O
= n
1 0 � o $ p WA
1 n n ^ngo
n 1p.' T 9 1'►7 0)
Y y n n ^ n
Q Ye 7 Z
. O = n
H �o w na
^ T O T
S
o n rt bo- c, HD A
g n z
0 Z
s c
v 0o G w rx m 0
ql O
2 ^_
O .0.�
_ _w
m S o. o
O .
Remarks`(' ed ✓)
Type of Appliance I Units Fees II New I Replace (,Relocate
Gas Ranges
\Vall Heaters
Gas Plates' I I: t
Circulating Heaters I I 1r
Blower Furnaces II I -!v0,
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
I II I
Miscellaneous
NAME TYPE ••
I I II I
Appliance Fees
Inspected and Approved .....1..`! ,..... ......
DATE IIINSPECTOR
h.
£:21