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2676 ST �r LOT NO. NO. SRU. N Z Z P .FOR BUILDING PERMIT N Q E a , 0 OF CUPERTINO ° J ,1 OCT i l �.� - Sanitary No. 30 i n Date 1963 Permit No. F o prpT p o a C1TYpliCFron i1sL[Feb}+;htkdNYa a m1� i am a�_story Building w cto be occupied only as 0 o in accordance with Plans, pecifications nd Plot Pl�n filed herewith. rg Estimated Value of Improvements,$ �200 : 00 iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and J z all other laws applicable to the construction, location, and use of buildings within the Cit of do Cupertino w' bec plicdwith`. -/ y 3 IC Owner y[yee4lg -fdAddress aX By T�l J �!� /f• 'Address 4 u -' G S`-7.�: A Moved a o Phone PP � k State Lice ns � - �"� BUIL15ING INSPECTOR j o c o t• o 0 0 o c , � y 6 L N 1 L L 6 O Z_ ? X_ 09 CL a ' Z o v W d N 1 O e S� VW W '•�� j o z. o s e a < < o z .N 1 AGREE 1 WILL NOT VIOLATE ANY OF THE WORKMEN'S COMPENSATION LAWS OF THE STATE OF CALIFORNIA. � o ^ r 2'- ® o 0 =� � 1 rnN ;Il c a.'n o V o, a 2 o. T u c S N cm 0 2g 'o' � . 0 ° O C ` wo W O H H20 T o b o o " x ao , � B hoz 4 p o pZ S z H Q i V 6w a > w e�o22o LL < i _ o c c o � 1 W a' vFi j•J'+.( ',` fi 04 (0 GREE I WILL'NOT VIOLATE ANY OF THE WORKMEN S COMPENSATION LAWS OF THE STATE OF CALIFORNIA. •wy Q N 2'O f r9 7 O 'a 0 � g wc0o' C. W \1 O ~ y Q o � o � G � r a ooh^ a H O7 b zw ° A o o va0 3 2 \ c w v Z nl 0 T C7 0 H 1 N x .n O c r° -NU l -R MAIN DRAIN UNITS FEES UNITS FEES Water Heater Size Ware, Closets Material Bath Tubs To Curb Showers To Prop. Line (Lavatories 4 To Existing Kitchen;Sink's Not Conn. Dish Washers Sewer Boxes Waste Disposals Wash Trays STORM DRAINAGE \Vashing._Machines Size Water Softeners Material Bar Sinks ' To Main Drain - Ce,mb. Sink i Trays To Curb D ntal Uriits, Drinking Fountains t (floor Drains WATER SYSTEM 1 Hoppers Size Rest_aumnt Sinks Material Sand Traps TOTAL FEES rinals Fixture Fee Area Drains Main Drain Pee Water Lea rs Storm Drain Fee Jpr ter ares Water Sys. Fee UT, . orry so Permit Fee cio (TOTAL GqJ TOTAL FEE <Z4 RECO F NSPEC N Underground Rough... .Partial Rough__ .Rough. Complete.. _ \•Iain Drain Final... State License p C °,N4 t7 Q 8 � g' N rn. i vo n a G,oc C ° Ro to r r = O n > > > ° m a ^ 3 « H lzi A ° N >< I Remarks (Check ✓) Type of Appliance I Units Fees II New Replace I Relocate Gas Ranges I II I Wall Heaters I I I I Gas Plates- Circulating Heaters lates Circulating-Heaters Blower Furnaces II I • Gas Fired Boilers Warming Ovens �01?ercolators I I r Griddles II I I Steam Tables ravity Furnaces I I ,Suspended Unit11 yfloor Furnace I II Miscellaneous NAM TYPE) o0 I II I II I pp lance Fees �— .Inspected and Approved . .. _ . ...:....... ............. DA INSPECTOR I � I 2,& \& VIOLATE _ \a. _RK% COMPENSATION ra LAWS zTHE STATE aCALIFORNIA. \ ® � i ( / j: /: } \\\ƒ C, § { ] § % � \\ � t \j 4 ® ` ƒ \ \ \ \ \ Ou - I 00 � � \ - . § ■ .) m ) _ § a q 0 > § ® eaƒ y « rz , / E) / V , a ) � � ' 0 \ = i \ • \ j \ j \ \ \ � ) � § \� � \ \ \ \ \ \ \`\ � / ©\ � \\ - /(( \:\� � � \ � � � \ / � � ) � 114 0 0 15 -0 z z 11-F.eEIWILL NOT VIOLATE ANY OF THE COMPENSATION LAWS e �. �eCALIFORNIA. 7 / } %r : = o } . r%% % ` `{\g~ C) +® S0 It= q 00 ; Ll ! \ � � 2 * -Fro \ ) z ) ® 7 / / 0 § § � � �. m \ \ ( m § {\, ƒ . , § ( ; § . 0 � \a4 Remarks (Check d) Type of Appliance Units Fees II New Replace Relocate Gas Ranges Wall Heaters 'Gas Plates Circulating Heaters Blower Furnaces ,; 6 Gas Fired Boilers Warming Ovens .9. Griddles Steam Tables Gravity,Furnaces Suspended Unit .� Floor Furnace Miscellaneous YI (NAME TYPE) HOUSE GAS PIPING sy ,Number of Outlets Size of Main ,7 Gas Piping Fees Tested and Approved ^-/_f....3.. ............4.............. DATE- INSPECTOR 1 11