NO PERMIT NUMBER (3)/03 / I Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. /00
Sanitary No.
Date 196
Applicion is here axle for a permit to
a story, Type
to be occupied only s
n accordance with Plot Plan, Plans and Specification filed herewith.
Esti atd Value of Improvements $
FEES o ' Plan Check $
Owner r • •04611 �nrn�/Address
Contr. - Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 7-41 196 GAS FEE $
PLUMBING FEE $
Contr. ' -/�f.i.�P..iMtflidress 3311 r. "
PCPhone wz 7 C—.3 2. State License
'f./
Approved o �/
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
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
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Dote Inspector
FRAME
Date Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Ins De c tar
ELECTRICAL
,OUTLETS SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
FIXTURES FINISH WIRING Date Inspector
H.P. CHARGE FIXTURES Date Inspector
Date Inspector
PERMIT FEE Motors
TOTAL FEES FINAL Date Inspector
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I 191m6TERIAL
WATER SYSTEM SIZE IATERIAL
TOTAL FIXTURES WOOL UNDERGROUND '
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Data spector
STORM DRAIN FEE MAIN DRAIN
Date n actor
WATER SYSTEM FEE GAS PI I
e or
GAS PIPING FEE FINAL
Data
PERMIT FEE 40691 MISC
TOTAL FEE � 4144% Date Inspector
M_ ISC -
Date Inspector
APPLIANCE
TYPE OF APPLIANCE UNITS FEE TYPE OF APPLIANCE UNITS FEE
CIRCULATING HEATERS REGISTERS
BLOWER FURNACES COMBUSTION VENT
SUSPENDED UNIT MISC
GAS RANGE MISC
f
GAS DRYER PERMIT FEE j
FLOOR FURNACE TOTAL FEE
INSPECTED
Data Ins pe star
I /cu���
G T, LOT x0,
No. STREEI
CITY OF cuPERTNAPPLICATION FOR PLUMBING PERMIT
w JUN 2 7 1972 CITY OF CUPERTINO
Y 0 Sanitary No.
L, p
o Ill'teAr-- 17 DJy'U.� IggzL Permit Nn,_.5 o o g
a
3 4 Pee $13�a
x 0
Application is hereby made to the City of Cupertino fora permit to install Plumbing
.;, a a pipes and/or fixtures listed on tthe reverse side hereof, and agrees to install said prices
'r and/or fixtures in accordance with the provisions of the Plumbing Code of the City Of
a w Cupertino, and all other Erns applicable thereto.
w x
T
Use of Premises
00
> m ��.�,
r 3 Owner v'LN��ti Address.$/O AZ• r,(l irueNe�3TL'12 $_J,
0a
z
� z By W%vkc WS7 '? �e-esr'` tsinn Address 1211 bc—L, GI
✓d C..a .
0 CONTRACTOR, AGENT
3 �
a o
State License ald - 2w5 Approved'
—U
PLUMBING INSPECTOR
�Ir < 1QR22El , , , @ ! , r = „
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rn ) = 2
CITY OF CmkTINO COPY
GAS SERVICE NOTICE
J•
To
You are hereby authorized to connect the GAS service for
Owner or Tenant L)
At
New Service
No.of Merm :.Pr Reconnect
No.of Add.Meters I Move Service
Move Motor L•
PLUMBING INSPECTOR /A /•G'r I ®r
• r
. �
OWE
CITY OF CUPERTINO
R
GAS SERVICE NOTICE
To U
You are hereby,authorized to connect the GAS service for
Owner or Tenant
At
New Service y
No.of Meters Reconnect
No.of Add.Meters l Move Service
Move Meter
PLUMBING INSPECTOR