NO PERMIT NUMBERi 1 Ltn. LOAJ •Lot No.30
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.qs/O�
Sanitary No. 7clo
Dote � � � 196
tion is hereby made for a permit to
to be occupied only as
R
story, Type �~ t
in accordance with Plot Plan, Plans and Specification
`nfiled
herewith.
Estimated Value o4 Improvements $ 4=203 , 00�+
FEE$ 111 7, 41 0 Plan Check $
Ov,r.er s
Contr. Address
Phone State License
Approved
Applicants agree notito violate any of the
Workman's Compensation Lotus of the
State of California .• ..
APPLICATION FOR ELECTRICAL PERMIT
Date 196
FEE$ I"5/�
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APPLICATION FOR PLUMBING
& GAS PERMIT /
Date,
_ 196 sl
GAS FEE $
PLUMBING FEE
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Approved WILLIAM D. SENEVICH
C� APPLICATION FOR
APPLIANCE PERMIT
DateT
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Approved WILLIAM D. HENEVICH
Applicants agree notito violate any of the
Workman's Compensation Lotus of the
State of California .• ..
E%Y%G� �S A
R COR OF IN PECTION A ALS
FOUNDATION
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Date
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Inspector
Date
MISC i
Inspector
FINAL
STORM DRAIN FEE
Date
MAIN DRAIN ll
Inspector
Do to
WATER SYSTEM FEE
Ins De c tar
ELECTRICAL
SERVICE SIZE
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I SIZE
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TOTAL FEES
3
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STORM DRAIN
I SIZE
ROUGH WIRING
(o
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WATER SYSTEM SIZE
Data
4TERIAL
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FINISH WIRING
TOTAL FIXTURES
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MAIN DRAIN FEE
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Date
In or
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Inspector
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MAIN DRAIN
I SIZE
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I SIZE
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COMBUSTION VENT
FIXTURE FEE
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Date
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or
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GAS PIPING FEE
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'• PERMIT FEE
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Inspector
PERMIT FEE
as
MISC
TOTAL FEE
6 S
Data
Inspector
TOTAL FEE
MISC
Date Inspector
APPLIANCE
TY09 OF APPLIANCE
UNITS
FEE
TYPE OF APPLIANCE
UNITS
FEE
y Z
CIRCULATING HEATERS
REGISTERS
BLOWER FURNACES
COMBUSTION VENT
Y
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SUSPENDED UNIT
MISC i
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MISC
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'• PERMIT FEE
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as
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TOTAL FEE
INSPECTED Y
Date Inspector
ROUTE SLIP
File No.
Date Out
Date In
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Notes
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Date Inspector
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ROUTE SLIP .
File No. J7 a ��
Date Out
Date In _
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Notes
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Date Inspector
11
CERTIFICATE OF COMPLETION
summlo INSPHcmws oma
CITY OF CUPHHTINO
Daze.....,� .......:......, _ G 19 Handing Permit No. of P
They,,il,ri•,,,, Locadsat
Owned by.._+"::.:rt..'.!.k::1.af.:L�!'P�.•.,G..l...':.r•!Ci/,,,Kil.......✓..�.:4'-:1�_:.._...._.....
Has Beed •P�) For Use As:....-Mge-1..... _.... _....
_..._._..
102 7/63-M
OFFICE -COPY
ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
................./..//........................., 196-0!
TO
You are hereby auVrizedto =pfielec.t i ervi
t
Owner or Tenant ................
......................
At..._ .........................
No. of Wires ............ Size of Wires ................
.... Size of Switch
MotorLoad .......................... Voltage .............................. . Phase ..................................
Heating Load ........ ......... K. W....._ ...................... ..... Voltage ...... ..................
Light. ............... 110....x.... New Service..:............. Reconnect..................
No. of Meters .................... Heat ................. 220............ Three Wire................ Move Service............
No. of Add. Meters............ Power .............. Move Meter..............
............
F.LECTIUCAL INSPECTOR
GAS SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
_....... _. _.
..... _...................
OFFICE
COPY
I 964
To
You are hereby authorized to connect the GAS Isemceeffor
Owner or Tenant
At .
New Scnicc ..' ................
No. of Meters Z.— ...... Reconnect ....... ......... _...... ......
,hove Service ........................
No. of Add. Meters ........ Move Meter ... ................
PL MBING INSPECTOR
111da. Dept
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Sewer Connection Sanitary Permit No . ......... 0-70 ........
Plumbing Final Plumbing Permit No.1411047 .... ....