NO PERMIT NUMBER 0J 4 J I zh 4i— �� Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
File No.
Date 2' L 196
Application is hereby made for a permit to
a ;tory, Type.
to be occupied only as
in cordance with Plot Plan, Plans/d d Specification filed herewith,
Estimated Value of Improvements $
FEE$ 3 !a Plan Check $
Owner ''� Q- ' Address
/Y
Contr. - � �i++s'✓�`✓f7C Address -21 7$ u
Phone -2s-o22.3.3r State License /,r&,F5e
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
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 FEES
Cont,. Address
Phone State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Latus of Che' '
State of California
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
MOTORS
FINAL
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG. ,[
FINAL GAS 16 Z �-+
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
MISC
Y
GAS SERVICE NOTICE OFFICE.
COPY
BUILDING INSPECTOR'S OFFICE
CITY.. F CUPERTINO
22 �
1 ...........................� 19G.
.....
................................
.[� ..
To
You are hereby authorized to conned the GAS service for
kEN Lyrz
Owneror Tenant .... .................... ...............................................................................
At .....los.b.5.........mA.lZ
.......�� .....................................................................
New Service ..,x...............
No. of Meters ..../................ Reconnect .............................
Move Service .......................
4 No. of Add. Meters .............. Move Meter
.. ........................
1J. .........................
V PLUMBING INSPECTOR
1o5-(5-- I 4c) 4 LOT NO.
TRE l'
® IR PLUMBING PERMIT
a tool,
CUP17RTINO
� Z
(SEP 1. 9 1969
r a Sanitary No.
R4Qy _
o a Date 66-7 Permit No /
3u CI U
w a Pee $3 —1—C
= o
Application is hereby made to the City of Cupertino for a permit to install plumbing
oan
ipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
> anr fixtures in accordance with the provisions of the Plumbing Code of th• :Ity of
a w Cupertino, and all other laws applicable thereto.
r
a 4 Use of Premises K•P/J Gu
oo G
> NAddress
o < Owner 1 y � 111
Z J -}},� J�
Z By dY ✓ Address
CONTRACTOR, AGENT
3 < iS z - X336
— 0 Phone
wW
aorate License' 455; 9V-Z— Approved. �.al�+ `-�
U �/ PLUMBING INSPECTOR
O G K < b d D.7 5 �o O p R v o w w m w :C. a w
A
C z
tr1
o 0 3N 2H -1 -3gvi
Y o 0 0 o w
m ti d rn .3 m' CHn y t w. N O x �
o y m
m - Hyo ^n O — 0 N � w a
a
7 - 7
N
z � z
ft t C)
N