NO PERMIT NUMBER ZZ►S�� MC-C1e11ArJLotNo.02/
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. 'G' 08
Sariitory No..
Date 196
Application is hereby made for a permit to
story, Type
S 1'
to be occupied only as
in accordance with Plot plan, Plans and Specification wfiled herewith„
Estimated Value of Improvements E =123I
O_0
FEES Plan Check E
Ovrr.er *b`�#A-W IIW 4ddress
Contr. Address
phone State License
Approved WILLIAM D. GENEVICH
APPLICATION FOR ELECTRICAL PERMIT
Dote ��- .-� 196 a FEE$ Ai 7J
C --C- -<-t/ Address
Phone x377 - State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT /
5
Dare ' 196 41� GAS FEE $ / Z
,fn ,- ,,/r• PLUMBING FEE $ ��`�,���- p
Contr. r, Z4� (& Address T 4
Phone 2'�a 0 `S State License'. 71 ,:57 ,3 7 (/
Approved W"-'/u i � i /i
APPLICATION FOR APPLIANCE PERMIT _, -p
Date �6 196 -
FEE$
Contr. "'n-c-�'' /^'�"'^ Address
Phone vhf fG—y 937"/"' State License
Approved VALL1AM D. GENEVICH
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
FOUNDATION _ �BUILDING
Data ,/s i
UNDERFLOOR _ �i cror
Drua `s/ pa ctor
FRAME �L
. .• pector
LAL14 pPCL22 -Li pector
FINAL
Dote Insoector
ELECTRICAL
,OUTLETS SERVICE SIZE
SWITCHES 2-0 a UNDERGROUND
pfd Date i r
RECEPTACi ES ROUGH WIRING -Cs
/,!67 / D e Inspector
FIXTURES FINISH WIRING
U Y off- S- era , Inspector
H.P. CHARGE ,I FIXTURES
/ a to Inspector
ft-ilMIT FEE j 'rt Motors le j
D re
TOTAL FEES 2 9" FINAL � s pector
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I L.M.6TERIAL
WATER SYSTEM SIZE ATERIAL
TOTAL FIXTURES / a Q UNDERGROUND
FIXTURE FEE PARTIAL ROUGH /-�IyCJ
MAIN DRAIN FEE `'' ROUGH COMPLETFI/ tl(� s r
STORM DRAIN FEE MAIN DRAIN
OL Date In r
WATER SYSTEM FEE "� GAS PI ING Z2
GAS PIPING FEE `�-- FINAL - ;?
Data napector
PERMIT FEE o2 chi MISC
Date Inspector
TOTAL FEE MISC
Date Inspector
APPLIANCE
TYPE OF APPLIANCE UNITS FEE TYPE OF APPLIANCE UNITS FEE
CIRCULATING HEATERS REGISTERS 0 '�
BLOWER FURNACES �� COMBUSTION VENT
SUSPENDED UNIT MISC
GAS RANGE MISC
GAS DRYER PERMIT FEE c2 �'
FLOOR FURNACE TOTAL FEE 7
INSPECTED
Dote Inspector
ROUTE SLIP
File No. .S irk 7
Date Outer �k -S-
Date In
Locatio". 4 — —
Notes
Approved sx s A ( lam
( — Date Inspector----
ROUTE SLIP
File No. -J /d S'7
Date Out 3.0 -5—
Date In
Location 'Z
Sub,iec.t .—
Notes
i
Approved a, . ,&(
Date Inspector
�.� GAS SERVICE NOTICE corm''
BUILDING INSPECTOR'S OFFICE
CITY OP CUPERTINO r
To
You are hereby authorized to connect the GAS service for
ON%ner or Tcnan v.. . � . _.._... ... .. ..... ......
At .d �9 .CC% 'cEZ6C/v. '. .... ........
New Service /..... ......
.
No. of Meters/................ Reconnect .....
Move Service ........................
No. of Add. Meters .............. Move Meter .__............."_......
PLUMBING INSPECTOR
l
- - OFFICE COPY
,y ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
' ............... 3....... ..' .._.........__..., 196. ..
To
` to n electrical_service for
Owner or Tenant ..... .� ^...� ..........................
You are hereby au
At .........1.9........ ;W-g
No. of Wires............. Size of Wires ......�9......... Size of Switch
MotorLoad .......................... Voltage ---------------- ............. Phase ......_......_—
HeatingLoad ........................ K. W. .................................. Voltage ................................
✓ 01�
' Light_.............. 110........._ New Service................ Reconnect............
' No. of Meters.... .............. /�
Heat............_.. 220............ Three Wae._........_._ Move Service........_..
i No.of Add`Meters............
Power............... ace......... ...... Move Meter..............
. ........._
.............................._......._..
ELECTRICAL INSPECTOR
Bldg. Dept
Onitc Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Sewer Connection Sanitary Permit No. ......
. .....I----------------
Permit N
Plumbing ermt o. - o P7
Plumbing Final ...........0--e..........
o ----------------
Owner or Tenant ............ --
..
. ...........................
At ----------------.._-------- ----------
a
r
I Tract
----------------- - ----- ----------
Tract ........... -----------
I pp
19.
Dqte Connected ---------------------- --- ------------- ----- ---------------- --
DateFinal .............. ............... ..................................................
............�,- ?�-wi .........................
PLUMBING INSPECTOR
111 7/63-IM
{CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Date ----Z?r.....'.:..:.7..................... 19., :,i^" Building Permit No. f
The Building Located at
i�j/ . / r
Owned by .....>.----. .^.wcT���J6.e`-...-,.......::.....�✓rf:..-..-------:............:.....................
Has Been (Compl'ted)
Por Use As: .....
� •'". ......t-..._.....................'�---......
(Altered)
f'
_......................------........_--................--'--.........._......----.......--.....------"------................--......
IIS -----_....---..............................._..`....._....r ................................
It 7.r -fes.. ......_.........
.................A.-.... . ..-..
BUILDING INSPECTOR
1027/63-500
.2./ GI 1� /-7c CLC`'Y vD RO
,y-- LOT NO,
NO STREET /�_ �, re
G�-i"F
CI OF CUPERTINO
APPLICATION FOR PLUMBING PERMIT
Olt
CGp.� Sanitary No. _
Date _ `ANO ,19 7 If- Permit No. O c5' 7
9 Fee$
Applica"titin�c here�j�made to the City of Cupertino for a permit to install plumbing
pipes and/or flxt^s listed on the reverse side hereof, and agrees to install said prices
and/or fixtures in"6ccordance with the provisions of the Plumbing Code of the City of
Cupertino,and all other laws applicable thereto.
Use ofWork To Be
Premises /�E Performed
]]��
Owner "' 1 SELY S Address Sal M E
2512
Phone 7- 69qq
B A�'E PL(jGl(/6-✓u-. Address '2/S^O STO.VG /QV S/I•v,'rOSE
By
Contractor, gen `Irl 2-5—
Phone—r2
'5
Phone r� '77 - O /07
,Z.F/ z �7 Approved /
$tate License Plumbing Inspector
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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