51145 2 /,SJ rI MONROVIA Let Mo.,"/
No. Street S-0
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. 51145
'Sdnitary No.
Date 7-16 196 5
Application is hereby made for a permit to
CnrRtrurt a l ,story, Type F-T-.T
to be occupied only as Single Family Dwelling
in accordance with Plot Plan, Plans and Specification filed herewith
Estimated Value of Improvements E 26,o0O. 00
FEES - 80• 50 Plan Check E 40• 25
o,,,,,ar Ward Crump Development Qyyte55 _ Box 634, Cupertino
C,ner, By Ward Crump Address
Phone P5'�-0800 State License l gp6oq
Approved W.D. Benevich/hm
APPLICATION FOR ELECTRICAL PERMIT
Date °? 196 FEES
Contr, ��-<--� Address 1-76 X4
Phone _ ��d - �/ `1 State License 70 y 95
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 7- I 196 -1 GAS FEE E
p//� n / PLUMBING FEE E VM
Cont,. _L/r-/"�✓�✓ .�L'^!�' . Address
Phone 3 7 `J 1 State License( 3 "Z 30 -"e'C
Approved
7-3 APPLICATION FOR APPLIANCE PERMIT y 5
Date 196 r3— FEEE �/� ,�
Contr. -Q � 111A;�;s �-�.� 6etfe , �-O-z
Phone �ti_ 3-,241 3 e
State Lice ns/e '_CQ�-Z�' "2/ 9.r
Approved Lam/✓
Applicants agree not to violate any of the
Workman's,Compensation Laws of the
State of California
I
RECORD OF INSPECTION APPROVA S
FOUNDATION • ��� ILDIN
_Dote /� spa cf or
UNDERFLOOR
FRAME -�✓ 18 .5/ Inspector
D to r--.� �� Inspector
LATH PLASTER -r' ✓
Inspector
FINAL
Date Ins oect°r
ELECTRICAL
,OUTLETS /� / d
SERVICE SIZE
SWITCHES y[i�3/ „L 3-0 UNDERGROUND -
RECEPTACL@$ ROUGH WIRING e,C-S/ Pector
FIXTURES 9 �d FINISH WIRING D to Inspector
1�4
Date Inspector
H.P. CHARGE FIXTURES
Dara Inspector
PERMIT FEE / Motors
L Da actor
TOTAL FEES %a FINAL -� -G-Y
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I MATERIAL
STORM DRAIN SIZE I LiATERIAL
I_
WATER SYSTEM SIZE ,TERIAL
TOTAL FIXTURES / CSD UNDERGROUND
FIXTURE FEE PARTIAL ROUGH -9:
MAIN DRAIN FEE `1'a-o ROUGH CE DS-
OMPLET -- to r,- -
STORM DRAIN FEE MAIN DRAIN '3'GS�
WATER SYSTEM FEE GAS PI ING --?- D to r r
pate n
-6-
GAS PIPING FEE FINAL y
PERMIT FEE o2 q Date nspector
'— MISC
TOTAL FEE 0 _ MISC Data Inspector
_
Date Inspector
APPLIANCE
TYPE OF APPLIANCE- UNITS FEE TYPE OF APPLIANCE UNITS FEE
CIRCULATING HEATERS REGISTERS // oZ7s
BLOWER FURNACES COMBUSTION VENT
SUSPENDED UNIT MISC /
GAS RANGE MISC
GAS DRYER PERMIT FEE nZ ca
FLOOR FURNACETOTAL FU—
INSPECTED
- Date Inspector
n ACERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
/ CITY OF CUPERTINO
Date ....... '^ t"
..-..<:........................... 19.1!..:^.. Building Permit ll./...-:..-
The Building Located at `'1 ✓ -�. J/�1ti/�}7i C�
L
..
Ownedby ....... ...... ..........................
Has Been (Completed) For Use As: Z;...... f
(Altered) .....;:,�''�: .................... ............................................
............... ........................................................./...........................
.........................................
...... ........................................................................................... ........................................
v
102 1/63-500 IN
t%. BUILDING SPECTOR
Bldg, Dept
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Sewer Connection Sanitary Permit No. .......!�pelo.........
e-010FIumbing Final Plumbing Permit No. ---------
Lot N ..............
Owner or Tenant ...
At
Tract ----------------
DateConnected ....4e7................. --------------------------- -----------------.... 19A(a4r
Date Final -------------------------------
-5 PLUM 1UNSPE 17011
Ill 7/63-1M
* GAS SERVICE NOTICE O F[Ci:
BUILDING INSPECTOR'S OFFICE COPY
CITY OF CUPERTINO
n
To
You are hereby authorized to
connect the GAS
SSseservice for
Owner or Tenant .� ✓J_�{
New Service ......
No. of Meters
_./........._... Reconnect .........
Move Service ........................
No. of Add. Meters _.... ....... AIove Meter
PLUMBING INSPECTOR
TEMPORARY GAS SERVICE
DATE: ... 3
Fee: ..._......:77=
OWNER: ........
AT: --------- ----------------------------------
LOT: ------ -^...-
4ror:�,,
REASON:
The undersigned agrees to be responsible for the gas service at the above location,
until the building is ready for occupancy, and is released by the Building Department,
City of Cupertino.
Phone I.........
-- --
--- ------------------------------------------*-------
INSPECTOR TENANT OA OWNER
117 1/63-500
I
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uI a�e(I
'no Ggpc
O14 BTT3
dI`Is aipod
ROUTE SLIP
File No. ��TS
Date Out
y� Date In
Location
Sub'J'ec't
Notes
Approved --
Date Inspector
PAe-) EL..✓ 444.5'6