NO PERMIT NUMBER r
Co C. .
_ 21555 I MONROVIA ST. Lot No. 208
No. Street Model #3o4
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. 51145
Sanitary No. 46PR
Dote Nov. 196 5
Application is hereby made for a permit to
Construct a 1 story, Type 5 I J
to be occupied only as Single Tamily Dwelliniz
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $ 24,000. 00
FEES , ) Plan Check $ 37• 50
Owner _Ward Crump Address BOX 6,14
Contr. Address
Phone 253-0800 192609
State License
Approved W. D. Beney; nh/h
APPLICATION FOR ELECTRICAL PERMIT
Dote � a `�t
196��7 � FEES /-? �Q
Contr. /� c'c-r�•t� e��d"ss -7-71) �r'r't d ' ?r /A/L
Phone f�—-55��-f State License - 1 '70
G�
Approved ' '
APPLICATION FOR PLUMBING & GAS PERMIT CWT—
Date /L �� 196 �'�~ GAS FEE $ 7
�j
PLUMBING
FEE $
Contr. 64�( 7"" " . Address
.meqi
Phone LL/ ' '�� State License '20 y 7
¢nom �-
Approved
Dara /' 7 APP ACATION FOR APPLIANCE PERMIT 7 7S
196 FEES
Contr. � Ga..,2.-� - dies 7 7 ,�{>�.y
Phone 52? r:2- G O I State,License///p0 �-� /"^� /6t -z--tom
1
Approved
Applicants agree not to violateany of the /T�
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
FOUNDATION — BUILDING
UNDERFLOOR _
_ pecfo
Date Ins pecfor
FRAME
Date spe c for
LAT PLASTER ��D �'
FINAL tea^' �f Inspector
Date Insoector
ELECTRICAL
,OUTLETS
/� a SERVICE SV_E �
SWITCHES Z UNDERGROUND /
RECEPTACLES 3 J60 ROUGH WIRING
% / �� f
FIXTURES � FINISH WIRING � C �at9b pecfor
a 2 z-J atInspector
H.P. CHARGE FIXTURES
Date Inspector -
PERMIT FEE Motors
f �[ p = e pecfor
TOTAL FEES FINAL •l O
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I MATERIAL
STORM DRAIN I SIZE I 4TERIAL
WATER SYSTEM SIZE I'TERIAL
TOTAL FIXTURES UNDERGROUND
oa
FIXTURE FEE PARTIAL ROUG -S-C
Date//
MAIN DRAIN FEE -- ROUGH COMPLET - -)64
A
STORM DRAIN FEE MAIN DRAIN -`y`9 - or
WATER SYSTEM FEE / c' GAS PIPIN '�?'bib for
Dade for
GAS PIPING FEE FINAL
DataInspector
PERMIT FEEC� .MISC
Date Inspector
TOTAL FEE MISC
Date Inspector
APPLIANCE
TYPE OF APPLIANCE UNITS FEE TYPE OF APPLIANCE UNITS FEE
CIRCULATING HEATERS REGISTERS / / "Z T6
BLOWER FURNACES % Com, COMBUSTION VENT P�
SUSPENDED UNIT MISC GU /b V,. / H
GAS RANGE MISC
GAS DRYER PERMIT FEE
FLOOR FURNACE TOTA E 7 7L
fl
INSPECTED �42:2-b/
Date Ins pe c for
16
16
Bldg. Dept
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Ej Sewer Connection Sanitary Permit No. ............
Plutnbirig Final Plumbing Permit No. ........
Lot No. -----------
Owner or Tenant ...Ga.l
4�, .........................
At
Tract ..
sf:74---------------------------------------------------- 19-4;C
---------------------------------------------
........... .....................
--------------------------------------------------------------------------------
Date Conne ---------
--- ------
Date Final ..................................1;.1:1
........................................- ------------*----- ------- --*......
PLU BING INSPECTOR
Ill 7/63-IM
L
:
GAS SERVICE NOTICE COMOFFIC"
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
To
You are hereby authorized to connect the GAS service for
Owner or Tenant av'lelo lx .(164ee�-
At -e-V50.
New Service
. ....
No. of Meters ... ............... Reconnect ...... ...
Move Service ..... ........
No. of Add. Meters .............. AfoJe Meter ................
lzx—
. . .........
Z��' PLUMBING INSPECTOR
ELECTRIC SERVICE NOTICE OFFICE COPY
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTIN(�
.......?r�................... 196
TO
You are hereby aut01 to n e electrical service for
Owner or TeWnt ...........i
............... ............- ................
At .......
................. ........................... ...........
......... .... ----
—----- -
3 ---.....
*— - - /bA
.
No. of Wires ........................ Size of Wires Size of Switch -,...C).............
Motor Load ....................
------ Voltage .............. ................. Phase ... ......... ........ .. .....
HeatingLoad ........................ K. W. ..........._..................... Voltage ....-.........................
If (Light.. 1t0........_.: Nrvice.i��... Reconnect...........
No. of Meters.................... , o....
Heat.......... T
N Mete .. 220...t(..... Th Wi ...... Move Service............
Meters............
M
e
e M
Power............. T .. ..... 'Move M ........
.... ........ .. ...... ....
....... .....
ELECTRICAL INSPECT
ROUTE SLIP t
File No .
Date Out Z2:gpe�i;
Date In
Location
Sub j e e t
Notes
1
Approved_3-'y�i�p �--
Date inspec dor
ROUTE SLIP
File No .
Date Out -G.—�
Date In
Location mac'
Subject .
Notes '
Approved
Date Inspector
410, v
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