File 51069` Lot No.
Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
San Ito ry
File No.y / 4
c! ' �
Date �' 196-/ ... . .
Application is hereby made for,p permit to -
to he occupielyonly as '
in accordance with Plot Plan, Plans and Specification filed herewith.
Estimated Value of Improvements
FEE§ % Plan Check §
Owner ,C.[ /M1 . LZ 'f' ' Address
1
Cont,. _ ,dress
Phone 02 r-2 ,',3 % 0�O
State License
Approved A-J
APPLICATION FOR ELECTRICAL PERMIT
Date 196 �'U
FEE§
1 r' 1
Contra ®� Address0�
sv/-e/�+`+--•��'
Phone a % 7 —' ��� t� State License /S-O.a_S w9�,
.. Approved—
APPLICATION FOR PLUMBING & GAS PERMIT -
Contra Address
I Phone State License
Approved _
Applicants agrcc not to violate any of the
Workman's Compensation Laws of the
State of California
I Date
196 '71
GAS FEE '§
PLUMBING FEE §
Contr,
`nI- �Q
�r,lyr!��T
Address
Phone
S
State License— ,2
Approved)
v
i
APPLICATION FOR
APPLIANCE PERMIT
li Date
196
FEES
Contra Address
I Phone State License
Approved _
Applicants agrcc not to violate any of the
Workman's Compensation Laws of the
State of California
PAD FINAL
FOUNDATION
UNDERFLOOR Q
FRAME
LATH a PLASTER_
GRADING FINAL_
FINAL BLDG.
UNDERGROUND ROUGH
ROUGH WIRING
FINISHED WIRING
1.
FIXTURES
MOTORS
-FINAL
BACK FLOW REO.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH_
ROUGH COMPLETE
MAIN DRAIN
"FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
RECORD OF INSPECTION APPROVALS
BUILDING
NSPECTOR
ELECTRI L
DATE INSPEC OR
.�
if -*70
' eft
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR
DATP INSPPCTnp
D
MISC
MISC
I �
MISC
NO. { STRP LOT NO.
A jr POR ELECTRICAL PERMIT
6 �0�10 CITY OF CUPERTINO
. Date "lS� �G �\ 191U Permit No. v 6
i , I
I=ce :S
Applicati `i heCeby made to the City of Cupertino for a permit to install electrical
wiring and�� fixtures as listed on the reverse side htll� and agrees m install said
wiring and/or fixtures in accordav ci c with t 'provisiothe Electrical e of the
City of Cupertino, and all oth applicable therUse of Premises! 1
N
Owner
� � f/Z/ SELL
2Y h`Address9(�l V
w
By_,(c� y
r/t<l-f'l��,r
- . AddressY
CONTRACTOR, AGENTZ�o
r/A
pp roved
Phone:.T!,
7— �L( �f ',
f ELECTRICAL INSPECTOR
State L cense
_Z�2 )6
T l/
Motors _----------------f P
Motors HP
Motors.........._........ HP
Rough Wiring
DATE
Finish Wiring ................�..
DATE
-... Phase -----
..... Phase ----
_.-. Phase .....
A
..--------------------------------
I ...
'...
1 ---
-... ---
------- Permit Fee oo
..- ...
H P Charge ----------------
TOTAL
...--- ------ TOTAL FEES3��
OF INSPECTION AYMIVVALJ
...... Fixtures -------------- ------- --------------- ------
INSPECTOR DATEINSPECTOR
Motors --'-'
INSPECTOR DATE INSPECTOR
Final----- ---------------
- DATE INSPECTOR
Size Service Conduit ......................Number
of Outlets................
Size Service Wires........................:Number
of Switches................
Size Service Switch ---------------------
...Number of Receptacles............
Size Sub Feed Conduit ------------------
Number of Fixtures ..................
Size Sub Feed Wires...................Ranges................
KW ..............
Number of Circuits ...................
Oven .............. KW,....
Number of Meters ...../._------__---Signs..�E
rmee, s`v--------
Motors _----------------f P
Motors HP
Motors.........._........ HP
Rough Wiring
DATE
Finish Wiring ................�..
DATE
-... Phase -----
..... Phase ----
_.-. Phase .....
A
..--------------------------------
I ...
'...
1 ---
-... ---
------- Permit Fee oo
..- ...
H P Charge ----------------
TOTAL
...--- ------ TOTAL FEES3��
OF INSPECTION AYMIVVALJ
...... Fixtures -------------- ------- --------------- ------
INSPECTOR DATEINSPECTOR
Motors --'-'
INSPECTOR DATE INSPECTOR
Final----- ---------------
- DATE INSPECTOR
No. STREET
W z A [CATION FOR BUILDING PERMIT
r ° CITY OF CUPERTINO
3a _In s Smiital,a No.-
;t
u.
U
U:iie`q _ �� G 19� Permit No.
'o a �A3pllcati n is Made Ja per it to — J
a N` a� ry, ype. Y'T Building
to bo;bkcup ed only as in accordance with
0 o Plans, Specifications and Plot -Plan filed •herewith. P1 Ck Fee
3 Estimated Value of Improvements, $ %.SOo I gee
oa
z J It is hereby agreed that the requirements of the Cupertino. Building and Zoning Ordinances and
* Z all other laws applicable to the construction, location, and use of buildings within the City of
O Cupertino will be complied with. _
3 `m Owner a� a ress G /
wZt
a By. 1 ` ress 'Y)
a 0 Phone S Z S 3%p t
Approve
;L State License 7— 51 �7 0 n.DING INSPECTOR v