NO PERMIT NUMBER21063 Patriot War; 12L 46
NO. STREET -a • ^' - '" - - " - LOT NO.
\, 3.08
CITY,.OF CUPERTINO
APPLICATION FOR BUILDING PERMIT
SANITARY NO. 9414 BF
FILE NO. 51.150.2
DATE _ 6/17/76 19
Application is hereby made for a permit to
r.nret Pt, Plan A) a i story,type 5-N- Nr-
to be occupied only asT F. .T Eli ngl e Family Dwelling
in accordance with plot plan, plans and specification filed herewith.
FEE $
ESTIMATED VALUE OF IMPROVEMENTS s_ 44, non
CHECKS
OWNER ADDRESS_2570 El Camino Real, M.V.
PHONE 941-6o5o
255-1422
PHONE
ADDRESS
STATE LICENSE 220382
APPROVED James H. Sisk/h
BUILDING INSPECTION RECORD
DATE
PECTOR
DATE
INSPECTOR
FOUNDATION
FLOOR STEEL
PRE-GUNITE
FRAME�-
BOND BEAMS •• -
LATH
WALLBOARDS - T BExT.
2•/7 7
FIREWALLS _
MEMBRANE
LANDSCAPING
F.M.O. INSPECTION,
FINAL BLDG.
UNDER -FLOOR
TIEDOWNS
-MISC-
DIAPHRAMS
MOORE BUSINESS FORMSINC_LA
ELECTRICAL INSPECTION RECORD
RESIDENTIAL
DATE
INSPECTOR
COMMERCIAL
DATE
INSPECTOR
UNDERGROUND ROUGH
UNDERGROUND ROUGH
ROUGH WIRING
ROUGH WIRING
FINISH WIRING _
FINISH WIRING
FIXTURES
INTERIOR FIXTURES
MOTORS
EXTERIOR FIXTURES
FINAL
C.MOTORS
FINAL
MISCELLANEOUS INSPECTIONS
PLUMBING INSPECTION RECORD HEATING 8 A/C INSPECTION RECORD
DATE
INSPECTOR
DATE
INSPECTOR
BACK FLOW REQUIRED
UNDERFLOOR S.M.
-%
BACK FLOW INSTALLED
DUCTS 81NSULATION
UNDERGROUND ROUGH
- -J(o
FLUES & COMB. AIR
PARTIAL ROUGH f/
3
CONDENSATE DRAINS
ROUGH COMPLETE
FINAL APPLIANCE
2%
ROOF DRAIN & LEADERS
MAIN DRAIN
;>6 72
FINAL GAS i
LC
FINAL PLUMBING
L(
MISCELLANEOUS
ROUTE SLIP
File No.
aa Date J� 7
Location 14 � ` C
Subject
J
Notes
Approv -
idftEe: r specto
CERTIFICATE OF COMPLETION'
BUILDINGINSPECTORS OFFICE ,
CITY OF CUPERTINO '
,QATE Z d tll'9'.- BLDG: PERMIT NO. � // i
THE BLDG. LOCATED AT Z1063' •T�/OT W�"y\..
OWNED BY �2IIeT/b I�l w.d 6 e� /7�-y(G�W: f'1 D -
HAS BEEN TEDI OR USEAS1 //%/,vim• �i V• �/-
(ALTERED) _
UILDING INSPECTOR
/ELECTRICSERV ICE NOTICE' .OFFICE COPY
p�b BUILDING INSPECTOR UPERTISNOTICE .
/ CITY OF CUPERTIfSO„t—.,;;,1.J:
To ig
You are hereby
authorized to Connect efectncol servicejor
Owner
No. of Wires _
Motor Load
Hearing Load _
Size of Wues
-,Size Switch
/oo
Voltage. p Je
K.'W'
t
No. of Meters
( Hear_
No. of Add. Meters
2 Power_G
@
ELECTRICAL INS PECTOR
/A
IO r/ New Service Reconnect
20Three Wire More Service
Three Phase- Move Meter
Bldg. Dept '
Office Copy
BUILDING .INSPECTOR'S OFFICE
t
CITY OF
CUPERTINO -
'/1l�? T
7 Se' wer Connection
Sanitary Per mit No..���.�� -
Plumbing
Final -
Plumbing Permit No. S.0 i /.30• �—
Owner Tenant
��
Lot 'No.. -= ...1/6 .- - -
-
. or
... ...!.:der•.?..R;tl.�..,,...Q.....f/.._......
<
At ....02.!!L
. �-- ....�L_ f�± r-f.::�.
.:......................................................
Tract--
-- -...-. ---------------------------------
Date Connected......
f__ .........................
--------------------------------- 19-.... -
- - Date Final .......
..... /...— 7(, - ?,
----`-------.. _--------------
-----.......------....-'------------
- --------- 19---....---..
-
--'--------....L------ ---- -----'.t ... �.?iG.
PLUMBING INSPECTOR
OFFICE
r9 CITY OF CUPERTINO COPY
/IJ GAS SERVICE NOTICE
,t9 7 7
To .. ..
You are hereby authorized to connect the GAS service for p
Owner or Tenant
,. New Service i
No. of Meters Reconnect
No. of Add. Meters Move Service
Move M
ete
r�-
PLUMBING INSPECTOR
LOT NO./6 - A
CITY OF CUPERTIN
d
.
APPLICATION FOR WILDING PERMIT
CAP. I
l FEE 3.08
w z
Building
Date flry r- �..____...
Per. No. .i//.i�. L.
><0
19
Sanitary Per. No. _qVf
APPIIcP,,?, is haieb--made for a permit to NT_s rssT�Q
3
�—
a story, Type
Structure
cc to be occupied only ai x'4.,P&—--�--�
�` in
a
accordance with
'Z N
Plans, Specifications and Plot -Plan filed herewith.
a w
F
Estimated Value of Improvements, $ 0
a
O_ O
It is hereby agreed that the requirements of the
PI Ck Fee $
u,
Cupertino Building and Zoning Ordinances and all
Fee $ Z6 9 O U
aother
laws applicable to the construction, location, and
Z
use of buildings within the City of Cupertino will be
Total Fee $
ZO complied with. 3 a r e U�p o eaG^I
N _
w Z NER PHONE
it a
Q 0 AT CONTR. OR AGENT
PHONE STATE LICENSE
9f%� CI Lr19�+t/IYO
A RE65
AD RE S
BUILDIN INSPECT
21063 PATRIOT WAY - 46
_ LOT NO.—,
ST NO. REET -
cuae:.T1N CITY OF CUPERTINO PLAN "A".
1 ,SAPPLICATION FOR.ELECTRICAL PERMIT
EC � ,
%
O �� * Permit No. ,.
Date /%�.23�- , 19 76' . ' Fee E logo
g
,Application is hereby made to the City of Cupertino for a permit'to install electrical
wiring and/or fixtures as'listed on the reverse side hereof, and agrees,.to instdll said
wiring 'and/or fixtures in accordance with the provisions of the Electrical Code of the
eCity of Cupertino, and all other laws applicable thereto.
use at � 1) Fam. Residence Work.To Be '
Premise Performed
Own.XILLAGE GREENS Address
Phone '
8,ALL—CAL ELECTRIC CO. Address10 STOCKTON AVE. 'SAN JOSE
Contractor, Agent
Phone-295-5230
State License '22s �622 Approved _
. Electrical spec r
I AGREE I WILL NOT VIOLATEIANY OF THE WORKM 'S
COMPENSATION LAWS OF THE STATE OF CALIFOR - t
LA
PLAN "A" TRACT'
-ITEM - NEW RPL FEES
Number of Outlets '
Number of Switches -
Number of Receptacles'
Ranges or Ovens K.W.
Size of Main Service-
- 'Number of Meters - _ -
Number of Panels
H.P. Phase.
. H.P. Phase
' H.P: Phase -
Power Poles - - -
Misc. '
Permit Fee -
H.P. Charges
Total Fees - - -
LA
21063 Patriot Wav' Plan A LOT
NO ST EET
CITY OF CUPERTINO
"APPLICATION FOR PLUMBING PERMIT
JAN19 1977
'C
• Sanitary No.
Date Jan. 2;2 ,I9.76 Permit No.`
L s-i 0 V Fee E
Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said.prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use ofSingle Family Res, Work To
Be
Premises 9 Performed
Plumbing
OCupertino Village Green 2�5�d0tEl Camino Suite 302, Mt. View, Ca,
Phone 941 —6090
doe Amaral Plumbing Addre,,P•O,Box 150, S.C., Ca.
Contractor, Agent
Phone 296-3963
State License 175299 Approved
Plumbing Inspector
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
® L,
FIXTURES
NUMBER'
MAIN DRAIN
Units
Fees
Units
Fees '
Water Heater
Size
Water Closet
Z
Material
Bath Tub
To Curb
Shower
' To Prop. Line'
Lavatories
To Existing
Kitchen Sink
Not Conn.
Dish Washer
AIP
Waste Disposal
d
Wash Tray
STORM DRAINAGE
Washing Machine
Size
Water Softener
Material
Bar Sink
To Main Drain
Comb. Sink 8 Tray
To Curb
Dentol Unit
Drinking Fountain
Floor Drain
WATER SYSTEM
Hopper
Size
Restaurant Sink
Material
Sand Trap
I TOTAILIUS
Fixture Fee
2 �,00
Main Drain Fee
r
Storm Drain Fee -
em
n
Water Sys. Fee
,
Gas Fee
Z . G Q
Skimmer
Fiber
Pool Sweep&
Permit Fee
Total
Total Fee
21063 Patriot• Wy LOT
NO, STREET
CITY OF CUPERTINO
cnY o7 ,CLL'"APPLICATION FOR APPLIANCE PERMIT
JoA T01976
#46
y
6-18- 76 Permit No.
Date,,Is_ Fee E . . 00
n � r
Application is hereby made to the City of Cupertino for a permit to install gas
appliances as listed on the reverse side hereof, and agrees to install said appliances in
accordance with the provisions of the Plumbing Code of the City of Cupertino, and all
other laws applicable thereto. "
Use of • Work To Be '•
Premises Reg. Performed HPa't/S}1PPt MP al
Ov,ner Cupt. Village 4pess 2570 El Camino Real #302 Mtn
_�_--'®855Q41.-E�O50 Lew
Ph°ne �- ,SAN CARLOS SHEET METAL WORKS, INC.
i i
`""59127292 SAN CARLOS, CALIFORNIA
Phone
' 110828
State License Approved
Plumbing Inspector '
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S '
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
0 i.n
APPLIANCE -
UNITS'
FEES
i) FORCED AIR OR GRAVITY FURN. TO AND INCLUDING
100,000 B.T.U.'S
2) FORCED AIR OR GRAVITY FURN. OVER 100,000 B.T.U.'S
1
4.00
3) FLOOR FURNACE - -
4) SUSPENDED, REC. WALL, rLOOR HEATER
5) INSTALLATION OF APPL. VENT
6) REPAIR OF, ALTERATION OF, OR ADDITION TO
'
HEATING APPL., REFRIG. UNIT, ABSORP. UNIT,
COMFORT HEATING,COOLING,ABSORP.,OR EVAP.
COOLING SYSTEM
7) BOILER OR COMP. TO 4-HP. ABSORP. SYSTEM
10Q001 B.T.U.'S.. - -
B) BOILER OR COMP. TO 16-HP. ABSORP. SYSTEM
100,000 T0500,0018.T.U'S -
9) BOILER OR COMP. TO 15HP. T031-HP. A850RP:
'
SYSTEM 500,000 TO 1,000,001 B.T.U'S _
10)'BOILER OR COMP. 30-HP. T051-HP. ABSORP.
SYSTEM 1,000,001 TO 1,750,wI a.T.U.'S
C_
11) AIR HANDLER 10,000 CU. FT.
12) AIR HANDLER OVER 10,000 CU. FT.
13) EVAP. COOLER PORTABLE
14) VENT. FAN CON. TO SINGLE DUCT
.>
15) VENT. SYSTEM NOT A PART OF HEATING OR
AIR CONDITIONING
16) HOOD -MECHANICAL EXHAUST
17) DOMESTIC INCINERATOR
18)COM. OR INDUST. INCINERATOR '
19) EQUIPMENT NOT COVERED BY THE ABOVE
O
3.00
vERMIr fEE
- �
iOlRI fEE