NO PERMIT NUMBER21103 Patriot Way — -49
NO. STREET «R LOT NO.
3.o8
CITY OF CUPERTINO
A
' APPLICATION FOR BUILDING PERMIT _
SANITARY NO. 9399 BF
FILE NO. - 51 150.2
DATE_2/10/76 19_
Application is hereby made for a permit to
Conctrir•. (Plan A) a P story, type
to be occupied only as Single Family Dwelling
in accordance with plot plan, plans and specification filed herewith.
ESTIMATED VALUE OF IMPROVEMENTS s 44,000
FEE S 169.00
PLAN CHECK S
OWNER Mipt. Village
rrppn ADDRESS P�70 F.1 C,minn, M_V_
PHONE 91" _405f1
/cT]1012*&7
PHONE P55_14PP (.Tnh) STATE LICENSE P3R433
APPROVED J.' Busto/h
" BUILDING INSPECTION RECORD .
DATE -
ECTOR
DATE
INSPECTOR
FOUNDATION
FLOOR STEEL
PRE-GUNITE
FRAME
BOND BEAMS
LATH
-
WALLBOARDS- BEXT.
Z•-
FIREWALLS
-
MEMBRANE
LANDSCAPING
F.M.O. INSPECTION
FINAL BLDG. z
UNDER -FLOOR g
TIEDOWNS
-MISC.
DIAPHRAMS
MOORE SU SINES S FORMS INC.. LA
FI FfTRIr AI INSPPCTInkl PgrnPn
- 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- /
MOTORS
FINAL
MISCELLANEOUS INSPECTIONS
PLUMBING INSPECTION RECORD
HEATING A A/C INSPECTION RECORD
DATE
INSPECTOR
DATE
INSPECTOR
BACK FLOW REQUIRED
UNDERFLOOR S.M.
BACK FLOW INSTALLED
DUCTS & INSULATION
UNDERGROUND ROUGH
1-
FLUES & COMB. AIR
PARTIAL ROUGH
CONDENSATE DRAINS
ROUGH COMPLETE /
FINAL APPLIANCE
ROOF DRAIN & LEADERS
MAIN DRAIN
FINAL GAS
FINAL PLUMBING .
'i„b.%
'
MISCELLANEOUS
CERTIFICATE -,OF! COMPLETION—
BUILDIN61 SPECTOK'S OFFICE
CITY.OF-:CUPERTINO
q I
DATE 'O 19 B,tL/LDD�G:;PERMITNO.,
THE BLDG. LOCATED AT //� I��3� �/ ,4TQfO�
OWNED BY CJ _114se ()✓'�i /J
HAS BEEN "" ' FOR USE ASJ �• �W�''
(ALTERED)
NOTICE OF INSPECTION CHARGE
CITY 0E-COIERTINO
BUILDING INSPrCTOR'S OFFICE
Date ze ----- ci-,� .. .... 19616 Permit No.
To........ -- ----- ....
0
Location ......... ------------
Reason ... q-
(-10
. .... .......... ...................... ------ ------- ............................... u
NO. ]IREET '•
CITY OF.CVPERT O
CAP.
C.T, APPLICATION FOR BUILDING PERMIT FEE •3
Date
Building Per, N,..s—ii
- n'� 19
Sanitary Per. No.
Application is hereby made for a permit to CdN37,(�7 (A"-j 4
a— 2 st , � ypeD Structure
to be occupied only as S"WcLE' roA 6 y v! Cati 6 in accordance with
Plans, Specifications and Plot -Plan filed herewith.
Estimated Value of Improvements,
It is hereby agreed that the requirements of the
Cupertino Building and Zoning Ordinances and all
other laws applicable to the construction, location, and
use of buildings within the City of Cupertino will be
PI Ck Fee $
Fee$
Total Fee $
ROUTE.SLIP
File No.
Date
Location 4�
SubjectlTn sciC
Notes
Approved
Date
21103 PATRIOT WAY CUPERTINO LorJo' 49-
NO. STREET
of LAP ^K'�N C CITY OF CUPERTINO
0tt. APPLI(L'�ATION FOR ELECTRICAL PERMIT
Permit No.
Date , 1976 Fee S.
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 install said
wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino, and all other laws applicable thereto. -
useo} (1)Fam.ReSidence eWork To Be
Premises —_ ' P.dn.....J -
Owner VILLAGE GREENS.
4ALL—CAL ELECTRIC CO: Addressl•098" 'sTOCKTON AVENUE` S:J.
Contractor, Agent
Phone 295-5230
State License-228-622 APProved
Ele ricalI pactor
I AGREE i WILL NOT VIOLATE ANY OF THE W KME I _' r
COMPENSATION LAWS OF THE STATE OF C IA.
v _ .. Oce
PLAN. "A TRACT #5696 oZ 07 5i9
. ITEM
NEW
RPL
- FEES
Number of Outlets
'
Number of,Switches
�•S
Number of Receptacles
eZ.J
Number of Fixtures -
• �' .S
Ranges or Ovens K.W.
Size of Main Service
Number of Meters
Number of Panels
Signs =Trans formers'
Dryers
2%
Motors:
a
- H.P. Phase
- H:P.. Phase
-
- H.P. Phase
Power Poles
'
Misc. .
Permit Fee
H.P: Charges
'
Total Fees
® Lx
21101 Patriot Wav Plan A LOT
NO ST EET
CITY OF CUPERTINO
c,APPLICATION FOR PLUMBING PERMIT
JANI9 1S//
Sanitary No.
Date Jan•22 ,1976 Permit No.
I't H ' D Fees 3 , 00
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 of
Premi.,Single Family Res.
Cupertino Village Green
Own
Phone 941-6050
B�oe Amaral Plumbing
Contractor, Agent
Phone 296-3963
175299
Work To Be
Performed Plumbing
2�Jd0 E1 Camino Suite 302, Mt. View, Ca.
re
Addre,,P•O.Box 150, S.C., Ca.
State License Approved
Plumbing Inspector
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
® LA
FIXTURES
NUMBER
MAIN DRAIN '
Units
Fees
Units
Fees
Water Heater
Size
Water Closet
Z
Material
Both Tub
To Curb
Shower
To Prop. Line
Lavatories
To Existing
Kitchen Sink
Not Conn.
Dish Washer
M
Waste Disposal
Wash Tray
STORM DRAINAGE
Washing Machine
Size
Water Softener
Material
Bar Sink
To Main Drain
Comb. Sink & Tray
To Curb
Dental Unit
Drinking Fountain
Floor Drain
WATER SYSTEM
Hopper
-
Size
Restaurant Sink
Material
eC
�i-
Sand Trap
TOTAL '
Urinal
Fixture Fee
Z 2_ 19d
Area Drain
Main Drain Fee
5,670
Water Leader
Storm Drain Fee
Sprinkler System .,
Water Sys. Fee
•-�-(.t (�
Relief Value
_ '
Gas Fee
7 en
Voc Breaker
Skimmer
Filter
Pool Sweeper
Permit Fee
7L�)
Total
Total Fee
j L r!
21103 Patriot.Wy
LOT NC
. NO. STREET -
O
C,tl O��F CITYOFCUPERTINO
APPLICATION FOR APPLIANCE PERMIT
It V
Date 6�18=,76
19_
#49
A
Permit No.
Fee S O0
Application is hereby made to the City of Cupertino for a permit to install gas ,
appliances as listedonthe 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.
of Res. P-4-,— A Heat /Sheet Metalvises o,k T o Be
Villlage j;grp '2570 El Camino Real'#302 Mtn.
41-§ 50 • . - View
— _ SAN CARLOS SHEET,METAL WORKS, Imp,
Contractor, Agent SAN CARLOS,*CALIFORNIA
Phone 59 — 9 , _
State License 110828 %
Approved—
PI mbing Inspector ,
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS, OF THE STATE OF CALIFORNIA. ,
0u
APPLIANCE - _ I UNITS FEES
TO
FT.
OR
Ion FnuIPMENT NOT COVERED BY THE ABOVE /- fl I
PERMIT FEE
ELECTRIC,SERVICE NOTICE OFFICE COPY
BUILDING -INSPECTOR S NOTICE
--61TY'ORCUPERTINO
19
To 3
You are hereby authorized to Connect electrical service for
Owner or Tenant
No. of Wires ' Size of Wires Sizeof Switch ' C)o
Motor Load Voltage Phase
Heating Load K. W, \/-I,�„e
No: of Meters / L ghi- c✓110 � New Service Reconnect
120Three Wire More Service
No. of Add. Meters �. Power' 1� Three Phase // Move Meter
ELECTRICAL INSPECTOR'"` ' '- `" / l�/ `—�ll u.
<J <J
zotCITY OF CUPERTINO OCOPYE
GAS SERVICE NOTICE
7i
To ,.
You are hereby authorized to connect the GAS service for -
Owner or Tenant,
IF
At
a New Service
No. of Meters - r Reconnect
No. of Add. Meters Move Service
Move
//Meter -
PLUMBING INSPECTOR.,
Bldg. Dept
Office Copy -
BUILDING INSPECTOR'S
OFFICE -
"
CITY OF CUPERTINO
.
_
Sewer Connection
Sanita n -Sanitary Permit No.:.----7...L�'-., �...
Plumbing Final-
.Plumbing.
Permit ,No.
t No. . G
- - Owner. or Tenant---rrw.:r.il�/�,:..._•.e-_:. f�wF...---'.wl-f!YJr...------..:...---..-...-
At
• Tract ._---------- -�
_ . o
----------------------"-------------------.--------.------.-----------
-------.............. :.
Date Connected
'- �- '...7 ------------------- ----------------=----
-' ---- --- 19-------- ----- . .
Date Final--..t.-:--.-L.---.,�ti
:- % ..
•.. - ,,.,
------------------- -------- 19.............
-
PLUMBING BNSPECTOR---"-_:1-