1917 /0 7 LOT NO.
NO. ` % TREET
10
® - Ctf( M, FOR GAS PERMIT
CF CUPERTINO
AUG" 1 1962 Q
Date , 195_ Permit No. / 7
CITY. OF. CUPERTINO Fee s s`J
Application is hereby made to the City of Cupertino fora permit to install gas pipes
and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other I ws applicable Pereto.
c
Use of Premises
u /
Owner Address //M�%
By Address
CONTRACTOR, AGENT �e
Phone 4L�- 2G gJ^ Approved �u
PLUMBING INSPECTOR
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I, the undersigned do hereby certify that
I am the owner and occupant of the single
family dwelling at /p?1i rfIfIVII,i �ai�y ,
for which I am making application to do
A-V i^l ' work .as a homeowner.
I also certi y hat I will not hire any
non-licensed Unci Fi,, or contractor,
but will do this work myself.
TELEPHONE NUM EN r`.1 f SI - ATURE
a7aL I
NO.
STREET
� �OT NO.
APPLLIWI FOR ELECTRICAL PERMIT
CUPERTINO
Date ? j A. 196395'— Permit No. `
Fee $ I
Applica ' h� Y SS`pE ll�eT$j` @f Cupertino for a permit to install electrical
wiring an j ixtlf s as lilsted 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 oothelr laws applicable thereto.
-a
V1 Use of Premises lb ��
c
a Owner i � r �c c-- Address /VR*6 /9N(J �AA4
51
By Address
h CONTRACTOR, AGENT
x�ts��aGn�r Approved
Phoney — / H eCT1UGL INSP8crox
I
NEW RPL FEES
Size Service Conduit......................Number t: Out'ats.................. ...t----- -.........� .o...
I
Size Service Wires..........................Number of Switches..........-----. ---------- ----------
L.....-----.
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---------- Transformers--------
- ..........
---------- ------------/
Misr------------------------------------------------Dryers...------ - ..Y......... ........ ......... J_
Motors-------------------- HP.................... Phase-------------------- Permit Fee $1.00
Motors.................... HP.................... Phase....................
Motors.................... HP.................... Phase------------------ H P Charge-----........ .. _.
TOTAL FEES
RECORD OF INSPECTION APPROVALS
RoughWiring---------------- --------------------------- Fixtures ...................... --------------- --------
DATE INSPECTORDATE INSPECTOR
Finish Wiring ......DAT--[------ --- IN
SPCTOR---EC.0-R Motors
------------- ---------
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E
Final -�...::.�..�.....�. .. ...-'-'---.........
DATE INSPECTOR
I, the undersigned 'o hereby ' ',tify that
I a the owner and occupant o . , he si gle
fam ly dwelling; at
for h h I making applica n to do
rk as a homeowner.
I a so cer i Awor
hire anynon-licensed r contractor,
but will do tk myself.
TELEPHONE NUMBER SIGNATURE