NO PERMIT NUMBER � V.
h' — /a(ot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO ' ''11
File N/ V
Sanitary No.
Date 196
Application is hereby made for a permit to
to be occupied only as a story, Type
in accordance with Plot Plan, Plans and Specification filed herewith.,
Estimated Value of Improvements $
FEE$ ^K L Plan Check $
Owner Address
Contr, Address
Phone State License
Approved
p APPLICATION FOR ELECTRICAL PERMIT
Date 196S FEE$ -Z T/9
Contr. Xs'""�+s/ /�-I'[/_F Address / 0 . 71 /(•/ /►Y.Wy ,�
Phone _ 01 State License
Approved O
APPLICATION FOR PLUMBING 8 GAS PERMIT
Dote 196 GAS FEE $ - So
PLUMBING FEE $
Cont,. Address
Phone State License
Approved aG
Dote
����� APP ATION FOR APPLIANCE PERMIT
(� 196 FEE$ y
Contr. X�'N/ 9 Address /03 / / le �—
Phone 42 —J .4 State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
Slate of California
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Ins ae ctor
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
Date Inspector
H.P. CHARGE FIXTURES
Date Inspector -
PERMIT FEE / � Motors
` a e n actor,
TOTAL FEES a — FINAL `
Data Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I Llm.6TERIAL
WATER SYSTEM SIZE ITERIAL
_TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN,DRAIN FEE ROUGH COMPLETE
Date Inspector
STORM DRAIN FEE MAIN DRAIN
D tem n r
WATER SYSTEM FEE GAS PIPING S
atp I or
GAS PIPING FEE S FINAL
Date Inspector
PERMIT FEE MISC
Date Inspector
TOTAL FEE MISC
Date Inspector
APPLIANCE
TYPE OF APPLIANCE UNITS FEE TYPE OF APPLIANCE UNITS FEE
CIRCULATING HEATERS REGISTERS
BLOWER FURNACES COMBUSTION VENT
SUSPENDED UNIT MISC
GAS RANGE MISC
GAS DRYER PERMIT FEE LE OZ
FLOOR FURNACE TOTAL FEE
� r
INSPECTED
Date r Inspector. _ _
OFFICE COPY
EELECTRIC - SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
............ ..4- 1 �
TO
You are hereb;y,_�aut�hot eon ne e rical s is for
Owner or Tenant ..........
At ........... 7-5;.114
..... ..... ....... ----- ......
No. of Wires ............. Size of Wires ---- ---- ... ize of Switchl.p_
m'�'
Motor Load .......................... Voltage . . .. .................. Phase ..................................
Heating Load ........................ K. W. ..... . .. ... ... ...._ Voltage ................................
No. of Meters................. Light....
. ....... 110............ Servi .......... Reconnect.........__.....
..
IHftt.. ��.�: hrce� re.. Move Service............
No.of Add. Meters
Power...17�7... e Move ter..............
A ....... .. ... ..... . . ... ....
ELECTRICAL 7INSP OR
GAS SERVICE NOTICE OFFICE
BUILDING INSPECTOR'S OFFICE COPY
CITY 'OF CUPERTIINO
To
You are hereby authorized to connect the GAS service for
Owner or Tenant ........... .. .e C*.`--- I........... ....._._...........
. ...... . .......
At
New Service
..........................
No. of Meters �......_........_ Reconnect
..............................
Move Service _......................
No. of Add. Meters .............. Mode Meter .............. ...........
PLUMB NG INSPECTOR