FILE 51139 ��lJ(�� �
p2-0 7 to I. (V -t� Lot No.
No. Stre
i
CITY OF CUPERTINO
APPLICATION FOR BUILDING PERMIT
Sanitary No.
v
Date 19 7 3 ii'3�
File No.
�J Fil
Application is hereby made for a permit to
scary, Type
_.r,
to be occupied only as �
in accordance with plot plan laps and Specif' ation filed herewith.
Estimated Value of Improvements $
O
FEES � -_ Plan Check $
Owner �dress
ell
Conrr. Address
Phone __ o2„fa `f�`� T State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Data 19 FEES
Contr. Address
Phone Stare License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 19 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 19 FEE$
Contr. Address
Phone State License
i:. Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California ,2
PD-1
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
PAD FINAL
FOUNDATION
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL
FINAL BLDG.
ELECTRI
DA E INSP O MISC.
UNDER OUND ROUGH
ROUG R
FINIS ING
FIXTURES
MOTORS
FINAL
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC r
MISC s
l
it
` �. OFFICE COPY
ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
_._...... ._. ...-.. 1_ . ._.. . ...., 1-97
To
You are herebyut orized to connect el ctrical r tce for
I
r Owner or Tenant .. .. . �...-..At _...�� ..... ._�..lJ....... �_n V�J
.... . . �'�.3 ....... ..
No. of Wires ....................__ Size of Wire , X�:
--�-��............. Size of Switch .�� .. .
Motor Load ..... .................... Voltage ......... .................. Phase ... ........
Heating Load ........... ............ K. W. . ...........:...._.......... --- Voltkge ............
._...._.
Light................ n0....__.._ N Sery"ce. ...._.......
No. of Meters.......... .. --
Heat................. 220............ ee ire .... ........ Move Service......... .
No.of Add. Meters............
Power............... ....r.. as . .._.._.... Move eter......
i. P.LECTRICAL IN EC OR
0 Q NO. VRE ET LOT NO.
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O NO CITY OF CUPERTINO
5 a FEB j j,§f�ICATION FOR ELECTRICAL PERMIT
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F Date _ ' � 19 _ Permit No
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Fee ti
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a W 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
a o wiring and/or f' in accordance with the provisions of the Electrical Code of the
> City of Cupertl a d all other law a 4'licable thereto.
4))4r!jeVCq.C%3t
z� Use of Premises VICE IK06"e
J L e /r/
Jo �/
3 a Owner
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W W By Address _
M a
O g CONTRACTOR, AGENT
a 0 Fhnn : X S Z^ y� J If Approved _-
E ICAL INSPECIp;
State License -AMMAWMAM&IRAV �//
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I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN S
COMPENSATION LAWS OF THE STATE OF
CALIFORNIA,
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FIXTURES NUN BE MAIN DRAIN
UNITS FEES UNITS FEES
Water Hente Size
Water Closcts Material
bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers I Sewer Boxes
Waste Disposals
'Was—Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bat Sinks To Main Drain
Com . Sink s Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material �—
San raps TOTAL FEES
Urinals Fixture Fee e°
Area Drains Main Drain Fee
Water Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee
Permit Fee 7
TOTAL TOTAL FEE
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final