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1605 roT No.- .;;y�APPLICAI .1 N FOPt��,8�UILDING• PERMIT/'/ �i• lKyo,'3 CITY OF//QG hRTJigO ^. J Date .,�, 19�A Per it NO'. fi 0j Application is hereby made for a perinit to • a��f story,Type ��• ' ti ��a.. ,,[...Building 2t . .. . � r1�- ..i� •��:. apt��GM," � .fir-''y� to be'occupied only as"- �+ + in accordance with Plans S ecificati f et a d'Plot-Plan herewith a I P a� Estimated_Value of Improvements; i '�. y' • It.is;hereby agreed that the requirements of the Cupertino Building-and,Zoning' Ordinances and - "'call 'othi F laws applicable to the construction, location an use of,buildings within the City of "-I Cupertino.ivi I e comp 'ed.0•th: '•Nk `^Ad 4, I 1 i •Own ress /"p49 414 X14 L✓ SW�'� �. Sa�.-;:c�.1,-.`, ,-,.jiy,•" =' ..Address-��'�' ✓dlC '��� i •� � a��• 2,ONTRAC iACINT Y Phone Approve �, ..�,. � $..•fib. - •..fl7,.w 5•. ..t r _ RECORD OF INSPECTION APPROVALS i c INSPECTOR Y A FRAME' !? �.: > •? •: •I 4 DA R INSPECTOR LATH:, d PLASTER —.�.S '•. DATR INSPECTOR ' ;• FINAL BLDG. DAT INSPECTOR 1 } FINAL ELEC. Z S I '4 D E U INSPECTOR -- r••.a�.. I• FINAC•PLBG. _ . INSPECTOR , . FINAL GAS DATE INSPECTOR I �I; the undersigned do hereby certify ,' hat I�:<^,m the owner and occupant of theyf1'e t. " . 'Emily dwelling at•'C,.� ;. or which I am making application to do work as a homeowner. al soccer i y that I will not hire any ,-. . non-licensedan;256. � I., this but ,will do s work myself. or contractor, UMBER SIGPtAT[JR OFFICE _4 GAS SERVICE N� fa E BUILDING .INSPECTOR'S& "O ICE ; CITY OF CUPLRTIN© re N f. i, x�,�. �. u•..,3,'"�..,,...._ •. ... 796. You are hereby author co• ct th servi6" for •: �' Owner or Tenant ........ .._. ........ ......_.. a At .. .. ._� ....--. '. . - A'S wt - _ New Service I •'a No'of,Meters � '. `.v ` Reconnect i. J Move 'Service ... ..._... .... No. of Add. Mete-rs............... Move Meter ....-�...;.._-....:.... t. .� .......L.. ... " ' -:' •' 'v;:.. - �� .0MBIG INPE�CLN . T.:O�.R:x;..+ -500110 7/61 ez � FZgtate UcenseJ-�S.� n • � _ E" S '3 '�/O ro. O " �• O on an 0, oz IG1 C1 .� Remarks (Check ✓) Type;of Appliance I Units Fees II New Replace Relocate Gas•F.anges Wall Heaters Gas Plates I II Circulating Heaters BlowerFurnaces / SII Gas-Fired Boilers Warming 0vens' 1 ?.'' Percolatorv'T ,_N _Griddles' Steam Tables Gravity Furnaces Suspended Unit Floor Furnace Miscellaneous NAME TYPE) pp lance Fees Inspected and Appro"ved -................................ DATE INSPECTOR 1i • a�a, State License •� �GGt w_ ro y z O an o jj , 3 ° p n In A 3 � n; a 9 e o .� � m O Z T � h °a o a' O N 0 n ; 10 Q 21 s * w z M.. Z C ITS 3 A. li` n� 'TJ � � �• Remarks (Check ✓1'.. Type of Appliance Units Fees I New Replace Relocate Gas Ranges Wall'-Heaters Gas.Plates Circulating Heaters Blower Furnaces Gas Fired Boilers Warming Ovens Percolators Il I I Griddles Steam Tables Gravity Furnaces Suspended Unit II Floor Furnace Miscellaneous � � i� � i NAME TYPE) 4 pp lance Fees 1 11 1 1 Inspected and Approved .............. ................. ...... ...........:......... .. DATE INSPECTOR HOUSE GAS PIPING Number of Outlets ,� Size of Main ' Gas�Pipin9 Fees . O Tested and Approved .. .-....91 .:x. _:: ... .,_.... DATE INSPECTOR I 1. State Licensef O b w n T 2 b ro OR Y Q ooQ Z 0 w` a z . E y ^ m � r) O o n H y S 0 w r q n n o � o, •• n a , a 10 i.. •� T N GO FIXTURES NUMBER;;_ , MAIN DRAIN ' UNITS I FEES -" IUNITSJ FEES (Water Heater _ �' ��- Size I Water Closets Material , Bath Tubs I To Curb d � Showers To Prop. Line Lavatories To Existing Kitchen Sinks l Not Conn. Dish Washers Waste Disposals Wash'Trays �,; �� STORM DRAINAGE Washine,,Machines. l Size W—atteer`�Softeneis^ " ,;.; ' L` jj Material +T ' 11 To Main Drain Comb. Sinka,Tiaysl l +. ll To Curb �, Dental Units" l l� l-\® Drinking Fountains) I,I 1_ Floor Drains WATER SYSTEM ; Hoppers Size l '.v Restaurant Sinks l l ll Material "r 1 eel, Sand Traps TOTAL FEES Urinals Fixture Fee - %,G O Area Drains Main Dram Fees ,c, 0 Water Leaders Storm Drain Fee Sprinkler Va,s I_ l Water Sys.'Fee. %, C O' Permit Fee TOTAL- - 'l �'� :`OOII TOTAL FEE .� [/_, 0 0 RECORD'. F.INSPECTION Partial Rough;;., C y 2- ' Rough Com etc - Z. Final. � R� z xOn { . } : R- ) ~ ' : . \ m \�« 4 \ \ < ±\B \ Q) �§ \ z . 22 z 0 �- � . � 7 -! �, State�l.icense •� ���•�r ° O C-1 n E E d w N AM w n n Ij 1 r \ m o r .o } � « A p / � . , o � � / / � : : � : � � : \ \ � \ : .0 0., 0 \; } \ 64 'xi \ \ 0 0 o 0 15 i7) Z. Z 4 4 f r ro r ; tz J (� 1 { �: ♦ S t h'1 � d � ' �4, , 3 4