NO PERMIT NUMBERr
to Ct.• 17
j LOT NO.
1 4•76
CITY OF CUPERTINO Const. Tax: 126.88
APPLICATION FOR BUILDING PERMIT
SANITARY NO. 9250
I
J
FILE NO. 51,353
DATE 4/28/75 19
Application is hereby made for a permit to
11rna1-._ (PTpn R) a 1 story,ype 5 N. Hr.
to be occupied only as T_,T Thlplex ( 52 04 sQ £t L•iV 660 sa ft Gar.)
in accordance with plot plan, plans and specification filed herewith.
ESTIMATED VALUE OF IMPROVEMENTS $ 68.000
FEE $ 223-00 PLAN CHECK $
OWNER Dividend Industries ADDRESS 2160 Forest Ave. S.J.
PHONE 275-8430
PHONE
STATE LICENSE 275773
APPROVFD James H. Sisk/h
BUILDING INSPECTION RECORD
BOND BEAMS
v
owes,
410F
wawl
• .. R
��r:
ri w�■�
GMNI
��
i
ELECTRICAL INSPECTION RECORD
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/C INSPECTION RECORD
DATE
INSPECTOR
DATE I
IN PECTOR
BACK FLOW REQUIRED
UNDERFLOOR S.M.
BACK FLOW INSTALLED
DUCTS & INSULATION
UNDERGROUND ROUGH
%
FLUES & COMB. AIR
PARTIAL ROUGH
CONDENSATE DRAINS
ROUGH COMPLETE g
-%
FINAL APPLIANCE
ROOF DRAIN & LEADERS
MAIN DRAIN
�)
FINAL GAS
FINAL PLUMBINGIC;
MISCELLANEOUS
�
ROUTE �T !:...
i'a1e �tU•
Da' c
1
Sub
Notes
Approved
CERTIFICATE OF -COMPLETION
BUILDING INSPECTOR'S OFFICE,',. .,.Y
CITY OF CUPERTINO
DATE iq 72f- BLDG, PERMIT NO.- -S/. 3.S 3
THE BLDG. LOCATED AT 20,16��- n� 0a6G
OWNED BY
HAS BEEN ICOMPLETEDI' OR USE AS
IALTEREDI
OIPICE COPY - + ' .
4�pEUICMIC iCE NOTICE
J� f HUa.Davc CYMS OFFICE
�! CITY OF CUPERTINO
...................... r9 ."•` 1.
To
i
a
You are hereby a and toconnectelectrical service for .
Owner or Tena�ntt ... 5 ✓'< R�4rca/ a ...........................--
No. of Wires ........................ Size of Wires ...................... Six of Switch�i.--
Motor Load .......................... Voltage
Heating i sad ........................ K. W.
No. of Meeea..._.Z'"'.__.........
beat .............._
No. of Add. Meeen__....._
Power.._..........
Phase
.................. ............... Voltage ...............................
llo_� New Service ... An..... Seoonoert..._.............
220... Three Wire ................ Mme Service............
Three PhmL ...............
Mo►e ..............
Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Sewer Connection Sanitary Permit No . ........ `.....-) ....-s-0
.............
Plumbing Final Plumbing Permit No. -S. S7-17 ......
LotNo- -------- L? -----------------
Owner or Tenant ------ oL ..... =,2 --- --------------------
At .....
�i .........................................
Tract------------------------------------
Date Connected ........
Date Final .......... 3 — '75
19 ............
INSPECTOR
OFFICE
CITY OF CUPERTINO COPY
GAS SERVICE N11 TI
TO
You are hereby authorized to connect the GAS service for
Owner or Tenant ... 44-
At 01-0�
New Service ........
No. of Meters ...... (k ........ Reconnect .............................
Move Service ............
No. of Add. Meters .... ..... ... Move Meter ....
...................................... V—
PLUMBING INSPECTOR
T
920 O(e SL'.'c3-U G �, f'V/ J F :'4 _li.GTl:
M co
LOT NO.
. STROJJ�vO
CITY Oi cj, - CITY OF CUPERTINO
( VAL,
CAP. { ,x
Z d
p APLPL'ICATION FOR BUILDING PERMIT
PrEE
Z�
I�PR Building Per. No. -Rle,�
Date 9.
Application is hereby made for aper/mit to (/ /fl�w(V�,�
3 V
a�story, Type �;/ �� (i���/(_�✓��jy_yy$iructure
F O
O .
a
to be occupied only asl^cl ,mC�
in
v'-i
Plans, Specifications and Plot -Plan filed herewith.
Z'
Estimated Value of Improvements,
LL
O
PI Ck Fee $
O
It is hereby agreed that the requirements of the
v,
Cupertino Building and Zoning Ordinances and all
Fee $.de�J
~O a
other laws applicable to the construction, location, and
-
Z
use of buildings within the City of Cupertino will be
Total Fee $ owl?
=,
complied with.
OZ
o \AiL. ate.--`J
w wOWNER
PHONE
ADDRESS
00
_v
CONTR. OR AGENT
.2Zu— -� 7,J-77;
RE 5 r
PHONE STATE LICENSE
BUILDING IN5PECTO ,6
aasGfl- 20o n
1��a7�il / "-'9-&4w LOT NO. 17
NO. •'STREET
z d CITY OF CUPERTINO
W
y (;IT,, Op CUi::.•TIN
CAPPLICATION FOR APPLIANCE PERMIT
O
LL
31.4 I `� 21 1975 y� Permit No.
U Date l -��-, 19 _5L Fee $
W
�
p Applicati� hereby made to the City of Cupertino for a permit to install gas
o F appFAncA as listed on the reverse side hereof, and agrees to install said appliances in
> F accordance with the provisions of the Plumbing Code of the City of Cupertino, and all
a 0 other laws applicable thereto.
Use of Work to Be
Premises���J Performed
Owner i L�y^+�. gtldress D%�„O Ai� ond'fioning
By
Address 13270 Depot Avenue
C nttactor, Agent an Martin, a itornie rJ046
Phone (408) 683-411001
LA69 C•20 LlC
State License . $ 27907r �
Approved fFFrrbrr"
�mbing Inspector
'C1;A58 0-213 CIC. aS 279O3T
APPLIANCE
UNITS
FEES
Gas Top
Gas Oven
Wall, Gravity or Forced Air Furn.
V
Gas Fired Boilers
Warming Ovens
Susp. Units
Dwelling Kit./Bath
Independ. Vent System
Com., Indust., Inst. Kit.
Hood & Vent System
Forced Air Under 4000 CFM
Forced Air Over 4000 CFM
Ind. Ventilation System
(without Comfort Cool.)
Forced Air. Mach. each Power
Gravity System
Nb. of Air Outlets
No. of Flues
Stacks for Metal Fireplaces
-Smoke Stacks, Misc. Equip.
Under 15' High
Over 15' High
- Comfort Cooling
Comp. of 20 HP or less &
absorp. units with input
of 500,000 BTU or less
Comp. over 20 HP & Under 50 HP
& absorp. units with input
of 500,001 & Under 1,000,000
Permit Fee
3, OC
Total
Total Fee
N Q
Z-
wZ
YO
0W
OJ
3U
w
= 0
f Q
0
OF
>a
Zr
a N
wW
F=
a�
J iy
_OQ
�N
0
oa
Z J
JZ
JQ
3 F
_a
z
W Z
W
� a
70
aQ
—U
V-
z4026V .
LOT NO. 17
No. ggTREET '
CITY OP CUiEi.TINO .
tq r CITY OF CUPERTINO
JUL 1♦ APPLICATION FOR ELECTRICAL PERMIT
PF^ ' D Permit No.
Date ,797� Fee$
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.
Use of
Premises
owner .i(/ii A/,..ir. ✓15✓li
RY
ontractor• Agent
Phone 374-20/0
State License_ 296 7a8"
407- /7
ITEM
NEW
RPL
FEES '
Number of Outlets
/8
Number of Switches
is,//3
V��
Number of Receptacles
67
Number of Fixtures
Ranges or Ovens K.W.
Size of Main Service 'ply
?,
Number of Meters
Number of Panels
Signs - Transformers
Dryers
Motors:
f H.P. Phase
' H.P. Phase
H.P. Phase
Power Poles
Misc.
Permit Fee
2.00
H.P. Charges
Total Fees
3Si
NO STREET
LOT NO. .1
.1T2;T1H0 CITY OF CUPERTINO
0? �' APPLICATION FOR PLUMBING PERMIT
Sanitary No.
Date 19.1, 1 Permit No.
(� Fee S—
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.
Work Ba
Perform ed 77�./✓
Addresses ��a/.�.pN
Address /r' /P_s' /o:::V�
Approved
Plumbing Inspector
I AGREE 1 WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA. /
\ ®ce
FIXTURES
NUMBER
I MAIN DRAIN _
Units
Fees
I
Units
Fees
Water Heater
of
Size
Water Closet
Material
Bath Tub
To Curb
Shower
y
To Prop. Line
Lavatories
'
To Existing
Kitchen Sink
Not Conn.
Dish Washer
y
ev
Waste Disposal
Wash Troy
STORM DRAINAGE '
Washing Machine
Size
Water Softener
Material
Bar Sink
To Main Drain
Comb. Sink 8 Tray
To Curb
Dental Unit
Drinking Fountain
Floor Drain
WATER SYSTEM
Hopper
Size
Restaurant Sink
Material
Sand Trap
TOTAL FEE
Urinol
Fixture Fee
Area Drain
Main Drain Fee
Water Leader
Storm Drain Fee
'
Sprinkler System
Water Sys. Fee
Relief Value
Gas Fee
—
Vac Breaker
Skimmer
Filter
Pool Sweeper
Permit Fee
Total
AtWToto1Fee
LOT
NO STREET _
CIV O? CUp.:11 O
CITY OF CUPERTINO
OCR AP1P,LICATION FOR PLUMBING PERMIT
•- Sanitary No.
e n ,19_ Permit No.
Fee $ O7_
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
Premises%%��
Owner+Z-
2'�/J10
y
Phone
By �
/' /'
& t-¢Y �-! fl,Z/J S
Contractor,
Phone ��4r,-
/en
Work To Be
State License Approved
Plumbing Inspector
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
® L.
FIXTURES
NUMBER
MAIN DRAIN
Units
Fees
Units
Fees
Water Heater
Size
Water Closet
Material
Bath Tub
To Curb
Shower
To Prop. Line
Lavatories
To Existing
Kitchen Sink
Not Conn.
Dish Washer
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
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee
..Water Leader
Storm Drain Fee
Sprinkler System
Water Sys. Fee
Relief Value
Gas Fee
Vac Breaker
Skimmer
Filter
Pool Swee er
=PermitTotal
c `