5109 1
V�Z6d , Lot No.
No. Street
AP KATION FOR.BUILDING PERMIT
CITY OF CUPERTINO
File No.�
• �`��`t�lJ Sanitary No.
DE
Date 196 iJJJ'�����'
ioi
'Y OFcCUPERT( de'for a permit to
1 �ItJr
a story, Type
to he 07 ed only as
in accordance with Plot Plan, Plans .041-Sp ecifica lion filed herewith,
Estimated Value of Improvements $ I&d.
FEE$ (0 C Plan Check $
Owner Ad�� i .- Address 14
Contr. 94uAddress �Q
Phone State License A
Approved
®1 Ftl(�4MO* ILECTRICAL PERMIT _Do
Date d- �—
A{Yrq� 19�,6�r���Q7� FEE$
Contr. .�ilL.r� �1.C.� �o Address 7f-,3 / r� T: {I(��•�`
Phone
40, 14 7 7— 7 1/Sa State License
6, c')
Approved _L �f
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone .r State License
'
Approved
APPLICATION FOR APPLIANCE PERMIT
Dote 196 'F. NE$
Contr.
•Address
Phone State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California f �.
;f 1
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Spector
FRAME
DateInspector
LATH 8 PLASTER
FINAL
Date Inspector
ELECTRICAL
,OUTLETS 2,
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
R ECE PTACL S ROUGH WIRING
Date Inspector
FIXTURES oe FINISH WIRING
Date Spector
H.P. CHARGE FIXTURES
Date nspector
PERMIT FEE Motors AOE .1000`1
d tor
TOTAL
TOTAL FEES s FINAL —0 CIA
Date Inspector
PLUMBING 8 GAS
MAIN DRAIN SIZE I MATERIAL
STORM DRAIN SIZE LLATERIAl.
WATER SYSTEM SIZE IATERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date Inspector
� STORM DRAIN FEE MAIN DRAIN
Date Inspector
WATER SYSTEM FEE GAS PIPING
Date Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE MISC
i � 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
FLOOR FURNACE TOTAL FEE
INSPECTED .t
Data Inspector __
G i r f
®6 LOT NO.
No. sraeer /
w APPLICATION FOR BUILDING PERMIT
Y ° CITY OF CUPERTINO
e _
9 � Sanitary No.
5 � L '� �IG.�'
F `o Date 196 a it No.
o Applicatjon is hereby made for a permit to
a N a / story,T r Building
W
to be occupied onlyas
� a
0 o in accordance with Plans, Specifications and/Plo�t-Plan filed rewith. OQ
"; Estimated Value of Improvements,$.��p,aJ Fez$
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* Z all other laws applicable to the construction, location, and use of buildings within the City of
O Cupertino w' be complied with.
34
_ m Owner �� E Addres
W 2
a a By Address
us
a 0 Phon
Approve
State Licens BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER
DATE INSPECTOR
FINAL BLDG. j
DATE INSPECTOR
FINAL ELEC. j
DATE INSPECTOR
FINAL PLBG. .�
DATE INSPECTOR
FINAL GAS Amilk
DATE INSPECTOR
141-9 m o _
NO. ST ELT LOT NO.
N Q
z ¢
t O APPLICATION FOR ELECTRICAL PERMIT
3 a CITY OF CUPERTINO
U
W w
4 w Date l , 195— Permit No,
Fee ;S 7 SD
a N Application is hereby made to the City of Cupertino for a permit to install electrical
W
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
o o wiring and/or fixtures in accordance with the provis. ns of the Electrical de of e
> a City of Cupertino, and all other laws applicable ereto.
__ _ 2 �>
Use of Premises
J Z
O
3 a Owner„ �+A+ �e-- `nQ' Address
X n By �Y-� de, ie�� _ Address
lip CONTRACTOR, AGENT
a o � 7y3O Approved
col It
L) Phone: / ELECTRICAL INSPRcrw
Siate License:!9/[NJo
NEW EEL FEES
lets------------------ ---------- --4"�
Size Service Conduit.....__.............Number of Outl ..... ........ .
Size Service Wires.........................Number of Switches----------------
-- ------
7 --------_
Size Service Switch........................Number of Receptacles.. ......... .. ...... J -- --
--------------
Size Sub Feed Conduit..................Number of Fixtures...._------------ ---------- ----/_
Size Sub Feed Wires....................Ranges---------------- KW.............. *...... *.*-,*... **'*..........
Number of Circuits._.........------ Oven -------------- KW.............. .......... .......... ..............
Number of Meters........................Signs.......... Transformers......- ---------- ---------- --------------
Misc------------------------------------------------Dryers........................................ ---------- ---------- --------------
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
. .... --- - ------ -----
DATE INSPECTOR DATE I INSPECTOR
Finish Wiring ......**-------- .............*------- Motors .....---- INSPECTOR......... ----------------------------
DATE . IkSPEC DATE INSPECTOR
--
Final ------------- ----------- ---------------------------
11 DATE INSPECTOR