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APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO �j
File No. -1'//46/
Sanitary No.
Dote 196
Application is hereby made for a permit to
to be occupied only as
a story, Type ..T Z %7
in accVance with Plot Plan, Pians and Specification filed herewith.
Estimated Value of Improvements s.7 it, 0 d d '*"—
FEES G !.O ti
Owner J!Z k.%y�
Contr,
Phone -OXS—.x —,-G T3
Plan Check $
Address dx 9 J—•.� mal
Address
State License
Approved 1c1 �, don .� •/1�
APPLICATION FOR ELECTRICAL PERMIT
Date 196
Contr.�yJ
Phone / 6 4 -AZ' s3/
FEES - C)--4 /s
Address
State License
Approved
J
APPLICATION FOR PLUMBING & GAS PERMIT
Date -,L 196 Z? GAS FEE $
PLUMBING FEE $
� /
Contr. L/s�/�-/ Address 1.2.3,>--"�`jr/
Phone State License .fo r 7 57
WILLIAIM D. U—RItViC.'H
Approved
APPLICATION FOR APPLIANCE PERMIT
Dote .6`. 196 X FEE$ fd-'(--d
Contr. Address •/.3-4 4 r1&-L� e�
Phone .37rr— O 9 d iC State License 1542-6 i
Approved
Applicants agree not to violate any df„the
Workman's Compensation Laws of the
State of California
f�
RECORD OF INSPECTION APPROVALS
`BUILDING
FOUNDATION
& GAS
-- -
D -
IN TOR
'R
UNDERFLOOR r,
ROUGH
ROU
LDA
MAIN
N9PECTOR
IN SP T R
FRAME v
FINA
D E
/10 'Et
MISC
lX
ATH PLASTER
MISC
ATE
IN9P R
DATE
]
_ 60
FINAL J
DATE
DATE
L
INSPECTOR
ELECTRICAL
DATE
INSPECTOR
DATE
ELECT. SE CE
DATE
INSPECTOR
UNDERGROUND
/ _ 1 `DAT
((O S
INSPECTOR
ROUGH WIRING
AT
INSPECTOR
FINISH WIRING
DATE
INSPECTOR
FIXTURES
DATE
INSPECTOR
MOTORS
D T
INSPECTOR
FINAL
DATE
INSPECTOR
- PLUMBING
& GAS
UNDERGROUND
PAR
I ECTOR
ROUGH
ROU
MAIN
N9PECTOR
GAS
FINA
D E
SPEC TOR
MISC
DRAIN
MISC
TIAL
GH
DATE
I ECTOR
ROUGH
AT
N9PECTOR
COMPLETE
D E
SPEC TOR
_
DRAIN
ATE
NSPECTOR
PIPING
DATE
INSPECTOR
L
DATE
INSPECTOR
DATE
INSPECTOR
INSPECTED
MISC
MISC
MISC
DATE INSPECTOR
DATE
APPLIANCE
IN.Y..TVN
INSPECTOR
INSPECTOR
NS1111.N
ROUTE SLIP
File No.
Date 6 �_
Location %
Subject
Notes
Approved
Date Ins eczor
CERTIFICATE: OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Date ..... I .. ........ ............. Building Permit No. 5 tkZ
I
The Building Located at ....... ........... 4 .............
Owned by ........... — ......... .. ------ (�
= ............. ......... :- ............. ........ .......
Has Been Ply) For Use As:.......... . ...........................................
(-M
BUILDING INSPECTOR
102 12/66-1M
GAS SERVICE NOTICE OFFICE
COPY
BUILDING TY OF INSPECTOR'S ICE
CUP RTID� �y
l ........................11 u�.3..........................., 196.1
To
You are hereby authorized to connect the GAS service for
Owner or Tenant ..
..........................................................
At..a�/..........�....... P�/................................................................
New Service ... !?!:�............
No. of Meters .../............. Reconnect .............................
Move Service .......................
No. of Add. Meters .............. Move Meter ........................
...................................................
PLUMBING INSPECTOR
OFFICE COPY
(:�p 1.
ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE,
CITY OF CUPERTINO
To.............. ___ ....... .p.r.•.I._..._.., 19G�
You are hereby author' to conne t lectrical service for
Owner or Tenant ............
At.......
No. of Wires .......�.......... Size of Wires ..:.")w ....... Size of Switch
Motor Load .......................... Voltage ............ ........... ,....... Phase
HeatingLoad ........................ K. W. ... .._...... ........ ..... ........ Voltage _.......... ..................
No. of Meters......_,,,_,,,...1 Light .......... ... no.....`New Service... ...... Reconnect.........._..,.,
No. of Add. Meters............1 Heat ................. 220..... ... hree ire....... ... Move Service..........
`Power ............... Three ......... Move Meter....:........
.............................'.. .............. _....... __... .
ELECTRICAL INSPECTOR
Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
r-1 Sewer Connection Sanitary Permit No.
21-1Plumbing Final Plumbing Permit No. 5..11?7 ----- --
......Lot No . ........ --------------
Owner or Tenant ...... Zzl/.,
................................................
At
............................. - .....................
Z
Tract....... 4.. .....................................................
Date Connected ...................................... / 19-fa6./1.
Date Final ...................................
W ........................... . ... . ....................... 19.Ail
PLUMBING INSPECTOR
111 12/66 -IM
OFFICE COPY
ELECTRIC .SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE p
CITY OF CUPERTINO 5 194.,
To lJp
You are ereby au orized to connect electrical service for
Owneror Tenant ............ .........................................................................
At....1...3....Y............. ,c.....�9-►
...................... ..............
/�../.....^.......
No. of Wires .....3 . .L..
............ Size of Wires ...Z... Size of Switch . T....
Motor Load .......................... Voltage ................................ Phase ..
HeatingLoad ........................ K.W . ................................... Voltage ................................
No. of Meters........Lighttt0............ New Service................ ReconnW ..................
Heat ................. 220............ Three Wire................ Move Service............
No. of Add. Meters............
Power....... Pha;e....... Move Meter..............
..................................................................................
ELECTRICAL INSPECTOR
I�% I/��TT. ��2 " OT No. �3 2,6
NO. SIIEET
z ¢ )APPLICATION ORS BUILDING PERMIT Eil2�
r ° /APR CITY 00i UPERTINO
o Q 15bb I�. Sanitary No.
SO
W Date �'3•`� 196 S Permit No.
D7rnTI t�
o Application is heieby mfora permit to-
o fo
a
i In a story,Type .�— Building
a W
to be occupied only as in accordance with
0 o Plans, Specifications and Plot-Plan filed herewith. d PI Ck Fee -0
> 0 O C/
� ; Estimated Value of Improvements, O D_ Fees (07 D
i J 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 ill be complied with.
; i
_ Own�ei Addres
Wz By.[y .o�o-2 Address�z2�+-�a
W W
¢ a
aU Phoner�rS� — 2G .s3 State Livens APP ro LLIAM D. DENEVICH
r/S'/ 7 Q BUILDING INSPF.CI'OR /