NO PERMIT NUMBER (2) lz7l" Lot No n3�
No. Stre
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO {
File No. /)4 rQ✓
Sanitary No.
Date__!¢�(�196-O�
j Application is hereby made for a permit to T
a story, Type ��✓
to be occupied only as -
in accordance with Plot Plan, Plans and Specification filed herewith„
pE�stimated Value of Improvements $ "R4� ���
jl FEES /t Jo• ar to Plan Check E
Owner Address /0
Contr. �J wtD _ Address swiI s^'r
Phone V.5,7- 1//19 State License
Approved WILLIAM D. BENEVICH
/ 2/��Q� APPLICATION FOR ELECTRICAL PERMIT
Date 1 196 FEES 23.7G� Q
Contr. Wyr���L1�1-- Address
Phone _ 1 36'S f':A State License e/?-7
Approved A/ io•
APPLICATION FOpR� PLUMBING 8 GAS PERMIT 41
Date 196 a GAS FEE $
PLUMBING FEE $ V 3.a
Cont', `` 4 Address 3 /
Phone - 2/// ��S 3State License /6eel
Approved WILLIAM D. BES
APPL ATION FOR APPLIANCE PERMIT - Y
Date 196 FEES yp ^ - ,p^/
Contr. Address 4,U �/• -6im4
Phone State License - .2 115
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
FOUNDATION ' /—.8-0pBUILDING C.�tta.c.VrW
D
UNDERFLOOR z' p t� y Inc
Dat 0 Ins e o
FRAME 1
Dar —k n pe o
LATH PLASTER
te In ctor
F NAL
i
t Ins Dec tar
ELECTRICAL
,OUTLETS
SERVICE SIZ
SWITCHES UNDERGROUND
p ctor
RECEPTACLES ROUGH WIRING
_Lla _f Inspector
FIXTURES FINISH WIRING
—Dr
l� JA
_Tr_(g_
CHARGE FIXTURES Da}�
� tl\nspector
Inspector
TOTAL FEES FINAL `�
PERMIT FEE Motors
Tare (, tj � , pector
Date .-Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
/z :_j 6 8" & iL
WATER SYSTEM— SIZE TERIAL
TOTAL FIXTURES UNDERGROUND Q
FIXTURE FEE PARTIAL ROUGH 12--W-9f el--
Dote ctor
MAIN DRAIN FEE ROUGH COMPLET '7'6
ate for
STORM DRAIN FEE MAIN DRAIN —/7�
to ctor
WATER SYSTEM FEE GAS PIPING
n� Dote for
GAS PIPING FEE FINAL J9
Date Ins pa<tor
PERMIT FEE MISC
Date Inspector
TOTAL FEE MISC
Date Inspector
APPLIANCE
TYPE OF APPLIANCE UNITS FEE TYPE OF APPLIANCE UNITS FEE
CIRCULATING HEATERS REGISTERS
'I-
BLOWER FURNACES- COMBUSTION VENT
SUSPENDED UNIT , MISC
GAS RANGE MISC
GAS DRYER PERMIT FEE -
F100 FURNACE TOTAL FEE
Dot Inspector _
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Date .....�/.............�3............... 19...6.Y. Building Permit No.,
The Building Located at ,1.4--- . ..... ....
. ....(... ---- 30"),............
Owned by .......... ..................... ..........................4---..........................
...... ..... -
Has Been,' (Completed) For Use As: ...............................................................................
....................................................-----...........................I...................................................
-
-------------------------........................................ ..............................................................................
................................................................................ .. ...... .........................
....... ..... ......4--- ......................
BUILDING INSPECTOR
102 12/66-IM
GAS SERVICE NOTICE
com"
j BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTI�
196e-
To
You are hereby authorized to connect the GAS service for
Owner or Tcnant ....4 .. ...,..'..�Z.G<......_......... .......
At ..l�d'�'.S"--A. . .._✓_ r. ............. ... ........................ ......... ..........
New Service `�
..........................
No. of Meters ..... ........... Reconnect ............._...............
Move Service .... ..........
No. of Add. Meters ........... Mone Meter ......_.____...._...
PLUMBING INSP17CTOR
_�..f•.. d F Yd �� - -
d ,
��• ..�.., ice. {`; i.-. _ -
Seargr its $ _
• ( ear`� � �, _
nor WIMS
aRqu
MY or Cupg&Tmi
T
I DO
ISN .
i
OFFICE COPY
ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
.......-..... ....... 196�
To
You are hereby auth r z d Coll t electrical service for
Owner or Tenant ............ &1ectri-cal ler
. ...... ... ..... . ... ............ .....................
At ............I..USA.,!r... '11�
............. Si' -
No. of Wires ...... Size of it ... Size Of Switch JM fq-
Motor Load .......................... Voltage . .. . .. .................. Phase ...... ......
Heating Load . ...... ............. K. W. .........._..._._..._.__.... Voltage ...... .. .......
No. of Meters.........' . Light.. New Service Keconneu..................
No.of Add. Meters---�::,*�: He.. .. InP1.2_0_...... Tfir i, ...... Move Service._...._.
:
Power.......__..... 'let...............
..—......
...C"CAL ..l"Pc
E I WILL NOT VIOLATE ANY OF THE WORKMEN'S
C _,_ awseEseecIFOR,A
_ / \ ` \
-
\ J
s
§ ; ; (
\ % J6� �
}/ - 2 �
/ &
! , r
> » . .
(
OL
{{/ 3 ! ° ■
fCIO-0
\ � § � \ 0
cL
n® E
ft
§ n
}EE �
/42w
.
NIBLR 11,0 MUM
UNITS FErOl X UNITS FEES
Wnter Heate laterial
Water Closets
Bath Tubs rb
ihowers op. Line
Lavatories isting
Kitchen Sin . onn.
is Washer Sewer Boxes
Waste Disposa
t(/as7i Trays NSTOR DRAINAGE
Washing Machi
Water Softeners
gat Sinks rain
Comb. Sinks rays Dental Units
Dnn ing Fountains
F oor Drains YSTEMuppers RestaurantSinks San raps TAL FEESnna s e
�.r�ea rains Main Drain Fee
i
water Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee
Permit Fee SU
TOTAL TOTAL FEE 3. D
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough. Complete..
Main Drain '
Final...