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2532 (2)
prOl I' 1AJ D/r w hlq LOT NO.-- NO. O.NO. �?rREElII n- p ® 7961 FOR4UILDING PERMIT O OF CUPERTINO' .. .3 ' J,USanitary 1'0.O PermitNo. w n Date = o :r.bFmairdT uoriapermit t oa TYPe Io 77, _ Building .i wtobe'occupiedonlyas .SINGLE -f4/9iLY '�h/c.. vr r 00 in accordance with Plan's;_Specifications and Plot-Plan filed herewith. F ; Estimated Value of Improvements, $ U' 0 Fee$ 57. 00 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„ihe•City of o Cupertino will be"complied'with. 3 < _ 5SG-4/ /'�S' S T _ a Owner. �9�i,Q71 C,fAiJc/ —Address--^ Ww BY4"` `Address ¢ a a 0 �S3Phon '-3/J3 ' APProve ` Q,, State License /`�/7�1/ a +rvc wsvecT0 �n gWu o 0 0 o �y LL u ce - - -• - d IL Q V w M imLU +O z O Q W W a W W Qcl 5y m z w aQQ a < State License 12422 & f / g L) o ; / e § � .ate § / p \\\ \ -_ / \ ƒ -;SL � E > o § \ \ \ �:� � \ 9 ®\ § ° X 0 ( 7 z ° CD \ \ ) @ ®C » \ (\ , ) 2 . � L. } § � } \ 15 j / \ j ( ( \ � : ) � � 0�F. 2 iz 0 0 4 � \ } ) \ � } { � � � � J/\ � o 'EA U5 65 iz i73 Z }� )\/\ XANWO &S'3 STATE OF CALIFORNIA. - 7 0 \ © ZI � & \ \e � ( \}\\ g � � x §� � wz \ 22 � \§ (; }a M co a w {»0 spa � \ 1 & & * . m � » ) � \ ( « \ f ) { 0 k \ ) i Fl=RFS NUDIBER MAIN DRAIN UNITS FEES UNITS FEES Water Ileter / Size /t Water Closets ,Z. Materia; Bath Tubs To Curb Showers / To Prop. Line Lavatories Z To Existing Kitchen Sinks / Not Conn. Dish Washers Sewer Boxes Waste Disposals Wash Trays STORM DRAINAGE 'Washing Machines Size Water Softeners Material Bar Sinks To Main Drain Comb. Sink s Trays To Curb D2ntal Units Dunking Fountains _ Moor Drains WATER SYSTEM' . HoppersZ,Fixftine l rRestaurant SinksSan-- TrapsOTAL PEES UrinalsFee jr Area Drainsrain Fee VE'ater Leadersrain.FeeSprinkler Vrvesys. Fee iFee $iTOTAL FEE f5OC6 RECORD OF INSPECTION Underground Rough... .Parti:d Rough.. Rough. Complete.. :. Main Drain Final.... (� �jj , WILL NOT VIOLATE ANY OF _._\_'S COMPENSATION LAWS OF THE STATE OF CALIFORNIA. 7 .f 2E 0 2 ; a � \{ \\� uv 2 7z f �w n \\j / § . � 2 ' m / - o 0 ] { fir? ) }j '� z \ , M F5 , /\\ •:,ivry.,a: ::>..kemarks (Check J) .; Type of Appliance Units %Fees r Nesvk:. :Replace Relo cate Gas Ranges Wall Heaters Gas Plates Circulating Heaters Blower Furnaces Gas Fired Boilers Warming Ovens Percolators _ Griddles ' Steam Tables Gravity Furnaces Suspended Unit Floor Furnace Miscellaneous NAME. TYPE) HOUSE GAS PIPING Number of Outlets J Size of win Gas Piping Fees 2' Tested and Approved/.(.Q..r.�� . ... .. A.._....................... DATE INSPECTOR •State"License ( G — b' q o vlo' Z tTZ 0 C tND u m CD `o ~ 07 Wn,Z o_ n p•t:ti1i.,0.v;jti7 .t 11�i' 'd+'_ t •� o. � 3 c. R9 9 _I w Remarks (Check ✓) Type of Appliance Units Fees,.Il New;. I Replaze,;I:Relocate Gas Ranges I ��".��: !k; { •���-:r":._ Wall Heaters Gas Plates I II I I Circulating Heaters Blower Furnaces I I I Gas Fired Boilers I II I I Warming Ovens I II Percolators I �_ Griddles II I Steam Tables Gravity Furnaces I II Suspended Unit I II— Floor Furnace I II IIlaw Miscellaneous I ii x NAME TYPE) I I I I I I II I Appliance Fees I r--�— Inspected and Approved fo--- *3 . -- .. -- ...... DATE INSPECTOR ry11Ys : m n 2 �� •/ § n r)2 � 22 0 \d \ . �� . � � �� ~� ` ■ . - ( q$\ d m � r - . m . �[ ; A : I o z z p 9 C� M Z (A M r) Rol 0 tzA z 0 0 z ql 0 '21 LC m A 04" n - � \ / CA . } o n ) 2 . . . , Q. � r � 2 § � � ) § ` < C) § /\