NO PERMIT NUMBER (2)217V M ..l -Ll' n Rd. 19
NO. STREET %t - '! LOT NO.
CITY OF CUPERTINO 4.25
APPLICATION FOR BUILDING PERMIT
SANITARY NO. 9199
FILE NO. 51,344
DATE -3/10/75 19_
Application is hereby made for a permit to
('nn c t rvot. (Plan ) a 2 story, type 5 N. Hr.
(2236 sq. ft. Liv. & 675 sq. ft. Gar.)
to be occupied only as T & .T Single Family Dwelling
in accordance with plot plan, plans and specification filed herewith.
ESTIMATED VALUE OF IMPROVEMENTS $61.000
FEE $ 209.00 PLAN CHECK $
• .�.71i�1 ••
PHONE
ADDRESS
STATE LICENSE PrSg5fi2
.B
APPROVED .Tampa H. Si ck/h
BUILDING INSPECTION RECORD
• .. • I.[Js.�i
• • • STEEL
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•'/I^c)lr��}�
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BOND BEAMS
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LANDSCAPING
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F �.
DIAPHRAMS
MOORE BUSINE55 FORMS INC., LP
ELECTRICAL INSPECTION RECORD
RESIDENTIAL
DATE
INSPECTOR
COMMERCIAL
DATE
INSPECTOR
UNDERGROUND ROUGH
UNDERGROUND ROUGH
ROUGH WIRING
ROUGH WIRING
FINISH WIRING
y
FINISH WIRING
FIXTURES
7
INTERIOR FIXTURES
MOTORS
EXTERIOR FIXTURES
FINAL
MOTORS
FINAL
MISCELLANEOUS INSPECTIONS
PLUMBING INSPECTION RECORD
HEATING & A/C INSPECTION RECORD
DATE
INSPECTOR
DATE
INSPECTOR
BACK FLOW REQUIRED
UNDERFLOOR S.M.
BACK FLOW INSTALLED
DUCTS & INSULATION
71
UNDERGROUND ROUGH
FLUES & COMB. AIR
7
PARTIAL ROUGH
CONDENSATE DRAINS
ROUGH COMPLETE
FINAL APPLIANCE
ROOF DRAIN & LEADERS
MAIN DRAIN _
FINAL GAS
-
FIN L PLUMBING
7 _
MISCELLANEOUS
CERTIFICATE OF COMPLETION: -
`!BUILDING INSPECTOR'S OFFICE
CITY OF.CUPERTINO _
E
DATE , � \ a BLDG. PP�R,(MICNO(/.'��� /n/
THE BLDG. LOCATED AT C2 �"`�"-��
OWNED
�BY.`----.p���..���..._.""�n-�e'u-,w
HAS BEEN` DFOR USE AS - ' t �--
IACTEREDI
ROUTE SLIP
?pile ro.
Date
sec<':.ion
�i
'cotes
Date lnsgectoz
i, Bldg. Dept.
Office Copy
CITY OF CUPERTINO
SEWER -PLUMBING NOTICE
F-1 Sewer Connection Sanitary Permit No . .... Q.., ... ..... ...
;--Plumbing Final _tiPlumbing Permit v/
-------------
Lot No........ C, --------------
Owner or Tenant ....... .. �_ .8 .................
— --------- -------------
At ...... .... . ......1.- -
Tract
Date Connected --------------------------- %4- —
Date Final
PLUMBING
CITY OF 'CUPERTINO '
GAS SERVICE NOTICE
OF 171CF
COPY
......... -- 4/., ....... r ............ - 1975
To
You are hereby authorized to connect the GAS service for
Owner or Tenant ... 100—..._ ......... ........ ....... ............ ........... -
At '23 7 '3Zr, 4:�� ......... ......... ......................
New Service — .......................
No. of Meters ....... / -
Reconnect .............................
Move Service .......... ............
No. of Add. Meters .... -- ..... Move Meter ........................
PLUMBING INSPECTOR
OFFICE COPY
Q ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
............... y".'....,7.-........., 19Cr
To
You are hereby authorized to conned electrical servi a for
Owner or Tenant _l riY. v`���4.� ... ., !A4tQc �..,..... ....._...........- .........--
At..r../...2-.7--...r..:....i.1.C...__ll..r.�f-........ .... .................. ......... ........ .........
No. of Wires ........................ Size of Wires ...................... Size of Switch !,:tl.......
MotorLoad .......................... Voltage ......__...................... Phase ................... %.... ...,:..
HeatingLoad ........................ K. W.......... .... ......... .......... .. Voltage ................................
Light ............... iio.�.... New Service.4........ Reconnect..................
No. of Meters ...... F...........
Heat ................. 220............ Three Wire................ Move Service............
No. of Add. Metecs............
Power ............... Three Phase ................ Move Meter..............
ELECTRICAL INSPECTOR
R. F. BENNETT, C.D.T. • PHONE 326.6160
•
BENNETT CERAMIC
LABORATORY
658 HOMER AVENUE PALO ALTO, CALIFO IA 94301
DATE '5'rl� /
DOCTOR
t
" ��
ADDRESS
��-�-
PATIENT'S NAME
DESCRIPTION PRICE AMOUNT
•
L07 NO,
NO. STREET
CITY OFCUPERSCAP. {l
INO (vAL. 1 d20
d APPLICATION FOR BUILDING PERMIT FEE
w Z CITY O-, CUPE'TINO Building Per. No.
x Q Data 1 r • 19 Sa nary Per. No.
i ra
- Appli�at�a is ere by ma(d�e�ffoorr as permit to Oft
Fw0 a�,:story, IType,��//c �^� �� ��!•Sf�� � Structure
u_ w to be occupied only as in accordance with
OQ
'Z , Plans, Specifications and Plot -Plan filed herewith.
Q
w t=. Estimated Value of Improvements, $ D�
a LL
O O It is hereby agreed that the requirements of the
3 Cupertino Building and Zoning Ordinances and all
p a other laws applicable to the construction, location, and
Z use of buildings within the City of Cupertino will be
Z complied with.
PI Ck Fee $
Fee$ a09 00
Total Fee $
_ 3oYa ( .zY S (a
3 R
aV% )��O ADDRESS
PHONE
w Z �OWNEg/f / // �pYr-C---
<� A` CONTR. OR�A ESL ADDRESS
PHONE STATE LICENSE BUILDING INSPECTOR -/
O �,
,LOT NO. 4X
r� NOI STRUT
CITY t-r C��: Y't't .,� CITY OF CUPERTINO
APPLICATION FOR PLUMBING PERMIT
MAY 22 lgij
Sanitary No.
T . I ) _,19_ Permit No.
Dote
Fee �,O
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 Work To '
Perform
Premise t
Ow Addre
Phan-=2 // 9�"3
State License Approved
Plumbing Inspector
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
6 �.
FIXTURES
NUMBERNExisting
DRAIN
Units
FeesUnits
Fees
Water Heater
, e-e
r
Water Closet
_.�
Bath Tub
,p-p
Shower
Lavatories
,�
Kitchen Sink
,cc
Not Conn.
Dish Washer
Woste Disposal
Wash Tray
STORM DRAINAGE
Washing Machine
,�T
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
Z��—
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
Pool Sweeper
Permit Fee
Total
Total Fee
✓N Q
21737 ( McClellan Rd. 19 Plan
E,7.. -,. �nr=-ruin
NO. 5'rREET 'LOT NO. '
MAY u 8 1975 CITY OF CUPERTINO
p �APfLICATION FOR ELECTRICAL PERMIT
Date 19 Permit No. _
1eeSds s
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 R s i den c
Owner Ponderosa Homes A
By Hill Electric A
CONTRACTOR, AGENT
A
Phone; 734 3800
State License 220068
ITEM
NEW
RPL
FEES
Number of Outlets
.?. / 0
Number of -Switches
19
3.35
Number of Receptacles
3g
6,�261
Number of Fixtures
/
7, O
Ranges or Ovens K.W.
Z
o?, n
Size of Main Service / .,g
Number of Meters I
Number of Panels
/
/. A O.
Signs - Transformers
Dryers
/
D
Motors: 7?
3112, Phase/ 0 A, i0e.
e 0
H.P. Phase
H.P. Phase
Power Poles
Permit Fee
2.00
H.P. Charges
Total Fees
21737 McClellan Rd. LOT NO 19
NO. STREET „
- CilpPCTIKO CITY OF CUPERTINO
TY APPLICATION FOR APPLIANCE PERMIT
';UL21 1575
Permit No.
Date 4^2q-7!i 9_ Fee$ 12.00
F'
Application is hereby made to the City of Cupertino for a permit to install gas,
appliances as listed on the reverse side hereof, and agrees to install said appliances in
accordance with the provisions of the Plumbing Code of the City of Cupertino, and all,
other laws applicable thereto.
Woof Res. Work ToBeHeating/Sheet Metal
Premises Performed
Owner
Ponderosa Homes Addre:sPO BOX 357, SM Santa Clara
,,,_ _ 247-4500
By a n t M@ . r San Carlos
c r,
Phone 592-29292
State License 110828 Approved
Plumbing Inspec r
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
0 u
APPLIANCE
UNITS
FEES
1) FORCED AIR OR GRAVITY FURN. TO AND INCLUDING
100,000 B.T.U.'S
2) FORCED AIR OR GRAVITY FURN, OVER 100,000 B.T.U'S
3) FLOOR FURNACE
1
S OO
4) SUSPENDED, REC. WALL, FLOOR HEATER
5) INSTALLATION OF APPL. VENT
6) REPAIR OF, ALTERATION OF, OR ADDITION TO
-
HEATING APPL., REFRIG. UNIT, ABSORP. UNIT,
COMFORT HEATING, COOIING, ABSORP., OR EVAP.
'
COOLING SYSTEM
7) BOILER OR COMP. TO 4-HP. ABSORP. SYSTEM
TO 100,001 B.T.U.'S
8) BOILER OR COMP. TO 16-HP. ABSORP. SYSTEM
I VV,000 TO 500,001 B.T.U.'S
9) BOILER OR COMP. TO )5-HP. TO31-HP. ABSORP.
SYSTEM 500,000 TO 1,000,001 B.T.U.'S
10) BOILER OR COMP. 30-HP. TO 51-HP. ABSORP.
SYSTEM 1,000,001 TO 1,750,001 B.T.U.'S
11) AIR HANDLER 10,000 CU. FT.
12) AIR HANDLER OVER 10,000 CU. FT.
13) EVAP. COOLER PORTABLE
14) VENT. FAN CON. TO SINGLE DUCT
IS) VENT. SYSTEM NOT A PART OF HEATING OR
AIR CONDITIONING
2
16) HOOD - MECHANICAL EXHAUST
17) DOMESTIC INCINERATOR
,
18) COM. OR INDUST. INCINERATOR
19) EQUIPMENT NOT COVERED BY THE ABOVE
FFEMIT FEE
11
TOTAL FEE