51043.1, Bldg 620975
No.
VALLEY.GREEN DRIVE
Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Dot, April 2X196 6
Application is hereby made for a permit to
to be occupied only as,
FEES
Ow na r
Contr.
Phone
�f 6
File No. 51043.1
Sanitary
a story,
in accordance with plot plan, Plans and
Estimated Value of Improvements
S
Plan Check $
Address
Address
State License
Approved
filed herewith,
APPLICATION FOR ELECTRICAL PERMIT
Data
%G Ta
1196
FEEE
Contr. (mac/
/j� Q9 n
Address -,c`/ /"r�`t'
Phone ZZ x0 7 6
State License
Approved
APPLICATION FOR PLUMBING
& GAS PERMIT
Date � .. 196 1�
GAS FEE E
PLUMBING FEE $
Contr.
Address
Phone — %� G �T/ 'd
G _
State License /'C7 -''a,
Approved���//
APPLICATION FOR
APPLIANCE PERMIT
Dote 196
.FEES
Contr. Address
Phone State License
Approved _
Applicants agree not to violate hny of the
Workman's Compensation Laws of the
State of California
UNDERFKOOR
FR�
LAT PLASTEEjR
FINAL
Data
,OUTLETS ,Z
7
SWITCHES Yk
/ f -d
/yL
/yw
RECEPTACLES
SIZE
TERIAL
FIXTUR S
TOTAL FIXTURES
�,�
H. .CHARGE
°o
AS ro
PERM! FEE
FEES
%
TOTAL
V
APPROVALS
✓r'�a �gILDING
-��7 Inspector
1 zpactor.
pector
oactor
OZ 016716,-E ��w. RVIC
SIZE
U E - to Inspector
ROUGH WIRING ` '
.specter
FINISH WIRING l�
Inspe�iar-
FIXTURES
^"- Inspector
Motors
IDI e
FINAL rs pactor
Date f, Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
Date Inspector
MENEEMENIM
APPLIANCE
TYPE OF APPLIANCE
UNITS
FEE
3
v
FEE
WATER SYSTEM
SIZE
TERIAL
TOTAL FIXTURES
�,�
�C•`�-%
UNDERGROUND
FIXTURE FEE
SUSPENDED UNIT
PARTIAL ROUGH
MISC
GAS RANGE
Date
I
MAIN DRAIN FEE
ROUGH COMPLETE _AD -CC
PERMIT FEE,`
FLOOR FURNACE
STORM DRAIN FEEMAIN
! .
TOTAL FE
DRAIN f• 6
_
D t
In
WATER SYSTEM FEE
`^
GAS PIPING
/ ates
"(0
for
GAS PIPING FEE
FINAL O O -
C..
Date
Inspector
PERMIT FEE
MISC
Date
Inspector
TOTAL FEE �
W IOt
MISC
Date Inspector
MENEEMENIM
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 FE
INSPECTED �� �D-Z% ` i
�r • Data Inspector
l .
To
You are herebv,
Owner ej Tenant
At .9..
IN
OFFICE COPY
ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
_194
No. of Wires ...W . ............... Size of
electrical
............
ze f Switch
y
Motor Load .......................... Voltage ._..................... Phase ._........
Heating Load ....................... K. W. ....... ....... ........ ........ . Voltage
Light.....Y...... IIU..Ah�,//-
/. Reconnect ...... _........
..
No. of Meters ....................
Powe..�220........ Move Service............
No. of Add. Meters............ Move
5
Power...............nr r_.__
11, ELECTRICAL
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Date ....... - vi/� ..................1 19.4 // j7- I -el- Buildine P&miit No, -4/1
The Building Located at
Owned by
Has Been ( mplet
Aller d) o, Use As . . . ......
...........
'BUILDING INSPECTOR
.• Bdg. Dept
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
❑ Sewer Connection Sanitary Permit N ...
�--� ------------------
[�Plumbing Final — Plumbing Permit &—,.-/
Lot No -------
Owner or Tenant
At
Tracf ---------------
.4..
-------------
Date Connected ...................................... 4-- 0
�Date
Final................................
•
III 7/63-1M PLUMBING INSPECTOR
� ,-
`BUILDING DEPARTMENT
CITY OF CUPERTINO
f � /
Job Located at ----------- - ---.......... Vim........ ...
I have this day in ected this structure and these premises
and have found the' ollowing violations of City and/or State
Lags, eovernine same.
premises
............................
shall be done
yse corrected.
: 7
ROUTE SLIP
File No. /
Date Out---�X,4p/i
Date In
Location _
0A
Subjeat
Notes
GAS SERVICE NOTICE OFFIC:
COM,
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
..............._.........I I96..
To�
You are hereby authorized to connect the GAS service for
Owner or Tenant
At
New Service ........ ........
No. of Meters ........ Reconnect ... ....... .......
Move Service ... .................. .
No. of Add. Meters .............. Move Meter ........
NG INSPECTOR
O. STREET
p L tTION FOR PLUMBING PERMIT
�`` ITY OF CUPERTINO
w z /
0 o /aY5 19 s;tnPerm No.
LL L
/[ � 196 Permit No �
U Fee $ G9
is j��
° Application SNP�e��� to the City of Cupertino for a permit to install plumbing
o a pipes and/or fixtures li"°°�� 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
a w Cupertino, and all other laws applicable thereto. ��
w Use of Premises
0 0
o a Owner��', � (� Address�3y�
z By�C! UlfiFC/n✓�StP/ l�' Address
O CON, ACTORb AGENT
jm Phone
W z
a �saa
0 f State Licence Approved
aU
PLUMBING INSPECTOR
UNITS FEES UNITS FEES
Water Heate Size if I
Water Closets /� Materia!CR! I
Bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing .�
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
agh Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Com . Sin s rays To Curb
Dental Units
Drinking Fountains
F' oor Drains WATER SY EM
oF�I Peers Size_
Restaurant Sinks Material q j
San raps TOTAL FEES
Urinals Fixture Fee .p-p
rea rains Main Drain Fee
Water Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee
Permit Fee
TOTAL TOTAL FEE
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
'.Main Drain
Final