641_ 10141 COLBY AVENUE
GREET
411 --AL PP ATION
D � CITY
f El 241960
ate_ ,
i.OT No. _26
—1 -01%
FOR BUILDING PERMIT
OF CUPERTINO (1130)
195_ Permit No. 641
-1rf1 t :I,V ade for a permit to erect
CITY 011"Pa one story, Type 5 I J Building
at above address
to be occupied only as sf'dwl
in accordance with Plans, Specifications and Plot -Plan filed herewith.
Estimated Value of Improvements, $ 13 9 000.00 Fee 2.00
v
It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws applicable to the construction, location, and use of buildings within the City of
Cupertino will be complied with.
i OwnerOLVIER ROUSSEAU DRGiMZAT ION Address
By Addr
CON OR, AGENT
4Phone AL-2-99� Approve
BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS ,
FOUNDATION
DAT INSPECTOR
FRAME t3
DAT$ r INSPECTOR
LATH and PLASTER
FINAL BLDG.
FINAL ELEC.
FINAL PLBG.
FINAL GAS
INSPECTOR
TE vT�' INSPECTOR
CERTIFICATE OF COMPLETION -
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
X_
Date19k4
... Building Permit No.
--------------------------
The Building Located ...............................
Owned by ------------------_-----
..........
(Completed)
Has Been'- _(AfterEd) For Use As:.._...._.. ....... ....................... ..............................
.......................................... ...................................................................................................
.............................. I ....................................... ................ 7 ........................................................
........... X-114c� ............................
BUILDING INSPECTOR
102 7/59.500
LOT NO.
O. S T
-Y �:PLICATI'ON FOR PLUMBING PERMIT
,SEP 2 ' CITY OF CUPERTINO
F- °- i9f Permit No.—
Fee
o. Fee $
0 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 Premises
a
Cd
OwnerS//�/0/r/j 'r. /f1-0e ff Address
� ` � CONTRACTOR, AGENT
4 Phone ,s 3 _ A
FIXTURES NUMBER
MAIN DRAIN
UNITS FEES
I UNITS FEES
Wates Heater
Size
Water Closets
Bath Tubs
Material
To Curb
Showers
To Prop. Line
Lavatories
To Existing
Kitchen Sinks
Not Conn.
Dish Washers Ii�
Waste Disposals
Wash Trays
STORM DRAINAGE
Washing Machines
Size
Water Softeners/
Material I
Bar Sinks '� I ��
To Main Drain
Comb. Sink & Trays
To Curb
Dental Units
,Drinking Fountains I II
Floor Drains ��
WATER SYSTEM
Hoppers
Size
Restaurant Sinks
Material
Sand Traps
TOTAL FEES
Urinals
Fixture Fee
Area Drains
Main Drain Fee
Storm Drain Fee
Water Leaders
Sprinkler Valves I I II
Water Sys. Fee
Permit Fee
TOTAL j, .ice 11
TOTAL FEE
RECORD OF INSPECTION
Partial Rough
Rough CompTete
Final
i
)/Z//&V I LOT NO.
NO. STREET
A ICATION- FOR GAS PERMIT
CITYO CUPERTINO
Date r� ~ 2 + 196,019 Permit No.
CITY Cr7 CUPERTINO Fee$
Application is hereby made to the City of Cupertino for a permit to install gas pipes
and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other )aws applicable thereto.
Use of
Owner
By c�' ''-rte- Address
CONTRACTOR, AGENT` `
Phone — :�z4cl Approved
PLUMBING INSPECTOR
Tyfe of Appliance
`
I Units Fees II
Remarks ( Check 0
New Replace Relocate
Gas Ranges
%vall •Heaters
Gas .Plates
Circulating Heaters
Blower Furnaces I ��
Gas Fired Boilers I (�
Warming Ovens
Percolators
Griddles
Steam Tables ( ��
Gravity Furnaces
Suspended Unit
II
Floor Furnace I
��
Miscellaneous I
i�
NAME TYPE) I I
II
Appliance Fees
Inspected and Approved .... :.-..--.................
DATE INSPECTOR
HOUSE GAS PIPING
Numoer of Outlets Size of Main
Gas Piping Fees
Testes and Approved
T)ATE INSPECTOR
AD
v
C:
V
ME
I. x J I . - LLQ-- LOT No.
a6. STREET
APPLICATION FOR APPLIANCE PERMIT
Ofa%CUPERTINO
Date----. p 961b Permit No. J,,,✓//_
QPR 8' .� Fee $--
Applicatip }� bereb made� � � I Cupertino for a permit to install
gas appl ancesW iisfed on the``tbhMTe ereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises<of
Owne C�
1� yZ
CONTRACTOR, AGENP'
Phone"�-
Address 7 L
Address,`_
Approve �-
UMBING INSPECTOR
I
Type of Appliance I Units Fees
Gas. Ranges
Wall Heaters
Gas Plates j
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace I I
Miscellaneous
(NAME TYPE
Appliance tees I I II I
Inspected and Approved . ..--.....--- •--.
• DA E INSPECTOR
L)
LOT NO.
• Wo. STREET
APrINION FOR PLUMBING PERMIT Il a
p CITY OF CUPERTINO
Dt{Q 195— Permit No.
," n�:l,�0 Fee $
A io i� he641made to the City of Cupertino for a permit to install plumbing
pipe�orxtures 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 Premises -s/
By 4`4.46^
CONTRACTOR AGE
Phone
Address
-x� F
Address
Approved
PLUMBING INSPECTOR
Z z4
ater
Comb. Sink & Trays) I II To Curb
Dental Units I I Il
Drinking Fountains) I II
Floor Drains I I 1I WATER
Restaurant
urinais 1 1 11 Pixture kee 1 y, e -v
Area Drains I 1 11 Main Drain Fee I /, 0'0
Sprinkler Vaives I I II Water Sys. Fee I ati
II Permit Fee
TOTAL TOTAL FEE
RECORD OF NSPECTION
PartialRough
Rough Comp ete �g
Final �
UNITS I
FEES II 1 UNITS I FEES
Water Heater
/ 14
6y
11 Size
Water Closets
I 2�- I
Material
Bath Tabs
To Curb
Shower's
/ I/;
�� To Prop. Line
Lavatories
^. 4-v
11 To Existing ,
Kitchen Sinks
jw Cony ,- �)
Dish Washers
SEWER BU16SI
Waste Disposals
I 1
II 1 1
ater
Comb. Sink & Trays) I II To Curb
Dental Units I I Il
Drinking Fountains) I II
Floor Drains I I 1I WATER
Restaurant
urinais 1 1 11 Pixture kee 1 y, e -v
Area Drains I 1 11 Main Drain Fee I /, 0'0
Sprinkler Vaives I I II Water Sys. Fee I ati
II Permit Fee
TOTAL TOTAL FEE
RECORD OF NSPECTION
PartialRough
Rough Comp ete �g
Final �
Cup,WNrl'() Sagitar'y
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
F-1 Sewer Connection Sanitary Permit No . ...... ...........
Plumbing Final Plumbing Permit No.....,��/
. ..................
Lot o . ..... 1c: ......................
...........-------------------------
Owner or Tenant ..... .. . ...... ----
j
'c
I .............................................................
At ........ /I.'
......................... ................................
Tract .........
DateConnected ----------------------- ---------------------------------------------------------------- 19--4/9Date Final ................... ...... 1 ............................
� d
............................................ 19.-
IQ
.......... ...............
RLUMBING INSPECTOR
111 7/59-500 'e�
v
C
N
v
a
v
N0. STREET
LOT NO.
CI aELECTRICAL PERMIT
CUPERTINO
TMAR?,5 1%0Date, 19K�L Permit No.
iS[; T�Y�( OF C q PERTINO Fee j o 70
tITI hereby ma e fo 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 Premise -
Owner
By
V) CONTRACTOR, AGENT
Phone:
Address ' =`
Address
Approved
ELECTRICAL IMPE(TOR
NEW RPL FEES
Transformers .........__._____I..........
-- ----------
Simi Service Conduit...-./-
.........
Number of Outlets ..................
Size Service Wires .......
?7_;* . .......
Number of Switches________________
Size Service Switch ....... _.Number
of Receptacles ............
Size Sub Feed Conduit
..................Number
of Fixtures ..................
Size Sub Feed Wires
...._.__p____.__..__Ranges........ 1_---- KW .... If-----
Number of Circuits ......... d._ -----
Oven ---- /.-------- KW ---- ------
._ _ Phase -------•-------•---•
- -
Phase --------------------
3
H P Charge---------------- -----
'Z �
NEW RPL FEES
Number of Meters --------- .............. Signs ..........
Transformers .........__._____I..........
-- ----------
--/17Q
----------
I
-- ' a
.----•-----
-
Motors ....................
.....7s r
---------- ----------
Permit Fee $1.00
------ --
Number of Meters --------- .............. Signs ..........
Transformers .........__._____I..........
.
.........-----
Misc------------------------------------------------
Dryers ..........
1 .....................
j
-
Motors ....................
HP ------------•-.-_-
Phase --------------------
Permit Fee $1.00
Motors ____________________
Motors-------�-------
HP.- ___
HP -- __�-_..._.
._ _ Phase -------•-------•---•
- -
Phase --------------------
3
H P Charge---------------- -----
'Z �
TOTAL FEES
I /A Zo
C ) oor
F INSPECTION APP?AT
/,I,� _ e
Rough Wlnn&�_ ..=- —Fixtures __..
p4z'e-
T� ECTOR TOR
Finish Wiring.. ... .___.__ ______-_---_ Motors _��_
DATE INSPECTOR Al OR
Final ..; �A . ..P ---------
INSPECTOR