3021NO. STREET
WZ APPLICATION FOR BUILDING PERMIT
-20: ° CITY OF CUPERTINO
o a _ Sanitary No.
= o Date 196 Permit No.
r
LL w Application is hereby made for a pe it to-
o
z Ln a stor Building
aW
to be occupied only as _e A-IejollaA
0 o in accordance with Plans, Specifications
//and
��Plot-Pla d here It J
3 Estimated Value of Improvements, $ Fee $ e
zJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
z all other I s applicable to the construction, locatio{�, and use of buildings within the City of
o Cupertino II be complied_ with
.
a Owner U Addres O
N
Z
W By Address
,U Phone��T A Approve
�' State Lice s -) BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
INSPECTOR
UNDERFLOOR
_
DATE
INSPECTOR
FRAME
DATE.
INSPECTOR
LATH and PLASTER
DATE
INSPECTOR
FINAL BLDG.
Dk E
INSPECTOR
FINAL ELEC.
J
DATE
INSPECTOR
FINAL PLBG.
DATE
INSPECTOR
FINAL GAS
DAT R
INSPECTOR
LOS NO.
NOSTREET
j.QalON
FOR PLUMBING PERMIT
APR 962
It,
CITY OF CUPERTINO
� 2 6
Date , I49 Permit No._�,/.
I CITY OF CUPERTINO Fee $
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
;.3
v, �° Owner Address J
By �� � � • Address'�a � �
_
CONTRACTOR AGENT
Phonel-2 Approve
PLUMBING INSPECTOR
TURES NUMBER
MAIN DRAIN
UNITS I FEES II
UNITS FEES
Water Heater
Size
Water Closets
Material
Bath Tubs
To Curb
Showers
To Prop. Line
Lavatories I �I
To Existing
Kitchen Sinks
Not on z
' Dish Washers I I 11_3EWER
BOXES
Waste Disposals
Wash Trays
STORM DRAINAGE
Washing Machines
Size
Water Softeners
Material I
Bar Sii ks 11
To Main Drain
Comb. Sink & Trays
To Curb
Dental Units I ��
Drinking Fountains
Floor Drains 1 11 WATER SYS"1-EM
Homers I 1 II Size I
Restaurant
Area Drains Main Drain Fee O o
Water Leaders Storm Drain Fee
Sprink r Vaives Water Sys. Fee
611 Permit Fee
TOTAL 111 TOTAL FEE 6
RECORD PECTION
Partial Rough �j� Z
Rough CorLolete -
Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO 4
Sewer Connection Sanitary Permit No. - -----------------
c --Plumbing Final Plumbing Permit No..1- / -----------
Lot No. ---------- ------- -- --
Owner br' Tenant -----------------
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At....G7�- � -".. ..-----------------------------------------
Tract
Date Connected ----------------------------- �-// Date Final Final --------- ----- 19.%,-----_-
------------- - - -- ------ f��------------------------
LUMBING INSPECTOR
111 7/61-500