2267/4%5_71 I Q l� I LOT No. �
NO. STR F.ET
z /`
s. APPLICATION FOR BUILDING PERMIT
Y o CI OF CUPERTINO
3a 4
ft APR 2 6 1963 Sanitary No. � t
nl:) 67
_ LL Date 196_ Per
No. —T
,o
LL 0 TCYtioak M Ibr a permit to _ —(z z C�
Q_
zz U) a story, Type —� rr Building
W
to be occupied only as •� . �t� 4�
0 o in accordance with Plans, Specifications and Plot-Plan filed herewith.
> (n-5t> e
3 Estimated Value of Improvements, $DC) t 6� Fee $
i J It is hereby agreed that the requirements of the Cupertino Building and Zoni Ord' antes and
* Z all other laws appliclble to the construction, location, and use of building wi hin e City of
o Cupertino will be co lied with.
3� Aly
P
— a Owner_k/ojSc� dA/Ze ?uhir5 i c Address
W Z
W w By 60 Address
0
° Phone — /
Approve `-
State License 14 —(o / 7 .�3 BUILDING INSPEC o
RECORD OF INSPECTION APPROVALS
FOUNDATION
UNDERFLOOR
FRAME
LATH a PLASTER
FINAL BLDG.
FINAL ELEC.
FINAL PLBG.
FINAL GAS
DATE ���JINSPECTOR
• / I I LOT NO. /�
NO. STREET
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
Date 198=5' Permit No./1�
Fee $ �6?
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 / 11`�''h I Z' �s
By oG
CONTRACTOR, AGENT
Phone �� 'c�`��
//q ,-/ c,2 '/o D=/'/oal, z
Address
Addres 2% c 16111 e 6
A
MBING INSPECTOR
-RE NUMBER MAIN DRAIN
UNITS FEES
UNITS I FEES
Water Heater
Size Lf
Water Closets
Material C,
Bath Tubs ��
To Curb
Showers
To Prop. Line
Lavatories I
To Existing
Kitchen Sinks
Nod onr� —
Dish NVashers
-c—
GWaste
WasteDisposals
Wash Trays
STORM DRAINAGE
Washing Machines
J �I
Size
Water Softeners
Material I
Bar Sinks
To Main Drain
Comb. Sink & Traysl
111
To Curb
Denta] Units
Drink: ng Fountains
I II
Floor Drains
��
WATER SYSTEM
Hpppers
�I
Size
Restaurant Sinks
Material
Sand Traps
TOTAL FEES
Urinals
I�
Fixture Fee �� 'e—
Area Drains
I �I
Main Drain Fee I °�
Storm Drain Fee
Water Leaders
Sprinkler Vaives
��
Water Sys. Fee
Permit Fee
TOTAL
TOTAL FEE
RECORD OZ-1,N,SEACTION
Partial Rough _ _3
Rough Complete
Final
Gw!//jam
Ae LOT NO. /
NO. STREET
APPLICATION FOR GAS PERMIT
OF CUPERTINO
'� r MAY 8 1963
ICITY
Dat/� 194 j Permit No. /
r � !TOF C � 1"n C E R" 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 laws applicable thereto.
Use of Premises / —
Owne gess°� `�� p�ry�cs Address
CONTRACTOR, AGEN-P
Phone - F - of Sd!� —7 If Approve
UMBING INSPECTOR
Type of Appliance
I Units Fees II
Remarks. (Check J)
New Replace Relocate
Gas Ranges
WAW Heaters
Gas Plates
Circulating Heatdrs
Blower Furnaces
�� f
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Unit
NAME TYPE
Inspected and Approved ----------------- -------......-----..
DATE INSPECTOR
HOUSE GAS PIPING
Number of Outlets 1/ Size of Main —
Gas Piping Fees
Testedand Approved...................................................................
SATE INSPECTOR
10571 Blaney 14
NO. STREET LOT NO.
Plan 2420
AMI Ig_I�'0 CAD ELECTRICAL PERMIT
UPERTINO
J ,lUN 1963
Date Jun 3 ti-- Permit No. Q ✓
CIO
Fee 4,
ApplicatldjkYheOF rruy m'aflYlo4HZ 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 nT the2Electrical Code of the
City of Cupertino, and all other laws applicable thereto.
Use of
residence
;a Owner
Blossom Valley Homes, Inc 'Address u nnyva
H• G. WA
B P:DI=k,:".i;
14 y Address
OUNtiN' O'c.14,r' ,i. Approve
p , Phone: F}'''' ELECTRICAL INSPECPO
OF
NEW
RPL FEES
Size Service Conduit ----------------------Number
of Outlets-..-............--
---
--------
------- �.(q[� c)
Size Service Wires -------------------------Number
of Switches...---.---------
ZV
Size Service Switch -----------------------Number of Receptacles............
.A--
----------
----
Size Sub Feed Conduit ------------------Number
of Fixtures..----------------
- ..................
.
Size Sub Feed Wires --- ---------------Ranges
--- )........... KW----........--
--•-• ---
..........
7S
........
Number of Circuits ------------------- Oven 1..........-- KW --------------
----- i...
..........
i
--------
Number of Meters ........................ Signs .......... Transformers
........
..........
........................
Misc. . •-•••--- ...
Motors S---......_ HP
Motors-------------------- HP
Motors -•------------------ HP
D ers-1 ---- I -------------- .......7!S--
--.---------- Phase -------------------- Permit Fee $1.00
--------------••---- Phase ................. .--
-------------------- Phase •------------- H P Charge --.....----- I'�-�-
TOTAL FEES—
EES
OF INSPECTION APPROVALS
Rough Wiring* ------- Fixtures -------- ---- ---------- ----------------------------
&`� 3
DATE INSPECTOR
Finish Wiring .................Motors ............. .
DATE INSPECTOR DATE INSPECTOR
Final-------•------------------ ............................
11 DATE INSPECTOR
LOT NO. 7
NO. STREET - --
APPLICATION FOR APPLIANCE PERMIT
CITY OF CUPERTINO L
Date ----,196.3 Permit No.
Fees 7 y
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 slid
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
c
Use of Premises
c"n Owne Address
A
By Address
CONTRACTOR, AGE 7`
Phone �� / r%' y Approve
PLUMBING INSPECTOR
of Appliance I Units Fees II New
wi11 Heaters
Gas Plates
Steam
'Suspended Unit
Floor Furnace
NAME TYPE)
Inspected and Approved ..............: ..
DATF INSPECTOR