51087�1
L Q.IL
f �� • Lot
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. Shop
OWSanitary No.
Date
App li
to be occupied 41y as
tS
FEE$ I
Ow ne r
Contr.
is hereby made for a permit to
10 a story, Type
't -J: �
in accordance with Plot Plan, Plans and Specification filed herewith„
klue of Improvements $ QW, bow
I
•
—r APlan Check $
d ess
ss
Phone State Lice
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 7G �� 196.n—
C
C'
Contr.
Phone/ 3 7 7 7 z
FEE$
Address
State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $ 4 _
PLUMBING FEE $
Contr. 4'1--�n -Address/
Phone �o �S p State License �7/�
WILLIAM D. I3!-VICki
Approved
G—� APPLICATION FOR APPLIANCE PERMIT 7 s—
Date a 196 FEE$ ??
Contr. r /` Address rJ�!��
Phone -T/+. U / 3 State License 7 r
Approved b'VILLI.".','e J. !CH
Applicants agree not to violate any of the
Workman's Compensation Laws of the
Slate of California
RECORD'OFIINSPItCTION APP./
SIZE
-_,^ ,��" BUILDING
FOUNDATION
OUTLETS
D� �
UNDERFLOOR
STORM DRAIN
e for
may_ D_ot /
FRAME v S
W
nspector
Date
LATH &PLASTER
j
Inspector
D^te S
FINAL
�A�pe,r
U
H.P. CHARGE
Date
Inspector
ELECTRICAL
UNDERGROUND
ROUGH WIRING
FINISH WIRING _
FIXTURES
Motors
FINAL /-,
SERVICE SIZE
to ns
7T7or
Date
Date
to
Inspector
Inspector
Inspector
ctor
Date
Inspector
PLUMBING & GAS
MAIN DRAIN
SIZE
FEE
OUTLETS
UNITS
STORM DRAIN
SWITCHES ZU
W
G
RECEPTACLES/
3
G
%
FIXTURES
TERIAL
% D c
U
H.P. CHARGE
2j-
7
PERMIT FEE
1222
FIXTURE FEE
TOTAL FEES
IU
ELECTRICAL
UNDERGROUND
ROUGH WIRING
FINISH WIRING _
FIXTURES
Motors
FINAL /-,
SERVICE SIZE
to ns
7T7or
Date
Date
to
Inspector
Inspector
Inspector
ctor
Date
Inspector
PLUMBING & GAS
MAIN DRAIN
SIZE
FEE
I MATERIAL
UNITS
STORM DRAIN
SIZE
TERIAL
REGISTERS
WATER SYSTEM
SIZE
BLOWER FURNACES
TERIAL
% D c
TOTAL FIXTURES
�}t
UNDERGROUND
1222
FIXTURE FEE
MISC
PARTIAL ROUGH - -C3
GAS RANGE
cJZ
MISC
DateI for
MAIN DRAIN FEE
GAS DRYER
ROUGH COMPLETE
l) �?-()
FLOOR FURNACE
Do td r
STORM DRAIN FEE
MAIN DRAIN
—2w ��fl=
Date.. r
WATER SYSTEM FEE
GAS PIPING ,"
- -6.5
GAS PIPING FEE
FINAL
Date s
C
'Inspector
PERMIT FEE
PERMIT
MISC
/
�
Date Inspector
TOTAL FEE
LO
MISC
Date Inspector
APPLIANCE
TYPE OF APPLIANCE
UNITS
FEE
TYPE OF APPLIANCE
UNITS
FEE
CIRCULATING HEATERS
REGISTERS
%S
BLOWER FURNACES
% D c
COMBUSTION VENT
a2 !-G
SUSPENDED UNIT
MISC
GAS RANGE
MISC
GAS DRYER
PERMIT FEE
FLOOR FURNACE
TOTAL FEE
INSPECTED /c A� 6 5
Date Inspector
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Date ....
.................... Building Permit
The Building Located at
--^ -- ----------
Owned by
---------------------------------------------------------
fF
Has Been -ComP"F)>
(Aftere4For Use As: -------
r, - ------------------------------------- -
G
------------------------------------------------------
- --------------------
------------------------------------------------------ .................... --------------- ..................................................
- ....... 1-.1 ----------------------------------------------------------------- ..................................................................
................................................................................................................................................
. ........................
BUILDING INSPECTOR
102 7/63-500
Bldg. Dept
ofike Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
[:] Sewer Connection Sanitary Permit No. -----'T- / __.---..-._-----
pRo'Pflumbing Final Plumbing Permit No.
At -
t - o--.--.-.---.-/-----?----- ..................
Owner or TenantN-�--- --------------------- .... ............ ---------------------
-
Tract----- ....... --- -- ----------- i ---------------- ----------------------- .......................
Date Connected ------------------------------ 77...'e.5
? ----------------------------------------------------- 191,12
DateFinal ---------------- .............. ---------- ....................................
............ �� ---------------------------
PLUMBING INSPECTOR
111 7/63-1M