51226APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No. �I
File No.
Dote 19�u_
A 'cation is hereby ade for a permit to i
t !�
P \ )t. rY. fyYPe •�
to be occupied only as trY
in accordance with plot plan, plans and Specification_ filed herewith,
Estimated Value of Improvements $
FEES 61fA G-0 Plan Check
/5
Owner ' ress •�. �!r
Cont, Address
Phone .�, a - :1 (a 'L
d SSV
State License 7
Approved `
APPLICATION FOR ELECTRICAL PERMIT
Date` (.1 4 196 --) I FEE$
�t'^
Contr. Ap 0 ,f -'n4 Address
Phone - / -560- (-)7 VI State L
Approvt
APPLICATION FOR PLUMBING & GAS PERMIT _
Date 411A 196 71 GAS FEE $
PLUMBING FEE $
:ontr. t Address
Phone _3� �' 6 $tufa License - �7o1
Approved K.
APPLICATIONFORLIANCE ER IT 7 f
)a to196 �7 / FEE
:ontr.7i-
'hone — 7 1— l >
applicants agree not to violate any of the
''orkown's Compensation Laws of the
tate of California
Address
State Lice
Approved
PAD FINAL
FOUNDATIC
UNDERFLO
FRAME
LATH & PL
GRADING F
FINAL BLD
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR
AV E
UNDERGROUND ROUGH
ROUGH WIRING
FINISHED WIRING l
FI%TURES a^
MOTORS
FINAL
ELECTRICAL
INSPECTOR
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR
MISC.
MISC.
BACK FLOW REQ. -
SANITARY N
UNDERGROU
kSTER
PARTIAL ROROUGH COMMAIN
DRAINFINAL
AV E
UNDERGROUND ROUGH
ROUGH WIRING
FINISHED WIRING l
FI%TURES a^
MOTORS
FINAL
ELECTRICAL
INSPECTOR
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR
MISC.
MISC.
BACK FLOW REQ. -
SANITARY N
UNDERGROU
PARTIAL ROROUGH COMMAIN
DRAINFINAL
PLBGFINAL
GASCT
FINAL APPL
CW Gres witeowtr Hose ro Oft 7-16.71
�Ul.c.. 3-16-71�,
DRTE INSPEE/CTOR MISC.
CERTIFICATE' OF COMPLETION
BUMDING INSPECTOR'S OFFICE
MY OF CUPERTINO
Date -----/-Q...:!7=-;(.....,--...........,- 19.21 Building Permit No . ... ............. ..
The Building Locate)l at C-l� .. ..........
Owned by ....
--.' Q -
Has Been (@��FIF or Use As:.... ............. I ..... ...........
(Altered)
.......... . ........ .......
-------------
ING INSPECMR
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e'jPP�1ICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
Sanitary No.
pate J �i.��r 1
v , 196_
Lot No. 1' 3
Permit No. 5/ Z 2.6
(?!T�/ (jY VUt n Fee S28.50
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
rnone
State License %% kfZ Approved
Plumbing Inspector
r- IX. Coursr de (�.J. 31341 R
FIXTURES
NUMBER
MAIN DRAIN
Units Fees
Units I Fees
Water Heater
Size
Water Closet
Drinking Fountain
Material (a.
Bath Tub
iJ
To Curb
Shower
To Prop. Line
Lavatories
To Existing
Kitchen
t Conn.
Dish Washer
Waste Disposal
Wash Tray
STORM DRAINAGEry
Washing
Floor Drain
WATER SYSTEM
Hopper
Size
Restaurant Sink
Material
Sand TrapTOTAL
FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee . Iy
Water Leader
4/ V
t rm Drain Fee
Sprinkler System
Water Sys, Fee
Vac Breaker
Skimmer
Filter
Permit Fee
Total
Total Fee
Machine Size
Water Softener Material
Bar Sink To Main Drain
Comb.Sink &Tray To Curb
Dental Unit
Drinking Fountain