51226t c t 3z "Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
File No. o
Date a ��196Z9L_
licatioryis h reby made for a permit to
1 _
a story, Type
..to be occupiecAonly. as
in accordance with Plot Plan, Plans and Specif' all filed herewitk
a� o00
Estimated Value of Improvementsmel $
FEES a^Oo
Plan Ch
Owner r dress rb• �s
Contr. Address
Phone 3-tg - itnLa a 6 e OSG
State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Dote _ I L 1966) —7 1 .
Phone _ -7 36— o-7Li 0
APPLICATION FOR
Data 196 —7
-ont,.
Phone 37 e - 6 9 a /
APPLICATION FOR
)a to 6 11% 7/
.ontr.—.1Of�7/
'hone — 7 f — y % .j �Z.
1pp Ucants. agree not to violate any of the
7tirkmanrs Compensation Laws of the
(tate of California
FEE$ SC
Address 170 WAn
State License rzaQObs
Approved� 5t / '
PLUMBING & GAS PERMIT
GAS FEE $
PLUMBING FEE $
Address a`%t3zi a/ —,/�_v ,.
State License 7 d,
Approved
VG
APPLIANCE P MIT
FEES /j!
Address lj.,e
State License
Approved
PAD FIN,
FOUNDA
UNDERF
FRAME_
LATH &
GRADIN(
FINAL B
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
%L
TION •
ROUGH WIRING
'
LOOR
FINISHED WIRING
PLASTER
MOTORS
i FINAL
LOG. .
T� ial
ew
INSPECTOF\ ' MISC.
UNDERGROUND ROUGH
Y '
ROUGH WIRING
FINISHED WIRING
FIXTURES
MOTORS
FINAL
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH 2
ROUGH COMPLETE -3—/E
MAIN DRAIN 3-1R _7
FINAL PLBG. ( /
FINAL GAS —Z `
FINAL APPLIANCE 6
QatGGMElu*Wrodd NauJEro Oita. 7-16-11
3—/6-7 v /jIN SPECTOR
IMISC VG OK /14
MISC
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Date ..... LCP .... .................1 19 ... Building Panit No.
The Building Lmted at(C..j .. . ....... .. . .....
Ownedby . ........ . ........... ...............................................................
Has Been (cw—amm!�(Altered) 4or Use .As: ........... ............
.................................... ..... I ............... .............................
...... ...........
... ....... ....................
BUILDING INSPECTOR
w a
w�
> w
F 3
O J
a o
S'�L FOR PLUMBING PERMIT
® � OF CUPERTINO
�a (
o (77/ Sanitary No.
Date �W. 196— Permit No. 5122
`/ C ERT p O Pee $ 28. 50
AQplt�kYioAFhcrala�ttnis&Ft�tfttHCit}' 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 otherjaw•s applicable thereto.
Use of
Phone —? /
State License Z7y1-41
Addre
./
Approved
r_
X, PLUMBING ••
Water Heater
Wash
Comb.Sink &
Dental Unit
WA
Total Fee
5