51001.2Lot Na. �ze)
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Dare
Application is hereby made for a permit to
to be occupied only as
a
in accorda2VE with Plot Plan, Plans
Estimated Value of Improvements
FEES 40 .i=V
0.n. r e4.
Cdh. CC e
Phone Z C�
File No. 6 IOo1 .Z,
Sanitary No. lir, / 1
story, !Y'W :f Z T
s3o, 00 C°
r
filed
Plan Check E
Address #160y :2114
Address
State License �9 7sJ
Approved /
law
APPLICATION FOR ELECTRICAL PERMIT
Date � mt' �"� 196 7 FEEf
J4
Contr. (-`t-L.e,r_� �P�-�- � Address L/!? -I—
Phone % 9e--2 7 J D State License 1-6 9�
Approved rrlTi r Vkj4j D. EIENEVICH
AP LIGATION FOR PLUMBING & GAS PERMIT
Date S 196 GAS FEE s'
PLUMBING FEE
$
Cont,. Address '7c3 O �/�.c�c�'T-� •�✓ i,�'/
Phone — 3— % 7 . State License
Approved /.
APPLICATION FOR APPLIANCE' PERMIT
Date 'S S L 1% T Z FEES /�
_
Phone V State License 1,10e
Applicants agree not to violate any of the
Workman's Compensation Laws of the
state of California 1
Approved,
e
:i
RECORD OF INSPECTION APPROVALS
FOUNDi
UNDERI
FRAME
• LATH
FINAL
Do to
Ins oe ctor
ELECTRICA
E
UNDERGROUND I C-1 I
ROUGH WIRING
re
FINISH WIRING
e
FIXTURES -
� Inspector
Motors
FINAL 1f Ste Inspector
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE - MATERIAL
WATER SYSTEM
SIZE
-
,OUTLETS
_
TOTAL FIXTURES
SWITCHES
FIXTURE FEE
RECEPTACLES
�
3 �s
FIXTURES
for
MAIN DRAIN FEE
N.P. CHARGE
STORM DRAIN FEE
PERMIT FEE
,pector
TOTAL FEES
or
WATER SYSTEM FEE
Ins oe ctor
ELECTRICA
E
UNDERGROUND I C-1 I
ROUGH WIRING
re
FINISH WIRING
e
FIXTURES -
� Inspector
Motors
FINAL 1f Ste Inspector
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE - MATERIAL
WATER SYSTEM
SIZE
-
TERIAL
_
TOTAL FIXTURES
/9'� UNDERGROUN
FIXTURE FEE
PARTIAL ROUGH,6-.,2'G�"
�
3 �s
t
0� o
a
for
MAIN DRAIN FEE
ROUGH COMPLETE
STORM DRAIN FEE
ate
MAIN DRAIN
,pector
oto
�5
or
WATER SYSTEM FEE
GAS PIPING
ata
ns
GAS PIPING FEE
FINAL - J
• Date
Inspector
PERMIT FEE
MISC
' TOTAL FE%%•
Date
Inspector
TOTAL FEE
MISC
were inspecror
APPLIANCE
TYPE OF APPLIANCE
UNITS
FEE
TYPE OF APPLIANCE
UNITS
FEE
CIRCULATING HEATERS
REGISTERS
�
3 �s
BLOWER FURNACES
a�-�
COMBUSTION VENT
%
SUSPENDED UNIT
MISC
GAS RANGE
' MISC
GAS DRYER
PERMIT FEE
dS
FLOOR FURNACE
' TOTAL FE%%•
7
INSPECTED
Date Inspector
CERTIFICATE 7 'OF COMPLETION
BUILDING INSPEcrbR'S OFFICE
CITY OF CUPERTINO
Date ..... /h ......... ZY ............... 119,67. Building Permit Nos./0.01,2
12
The Building Located at ...2.3.jky ....... Ira.V14 .... aam-ra .......
V ....................
Ownedby .... 046k, ......... k,40 11 ....... co .......... : ..................................................
Has Been (Co(Ampleted ) For Use As: ... ......................................
kffeA)_
li,
BUILDING ANSPECTOR
102 7/63-500
GAS SERVICE NOTICE COPYOFFICE
BUILDING INSPECTOR'S OFFICE
CITY ,OP CUPERTINO
...... — 196.,7
To
You are hereby, authorized to connect the GAS service for
Owner or Tenant ... . . . ..... ....... ......... ...... ........
At....... ...................... ....
New Service
No. of Meters .../ ......... Reconnect .............. --- ...........
Move Service .... ... -.— -
No. of Add. Meters ............... Move Meter ..............
... * * R -
,!:::PL BI R
ROUTE SLIP
— �—
File No. ;,` 0dQ,-
Date Out1
Date In ii—iy-6
Location
�0
Subjeot G-'+^
Notes
Approved (Lf Cf -6 ClM—
Date Insp:c
Bldg. Dept.
Office Copy
BUILDING, .'INSPECTOR'S OFFICE
CITY OF CUPERTINO
❑ Sewer Connection Sanitary Permit No..... -------
[Ejhl F' I Plumbing Permit No. li:074.011Z
LotN ..........................
op
Owner or Tenant
At
Tract .........
Date Connected .............................
Date Final ............................ zz�7A
111 12/66-1M
UMBING INSPECTOR
O CE CO Y
s'
To
You are here
Owner or Tenant
At
On 01"I
ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY - OF CTJPERTINO
...............:: . .1`/ .—
G77
..
......................G............ 19
No. of Wires . ............... Size of Wires ....y..... Size of Swit
Motor Load .......................... Voltage ................................ Phase .........
Heating Load ........................ K. W . .................................. Voltage .......
Light...._ Ito/.. New Servic ............. Reconnect..................
No. of Meters ....................
' Heat ................. 220:.. .... T ee 3 .i.............. Move Service............
No. of Add. Meter............
Power ............... T 'P6 e,.,............ Movfi'Meter..............
�--�.
....................
ELECTRICAL 1tv ECro
"/4"• I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
n=
C
F _
Z
o`
o
T
�
A
C
bz
3'
x
cam'
�
ti
n
~
m O
P
T
w
1 e.
Ear
g
ro
a
n
;ti
° c
M n
n
w
=
�
a.
n n
Q
J
°
]A
F
° N
�
� o
w
O
o
0.
o_
s
ZIP
=fin
C
Z
o`
o
T
�
A
C
bz
3'
x
0
�
Z
fit a
4
~
m O
P
T
w
1 e.
-r-4 LOT NO. 'YD
NO. STREET'
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPF.RTINO
Sanitary No.—
Da
u. lla n`196Permit No.
19V L,;
Pee s�27 ,,i—Q
Application is hereby made to the City of Cupertino for a permit to install plumbing
xt reverse side hereof, and agrees to install said prices
an ( Izt s m r l the provisions of the Plumbing Code of the City of
Cupertino, and/" -4 Ther laws applicable thereto.
Use of
Owner_—r��'._.�::r/—� ,FaLr/� Addressd:
B}�sr �`r✓1C I Address
CONTRACTOR, AGENT ^�
Phone
State License��Sf� Approved
(1 PLUMBING INSPECTOR V
UNITSI FEES I
....... — , on
eater Leaders Storm -Brain Fee �,y
Sprinkler V]IVC5 Water Sys. Fee
11 Permit Fee I 2 •a�
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Final .