51006 r �
/e 7.�
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
- File No.
Sanitary No.
Dote
pplication is hereby Zt a permit to
a st ype
o`be occ i only as
in accordance with plot Plan, Plans and Specification filed herewith.
Estimated Value of Improvements $
FEES Plan Check $
Owner Address
Contr. Address
Phone State License
-- Approved
•-- APPLICATION FOR ELECTRICAL PERMIT
Date,' 1961" FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date / asy 196 GAS FEE $ ? a
PLUMBING FEE $
Contr. Address
Phone- dJ S 1 State License
Approved
APPLICATION FOR APPLIANCE RMIT
Data 1% FEE$
Contr. Address
Phone State License
Approved
Applicants agree not to violate any of the
W'brkman's Compensation Laws of the _
State-of California
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Inspector
ELECTRICAL
OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Dote Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
Date Inspector
H.P. CHARGE FIXTURES
Date Inspector
PERMIT FEE Motors
Dote Inspector.'
TOTAL FEES FINAL '
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
pate Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Dote Inspector
STORM DRAIN FEE MAIN DRAIN �o/
WATER SYSTEM FEE GAS PIPING d-�nC —`b - r
Date Inspector
GAS PIPING FEE FINAL
Dote Inspector
PERMIT FEE MISC
Date Inspector
TOTAL FEE - MISC
Date Inspector
APPLIANCE
TYPE OF APPLIANCE UNITS FEE TYPE OF APPLIANCE UNITS FEE
CIRCULATING HEATERS REGISTERS
BLOWER FURNACES COMBUSTION VENT
SUSPENDED UNIT MISC
GAS RANGE MISC
GAS DRYER PERMIT FEE
FLOOR FURNACE -- TOTAL FEE
INSPECTED
Dote Inspector
1067 2 7)E&-('' CL/Fr-E- b2 LOT NO.
NO STREET /& e`cf �'T
?11140 CITY
Cn" OF ' MOPLICATION FOR PLU`
PLUMBING PERMIT
t�AR 2 8 1915
�� ?�
Sanitary No.
Date ,19_ Peit
V, rfee.$5
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. n
Use of n ES
Work To Bye /L,
Premises /�- Performed
Owner L,6 i L/.vr T Address Sof-J,
Phone mss —Zv9 3
By Address.)/S� STONE /tV S�v Td5 r
Contracto Agant ;fS/2 )�
Phone a97-- F/67
State License 'L 237 Approved
Plumbing Inspector
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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lox
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LOT NO.
NO. ET
N APPLI AT,,ION FOR GAS PERMIT
��
a ® CITY OF CUPERTINO
` ° OCT 31 066 7 ,t— 00 /
3 a Uare 196_ Permit No. ✓/ 6
U d
W LL _ Fee $ -�`Z---
LL ° ca('p�is WrKRi q tgChe City of Cupertino for a permit to install gas pipes
o a
and gas app lances as listed on the reverse side hereof, and agrees to install said pipes
i m and/or appliances in accordance with the provisions of the Plumbing Code of the City
< W of Cupertino, and all other laws applicable the to.
u x
r �
J LL Use of Premises
O O /
. 3 Owner��� Address
oa _
Z_jy
J z By Addres
O SS CONTRACT , AGENT
3Q PryJ y � .,'9
_ N
W Z
W W
o s 'tate License Approved
G O/ PLUMBING INSPECTOR
—U v
Remarks (Check ✓)
Type of Appliance Units Fees New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
Miscellaneous
(NAME TYPE)
HOUSE GAS PIPING
Number of Outlets Size of Main
Gas Piping Fees
Testedand Approved ---------------_...... ...:------..........__.....................
DATE INSPECTOR