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51121� A&L') ID 5 -SJ I No. Street APPLICATION FOR BUILDING PERMIT CIT OF CUPERTINO Date 196 Application is hereby made for a permit to Lot File No. / / Sanitary No. a story, Type to be occupied only as FEES Owner Contr. Phone in accordance with Plot Plan, Plans and Specification filed herewith. Estimated Value of Improvements 5 Plan Check $ Address Address State License Approved APPLICATION FOR ELECTRICAL PERMIT Data 196 FEE$ . Contr. Address Phone State License Phone Applicants agree not to violate any of the Workman's Compensation Laws of the State of California State License Approved Approved APPLICATIOWFOR PLUMBING & GAS PERMIT Dote 196 GAS FEE $ PLUMBING FEE $ i AA a �Ws 7 Contr..'�n! V'AI/[� Address ��'�� r C )p Phone r State License Approved APPLICATION FOR APPLIANCE P MIT Date 196 FEE$ I Contr. Address Phone Applicants agree not to violate any of the Workman's Compensation Laws of the State of California State License Approved RECORD OF INSPECTION APPROVALS FOUNDATION BUILDING Date Inspector IINIIFRFI f1nR Date I I Inspector FRe uF Date I Inspector LATH &PLASTER Date Inspector Do to Ins De ctor ELECTRICAL SIZE FEE ,OUTLETS SERVICE SIZE FEE SWITCHES STORM DRAIN SIZE RECEPTACLES Date Inspector FIXTURES WATER SYSTEM H.P. CHARGE Date Inspector PERMIT FEE TOTAL FIXTURES. TOTAL FEES Date Inspector ELECTRICAL SIZE FEE I MATERIAL SERVICE SIZE FEE UNDERGROUND —_ STORM DRAIN SIZE REGISTERS ' Date Inspector ROUGH WIRING WATER SYSTEM SIZE Date Inspector FINISH WIRING TOTAL FIXTURES. MISC Date Inspector FIXTURES - FIXTURE FEE MISC Date Inspector Motors MAIN DRAIN FEE PERMIT FEE. ROUGH COMPLETE Date Date Inspector FINAL MAIN DRAIN Date Date Inspector PLUMBING & GAS MAIN DRAIN SIZE FEE I MATERIAL UNITS FEE CIRCULATING HEATERS STORM DRAIN SIZE REGISTERS ' LIM.6TERIAL BLOWER FURNACES WATER SYSTEM SIZE 4TERIAL SUSPENDED UNIT TOTAL FIXTURES. MISC / UNDERGROUND ' FIXTURE FEE MISC PARTIAL ROUGH GAS DRYER MAIN DRAIN FEE PERMIT FEE. ROUGH COMPLETE Date Inspector STORM DRAIN FEE MAIN DRAIN Date Inspector WATER SYSTEM FEE GAS PIPING Date Inspector GAS PIPING FEE FINAL e Date pe PERMIT FEE Q= MISC Date ns pector TOTAL FEE v= MISC ate Inspector - vma mapv mer 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 "I TOTAL FEE INSPECTED Aoss3 I 1'5�xtzco ve Die. OT NO. NO, STRF. F.t' P_PLIyCATION FOR PLUMBING PERMIT Y OF CUPERTINO z z Fr� r o Sanitary No. 2 LL ° Date ' • _ 1967— Permit No a 3U Pee$ / �v 2 LL ° A�,"t tiQf��Ts��ng�1�jR�e City of Cupertino for a permit to install plumbing o pips 3n�/o4�fixtut�S�1isF.B(drili 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 U) Cupertino, and all other laws a tplicable thereto. w 2 �r LL Use of Premises 00 X y� �. 14t O 3 Owner O'ylAowR Address _ �� G '""AW,e J, By a Address O CONTRACTOR, AGENT 3 m Phone A, 2S-2-t:T70 w z 0 a 0 s State License Approved a o 0 PLUMBING INSPECTOR FIXTURES NUMBER MAIN DRAIN UNITS FEES UNITS FEES Water Heater Size Water Closet Material Bath Tub To Curb Shower To Pro . Line Lavatories To Existing Kitchen Sink Not Conn. Dish Washer Sewer Box Waste Disposal Wash Tray STORM DRAINAGE Washing Machine Size Water Softener Material Btu Sink To Main Drain Comb.Sink&Tray To Curb Dental Unit Drinking Fountain Floor Drain WATER SYSTEM Hopper Size Restaurant Sink Material Sand Trap TOTAL FEES Urinal Fixture Fee Area Drain Main Drain Fee Water Leader Storm Drain Fee Sprinkler Valve Water Sys. Fee Relief Valve Gas Fee Vac Breaker Skimmer Filter Permit Fee Total Total Fee No. SR. I FOR PLUMBING PERMIT D OF FOR(, w 0 MAR 2 3 111���VV111/EEE x o 1966 sanitary No. 0 _ 0 a Date I76_ Permit No j7/1.2/3 U CITY OF CUPERTINO Fee s .? et? 0 Application is hereby made to the City of Cupertino for a permit to install plumbing `o a 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 wCupertino, and all other laws applicable thereto. 4 Use of Premises 00 � N 3 Owner __Address O J-2 e1 O ! re 3 � CON 'RACTOR, AGEN�T � —0 Phone 42,5 �� 6 Jr / 6 w z w w ¢ a a o State Licens — Approved U PLUMBING INSPECTOR UNITSI FEES rea Irr Valves RECORD OF INSPECTION Underground Rough Partial Rough Rough. Complete Main Drain