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