51140 Zo �A 2� I -yCiG1's�J Ll Lot No.
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No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
// .7 , File No. S
Data 196
Application is hereby made for a permit to
a story, Type
to be occupied only as
in dccordance with Plot Plan, P ns and Specification filed herewith„
Estimated Value of Improvements $
FEE$ Plan Check $
Owner Address /�,,/ rA , �j/��
Contr. Address 0L&/" 04 7-4• b�/ "�z�"
Phone J' State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 796 GAS FEE $
PLUMBING FEE $
Contr. / Address 0-a t
Phone - �`S'.3�d Gl State License o1 d Y
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$'
Contr. Address
Phone -State License
Approved
Applicants agree not to violate any of the t
Workman's Compensation Laws of the 0 t
State of California
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
PAD FINAL
FOUNDATION
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL
FINAL BLDG.
ELECTRICAL
DATE INSPECTOR MISC.
UNDERGROUND ROUGH
ROUGH WIRING
FINISHED WIRING
FIXTURES
MOTORS
FINAL
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO.
SANITAR�Yy-N 0.
UNDER O'll U ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
MISC
f
Bldg. Dept.
0- Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Sewer Connection Sanitary Permit No. .........
Plumbing Final Plumbing Permit No.
LotNo. ..................... ---------
Owner or Tenant ...._ xo .......... ...............
�11
.................................................
...................................................
Tract ...................................................... ............................
DateConnected ...... ................—:.............................................. 19.....--....
DateFinal .....-....21- l........�K........11...........................11...............................
.......................... .... ....... . .' L-----------
PLUMBING INSPECTOR
in 12/66-1M
e, _ /L� LOT NO.
NO. STREET /T
CITY OF CUPERTINO CITY OF CUPERTINO
in i WATER DEPT APPLICATION FOR PLUMBING PERMIT
r o AUG 4 1971 sanitary No.
o a Uat19 71 Permit Nn
3 4R�lm
Fee 5 _7a--o
' o
Application is hereby made to the Cit}' of Cupertino for a permit to install plumbing
o 1-W
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
a w Cupertino, and all other laws applicable thereto.
a ~ Use of Premises (..r""e T30, w
J 0
n
3 Owner ' Address-
oa
Z J r
z
By %ze-i �,Ir _ Address -J,t��y( 7
3 COYJTRAC R, AGENT
w z Phone 3 �S' e�o✓%
ww
R a
c o State Liceme / V/ V�b+�t Approved
U PLUMBING INSPECTOR ✓
FIXTURES INUMBER 11 MAIN DRAIN
Units Fees I lUnits Fees
Water Heater Size
Water Closet Material
Bath Tub To Curb
Shower To Proo. Line
Lavatories To Existing
Kitchen Sink Not Conn
Dish Washer
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine Size
Water Softener Material
Bar 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 System Water Sys. Fee
Relief Valve 11 Gas Fee
Vac Breaker
Skimmer
Filter
Pool Sweeper
Permit Fee
Total Total Fee /"�
c No. Street Lot No.
0
A CITY OF CUPERTINO
u WATER DEPT.. APPLICATION FOR PLUMBING PERMIT
E AUG 5 1971 CITY OF CUPERTINO
.G p
Sanitary No.
E Da19k-V Permit Nd�
�b
3 Fee$ �
r 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
o in accordance with the provisions of the Plumbing Code of the City of Cupertino,and all other
"P laws applicable thereto.
o n _
A `"A Use of Premises
s "
' o Owner Address
0 uper ino urn mg
o m By Address 204,32 .Sihrrnnln
4,,e
a Contractor,Agent Cupertino, (a. 95014
o Phone-42-0-6—
n
-a State License .—C �� Z 8 Approved
Plumbing Inspector
FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater Size
Water Closet Material
Bath Tub To Curb
Shower To P,. Line
Lavatories To Exi tin
Kitche
Dish Washer
Waste Dis oral
Wash Tra STORM DRAINAGE
Washing Machine Size
Water Softener Material
Bar Sink To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
I lopper Size
Restaurant Sink Material
Sand Trap TOTAL FEES
Urinal Fixture Fee
Area Drain Main Drain Fee d
Water Leader Storm Drain Fee
Sprinkler SystemI Water Sys. Fee
g
Permit Fee v1,OO
Total Fee sd