51273 1055 LI lkn� j. �rv_t_'• LOTNO. I T(0 2-4 Yz
NO. STREET . " ryp„tif D
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w Z CITY OF CUPERTINO
Yo cm Of cup"o APPLICATION FOR BUILDING PERMIT
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9a Building Per.No.
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, 19 - Sanitary Per.No.
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o _Application hereby made for a permit to A..4'r'� �C�
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a_story, Type Structure
m to be occupied only as ' in accordance with
w
Plans,Specifications and Plot-Plan filed herewith. PI Ck Fee$ .T
0 o Estimated Value of Improvements, $ Fee$ 78•P-0
�3 Total Fee$ 7 F,75r_
oa
Z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances
o and all other laws applicable to the construction, location, and use of buildings within_
3 a the City of Cupertino will be complied with.
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W W Owna^r-JL°pGh—, �" Address`� f/S�f
QBY yam' " �' Address
—U Contr.o Agent
Phone �'Uy ' 29f0I` APProvetl s
State License �'�a I �lT Building Inspector r
10904 I Northview 5q,, ' LOT No, 146
NO. STREET • • Plan 10-D
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Z CITY OF CUPERTINO
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APPLICATION FOR ELECTRICAL PERMIT
Y CITY OF GUPERTINO
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U MqNYQW373 Permit No.
Fu. Date , 19 Fee$
O F PPpliAtio4 i"reby made to the City of Cupertino for a permit to install electrical
Z r wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
a" wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
F F City of Cupertino, and all other laws applicable thereto.
a
JW
00 Use of - Work To Be 4
> PremisesPerformed ,N�,-n^^-•/1,Aq�pp����
ZF C U/lam I'ialkQ
Owner Atltlreca
J av WANDER ELECTRIC, . = Ada.e.. '
3 F Contractor,Agent
—a Phone
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w W 0�0�7 Y
w State License Approved
pQ. Electrical Inspector
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ITEM NEW RPL FEES
Number of Outlets Ia
Number of Switches 1-5
Number of Receptacles
Number of Fixtures / a. i.3c)
Ranges o&-Qvens-NrYV* I
Size of Main Service R.
Number of Meters
Number of Panels
Signs - Transformers
Dryers _
Motors:
H.P. Phase
_ 'H.P. Phase
H.P. Phase
Power Poles
Misc.
Permit Fee 2A0
H.P. Charges
Total Fees
[�/�( Z iTsLfLW o�J �Yi�%O�G LOT NO.
hljtitiC STREET
O�WFT'°•'1g�� CITY OF CUPERTINO
,z < 5 PPLICATION FOR PLUMBING PERMIT
W ¢
�_ nq(� Sanitary No.
a Dat q/9 19 _ Permit No
3� 10
W W Fee S 2L•q
3
O Application is hereby made to the City of Cupertino for a permit to install plumbing
o a pipes and fixtures listed on the reverse side hereof, and agrees to install said prices
i N 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.
W 2
1- h
W Use of Premises Single Dwelling
00 2295 De La Cruz Blvd. S. C.
�
3 Owner Ditz Crane Co. Address
0a
* z By L. C. Sohart Plumbing Co. Add esE. Fremont "e.9 Swale
o CONTRACTOR, AGENT
3 F
— Phone 245-2323
State License 186519 Approved-
40
U PLUMBING INSPECTOR '��
FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heaterf Size
Water Closet L Material
Bath Tub I To Curb
Shower To Prot). Line c/
Lavatories To Existing
Kitchen Sink Not Conn,
Dish Washer
Waste DiVosal'
Wash Tray STORM DRAINAGE
Waslung 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 StDrWn*Fee
Sprinkler System 11 Water Sys.Fee /
Relief Valve
Vac Breaker
Skimmer
Filter
Pool Sweeper
Permit Fee
Total Total Fee Z 3. Sp
�S7 EET LOT NO /x V4
Y
crtT °'=ATION FOR APPLIANCE PERMIT
m = CIIY OF CUPMTM
2 a< 2 51973 _
YLL ��
c Da{eM 19• _ Permit No. S^/3 73
uLL Fee•$
' o Application is hereby made to the City-of Cupertino for a permit to
$< install gas appliances as listed on the reverse side hereof, and agrees to
'z N install said appliances in accordance with the provisions of the.Plumbing
„ s Code of the. Cityf C ertino, and all other laws applicable thereto.
SUse of Premises
004
'; Owner Address
sir
o�
z /y
�z By � Address l0
-o
CO.
— Phone CAMpa ml
W LICENSE #2528c —
i o State License 25 Approve
U 'n% PLUMBING INSPHCYOa v
APPLIANCE UNITS FEES
as I op
Gas Oven
Wall Furnace
Gravity Furn.
Forced Air Furn. p'D
Gas Fired.Boilers
Warming Ovens
Susp. Units
Dwelling.Kit./Bath J'o
Inde end. Vent System
Com. Indust.,Inst.Kit.
Hood&Vent System
Forced Air Under 4000 CFkl
Forced Air Over 4000 CFM
Ind. Ventilation System
without Comfort
Forced Air.Mech.each Power
Gravity System
No.of Air Outlets,No.of Flues
Stacks for Metal Fireplaces -
Smoke Stacks,.Misc. Equip.
Under 15"High
Over 15'Ifigh
Comfort Cooling
Comp.of 20 HP or less
&absorp.units with input
of 500,000 BTU or less
Comp.over 20 HP&Under 50 HP
&Absorp.units with input
of 500.001 &Under 1,000,000
Permit Fee 30-0
Total Total Fee p-f�
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Date .........:gJ.::.. ................. 19.... ;3 Building Permit No. ....;.,
The Building Located at ... ....... .11152f2,TF;t.;,A.
jlt`->..........
owned by
jHas Been �Al For Use As:._.... :?..t..�`.........G ------------------------------------------- -----------------------
.........................--------------...----------....----•-------..................................................................-------.
-......._..... .......................................................................................••........---•--......---------.---
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�,. .............._..............:---...--•-•----......_...........---...........------- ----- ..........---------•-.`.......-................
$T 11NG INSPECTOR
RECORD OF INSPECTION APPROVALS
BUILDING //'
DATE INSPECTOR /I S(/
PAD FINAL
FOUNDATION �' 71)• —
UNDERFLOOR 4 g-? 4cql, D' 7
FRAME ' ) ��;
ATH PLASTER��
GRADING FINAL
FINAL BLDG.
ELECTRICAL
DATE INSPECTOR MISC.
UNDERGROUND
ROUGH WIRING
FINISHED WIRIN
FIXTURES
MOTORS
FINAL-IP
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO. 9--'7-73
SANITARY NO. ,
UNDERGROUND ROUGH c
PARTIAL ROUGH 7�
ROUGH COMPLETE
MAIN DRAIN �qd —
FINAL PLBG. d —�3 73
FINAL GAS _ ' 7317A= 11
FINAL APPLIANCE 3-7
DATE INSPECTOR MISC.
MISC
MISC
MISC
d ."'i Lot No. d
No. Street '• i7 L
CITY OF CUPERTINO
APPLICATION FOR BUILDING PERMIT
Sanitary No. 2S
Data 19
'' File No.
�
Application is hereby made for a permit to
a sto , Typ
to be occupied only as
in accordarQ with Pla lan, Plans and S cification filed herewit
Estimated Value of Improvements $ 2.S. Qo O
FEES - ]]''��78• OD Plan Check $
Owner J�/1/Z- 401'QI71J.+ Address
tt
Contr. .` e fs Address . ,♦
Phone ZT� e' ZA I(o State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 19 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS /PERMIT
Date /L S 79 -7� GAS FEE $ C/'c
PLUMBING FEE $ 21
Contr. '7 Address
A 2 L
Phone - --R 4L5 '«� j State License S
Approved
Lta AP L CATION FOR APPLIANCE PERMIT /3
Dote 19 FEES ,J
Contr. - Address 0✓� - ^'c-��
2 7 -O
Phone —3 / f ,� �� State License s- .;L-S
Approved
Applicants agree not to violate any of the )t(,--
Workman's Compensation Laws of the
State of California
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