51248.3 (�01 z y�o
Cjr&F CupST040 Street ' ' ' Lot No.
-a 1972 CITY OF CUPERTINO q�
AUC' APPLICATION FOR BUILDING PERMIT aboo4//�L
Sanitary No.
19 _ P r in No.
Y 'e Application is hereby made for a permit to /
`o o
3 � a story,T pe Building
o
to be occupied only as N accordance with
cy Plans,Specifications and Plot- an filed herewith. PI Ck Fee
„ Estimated Value of Improvements,$ ®DD S Fee$ JE4L,6
m It hereb a
0 o Y agreed that the
requirements of the Cupertino Building and Zoning Ordinances and
' all other laws applicable to the construction, location, and use of buildings within the City of
C
E upertino will be com ied with. n
.3 m Owne i Address
U
,d n BY Address
.� U Phone -� ! �� ( Approved
State License `` adding Inspector
iioojr
NO. STREET LOT NO.
a'o Op �1� CITY OF CUPERTINO
o a A1�PCICATION FOR, ELECTRICAL PERMIT
4 �� a
oW Date A 19 �� Permit No.
>-� Fee S
a W Application ishereby made to the City of Cupertino for a permit to install electrical
W = wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
0 o wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
0 City of Cupertino, and all other laws applicable thereto.
zJ Use of Premises SINGLE FAMILY RESIDENCE
. o
3 Owner /f 4C rVo/gf/S Address 9 d & 0"16�
By E 'ELECTRIC Address w Sly.
O.F CONTRACTOR, AGENT
a0 Phnne: �7j —S7—S7,40/00APP! d
ELECrR r�rNSPIIf[�1
State Licdnse �rl�9�G C
e
ITEM NEW RPL FEES
Number of Outlets
Number of Switches
Number of Receptacles
Number of Fixtures • 0
Ranges or Ovens K.W. �•
Size of Main Service od R • OB
Number of Meters
Number of Panels •0
Signs-Transformers
Dryers
Motors:
H.P.Phase
H.P.Phase
Power Poles
S
_uQ dtf-
Permit Fee 2.00
H.P.Ch es
Total rees •7d
. .
CERTIFICATE OF COMPLETION
BUlIJ31NG INSPECTOR'S OFFICE
CITY OF CUPERTINO
Date ....... ..... ...... ............... 19 .. Building Pernit No. ...
The Building Located at ---
...........
Owned by .....
.............................................
Has Been or Use As: ...........................
(Altered)
................................................................................................................. ...........................
----------........................................................................................ ....................
................................................................. ...... ........
.............\......;-------
............
4�
.�UDING INSPECTOR
//003 I ./�y LOT.NO.^,
NO. STREET
CITY Of GUPEF.T@10 CITY OF CUPERTINO
f'ENU G 3 0 197'Z APPLICATION FOR PLUMBING PERMIT
XX a Sanitary No.
O
3 aatS'', ZV 19 '�' Permit No
U
Fee $ o23iSo
LL w Application is hereby made to the City of Cupertino.for a permit to insiall plumbing
o pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
rand/or fixtures in accordance with the provisions of the Plumbing Code of the City VA
a w Cupertino, and all other laws applicable thereto.
a Use of Premises ses
0 /ry . �I n,
o a Owner y,,r,o�� Address/,93,5li-e -S7, �'�2•
2J n n
o �By ^ "—=Q die Address4--'5- g so
Q qq CONTRACTOR, AGENT
wz PhoneL79 O f
w w
ao State License 5- Approved
—U
;` =� PLUMBING INSPECTOR
C FIXTURES NUMBER MAIN DRAIN 1
Units Fees Units Fees
Water Heater Size
Water Closet Material
Bath Tub a'b To Curb
Shower •5V To Pro .Line
Lavatories Ex's in
Kitchen Sin C
Dish Washer
Waste Dis oral
Wash Tra STORM DRAINAGE
Washin Machine . Sa Size
Water Softener Material
Bar Sink To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Ho er i I I Size PI /SD
Restaurant Sink I I Material
Sand Trap TOT FEES_
Urinal Fixture Fee
Area Drain Main Dmin,Fee [Yr7
Water Fee
Sprinkler System 11 Water Sys.Fee
Relief Vnlve 11 Gas Fee
Vac Breaker
Skimmer
Filter
Pool Sweeper
Permit Fee U�
Total Total Fee
AWK-3 I JWW4Cr DAA S7kC % LOT NO. g
NO. STREET
City OP CUMTHO '
n CITY OF CUPERTINO
O 2 CT 1
f KATION FOR APPLIANCE PERMIT
3Y LL O�
U Date n/1 197 - Permit No. S/��d- 3
rn Fee$ Ar"
n W Application is hereby tirade to the City-of Cupertino for a permit to
Finstall gas appliances as listed on the reverse side hereof, and agrees to
C N install said appliances in accordance with the provisions of the Plumbing
�' Code of the City of Cupertino, and all other laws applicable thereto.
3 Use of Premises
00
og Ownei_g_#V..(' Y 11V,0ES Address /�/�LOIO�r
;,o Ry C�CIJiGrC gt9—' CD Address SeM 604'C
q Q CONTRACTOR,AGENT
- w Phone f �.aLQ"/—�DdjQ
as , D
t o State Limnse a�/D 9a'� Approved �i�G�. ' j
-U PLUMMG INSPECPOR
C
APPLIANCE UNITS FEES
as I op
Gas Oven
Wall Furnace
Gravity Fum.
Forced Air Furn.
Gas Fired Boilers
Waning Ovens
Susp. Units
Dwelling Kit./Bath
Inde end. Vent System
Com-Indust.,1nst.Kit.
Hood&Vent System
Forced Air Under 4000 CFM
Forced Air Over 4000 CFM
Ind.Ventilation System
twitho ut Cori fort Cool l
Forced Air.Mech.each Power
Gravity System
No,of Air Outlets,No.of Flues
Stacks for Metal Fireplaces
Smoke Stacks,Misc. E ui .
_Under 15'Hi
Over 15'I lief
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.runts with input
of 500,001 &Under 1 000,000
Permit Fee.
Total Total Fee "
Lot No.
No. Street / O Z
CITY OF CUPERTINO 0
APPLICATION FOR BUILDING PERMIT /' z
Sanitary No. -7 % 'l Z—
�( ''77 � File No.1
7
Date �19
�Application is hereby made for a.permit to
.story, Tya
to be occupied only as S 9� � y-e� 0
in accondAce with plot plan,Plans and/specification filed herewith.
Estimated Value of Improvements $ a wL0
FEES - �D� �� Plan Check $ 1 /M
Owner 7q0 /l Address ( `. ZIt /f,C
Contr. Address /_ �A1�
Phone ✓ �T/ State License- 4, ✓ v
Approved
i
APPLICATION FOR ELECTRICAL PERMIT
Date / 1 19 FEES /)-
Contr. 4 �n// Address >Z1,5 3 /Z
Phone 7 <0 State License
e
Approved vv' �
APPLICATION FOR PLUMBING & GAS PERMIT
Date �� 19 .L GAS FEES
PLUMBING FEE $
Contr. !
Address
Phone State License 7 S-3
Approved
APPLICATION"FOR APPLIANCE PERM13—,�a
Date 1d L 19 7 Y
FEES
Contr. ' 4�—� Address
Phone ,Ztf 7 ' 7 a .I--4 State License 0 9 oZ/
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
P D-t
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC
PAD FINAL ' 71
FOUNDATION A• t OA .'P
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL
FINAL BLDG.-
U ELECTRICAL
DATE INSPECTOR MISC.
UNDERGROUNDROUGH
ROUGH WIRING 1.r�FINISHED WIRING FIXTURES
MOTORS
FINAL
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REQ.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE - y
MAIN DRAIN S
FINAL PLBG.
FINAL GAS -/ 73
FINAL APPLIANCE �-
DATE INSPECTOR MISC.
MISC 7
MISC
MISC