51226Lot No.
No. Street
APPLIC ION FOR BUILDING PERMIT
CITY OF CUPERTI_NO
ti
Sanitary No.�r
File No.z—,
Z YO
Dote �- 196)L -Q—
A lication is her - made for a permit to
<1 story, Type
to 6e occupied only as , , ` r
in accordance with Plot Plan, Plans and Specification filed herewith,
Eafimoted Value of Improve menta f &�^ 60 4m OZ
0
FEES �I plan Chec(kjj,��'/''
Owner Addrosa
Contr. Address
t-"i�l(m
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date LIP 196 7/'FEES
Contr. Address �� 7 c /��.N �I2 S /�
Phone '� 6 10 7 u' o
State License �2-11LO aFiP
Approved
APPLICATION FOR PLUMBING OGAS PERMIT
r
s z.
Dote �� 196 7 0( GAS FEE $ <'/ )
PLUMBING FEE $
Contr. Address s ,A�
Phone jZ 71- – y �P State License
Approved
APP TION FOR APPLIANCE PERMIT " --
Date Date L—t� _ 1" �P nnae i�---
Contr.
of � Address ' �Q .21tcLL!_1'
Phone �� r� 3 State License ��. 9Z
l ,'/
Approved
Applicants agree not to violate any of the
VOrkman's Compensation Laws of the
5tate of California
-11111119
-1>111119
RECORD OF INSPECTION APPROVALS
EOF• 6W iw
_ y
BUILDING
DATE INSPECTOR MISC.
-% 0
PAD FINAL
FOUNDATION
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL
FINAL BLDG. /
v,F.
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
REQ.
EL E TRICAL C1 `Q .I 1 )
DATE
IN ECTOR MISC.
UNDERGROUND ROUGH
I'
PLETE2—
_ R. .�. wn .Scr.v.
.�. CLVO/NG ewer- -✓�
IRING
ROUGH WIRING—
l
AANCE _
?-7 ate.
FINISHED WIRING
FINISHED
�� 7
FIXTURES
OTORS4
MOTORS-
4-46
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
REQ.
0.
NO ROUGH -
UGH —
• pI1J W NOT Cowl• O J
PLETE2—
_ R. .�. wn .Scr.v.
.�. CLVO/NG ewer- -✓�
l
AANCE _
?-7 ate.
MISC KW'4
'MISC ' ,
MISC Neil'
DATE INSPECTQO
11✓.lf-7r-�i j•
F4v'aj S -/7 -?t
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Date ... .......... ........ 19...?3 ?.3. Building Permit.No. 567-:2-(q..
The Building Located at ...... 0-94p, �� .. IntIf L ...... 4:� .........
Owned by
Has Been
(C As ........
Use -------- - -- - ..................
,e
INSPECTOR