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No. y�St?eet Lot No.��
APPLICATION FOR PLUMBING PERMIT
iN OV 27 196 �." CITY OF CUPERTINO
l� Sanitary No.
Date ` ^' -'�r "TIN196(��J Permit No..J�J/p ..�
Fee S..2 -6o, S�
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
in accordance with the provisions of the Plumbing Code of the City of Cupertino, and all other
laws applicable thereto. n
Use of
9
By
Phone c5"' �---?'-3-2`�
State License /iP� 579 /vApprovedd"L.LA—"
Plumbing Inspector
FIXTURES
NUMBER
MAIN DRAIN
Units Fees
Units Fees
Water Heater
/
Size
Water Closet
Material
Bath Tub
To Curb
Shower
To Prop. Line
Lavatories
To Existing
Kitchen Sink
Not Conn -
nDish
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 LeaderStorm.Drain
Fee'
Sprinkler System
Water Sys. Fee /
Relief Valve
11
Cn� Fee.
Vac Breaker
Skimmer
Filter
Permit Fee dF�
Total
Total Fee
c. r
Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO r/
• File No. S t/" /..�
r/ Sanitary No. /'o
Dote .196 i
Application is hereby made for a permit to
a story, Type
to be occupied only as �_ rvn wed,
in accordance with Plot Plan, Plana and Specification filed herewith,
Estimated Value of Improvements $ 33 oco .z�
FEES �V' Plan Check $
Owner - Address /L/Lu.,
Contr. 'v Address cc�L—�rz�--�
Phone ^ C o'`� T f��� Stato License A� / 9/
Approved WILLLkivl u• bG1VEVICH
APPLICATION FOR ELECTRICAL PERMIT/ ''7
Date 196 djFEES �" ,Dv /
Contr. / 'Z// Address
Phone �3(0 —S1,21 1,21 — State License /12
Approved WILLIAM 0. EIENEVICH
APPLICATION FOR PLUMBING & GAS PERMIT
Date �� 196 O GAS FEE $-
PLUMBING FEE $ -$-
Cont,. .{-J�=7�k Address. •
2 3
Phone �7� - 32 State License, �Yl 79
Approved WILLIAM D. BENEVICH
APPLI ATION FOR APPLIANCE PERMIT
Dote 196 FEE$
C ontr. P- Address
� c^"'
Phone a State License
t Approved
Applicants agree not to violate any of the v
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
` BUILDING
FOUNDATION z s— o r
DAT F, IN SPEC R
UNDERFLOOR z' I. i a(J'
DATE INSPECTO
FRAME
GATE NSPE
LAT & PLASTER _ _L
DATE SPECTOR
FINAL "� � � �-6 q '
DATE INSPECTOR
ELECTRICAL
ELECT. SERVICE
DATE INSPECTOR
/UNDERGROUND ('��
I ^ ' �TE W l INSPECTOR
ROUGH WIRING Y `J 1
DATE INSPECTOR
FINISH WIRING i
DATE INSPECTOR
FIXTURES 1 (4-
DATE
GDATE INSPECTOR
MOTORS
ATE INSPECTOR
FINAL �
DATE INSPECTOR
PLUMBING & GAS
fL- iI-6P .,
UNDERGROUND
D'AT PECTOR
PARTIAL ROUGH
DATE PEC TOR
ROUGH COMPLETE
G[jATE PECTOR
MAIN DRAIN ' - 7
DATE INSPECTOR
GAS PIPING
DATEINSPECTOR
FINAL
DATE INSPECTOR
MISC
DATE INSPECTOR
MISC
.. DATE INSPECTOR
APPLIANCE
INSPECTED
DATE INSPECTOR
MISC
GATE INSPECTOR
MISC
DATE O R
DATE 'i SPECTOR
ROUTE SLIP
File No .
Date
Location B3
Subject 4iz
Notes
Approved C5—/ -�f��1����
Date Spector
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Date .... JV—._.S........._........,p19.AY. --Building Permit No.
The Building Located at 13.........kp.,U�...�—.(------------;..... --------------------
---- ------------------- ----
Owned by ...... ..........am-1k --
,
Has Been (Completed) For Use As: ........ ................................................
............................................................ ---------------------------------------------------------------
.................................................................................................................................................
------------------
.....---..._Y... ..............* .. .....................
--------------;....................... ........................
BUILDING INSPECTOR
102 12/66-IM
OFFICE COPY
{ ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO `
. . ' . r .....
To .�
You are hereby authoried�toc1onn fledricat service for
Owner or TenantL / " ...........................
At ............... ....... ...................... ........ Q� � ...�Lh -3 -...........
jc 11
No. of Wires ...... ^�............ Size of Wires ..........iE......�.. Size of Switch �......�.V.�T-.
MotorLoad .......................... Voltage ................................ Phase ..............................
HeatingLoad ........................ K. W. .................................. Voltage ................................
Light....../. . t 10.... New.Service.../..-.-. Reconnect..................
No. of Meters....................
Heat................ 220....._e�hm Wire............. . Move Service............
No.of Add. Meters............
Power............... T Phue ...f... Move Meter..............
m
...............!. .. ..V.:.1 ......:,l u..'_. S!�.......
ELECTRICAL INSPECTOR
GAS SERVICE NOTICE
COPY
BUILDING INSPECTOR'S OFIqCE
Jj CITY OF CUPERTINO/
196./o
.. ...........
0
You are hereby authorized to connect the GAS service for
Owner or Tenant ...
.......... ....... ......
At ....... ........ .......... ..... . .. ...
New Service ................
No. of Meters .... Reconnect ... ....................
Move Service .... .........
No. of Add. Meters ... Move Meter ... ......................
(��PLM;iBl�NOG INSPECTOR
Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
F1 Sewer Connection Sanitary Permit No. .......
QiPlumbing Final Plumbing Permit
Lot No. J--/------- -------------
Owneror Tenant ... -----,2-------- -------------------------------------------------
---------------- -
At .. ........................... ................................ ----
Tract ---------- -- - - ----------
------------------------------------------------- -----
---------
DateConnected .............................. ------------------------------------------------------ M/
DateFinal -------------------------------------- ...........................- ---- ----------------------
-----------------------
.................................................
PLUMBING INSPECTOR
111 12166-1M
LOT NO,
NO. STREET
W ?DECPPLRICATI IIOIN FOR BUILDING PERMIT
r o 1/ ! CITY OF CUPERTINO 071
o a - 968 I , . Sanitary No.
i 4 Uate 196Permit No. SIZZ 7.3
0
Lal f�IApplication is hereby madefor a permit to
oQ �. , I .� .I ,tl ., it)
im a '2 story,Type- I Building
,W. ; tube occupied only as 'Jc 00in accordance with
00 Plans, Specifications and Plot-Plan filed herewith. Fl Ck Fee
F ; Estimated Value of Improvements,$ oma ' Fee$
oa
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J z all other laws applicable to the construction, location, and use of buildings within the City of
O Cupertino will be complied with.
3 `a Owner Address 611&CRANE
— Address 2295 DE LA CRUZ BLVD.
o By aJ�i7_ SANTA CLARA, CALIF. 950W
u
Pone
ApprovedwJLLIAM H
/� State License— / BUILDING INSPECTOR `
10933 I Leavesley Place LOT NO. Lot #51
NO. STREET
n . APPLICATION."TOVAPPLIANCE PERMIT
m = � CITY OF CUPERTINO
Y LL
3 < Date 196— Permit No.
W U - FeeS W,5_
' 0 Application is h6r'cby nmmde to the Cityof Cupertino for a permit to
o i install gas appliances as listed on the reverse side hereof, and agrees to
i N install said appliances in accordance with the provisions of the Plumbing
= Code of the City of Cupertino, and all other laws applicable thereto.
5 LL Residence of Premises
00
R 3 Owner Ditz—Crane Address PLOG SHEET METAL CO.
°� 130 S. GILMAN AVE. (P. 0. BOX 9A
z By Address
J'0STWE NT N? CAMPBELL, CALIF. 95008
3r
W'W L I\\\I VV\L"t Y1�
ao State icense roved WILLIAM D. RFN�nrtl{
_V/(� PLUMBING INSPECTOR
a
* � ƒ 2 ( if97 ƒ 1,71
-MA
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10933 I Leavesly Place LOT NO.
NO. , STREF1
L TOO FOR PLUMBING PERMIT
rc km
(fOI' CUPERTINO
ro Snmtary i�u.
Q 12i)3 Ua 19G� Permit No So
w LL Pee S 3
x 0 lU1T (Olt P �i:fNd k a
�
"DIF,
h� i City of Cupertino for a pcnnil to install plumbing
o piPce'mn"/or ures listed on the reverse side hereof, and agrees to install said proes
> I 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 x
w Use of Premises fIOUSEIfOLD
00
3 Owner G. PETSENBARGER Address 10933 LEAVESLY PL,
o a
ZJ
, By y SOZTAIASTER. INC. Address P.O. Box 696
J O } CONTRACTOR, AGENT
3 �
— M Pltone 379-5050
, z
w w
R
u s State License 944981 Approved
a o
—U PLUMBING INSPECTOR
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