FILE 51167.1 J/ 711-A I (,�.(,�/ �. Lot No.Q 7
No. Street
APPLICATION FOR BUILDING PERMIT `, l
CITY OF CUPERTINO
File No.,T-11(; 7,1
Sanitary No. `s 3io
Date /r 196 7
Application is hereby made for a permit to T
a story, Type �� 2
to be occupied only as
in accordance th Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements s .,2-4 d G
p �
FEE$ a d• e�0 Plan Check $
Q..._.��� as 9
Dwner Address
Contr. Address fC�
Phone e2.r7 ///O State License )
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date /j 196 7 FEE$ d3"
Contr. Address P.2-
Phone '7 3 State License
Approved
APPLICATION FOR PLUMBING 8 GAS PERMIT )
Date /"/J—/-7 196 GAS FEE $ -
PLUMBING FEE $
Contr. - O4-e'i Address 11' 3 5r �`f Y
Phone a r{3—2 3 2 State License
Approved
6L.
APPLICATION FOR-APPLIANC ERMIT /
Date FEE$
Contr. L / Address
Phone .3 O 1 3 State License
r.
Approved
Applicants agree not to violate any of the /1
Workman's Compensation Laws of the
State of California - .
RECORD OF INSPECTION APPROVALS
BUILDING
FOUNDATION 8 r 7
DATE NSP
UNDERFLOOR -2 ^ ��
I / DATE INSPE OR
FRAME
ow Tyy, INSRE. R
LATH & PLASTER
FINAL
9 -� TE NS T
�I- `6 QA_TE n INSPECTOR OY EL}EeCTRIC.AI
ELECT. SERVICE
DATE INSPECTOR
UNDERGROUND
DAT INSPECTOR
ROUGH WIRING
DINSPECTOR
FINISH WIRING til Cl`
FIXTURES /`
��/'l LTS INSPECTOR
DATE INSPECTOR
MOTORS
I-Y-1 INSPECTOR
FINAL (m
DATE INSPECTOR
PLUMBING & GAS
UNDERGROUND
DA/T INSPECTOR
PARTIALROUGH —�— b
DATE INSPECTOR
ROUGH COMPLET
DAryTE � INSPECTOR
MAIN DRAIN
ATE SPECTOR
GAS PIPING
_�7 e�r/DATE INSPECTOR
FINAL
DATE INSPECTOR
MISC
DATE INSPECTOR
MISC
DATE INSPECTOR
Q�
APPLIANCE
INSPECTED
DATE INSPECTOR
MISC
DOTE INSPECTOR
MISC
ATE F ECTOR
MIS
DATE INSPECTOR��
':ROUTE SLIP
File No.
Date Out
Date In , 17 —
Location 7
Subject .
Notes
.J
Approved / f6 7 CT Ie-
Date Inspector
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
n( CITY //OFpCUPERTINO }
Date ...1 .....1.'.......................... 14S.... Build/Jing Permit No. ....................
The Building Located at .. .�....L.S ....... !? �`�........... ..:.
...............c.......
Owned by � �t'. .ti-� O
(Completed) r j.
Has Been For Use As: ......----------------- --
tart.{ `6...
0'.K::..y... .r.. ...�b.. .
BUILDING INSPECTOR
102 12/66-IM
OFFICE COPY '
ELECTRIC SERVICE NOTICE
G BUILDING INSPECTOR'S OFFICE,
D 1 CITY OF CUPERTINO
....3 :..Y�.7.. .. ....., 196_�
To l
You are hereby aut o @d o co ct electrical service for
Owner or Tenant .._.....
el
.. ... .....:...................................... ....
No. of Wires ------�. ............ Size of Wires ....7..... Size of Switch .LrJC)
MotorLoad .......................... Voltage ........_................._.... Phase ......._.................... ...
HeatingLoad ........................ K. W. ..................._............. Voltage .... ...........
� No. of Meters............. ..... Light......._...0 I IO..�![:�.. New Service::....__.. Reconnect..................'.
r Heat................. 230.....E -Thr Ah
MnveSerNo. of Add. Meters......._... Power............... ee .... MoveMe-46
RLPECTOR ✓
GAS SERVICE NOTICE OFFICECOPY
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTji��6
...... .......0 . ............. ..................... 196?
To
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 ....................
..........................
;PTEUMB&T6' INSPECTOR
Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Fj Sewer Connection Sanitary Permit No. ......
Plumbing Final Plumbing Permit
Lot No. .....
...................
Owner or Tenant ----- --- --- ......
At
..........................................
Tract .............
..............................................
Date Connected ......................... 1/0-1
.............................................................. 19.c4f------
Date Final ................................. P/
....... .................................................................. 19 .......
l2
........... iew� aor ----------------
�LUMBING INSPECTOR
III 12/66-1M
COT NO.
d_`.._.. ,... ` .NO.-. - STREET
1
A Aja¢ +J FOR tPLUMBING PERMIT c
Jugat. PEIRTINO
u � Samitary No.
O 3aDae _ � � � Permit No. .5 /I/o 7 p
U 7�
w LL Fee$ CA��
x
° Application is hetebyW3de�f of Cupertino for a permit to install plumbing
`o a :pipes and/or fixtures listed on HS hereof, and agrees to install said prices I
anti/or fixtures in accordance with-the pr si - ns of the Plumbing Code of the City of
a w _Cupertino, and all other laws appli ble thereto. - -
w x e
I'LL
'Use of Premises � Aa
00
> w'. n &
o a Ownej .W _ani .eL. Addre"$tQQ��7
zJ V � Addresy��'��.IiYI (_G1LQ-
A y lac B
COYTRACT y�R AGEM - - -
w Z+ Ph1-'�
w wxiM.�:
'Aft,kpprovecl
u "
p - PLUMBING INSPECI'OA - '
UNITS_ FEES UNITS FEES
`X/are, Hente Size
Water Closets Material
Hath Tubs To Curb
Showers - To Prop. Lin
Lavatories' To Existing
• Kitchen°Sihks Not Conn.
D-s Washers Sewer Boxes
Waste Disposals
as TrTrays STORM DRAINAGE
Washing Machines Size
V ter::lSofteners Material
Har SinksTo Main Drain
Com .��Sin Tray' To Curb
Dental"Units
Drin inR'Fountams
F onr Drains WATER SYSTEM
F uppers Size
Restaurant Sinks Material
Sanraps TOTAL FEES
riira s Fixture Fee
ren Tains - Main Drain Fee
��rater Leaders Storm Drain Fee
Sprinklci„valves Water Sys. Fee
' Permit Fee ,0C)
TOTAL TOTAL FEE ��,�
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough, Complete
Main Drain
final . OJ[ � r
�. I