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NO PERMIT NUMBER _ 21025 Freedom Drive 23
NO. STREET C .}. LOT NO.
P. 3.64
CITY OF'CUPERTINO
APPLICATION FOR BUILDING PERMIT
SANITARY NO. 9456 BF
FILE NO. 51,150.2
DATE i 7/14/76 19
Application is hereby made for a permit to
Construct (Plan D) a 2 story,type 5 N. Hr.
to be occupied only as I & J Single Family Dwelling
in accordance with plot plan,plans and specification filed herewith.
ESTIMATED VALUE OF IMPROVEMENTS $ 52,000
FEE$ 191.00 PLAN CHECK$
OWNER Cupertino Village GreenSADDRES$ 2570 El Camino Real,M.V.
PHONE 47.-6o50
. 255-1422
CONTR, ADDRESS
PHONE STATE LICENSE 238433
APPROVED James H. Sisk/h
BU LDING INSPECTION RECORD
DATE / INSPECTOR DATE INSPECTOR
FOUNDATION ,� / FLOOR STEEL
PRE-GUNITE FRAME T%; •'�
BOND BEAMS LATH ;09�-17
WALLBOARDS 450,&EXT. '
FIREWALLS
MEMBRANE r LANDSCAPING
F.M.O.INSPECTION
FINAL BLDG. •Z
UNDER-FLOOR
TIEDOWNS -MISC-
DIAPHRAMS
I
MOORE BUSINESS FORMS INC..LA
- i
ELECTRICAL INSPECTION RECORD
RESIDENTIAL kDATEINSPECTOR COMMERCIALUNDERGROUND ROUGH UNDERGROUND ROUGH esfROUGH WIRING GH WIRINGFINISH WIRING FINISH WIRING
FIXTURES INTERIOR FIXTU
MOTORS EXTERIOR URES
FINAL OT
AL
MISCELLANEOUS INSPECTIONS
PLUMBING INSPECTION RECORD HEATING&A/C INSPECTION RECORD
DATE INSPECTOR DATE INSPECTOR
BACK FLOW REQUIRED UNDERFLOOR S.M.
BACK FLOW INSTALLED DUCTS&INSULATION
UNDERGROUND ROUGH FLUES&COMB.AIR Q
PARTIAL ROUGH CPNDENSATED INS
ROUGH COMPLETE AL APPLIANCE 7
ROOF DRAIN&LEADERS
MAIN DRAIN
FINAL GAS
FINAL PLUMBING 7,17
MISCELLANEOUS
c r
CERTIFICATE OF COMPLETION
BUILDING INSPBCiOR'S OFFICE
-7 CITY OF CUPERTINO
DATE 7 ' �-y 19,, BLDG, PERMIT NO.
THE BLDG. LOCATEDAT �1Lr— g2 'afk—.- ,I�•
OWNED BY CJ �..� 't Y✓"C-[�!.` yn
HAS BEEN (� P � FOR USE AS
(ALTERED)
©M
BUtr
' t
DING INSPECTOR
Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
X 61--
Sewer Connection Sanitary Permit No. .... .........
Plumbing Final Plumbing Permit No. .. �—
Lot No. .......a_3.................
r ' )
Owner or Tenant .....6L ::..-r?....LhtP < fl....:.. .......... t..r:...................
At ---a.% r. - ✓LcerQr.+.........,4fG.sJ2 ............... ..........................
Tract .................._. .. ... .. .................--.........................................
Date Connected ....... ..-.p 7!%.. ................................................................. 19..... ....
DateFinal ..... ....-�7- --?---�.-_77................................................................. 19............
...................... ....................
PLUMBING INSPECTOR
//-�` /'� .ELECTRIC.SERVICE NOTICE OFFICE COPY
J (J� BUILDING INSPECTOR'S PJOTICE
IV\""6�],�� CITY OFPECTORI NO r
3 - LV , ' 1917-7
You are hereby a/utJhorized to Conne�c/tI electrical seeiry cce for ,�,� �,,/�/, F�,>f(�J p
Owner or Tenant V — �P ast X 1- --+-� ! )�,yp"r(f^' l
At I n>_\^ 1r 1 S? c) S/mow j A�J l V
J
No.of Wires Size of Wires Size of Switch
Motor Load Voltage Phase
Heating Load K.W. Voltage
Na.of Meters
Light /110 New Service ✓ Reconnect
i Hear 41120 ` (((jjjThree Wire More Service
No.of Add. Meters Power_T Three Phase Move Meter
OO " ELECTRICAL INSPECTOR R ��
CITY•OFCUPERTINO °OPYE
GAS SERVICE NOTICE
To . . ..
You are hereby authorized to connect the GAS service for
Owner or Tenant OLn f1��ti4*-r—.<1- r� .
At •�//)d��'�n o .. .• Wit'/.h
New Service
i
No. of Meters l Reconnect -
No. of Add. Meters
Move Service
Move Meter
PLUMBING INSPECTOR
( V Y
, AGREE , WILL NOT VIOLATE ANY eTHE WORKMEN'S
o__mN LAWS OTHE STATE > CALIFORNIA. z %
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21025 FREEDOM DR. ,CUPERTINO ' 23
NO. STREET LOT NO.
CITY OF CUPERTINO
=' APPLICATION FOR ELECTRICAL PERMIT _
1511 S ti�ibwn. v
1,7?47Permit No.
Date l ,19 In S
Applicaion is hereby made to the City of Cupertino for a permit to install electrical
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino,and all other laws applicable thereto.
Use of Work To Be
Premises Famn R -ci dPn ep Performed
Ov,nerVILLAGE GREENS Address
Phone
ByALL—CAL ELECTRIC CO. Address10 OCKTON AVE. .SAN JOSE
Contrador,Agent
Phone 295-5230
.State License 228-622 Approved 04
Electrical) ped
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEMiL
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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21025 Freedom Dr. Plan W, LOTNO. 23
NO STREET
CITY OF CUPERTINO
APPLICATION FOR PLUMBING PERMIT
J4N19 lye'
n''�
Sanitary No.
DoteJdn. L2N 1 D ,ig 76 Permit No.
Fees 3C.00
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.
Use of Work To Be
Premises Sl ngle Famlly RPS_ Performed Plumbing
Cupertino Village Green J�5d70 E1 Camino Suite 302, Mt. View
own r
ress
Phone 941-6050
i BOoe Amaral Plumbing Address P 0 Box 150 S.C. eCa.
Contractor,Agent
Phone 296-'1463
State License 175799 Approved
Plumbing Inspector
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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21025 Freedom Dr. 23
NO. STREET LOT NO.
le" CITY OFCLIPERTINO
G,S<ZAPIPI ICATION FOR APPLIANCE PERMIT
gyp" ' '�
" Ot r�t�JPermit No.
r $9-1-T6
Date r.`(. Iq_ Fee$ v�
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 install said appliances in
accordance with the provisions of the Plumbing Code of the City of Cupertino, and all
other laws applicable thereto.
Use of Res., Work To Be
Premises Performed Heating/Sheet Metal
Owner CuPt. Village GXdaress 2570 El Camino Real #302
Phone 1-6050
BY
�� ZA12LOS SHEET METAL WORK,
Contractor,Agent ,
Phone 592-97.92 BAN CARLOS, CALIFORNIA
5tote License 110828 Approved
Plumbing Inspector
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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