HomeMy WebLinkAbout1055rte^ ., r — r n•^ _ , t ;-_ ..
t ��jJ�C 1"7=}. '�. L,,-i .1�7'V 4:2' _roT No.
NO.
APPLIC
`f FOR BUILDING PERMIT_
', CITY OF CUPERTINO �. -�
j Date 195— Permit No.pp
Application is hereby made for a permit to ��- I Zk. ^
I r �`` �-� 'story, Type '�� f` Building
cz
atto (tel-c�..
be, occupied only as
in accordance with Plans, Specifications-and•Plot-Plan filed herewith.
'�- EsEimated' Value of ImproJeinetits, $`'` %''ta 'r Fee $' . j•.�
li is herebyagreed that the re uirements of'the.Cu ertino Buildin>;g `
g q p ,and Zoning Ordinaii<es,ngd
till :otlier, laws applicable-to the construction; location, and use-of Buildings ivithin,the City of
�
Cupertino will he complied with j -
.��y : .ry t " L� i" t'.a :a �.; .t - r
n Owner?t. -.�u:YAdd[ess':..
�, t .. :, t.. � Lot i `G � "'�• .1
/
,By i. `Q, oa':,'I 1. .. AddressIU-1 _ci
`C a CO Nt'RAf.TOR,AGr:NT•1,
l.° Phone i:1 'll p'l - t �i i' P YAPProved
BUILDING fiNSPP.CTOR1
RECORD OF IN�SPEC'
FOUNDATION
�.
DATE
/ FRAME/ S
ACU I : i
CATH' and PL,
FINAL BLDG.
G INSPECTOR
INSPECTOR
DATE
INSPECTOR
FINALELEC.
DATE
INSPECTOR
-FINAL PLBG.
DATE;
4.1 - J INSPECTOR
AL GAS
_
DATE INSPECTOR
'I1/61-500
'
C E R T I F VC.ATE OF -Ce%'MPLETION
BUILDING INSPECTOR'S FICE*
CITY OF,CUPER Fi7i,
... ii Building Permit No.
. ........
The Building Located :u:
-e - - y - -------------------------------------
Ownedby ----- .................. ............. ........ -----------------------------------------------------------
Has Been e (ComlSIFGd)r For Use AS: -------- -------✓o�:K
(Altered) - ----- ; ------------------------ ...... ......
................ f ........................ ---------------------------------------------------- ------ ........ _ -----------------
.............................. ----------------------- ............... .... ... 4..,
---- ----- ----- ---- -----
....... . ...... L� -----------------------------
/ BUILDING INSPECTOR
t NO - STREET `� + LOT NO. `-
10
sf A0PLICXTi N ,FOR,, ELECTRICAL PERMIT ; lt
ITY OFIGUPERTINO
Date e rf , 19sPermit No.
n
�Y' .� .Pn•�n'i:' -�" Fee
Application is hereby made to the City of Cupertino for a permit to install,"electrical
Vllwiring and/or fixtures as fisted on the reverse side hereof, and agrees tofnstalt 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.
T
T
v Use of PremicP<
a Owner "- " t' I Address
By '+ `i`�a.'�_ Address
CONTRACTOR,%GENT
(� - Approved,
/ Ph ne: \ J �Ll I •Y" ELECTRICAL INSP' 7M— _
NEW RPL FEES
N
Size $ernce.Condu,t-=,._r..------::-; ..Number,bE' Outlets-.---------------- 3.:3 ..... ........ :.....
.,.-2
ir
Siz�e4c-t�'.�X(trPs� �'�'f`• Numberof+'Switches -�,�
ci�.w"y. r: .' ja ,tom. n r.
y Size Sernce Sw,tchli � Number of'Receptacl�_ '!c,
Size Sub FeedCon�- �Nu }bei of FlxwiYes ` 3 5 ,Y3tip
i .� W T4
;e sizerSub';Feed,Wue } Y
^�
yi Number of(74.4
.^ v V�
= _NNumber �qf lMCtav '�°-a Signs , _ aTradsformers
Irl r +41" {��, �YY�f`3°•^L;.'� q•�'``y�F'c
,Motor YS DcYPhase� Dt -.t °"r+4: ;+�%i ''` •*;;i
> 'pP'i' i jp7
« /� PertTiR'ee.Ft$
.s 1,!'Motors .. HP _ Phase -
t Motors HP :Phase.- °ice HT Charge....
pi y t' f I Li •<r. »fk �ti,� t .-`ice �C{�Y J:S✓ . ��
„�..:4" s-'�„s' �.c',•' = _ TOTAL'1•EES c'1'. •;t a
RECORD OF INSPECTION APPROV/A'LS'. /
Rough Wiring -- Fixtures -,%`.l �.:�
�' i u a'rl .DATE1F•..w INSPECTOR GATE/ �. IMSPE.iOR
-Pirish
Wil
DATE
otors -- -.. .---....�....
DATE INSPECTOR ' ,/DAT[ �•IRSPECTOR
Final _l //1f /...�.....:..:.....r r
11J DATE INSPECTOR
�i. -
ELECTRIC' SERVICE NOTICE OFFICE
0^ ..>" - COPY
I •�' n tBUILDI'NG'
• INSPECTOR'S OFFICE.
t• I °,jl'''' CITY:.;OF- CUPER'CINO� ✓..'.;`.:,:.
/r
- .4, n.. ♦ i w..::. r s� ...`!"............ .t_ ,,196./
;..You are hereby au"fhonzed to connecbthe ELECTRIC smice for)
r- Owner`or.Tetnnt
y At !'../�,/Y/�'S `" i.'..rL?LGfJ, ref `'—• 5 ' ,s•ei."\
. � •, `' ..0 J. --------------3..E. 'S1Z `'cam ................
No of Wires ✓ Size of Wires`r.' �' m e'. f Switch
LoEdYr.` RRT,� te�okr�r�M :L .�.Phase �.
,,t. i e3ktng Load , .. i. K. W. ....
i,.a..-...110 ---- ..._[. New,Service ---------------__
.Reconnect ...----------
No. of Meteis„-r./.:., ..- ..1
.%, "'r• - Fleat - - 220 ................Three Wire .--...............Move Service ..........
No.•of`AdB. •Meters'_'_.:.^..-:
^ Power .._......... Three Phase ...._...-_--._.Move Meter __........
r -.^yam Three
ELECTRICAL INSPECTOR
1/60-500
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Bar Sinks II to Main urarn"1%,
Comb. Sink m Trays - I II To Curb I '..�.
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rea Drains ' I '
Tc Vai6es I" ; �� Water Sys. Fee
f * I. 11 Permit Fee ' ..'. �.;,• --
kL ' ' (I A „ II TOTAL FEE
RECORD ONSP--Ef-TION
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State License
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UNITS
Water Hearer Size t.•
Washing Machines Size
Water Softeners Material
Bar Sinks, To Main Drain
Comb. Sink a Trays To Curb '.
I
Dental Units II _
Drihkirig Fountains I I 11 l . e-., r-.``r�-
Floor Drains
WATER SYSTEM
Hoppers Size :,e •'
Restaurant Sinks Material
Sand
vowes
1019
TOTAL FEES
Fee I
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FIXTURES Y'+ NUMBER -,!I
+ t.MAIN DRAIN..
_'ice:• I'-UN[TS-I, FEES".11
: •? _ra �' ;,. I UMTS FEES
Water.4eater•, at �',; �� �A-`,-.
$i2e'.r, �.Si..:.. ,I �;�':
Water -'Closets°• .I ry �; +,4,':.
Material`,`;-
Bath TuKs• ° 6' ;
To Caf6 I .r
Showers .ls,��.�' I y•,x;,.•.�;
To Pr"op.' Line
LavatoriesLF7;:1,' 11Th
To, Ezisting;r q a c
Kitchen' Sinks : I. ;.'. . $'=o II
:Not. Coons Nil:
Dish;R!ashers •. ;?� �• "•'',IISE1yER[3pXEsatl7y*^
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Waste -Drs osal's
P-
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Wash Trays- %' . a'. III
�: STORM DR_iNAGE
Washing Machines 7"'; ,I ; ;.-•IIS=,Size
'.:;x9, .sr'I'
Water Softeners I A .11
'Material:!' •,l',.
Bar Sinks 'l, x` `:-•':.T,
, To.Mai-ri Drain"•h!`.; I -
Comb Fmk & Traysj, I 4.,Jj
To Curb.
Dental Units.a-I-
Drinl:ing Fountains
•I'
Floor Drains: ' !f,
WATER�SYSTEM
Hoppers'r`'! -:". .l iii: "+r' •
•.-Size't.'a
Restaurant Sinks .t I
II Material.";,
Sand Traps),-.. l' < I1= :'R
I TOTALEES -
Urinal's'I -"0
Fixture ,Fee ,I
Area Drains -'l'•_ +l�`I a-:- ,0
Main Drain Fee.I� '
Water Leaders; '•" " w
'+Storm
Sprinkler Varves ,f;� -,'
-1=s :I 3sllr:
Water S s._Fee "!•,1'
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Permit:Fee,
TOTAL Ir-t,.-.l•r.-,,n,I,.TOTALT-PEE
•State Uc,
N
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of Amliance 'I Units Fees
Gas
Inspected and Approved :...!.
DATE' INSPECTOR
HOUSE GAS PIPING
Number of Outlets „2 Size of Main
Gas Piping Fees
—�
Tested and Approved .�P171......I
—/f+� ..._.._9i .:....... ..........
DATE ',! INSPECTOR
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Type of Appliance
I Units Fees II
Remarks (Check d)
New I Replace .Relocate
Gas Ranges
Wall Heaters I ��
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam -TablesI 1 11
Gravity Furnaces
II 1 I
Suspended Unit �
II I I
Floor Furnace 1
11
Miscellaneous
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NAME TYPE)
.;;App.ance Fees
i "-Inspected and Approved ........... ...:_.........
......... .............................. ,
DATE. INSPECTOR
. HOUSE GAS PIPING
Number of Outlets Size of Main _
Gas Piping Fees
Tested and Approved ie7l.lf....�i_, ...............................
SATE tNSPECTOa
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Type of Appliance I Units Fees II
Remarks (CherkNV)
New I Replace" IaRelocate
Gas Ranges
Wall Heaters
Gas Plates
Circvlating,Heatersr.I'-
B1oaerlTEurnaces'.'r'"�rFra", �. � ;
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Gas`.F,,ii€ VBoilers •.I' r' •. •_
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WaYrdgg".Ovens z
-PercolifforsS
Stemn Takles •'"I - 'a�
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Gravity Fuinaces'A'k :I I aL;
Suspended U—C,
•Floor Furnace;-''t-_I,�'r'Ir' •::11"
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':,r•„ .. :.ICU �I .II,,
•'•Miscellaneous'."'
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(NAAU iTYPE) :.: '.I :.. 1
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�PBlance Fees':
InspecS and Approved ..................
_::...
DATE.�
• �gt[NWCTOR
HOUSE EAS PIPING „•u;i S•�°p.�!,y ';Y.;,J,�'i�
Tested'and Approved
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' . Type of Appliance
I Units Fees II
Remarks (Check d)
New. ( Replace Relocate
Gas Ranges ��
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Wall Heaters � �/� ��
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Gas—Kates
Circulating —HeatersI 1
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Blower Furnace's, /
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Gas Fired Boilers
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Warming Ovensj,
griddles � �
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)S am Tables
cavity Furnaces
Suspended
ace
Floot Furnace
Miscellaneous
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NAME :Y7pE I
II
tante Fees
Inspected and Appro"ved;cron
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FIXTIIR' S NUMBERS
MAIN DRAIN I
' UNITS FEHS•:Jj�
# UNITSI FEES!
Water Heater
Size c
Water Closets
Material ,•. _ •�
Bath Tubs '"
To 'Curb j
Showers • - "
To Prop. Lme -I
Lavatories -'
To Existing ,
Kitchen•Sinks
Not Conn. , •;f ,{,
_'Dish Washers ', • ' " II_SE-WE
S BOi Ejl 5
Waste Disposals �
Wash
Co Sink Trays ;
Dcntd Units
Dririog Founfams� -
�
STORM DRAINAGE
Size:.. ,. !
Material j
To,Main -Drain I t
To Curb
��_
Floor Drains' -' �
�� WATER SYSTEM•
Size
Restaurant Sinks.
Material ` • '�
l
Sand Traps . •
k
r TOTAL FEES ------------
Urinfils '..7 1
Fixture Fee
-;kr–ca-15r ai nSMain
Drain Fee +
Water Leaders
Storm Drain Fee 1•,
Spr,nkler Valves
Water Sys. Fee
"v
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�� Permit Fee
TOTAL
TOTAL FEE
RECORD OF INSPECTION _ f
Partial Rough .• .�
Rough Complete _
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