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' /�--�-� a ��' �;,C,}�'� --
, N�• STREET - � LOT NO." -- ��-
:��P��L 1'�,�1� OR �BJILDIIdG PER(11�1
�;� �����1��I� s���'• �III,ERTI .
, � � �'�� NO ��-�-�i�
Date „, ,�
�� �� _,�
,}���, � ' � 1�;Z Permit No. p�-�
f`a:a+as�� �• k i . . aw ��J ,
Application is hereby made for a��it to �,� �- C �--
a �� '' �o���'Yl'��! �� —�i.P /j�+ T
�$ � " � �r,.y�"i�, ,�� Building
at C' (�� .�,�� �Si
to be occupied only as s,�= �.,��L
in accordance with Plans, Speafications and Plot-Plan filed herewith.
„ Estimated Value of Improvements � % =3 c�e-c> � c�G
�� ' � Fee� �
It is hereby agreed that the requirements of the Cupertino Buildin� and Zoning Ordinances and
a all other laws applicabie to the construction, location, and use of buildin�s within the City of
� Cupertino will be complied with.
�
ci� Owner / ,{' `= t " "�
��`S Address�<3v �r
By g���=�j � .' ��sy';'�-'��f.���'�-/G°�
CONTRACTOR, AGENT ' AddIeSS Ci� � ��Q
Phone�i�/ L�'j lE-, :s ` Approved C `` �,�.�:_:
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-- ' BUILDING INSPECTO �
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' RECORD OP INSPECTION APPROVALS�
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FOUNDATION irrsPECTOR
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INSPECTOR
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FINAL BLDG. ixsrECTox
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FINAL ELEC. INspECTOR
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FINAL PLBG. INSPECTox
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FINAL GAS INSPECTOR
DATB
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����s,` ��,,r..�P�'�IC�,�'I�Q►� FO� PLUM�1 G PER 9T <'�
i'�� r� �i � ,�5� �C�� OF CUPERTINO \,
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('�,�, I�ate �� � �- p � �� 9g_ Permik No.
/ " �sg ���� ��� •7; �����4.����.r -
� z , ,� ��� � Fee ,$ ��'� a �� �
�,�' 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 proeisions of the �lumbing Code of the City of
"� Cupertino, and all other laws applicable thereto.
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� Use of Premises � /� ✓� ����
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CONTRACTOR, AGENT /
Phone "�-- ''-� � � '`��&. C3��; Approved �' _J ��r(�g,,.,q,���
�` PLUMBING INSPEG O J `'�
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� Cupertino Sanitary
� OEfice Copy
�� BUILDING INSPECTOR'S OFFICE
j CIT'Y OF CUPERTINO
I �j �}
j � Sea�er Connection Sanitary Permit No. __.�7�l------------
� Plumbin Permit No. __�"�-��-----
�Plumbing Final g """'
', Lot No. ------T�-------------
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� Owner or Tenant ._.__. ___ * �"-""'"'"
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� Date Connected __________________ - 19-��
� ----------------
------� --------
� Date Final - !!�� ----------------- 191a►--Z-'
� ---- -- -------------------------------
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( ------------ - --- -------�-------------------------------------
� MBING INSPECTOR
I ill 1/60-500 � ` :_ - �-�
� �' -
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� LOT NO. ��'
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�'-���� ����� � '; i����� C1F��4,��LJPERTINO
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Date � _lI�% 7, �� ��`�
� ,� � sp B� � w--�� ��� ,, �1�- Permit No. _�� _
��� � �,, '�: ig" ,:�� � ���N�� � � ��
' Fee $
Application is hereby made to the Gity of Cupertino for a permit to install electrical
wiring and/or �ixtures 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 Premi _ -/, ��� .�__
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V //�/ �� � I . /. .
Owner P^--%v:l��C—�i✓L " �::!` ✓ G! -' / 1 '1
a ,�, � /� -�- �� Address �_,��r �,,..�t {'�k,,� 9�'�s
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;� �,y � ,�u� � ���r ti �..-- Address %'G'( /��,� :�- —.� .. �
.
� C.ONTRACTOR, AGENT v- �r,/.� �
�I�prOV a �$�„'d ��-a.''�' z'`_ 'd
Phone: �`'% .-,c�� l�� /, � �
� ELEC7CREGL ENSPEG,"Pp$
_--
__ .,,,_�_ ;
NEW RPL FEES
. . ---------Number of Outlets------------------ -�-Z=- ------�--�-��------
Size Service Conduit_.__.�._`t_-
� �-----------Number of Switches---------------- --��-- ...__._�.i�f_��-------
Size Service Wires____.-_.._._-
� ��'-------
Size Service Switch____.��'-�-�-------N�bex of Receptacles____________ _�..3__ _.___.____. _
Size Sub Feed Conduit__________________Number of Fixtures__.__._____.______ _./:_�:.. -.-----1- --G-'.--�------
� --------- --7`�J----
Size Sub Eeed Wires----------------•--Ranges---------------- KW-------------- ------�--- -
Number of Circuits................... Oven
-------------- �W-------------- ------1-- ---------- -��-�----
--------•--•-Signs---------- �Transformers-------- ----------I---------- - -----------
Number of Meters.__..._..._ � -�
_ ,__
v_ /.�
Misc.-------��--`--`"`�-_=y`--cc�------------Dryers---------------------------------------- --
------�-�---------- - ------------
Motors------k___-----..N HP---•---------------- Phase-------------------- Perxnit Fee $1.00
Motors-------------------- HP-------------------- Phase-------------------- �
D_�
- ---
- -
Motors-------------------- HP-------------------- Phase-------------- ----- H P Charge---------------- -�----f
TOTAL FEES ��� �J'
�����p INSPECTION APPROVALS
- Fixtures ----------------------�----------------------------
R�ough Winng - --------------
- ------'-• ' "' tNSPECTOR
DATE
INSPECTOR /�'�� DATE
. • Motors �--""'" - oR
Finish Winng -----•--------------•---
--------- -- -
-------
---------------- •
DATE INSPECTOR /
Final .t�!..�_--'1�-----•---�-- - --------•----------
DATE INSPECTOR
F4
' � ��'�'� ����-'..tJ��% � S� � /�/' f '�
� � �' �u'"�- LOY NO.°Tl�—.���� 3
NQ. S'Y'RHET
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Date ' �'196.---- Perarfl�t i�o.
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� � �e�-. °�i���,..g� A ���s..F
f�pplication ls hereby t�a.de to ��ae Cgt� o� C�zpe�tl�so for a pe�rrait �� in§ta�l
gas�pplia�ce� � Iflsted on t�e reverse sid� �n�re��, ��� a�re�s to i�st�.11 said
appalaanses �r� �c�osdance with tl�e p�ov��po�n� �� r�� P��r�b�rs� �;od� �� t�e Caty
of �a�p€�tino, a�d a1� othg� i��vs ap�si�e�b�e t�ae���o,
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����� 2 � ���LI�TION POR GAS �ERMIT
�'�``��ITY OF CUPERTINO
Dat��� �'�'�' � 195_ ��
Permit No. �j�
�
� Fee � ,. � ��
Application is hereby made to the City of Cupertino for a permit to install gas pipes
and/or gas�ppliances as listed on the reverse side hereof, and agrees to install said pipes
� and/or appliances in accordance with the provisions of the Plumbin Code of
� of Cupertino, and all other laws applicable thereto. g the City
a�
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aUse of Premises I �/.�,�
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Phone � � � �S�(-p � � n � ' � �
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I CITY OF CUPERTIN4
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� Date --- �'�-,��' 19 �:} ����..
� �;s-- ,3 -------------------------- '�� Building Permit Na ,;'-F----=�=--=�--
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