51226No.
*.„4ft,k. Lot No.
Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No._S.iLp_
File No.
Date � � L96�
lication is hereby ade for a permit to
r
to be occupied only as .�
story, Type
in accordance with plot plan, plans and Spe' icat
Eion filed herewith,
c_Estimated Value of Improvements S oZ l ��
FE , K�(R2 Plan clacks
Owner
Contr.
Phone � L -I
Address
a�67)
State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date jJ /1 f) 119(6��� FEES - -/ ��
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Contr. jj-4.YK ('Y0d�^ Address
Phone - �"1t6 State License - e 2 00 0?
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
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Date I^Z 196 GAS FEE $ _
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PLUMBING FEE $
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Cont,. _bz`-++-v _
Address '! J-0
Phone -&% t -Co 9 0L-/ State License
Approved �K A
Date 3l„
APPLICATION FOR APPLIANCE PERMIT
1% :7r FEES
°ntr. Address
Phone - 3 / y State License
Approved
1pplieants agree not eoviolate arty of the
{rorkman's Compensation Laws of the
irate of California -
a.,3
RECORD OFINSPECTION APPROVALS
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PAD FINAL _
FOUNDATION_
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL_
FINAL BLDG.—
UNDERGROUND R
ROUGH WIRING_
FINISHED WIRING
FIXTURES
MOT ORS
FINAL
DATE
DDATE!
l�
BUILDING
INSPECTOR �-�- MISC.
ELECTRICAL C't z - k I- -11 `". I
INSPEeOR MISC.
-lk -7l
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO.
SANITARY NO.
UNDERGROUND ROUGH-
PARTIAL
OUGH PARTIAL ROUGH
ROUGHCOMPLETE
MAIN DRAIN J -
FINAL PLBG. 'Z 7 -
FINAL GAS -20 - ?/ C
FINAL APPLIANCE 4_2
?w.L. 3-9-7/ �.J;
MI SC3 -
MISC
MISC
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Date ... ....... 1-..3
. .... Budding Permit No.
The Building -Located at .
A
Owned by
................................................
Has Been For Use As: ....
(Altered) ..........
INSPECTOR
.10/Y.3 A r .( LOT Nn.
NO. STREET'
�APCATION FOR PLUMBING PERMIT
P' /�� I
ITY OF CUPERTINO
z i � r o ® , Sanitary Nu.R LL /o atr ° /d196_ Permit No. S�2 L6
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r� qp nl r51Pa' '"1 the City of Cupertino for a permit to install plumbing
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t he 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 Premises
Owner
B Addressf��0
CONTRACT�ORQ, AGENT
At
PhoneCn2'��/
„State
License _17-2- keol
PLUMBING INSPECTOR /
0
Water
Dish Washer
Water Softener I 1 II Material I I
Comb.Sink & Tray To Curb
Dental Unit
Drinkin¢, Fountain
Size
Water