51226No.
Street
APPLICA
^e y0
Dote 196
pLi catiolt is he e
to be occupied only as
Lot
ON FUR BUILDING PERMIT
rY OF CUPERTINO
Sanitary No.
File No.vS'
made for a permit to _
story, Type T w
in accordance with Plot Plan,
Estimated Value of Improvements $
and Specification filed herewith.
-2 .9,000 T, 6-
F"7 9
EE Plan Chey
r Qj
Owner dress
SkLCLA
Contr. Address
1- -7(,,,1L_ v(/
Phone -10S1Zt�icensa
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196--7/
96 -7/ FEE$
Cont', 1571 Y.1C CYQ.PM/.! Address ,,�,%%l7 ��i �QA
Phone _7:3b- 07'4U State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT l
Date 196 71 GAS FEE $
PLUMBING FEE �$
Contr. _ U"'�-+"ti(_, Address `� rLa— c
�y
Phone - `3/7 -6 %
PAD FINAL
FOUNDATION_
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL_
FINAL BLDG._
UNDERGROUND ROU
ROUGH WIRING_
FINISHED WIRING _
FIXTURES
MOTORS-
FINAL-
RECORD
OTORSFINAL
RECORD 6F INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
G- 7II&D Lld
ELECTRICAL
BACK FLOW REQ.
SANITARY NO.
UNDERGROUND ROUGH_
PARTIAL ROUGH
ROUGH COMPLETE Z
MAIN DRAIN 3-3
FINAL PLBG. -ZC)
FINAL GAS -?.4�
FINAL APPLIANCE 5-
Yl Ihl-v
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR
MISC.
M
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Date .......... ?-'O--- ....... / ...... ........ 19.-2-.3,. _ Building Permit
The Building Located at. . . ......z
...................... I .................
Owned by
Has Been or Use As:
I A �1. ...........................
Streel
A ZfE,ATION FOR PLUMBING PERMIT
IAA '� � �9 7 CITY OF CUPERTINO
J Sanitary No.
10
Lot No. Z
(+pa_t3{r� � ���3W0,196r
_ � Permit Nq�l"L
Fee Soa
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
V
Phone %.2 7d--& �y
State License f % kkd"Y Approved
Plumbing Inspector i%
x. COVrF.
Or
311.14 2
FIXTURES
NUMBEA
MAIN DRAIN
Units Fees
Units Fees
Water Heater
Size
Water Closet
Material
Bath Tub
rV
To Curb
ShowerTo
Prop. Line✓
Lavatories
t9To
Existing
Kitchen
t Conn
Dish Washer
Waste Disposal
Wash Tray
STORM DRAINAGE
Washing Machine
Size
Water Softener
Material
Bar Sink
To Main Drain
Comb.Sink & Tray
To Curb
Dental Unit
Drinking Fountain
Floor Drain
WATER SYSTEM
Hopper
Size
Restaurant Sink
Materi
Sand Trap
T TAL FEES
Urinal
Fix lure Fee Ae. 10
Area Drain
Main Drain Fee
Water Leader
SStorm Drain Fee
Sprinkler System
Water Sys. Fee
Relief Valve
Gas Fee /.f2
Vac Breaker
-
Skimmer
Filter
r
Permit Fee
Total
Total Fee , p