100145 10'117-1/7 7U19 LOT NO
NO. STREET
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, 1 FOR PLUMBING PERMIT
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'C� OF CUPERTINO
Sanitar Nu.
0aDate1967 y
6— Permit No.
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� A��a�on�ter�� �i��OCity of Cupertino for a permit to install plumbing
oa pipes and or f�i"xtures hste on t re reverse side hereof, and agrees to install said prices
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and fixtures in accordance with the provisions of the Plumbing Code o6 the City of
<w Cupertino, and all other laws applicable thereto.
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r3 Owner MawMrs. Crit Ld. L,no( Address /0*7 Ta/.r L�7E
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CONTRACTOR,AGENT
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ao State License Approved
U�I PLUMBING INSPECCOR
--TTXTURr9'- NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heate Size
Water C osets Material
Bath Tubs To Curb _
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
ish Washers Sewer Boxes
Waste Disposals
ash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink a Trays To Curb
Dental Units
Drin mg Fountains Alba
I' oor Drains WATER.SYSTEM
Hoppers ze
Restaurant Sinks Material
an raps TOTAL FEES
Urinals Fixture Fee
rea rains Main Drain Fee
Water-Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee
Permit Fee
TOTAL TOTAL FEE
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough. Complete..
N4ain Drain
Final...
/O 7 / ULA /--SAN LOT NO.
No. STREET
SPLE
ATION FOR PLUMBING PERMIT
aTYOP CUPERTINOw = p -�-
x o Sanitary No.
LL
0 a Dai r 19g�d Permit Nom `//�S•
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o a P T'�' �jt�is }y�rRo',gg jq he City of Cupertino for a permit to install plumbing
i a d xt �� reverse side hereof, and agrees to Install said rices
> and/or fixtures m accordance wit the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
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LL Use of Premises
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,. 3:Owner_,& 1 C �4- l h/ r-;, Address 16 / 7 TUL rf
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O CONTRACTOR, AGENT
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< oState License. Approved
U PLUMBING INSPECTOR ��
FIXTURES INUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater / "! Size
Water Closet _1 //,X7 I Material
Bath Tub -4,o C To Curb
Shower / 1 ), 5( To Prop. Line
Lavat .4,qk To E " tin
Kitchen Sink ! / zd I
Dish Washer /
Waste Dis oral
Uahn
Tray /,5 STORM DRAINAGE
Machine 6d Size
Softener / A/ Material
k To Main n
Sink&Tra To C
Unit
Fountain
rain WATER SYSTEM
r Size O
rant Sink Material
ra TOTAL FEES
UrinalFixture Fee �'---
Area Drain Main Drain Fee
Water Leader Stom Drain Fee
Sprinkler System Water Sys.Fee
Relief Valve Cqq Fee,
8
Vac Breaker
Skimmer
Filter
Pool Sweeper
Permit Fee
Total / Total Fee _6�p
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No.
Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Do to / 196
Application iby made for
to be occupied only ns
in accordance with Plot Plan,
to
Estimated Value of Improvements $
FEES Plan Check $
Owner ZA�.e /[�( O Address
Contr. Address
Phone State License
Approved
Lot No.
File No. /60,/ Y-14—
Sanitary No.
story, Type
and Specification filed herewith,
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT _
Do to /, 196 7 GAS FEE E 2
PLUMBING FEE E
Contr. _ tom/ ---. Address /0 -l7 k
Phone -3 ?.- 7 State License
Approved
l APPLICATION FOR APPLIANCE PERMIT
Data 196 FEE$
Contr. Address
Phone State License
Approved
Applicants agree not to violate any of the.
Workman's Compensation Laws of the '
.State of California
RECORD OF INSPECTION APPROVALS
FOUNDATION
SIZE
BUILDING
,OUTLETS
Date
ROUGH WIRING
SWITCHES
Date
RECEPTACLES
Inspector
UNDERFLOOR
FIXTURES
Inspector
Date
Inspector
Date
FRAME
Date
Motors
TOTAL FEES
Date
Inspector
Date
FINAL
MAIN DRAIN
Date
Inspector
LATH 8 PLASTER
WATER SYSTEM FEE
PERMIT FEE
Inspector
Data
FINAL
Date
Inspector
GAS PIPING FEE
FINAL
Date
Ins oe ctor
Inspector
PERMIT FEE
ELECTRICAL
SERVICE SIZE
UNDERGROUND
SIZE
IRWWATER
TERIAL
,OUTLETS
Date
ROUGH WIRING
SWITCHES
Inspector
RECEPTACLES
FINISH WIRING
FIXTURES
Inspector
Date
H.P. CHARGE
MAIN DRAIN FEE
PERMIT FEE
Date
Motors
TOTAL FEES
Date
Inspector
SERVICE SIZE
UNDERGROUND
SIZE
IRWWATER
TERIAL
Inspector
Date
ROUGH WIRING
UNDERGROUND
Inspector
Date
FINISH WIRING
BLOWER FURNACES
Inspector
Date
FIXTURES
MAIN DRAIN FEE
Inspector
Date
Motors
MISC
Date
Inspector
Date
FINAL
MAIN DRAIN
MISC
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
SYSTEM
SIZE
IRWWATER
TERIAL
TYPE OF APPLIANCE
TOTAL FIXTURES
FEE
UNDERGROUND
FIXTURE FEE
REGISTERS
PARTIAL ROUGH
BLOWER FURNACES
Date
Inspector
MAIN DRAIN FEE
ROUGH COMPLETE
MISC
Date
Inspector
STORM DRAIN FEE
MAIN DRAIN
MISC
Datp
""'Cia.
WATER SYSTEM FEE
PERMIT FEE
GAS PIPING r
FLOOR FURNACE
Date
Inspector
GAS PIPING FEE
FINAL
Date
Inspector
PERMIT FEE
MISC
Date
Inspector
TOTAL FEE
MISC
APPLIANCE
TYPE OF APPLIANCE
UNITS
FEE
TYPE OF APPLIANCE
UNITS
FEE
CIRCULATING HEATERS
REGISTERS
BLOWER FURNACES
COMBUSTION VENT
SUSPENDED UNIT
MISC
GAS RANGE
MISC
GAS DRYER
PERMIT FEE
FLOOR FURNACE
TOTAL FEE
INSPECTED
Date Inspector
(� 'O je/ 7 _. LOT
GNo, STREET
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x ° ® '- ��,SS--I '-''�`�d�.F CUPF.RTINO
o a J Sanitary No.
5" 1 JUS 31 3967 /
w Date 19 Permit No
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'o - Application((ii�sFFhere((b'� made fora permit to '
a to a stbry, Fy Building
w
r to be occupied only a n a rd th
0 o plans, Specifications and t -Plan filed herewith. PI Ck Fee �-o �a
j
N; Estimated Value of Improvements, $ Fec
z J It is hereby agreed that The requirements of the r t[�j�p at�/�nd`4
other her laws applicable to the construction, Ioca on, se o buil gs w" in the City of
j upertino will be complied with. 4
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Owner/&4-71 `%%/JO Limit �/7r/ �i z // Address
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tate LicenseBU ING INSPECTOR
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