NO PERMIT NUMBER 20121 Forest Ave.
NO. STREET LOT NO.
CITY OF CUPERTINO
APPLICATION FOR BUILDING PERMIT
SANITARY NO.
FILE NO.
DATE Aug 24 19 79
Application is hereby made for a permit to
construct 0—story,type
r
to be occupied only as Deck
in accordance with plot plan,plans and specification filed herewith.
ESTIMATED VALUE OF IMPROVEMENTS $ 9.000
FEE$ 40.00 PLAN CHECK$ 4.00
OWNER Q. Vl rak ADDRESS
PHONE
CONTR. ADDRESS
PHONE STATE LICENSE
APPROVED Angelo Leber Cz
BUILDING INSPECTION RECORD
DATE INSPECTOR DATE INSPECTOR
FOUNDATION /0—II-7tFRM
PRE-GUNITE
BOND BEAMS
MEMBRANE
F.M.O.
FINAL BLDG.
UNDER-FLOOR
TIEDOWNS -MISC-
DIAPHRAMS
MOORE BN5INESS FORMS!NC LA
ELECTRICAL INSPECTION RECORD
RESIDENTIAL DATE INSPECTOR COMMERCIAL DATE INSPECTOR
UNDERGROUND ROUGH UNDERGROUND ROUGH
ROUGH WIRING ROUGH WIRING
FINISH WIRING FINISH WIRING
FIXTURES INTERIOR FIXTURES
MOTORS EXTERIOR FIXTURES
FINAL MOTORS
FINAL
MISCELLANEOUS INSPECTIONS
PLUMBING INSPECTION RECORD HEATING&A/C INSPECTION RECORD
DATE INSPECTOR DATE INSPECTOR
BACK FLOW REQUIRED UNDERFLOOR S.M.
BACK FLOW INSTALLED DUCTS&INSULATION
UNDERGROUND ROUGH FLUES&COMB.AIR
PARTIAL ROUGH CONDENSATE DRAINS
ROUGH COMPLETE FINAL APPLIANCE
ROOF DRAIN&LEADERS
MAIN DRAIN
FINAL GAS
FINAL PLUMBING
MISCELLANEOUS
2-O/7i/ M2r,ST i•• LOT NO Y
I NO. STREET CAP.
CITYOFCUPERTINO B /�? � _
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z d APPLICATION FOR BUILDING PERMIT ( EEE._."
SZ Building Per.No.
Date
a, Sanitary Per.No.
VApplication is hereby made for a permit to
= O a story, Type Structure
O F to be occupied only as----/_}Q,0/7/a N sLv{/6cK in accordance with
a
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O O It is hereby agreed that the requirements or. he % C�
w Cupertino Building and Zoning Ordinances and p1ti Fee"$
p a other laws applicable to the construction,location,�t`d Total Fee$
z use of buildings within the City of Cupertino will be
zz complied with. Q
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PHONE STATE LICENSE 61JILDING INSP CTOR
Z-e-q1 z 1 '00tC£5'T L LOT NO.
NO. STREET
CITY OF CUPERTINO
APPLICATION FOR ELECTRICAL PERMIT
Permit No.
Date -19-Fee$ /LEs70
Application is hereby made to the City of Cuper�NnS for a permit to install electrical
wiring and/or fixtures as listed on the reverse In hertQ.Pf and agrees to install said
wiring and/or fixtures in accordance withthe provision of the Electrical Code of the
City of Cupertino,and all other laws applicable tphgreettro'. V
Use of Work To Be {�� +-
Premises '/ Performed
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Owner C . ✓LCe,� Address ZO/Z/ GnLIsTV-9 . y CJto,
Phone `/' �6 O 31/
By Address
Contractor,Agent
Phone
State License Approved t'e
Electrical Inspector
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S �sf
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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.NO STREET ,
- CITY OF CUPERTINO '
APPLICATION FOR PLUMBING PERMIT
Sanitary No.
li Date ,19_ Permit No:
Fea$ ///1`•6
Application is hereby made to the City of Cupertino�lor a�permit to install plumbing
pipes and/or fixtures listed on the reverse side hereef,' andfQgrees to install said pipes '
-and/or fixtures in accordance with the provisionst§f the Plymbing Code of the City of
Cupertino,and all other laws applicable thereto.,'} C��R
V
'Use of _ Work To Be p
Premises Performed ./�y�•�
Owner___r—{rLC L� Address Z-017-1Z-017-1rc"s7 A✓£• CraP
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Phone—/91-C 0 3
By Address
Contractor,Agent
Phone
State License Approved
Plumbin�tor
I AGREE I WILL NOT VIOLATE ANY O THE WORKMEN'S .fL
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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Z�IZ/ 'ArnegST LOT NO.
NO STREET
CITY OF CUPERTINO
APPLICATION FOR APPLIANCE PERMIT
Permit No.
Date 19_ Fee d
10
Application is hereby made to the City oit,Cu erf�o for a permit to install gas
appliances as listed on the reverse side hereof?'and4agrees to install said appliances in
accordance with the provisions of the Plumbing Code' of the City of Cupertino, and all,
other laws applicable thereto.
Use of Work To Be�v
Premises 1/ Performed /�
Owner C, ILC EAt Address Zo�Z/ �/LLST A'✓1 C Oto,
Phone 96 O 3//
By Address
Contractor,Agent
Phone
State License Approved61
Plumbing Inspector
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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