NO PERMIT NUMBER I
I I�--I9' "27
.1'0 A-� Lot No.
No. Street v
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
File No.
Date 196
Application is hereby made for a permit to
a story, Type
to be occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith.
Estimated Value of Improvements $
FEE$ Plan Check $
Owner _ Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date L 9 196 / rjI� � �jam-- FEE$ //y7-r,/SS_
Contr. � �. '"""�/widdrass �"(, , s
Phone 3 77`F— (s 9 -2._. State License a" --1 77
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr, Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
Contr, Address
Phone State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
Slate of Califnrnin
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
PAD FINAL
FOUNDATION
UNDERF OR
FRAME
LATH & PLASTER
GRADING FINAL
FINAL BLDG.
ELECTRICAL
DATE INSPECTOR MISC.
UNDERGROUND ROUGH
ROUGH WIRING
FINISHED WIRING
FIXTURES
MOTORS
FINAL--
PLUMBING,
INAL PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO.
SANITARY N0.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
MISC
LOT NO.
U
S
W ® AP 'I ALTTtTP FOR BUILDING PERMIT
" o /SEP 2 1966 OF CUPF.RTINO
o a Sanitary No.
SO
-n-
1 196,6 Permit No. ��
o1 Y [C
o Appll tion AtAp �r�a�delf�r a permit to
a
in a story,Type Building
to be occupied only as in'accordance with
a
0 0 !Tans, Specifications and Plot-Plan fi herewi Pl Ck Fee
Estimated Value of Improvements, S � Fee$ 1�
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J Z all other laws applicable to the construction, location, and use of buildings within the City of
d o Cupertino JI be complied with,
3
— Owner LWIY CWAACKSMA� Ad 7CUnc lfS �� .
Appro
u f By �i a1d66;e? —D -�H/Cd Address " "/,P< 0 Phone 392_57'5_2)
t
State Licens /50/>!Cs2Efa-' BUILDING INSPFCI'Oa