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m NO, �TRE 'yy 11 �. LAT NO.
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z PLIGA ;I : FOR ILDING PERMIT
0
'O JUN 2. 1' 1963 OF CU TINOanitary No.
3 u r{
a
3Dto 196.3 Permit No.
Tli�atinFs h^^JLTTfbpalpermit to am
a 1-1 _story,Type- `� Building
to be occupied only as
a o in accordance with Plans, Specifications and Plot-Plan filed herewith. _ -
Fstimated Value of Improvements,$c-,'SOD. oo Pee$ -
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J all other laws applicable to the construction, location, and use of buildings within the City of
j o Cupertino w'll be complic with. t ,�
3 a /'
— m Owne � 'Address
wZ ,
a By Address
a 0 Phony Ap ��o?.� �^.S'} s ed Approvti '
{ State Licensee _ BUILDING INSPECt'ON
RECORD OF INSPECTION. APPROVALS
FOUNDATION
DATE INSPECTOR
UNDERFLOOR
DALE INSPPCTOR
FRAME
DATE INSPECTOR
LATH and PLASTER
DATE /I INSPECTOR
FINAL BLDG.
DATE INSPEC"POR
FINALELEC. I }:4?L :•;r"
DATE - INSPECTOR
FINAL PLBG.
j DATE .o ''�, '•R.•'INSPECTOR `
FINAL GAS J
INSPECTOR
J State License
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-IIXTURES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heater Sae
Water Closets I Material
Bath Tubs II To Curb I
Showers To Prop. Line
Lavatories I To Existing I.
Kitchen Sinks Not Conn.
Dish Washers .
Waste Disposals
Wash Trays I 7STORM DRAINAGE '
Washing Machines .:-,I Size I J47
Water Softeners Material • �' ',?,: j '
Bar Sidks I To Main Drain I
Ccmb. Sink n Traysl I II To Curb I_
,)Dental Units 1 II
Drinking Fountainsl I ll I
Flobr Drains WATER SYSTEM
Hoppers - II Size
Restaurant Sinks I Material f • 'a.
Sand 1• aps I I TOTAL`FEES
Urinals I Fixture Fee I, _:I •`
Area Drains Main Drain Fee
Water Leaders Storm Drain Fee
rinks Vawes I Water Sys. Fee ;
o. �Sly I Permit Fee `
TOTAL I TOTAL FEE
RECORD OF INSPECTION
Partial Rough
Rough Com lete
Final f 0
the o-,.mer an: ct;i,a, tof tY.c sinc'7�e fl -ly dialling at
P. J I, -
fo which I am making
ap_rlicaticn to do �irork as a home owner.
I als certify th;:.t I Irll no hire any non-li eased
or contractor, b t ;' 11 do this a h ir:rsegl£.
M'EPI-IO I ;' Nt3j nw7;';s GGNATTIR
Y1t
I, the U.nclersivned dna hF,'rr.'ry no,•ki i, +t,.:+' —