354 (2) 10441 I Las Ondas Y
30
LOT NO,
NO. STREET / �.t 1W
;<JIOR BUILDING PERMIT l/!/ at o{
F CUPERTINO
Date Yl OM 5 9 Permit No
�
Application is hereby madefora permit to construct
a MY
OkCtorP RD1N0SIJ Building
at Pacifica Subdivision
to be occupied only as a single family dwelling
in accordance with Plans, Specifications and Plot-Plan filed herewith.
u Estimated Value of Improvements,$ 12,000 Fee$ J;7 Oy
y it is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws applicable to the construction, location, and use of buildings within the City of
"4 Cupertino will be complied with.
v
in Owner ED LAND CO. Address_132 Edith, Los Altos
By Address Same
CONTRACTOR, AGENT
Phone WH 8-4479 Approved C-e A
Bn1LING INSPECTOR__T
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Remarks (Check ✓)
Type of Appliance I Units Fees II New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces l ��
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit 1 II
Floor Furnace I
Miscellaneous I it
NAME TYPE)
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pp lance Fees Ti 7I IIS
Inspected and Approved ....... ._.:...
DATE. INSPECTOR
HOUSE GAS PIPING
Number of Outlets Size of Main
Gas Piping Fees
—�_.—
Tested and Approved ... /o.S.!... .....�...... ..... ...........................
oATe INSPECTOR
State Ucense
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Remarks (Check ✓)
Type of Appliance I Units Fees II New I Replace I Relocate
.,Gas Ranges
Wall Heaters
Gas Plates I
Circulating Heaters I I II I
Blower Furnaces II I I
Gas Fired Boilers I II I
Warming Ovens '
Percolators I I
Griddles I I II I I
Steam Tables - II
Gravity Furnaces II
—Suspended Unit I I II
Floor Furnace
Miscellaneous I I it I
NAME TYPE)
I it ili I it _
i I II I I
pp lance Fees f
Inspected and Approved ..............:...L.._._....................... - --
DATF INSPECTOR
HOUSE GAS PIPING
Number of Outlets I I Size of Main
Eeste�an
iping Fees I `✓)
pp. l� ......,..d A roved ._.. .. . ...
DATE INSPECTOR
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