NO PERMIT NUMBER (4) 2111s Marry F t.
NO. STREET LOT NO.
CITY OF CUPERTINO
APPLICATION FOR BUILDING PERMIT
SANITARY NO.
FILE NO. S1 .419
DATE 6-15— 197q
Application is hereby made for a permit to
install a story,type fiberglass
to be occupied only as SPA
in accordance with plot plan,plans and specification filed herewith.
ESTIMATED VALUE OF IMPROVEMENTS$ 3,500
FEE$ 28.00 PLAN CHECK$ 14.00
OWNER Carl Carlson ADDRESS 21114 March Ct.
PHONE 253-9533
CONTR. ADDRESS
PHONE STATE LICENSE
APPROVED Angelo Leber CZ
BUILDING INSPECTION RECORD"
DATE INSPECTOR DATE INSPECTOR
FOUNDATION FLOOR STEEL
PRE-GUNITE FRAME
BOND BEAMS LATH
WALLBOARDS-INT.&EXT.
FIREWALLS
MEMBRANE LANDSCAPING
F.M.O. INSPECTION
FINAL BLDG.
UNDER-FLOOR
TIEDOWNS -MISC-
DIAPHRAMS
MOORE BIISINLSS FORMS INC,.LR \
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 -L _ K MOTORS
FINAL
MISCELLANEOUS INSPECTIONS
PLUMBING INSPECTION RECORD HEATING 8 A/C INSPECTION RECORD
DATE INSPECTOR DATE INSPECTOR
BACK FLOW REQUIRED UNDERFLOOR S.M.
BACK FLOW INSTALLED DUCTS&INSULATION
UNDERGROUND ROUGH FLUES 8 COMB.AIR
PARTIAL ROUGH CONDENSATE DRAINS
ROUGH COMPLETE FINAL APPLIANCE
ROOF DRAIN 8 LEADERS
MAIN DRAIN
FINAL GAS
FINAL PLUMBING
MISCELLANEOUS
or mA{2C.y C_-T LOT NO' `
NO. STREET �AL.35a0
CITY OF CUPERTINO CAP. {
Za a-. APPLICATION FOR BUILDING PERMIT t FEE
r t'�,-� -; �9 G� Building Per.No.
Date O
Y O 1111 V ,-1 i , Sonifary Per.No.
r
3 v Application is hereby made for❑permit to__/1S!_J'7_'9'�'
\ G
= o ❑ '?tory, ype_1������S.T Structure
~ w to be occupied only as S.1�0 ' in accordance with
OQ
z , Plans,Specifications and Plot-Plan filed herewith.
a " 3 Soo
Estimated Value of Improvements,$ 1 t!
a w PI Ck Fee$ r
p O It is hereby agreed that the requirements of the
a Cupertino Building and Zoning Ordinances and all Fee $�d
other laws applicable to the construction,location,and �a O0
O a Total Fee$
Z - use of buildings within the City of Cupertino will be
Z complied with.
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w Z OWNER PHONE ADDRESS
4CONTR.ORAGENT ADD
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PHONE STATE LICENSE B II NU INWKWORI
2 \L T 4 rt\4?ft c y C—T , LOT NO.
NO. STREET
CITY OF CUPERTINO
cr-ri- r,T"APPLICATION FOR ELECTRICAL PERMIT
SU i- 6 1979 Permit No.
Date ` 1 5 ,19,9 Fee E O W
Application is hereby made to the City of Cupertino for a permit to install electrical
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino,and all other laws applicable thereto. \\
Use of Work To Be SeQ>- ( T�QJ
Premises Performed kC'S
Owner LA 0.1- C(lrl¢'%- Address 21\ \L� 'M•P,'Q.C.h C!
Phone •LS 3 9 S 3
BY
ea'.-WF-t• Address
Y Contractor,Agent
Phone
State License Approved
Electrical Inspector
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
01 COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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NO STREET
CITY OF CUPERTINO
V d APPLICATION FOR PLUMBING PERMIT
t
1; Sanitary No.
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Date -•'\� 19�� Permit N.
,p Fee s OV
Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said pipes
and/or fixtures 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 (—
Premises 'T 'T `O • Performed—
Owner
erformed Owner «R\•' C-0,Q-\-S o W Address 1 4-
Phan. 'i 5 3 - q S 3"S
By o W V RR Address
Contractor,Agent
Phone
State license Approved
lambing Inspec or
,p I AGREE I WILL NOT VIOLATE ANY OF E WORKMEN'S
Y' COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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NO STREET
CITY OF CUPERTINO
e7y ' APPLICATION FOR APPLIANCE PERMIT
3
—7 Permit No.
Date ` \ S 119—9 Fee S;,_
Application is hereby made to the City of Cupertino for a permit to install gas
appliances as listed on the reverse side hereof, and agrees 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 ToBeSeQ C kc z } e!a)
Premises L� Performeedd
Owner P-IQJA� Address
Phone --s S^ 9 5 33
ay b W 4 fz�Q Address
Contractor,Agent
Phone
State License Approved p bing Inspector
n I AGREE I WILL NOT VIOLATE ANY OF TH ORKMEN'S
9 COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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