NO PERMIT NUMBER (2) 20390 I TOWN CENTER LANE Lot No.
No. Street '
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Fiie No. 51027. 7
S6nitory No. 4637.
Dote Nov . 19 196 5
Application is hereby made for a permit to
Construct a 1 story, Type-5 F.--2-1 Hr.
to be occupied only as Medical Building
in accordance with plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $ 4o,000. 0o
FEE$ - 115- 50 Plan Check 5
ovrner Chrl sman . HOMPS Tnr . Address 654 Genrgi•a Ave . P.A .
Cont'. Same Address
Phone . DA 9—c)168 State License 2o67o6
Approved W. D. Benevich/h
APPLICATION FOR ELECTRICAL PERMIT
L� / s,
Data — l 7� 196 (n FEES"
Contr.
Phone r
�� /��
_ 1 6 ' '1 State License �'`Z 77 6 s /'
Approved
APPLICATION FOR PLUMBING 8 GAS PERMIT
Date �-� �� 196 a GAS FEE $
PLUMBING FEE/$ w/,,
Contr. Add
V
ress
Phone - 3 7State License .2 9 7
Approved
APP KATION FOR APPLIANC ERMIT
Do to 7� 2J/ 196
Contr. 4 o2/.�7/^r-...✓(,C.c.y X�j�'-
ass
Phone o2 9 7'/0 tf/- State License
Approved -Q2 s-ice,
Applicants agree not to violate any of the x
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
BUILDING
FOUNDATION -
e Ins pecror
UNDERFLOOR '
Data//Y nspector
FRAME (•
Date Inspector
LATH & PLASTER
D e Ins actor
FINAL
Date Insoector
ELECTR CAL
,OUTLETS tet'/ S lc7
SERVICE SIZE
SWITCHES _30 3 UNDERGROUND
./2 Data Inspector
RECEPTACLES ROUGH WIRING
77 a
FIXTURES 7l 736 FINISH WIRING s pe ctor
W �f {1rs� Inspector
H.P. CHARGE FIXTURES L� /�L� 1�M
ri/
a'^ Dateactor
PERMIT FEE 4'1) Motors ,,,,As�—st' Spector
TOTAL FEES GS oeo
FINAL _��' ��77
Date nspector
PLUMBING & GAS
MAIN DRAIN SIZE I MATERIAL
STORM DRAIN SIZE -MATERIAL
WATER SYSTEM SIZE �..ATERIAL
TOTAL FIXTURES . UNDERGROUND
FI ��II
FIXTURE FEE � 5 PARTIAL ROUGHla-7,1-4.r
Dote for
MAIN DRAIN FEE off'`�. ROUGH COMPLETE D
a t� r
STORM DRAIN FEE MAIN DRAIN �S
Dat r
WATER SYSTEM FEE / GAS PI ING f
_aa Da pector
GAS PIPING FEE � FINAL � �
Date Inspector
PERMIT FEE ���' MISC
1 0'L Date Inspector
TOTAL FEE — MISC
Data Inspector
APPLIANCE
TYPE OF APPLIANCE UNITS FEE TYPE OF APPLIANCE UNITS FEE
CIRCULATING HEATERS REGISTERS
BLOWER FURNACES 3 ti COMBUSTION VENT
SUSPENDED UNIT MISC
GAS RANGE MISC
GAS DRYERPERMIT E o2-�
FLOOR FURNACE TOT
INSPECTED
Do Inspector
Bldg. Dept
Ofike CGpY
BUILDING INSPECTOR'S OFFICE
CITY Or CUPERTINO
Fj Sewer Connection Sanitary Permit No. —a-U77.............
..... ........
flumbing Final Plumbing Permit No. ......7--
(.... Lot No
Owner or Tenant ......
----- ....... ....
. . .. ......4.
..... ...............
At ........
. .................... .. ....... .......... ............... ------- --------
Tract ............. ---------------------
-- - --- --- ------- --- -- -------------------:._..................r._
Date Connected ---------------------------------------I'.--- L-:. -
- ------........................................ 19-
Date Final ------------------------------------------------1.-- ---> !il
-- ------T- ...........
I...... ........ ........ . .......... ............
PLUMBING INS C OR
III 7/63-IM
i
OFFICE COPY--
ELECTRIC
OPY_ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTIN_ O .1 -
.................... ...............�
. .................., 196.
To
You are hereby aut o ze to conngt electrical serpic for
Owneror Tenant ................_.. .................------ ....._...------.. ....... .. .. ..._......'....`1r
At ....... ..... ..c7.��.G..0..... ..
L... U
No. of Wires ....�........... Size of Wires ... ................. Size of Switch .Fl..
MotorLoad .......................... Voltage ................. ............. Phase .._..._.................._.._.
Heating Load ........................ K. W. ................../.............. Voltage ................................
Light. 10 10......vN Service....
econnect..............
_.
No. of Meters......!..............
<II Hmt................. 220............ T ee ove ice.....
No. of Add. Meters............
Power............... ove Met .............
i
ELECTRICAL INSPECT R
OFFICE
GAS SERVICE NOTICE COPY
BUILDING INSPECTOR'S OFFICE
CITY OF CUPE TINO,
. ........ ... ........... 96(z�
.....................
To
You are hereby utho 'feto connect the GAS service or
Owner or Tenant ............
.............. ................................
At .......-4t. ..............
New Service
No. of Meters ...........(-...... Reconnect
.............................
Move Service ....... ..........
No. of Add. Meters .............. e Meter ........................
.... ................. .2r
PLUMBING�� . . . . .v.eINS. ....dCTO 4. .......