51118LOT NO.
NO. STREET
r Pkj� 11�1 FQA BUILDING PERMIT
'{! tom``" 64= 1 4�GUPF.RTINO
'a
Sanitary No. _
i m A Y 31 1968
Date , 196— hermit No.
Applicatigw• sr hereby made,Eolr- Fp�e mi
a story / -
Building
Plans, Specifications andiplot-Plan filed herewit .� PI Ck Fee
Estimated Value of Improvements, $ Fee $
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
Cupertino will �bbe�j com icd with.
Owner 1<L/17 Address_
Z; J I 444'—i"� Ci(..r�, Lot No
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO y
File N.r� O
Sanitary No.
Dote 196
Ap 11 ca tion is hereby made for a permit to
to be occupied only as vi— 24 � i _ 1
in accordance with plot plan, plans and Specification filed herewith,
ae
Estimated Value of Improvements S /-S
� FEES — 9 Plan Check $
'/
Owner J/ Address
Contr. (� Address
Phone S 1' ` 4 / r� State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date In" 02ZI T 196 FEE$ j�' 00
Contr. �� D '' "�`""�'� Address
Phone as a - by9p State License
Approved WILLIAM D. BENIEVICH
APPLICATION FOR PLUMBING & GAS PERMIT
Dote 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Data 1% FEE$
Contr. Address
Phone State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
BUILDING
FOUNDATION
� pl�T IcszINSP ' T R
UNDERFLOOR— 5--- DC
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH & PLASTER
[' D/yTCTOR
FINAL �" - V p
DATE INSPECTOR
ELECTRICAL
ELECT. SERVICE
DATE INSPECTOR
UNDERGROUND
DA�E IN CTOR
ROUGH WIRING 6
DATE INSPECTOR
FINISH WIRING
DATE INSPECTOR
FIXTURES
DATE INSPECTOR
MOTORS
6- 17- 011 ATE NSP OR
FINAL
DATE INSPECTOR
PLUMBING & GAS
UNDERGROUND
DATE INSPECTOR
PARTIAL ROUGH
DATE INSPECTOR
ROUGH COMPLETE
DATE INSPECTOR
MAIN DRAIN
DATE - INSPECTOR
GAS PIPING
DATE INSPECTOR
FINAL
DATE INSPECTOR
MISC
DATE INSPECTOR
MISC
DATE INSPECTOR
APPLIANCE
INSPECTED
DATE INSPECTOR
MISC
DATE INSPECTOR
MISC
DATE INSPECTOR
MISC
DATE INSPECTOR
r
/GJ% o I i) GvrS o r✓ t2 v C LOT NO. 1
N°. STHE.P.T
APPLI OR PLUMBING PERMIT
z a- C D P CUPF.RTINO
Z
wD
x o Sanitary Au.
3 w - �',7/
° a Date � 13 �' Permit No
UFee I
° Application is hereby �� of Cupertino for a permit to install plumbing
o pipes and/or fi to ist t Ie reverse side hereof, and agrees to install said prices
i m and/or fiYtt},r�stn�ordance with the provisions of the Plumbing Code of the City of
a w Cupertino, all other laws applicable thereto.
a w Use of Premises _ '✓L
00
,>. 3 Owner L4g-w Address SZ2-,,�
oa
ZJ
J o
By 151-6 ��u-I /�/h�� S�2 Address ?f
3 r CONTRACTOR, AGA'
— Phone 162 0a 7
w z
w w
a sta[e License_ X37 yo Approved_
U`I{r PLUMBING INSPECTOR
FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater Size
Water Closet Material
Bath Tub To Curb
Shower To Prop. Line
Lavatories To Existing
Kitchen Sink Not Conn,
Dish Washer
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine Size
Water Softener Material
Bar Sink To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size
Restaurant Sink ZFixtureFee
Sand TrapTAL FEES
Urinal .
Area Drain ain Fee
Water Leader rain Fee
Sprinkler System ys. Fee
Relief Valve 11 C,2q Fee
Vac Breaker
Skimmer
Filter
Pool Sweeper
/ -7Permit Fee
Total Total Fee YJ