NO PERMIT NUMBER .1WL/ 12 Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No. / '/
File No.4-10 6p Se
Date 196 YY
Application is hereby made for a permit to
a story, Type S
to be occupied only ash
in accordance with Plot lan, Plans and Specification filed herewith,
�..Estimated Value of Improvements s 'M c/ 0 1
FEES - �J Plan Check $ —.ze s�
OwnerAddress
Cont'. Address
Phone �a 4fo State License/a�33 S3
Approved t/s/
APPLICATION FOR ELECTRICAL PERMIT
Data 196 -7 1) FEES /J
Contr. �l� Address Sol e.Z `-+' / -. 'nom
Phone —02.-..1 X 0.7.1 State License a �e 5`-2 QI
Approved
APPLICATION FOR FOR PLUMBING & GAS PERMIT F�
Date 196 GAS FEE E
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 1% FEES
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
DATE INSPECTOR MISC.
PAD FINAL `
FOUNDATION
UNDERFLOOR air
FRAME �!
1 Q
LATH ER
GRADING FINAL
FINAL BLDG. 7G
ELECTRICAL
"
or
� 7R07UGH
DATE INSPECTOR MISC.
UUNDERGROUND
ROUGH WIRING
FINISHED WIRING Q
b
FIXTURES
MOTORS
FINAL •, /1 G Y
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
MISC
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Q NO. STRE.CT LOT NO.
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0O ° ELECTRICAL PERMIT
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s IT ' CUPERTINO
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0 ` �� �pT Fee `; ��
<� Appl(e.ttwn isUi6rebtt�l h of Cupertino for a permit to install electrical
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w wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
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LL wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
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I > y City of Cupertino, and all other laws applicable thereto.
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3 < Owner !. ! _ Address
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w w By —�- Addressn.
¢ 7 CONTRACT AGENT
a Approved _.
Phony: �,�-o�ss ELECTRICAL IM
State License y2 yy�
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