NO PERMIT NUMBER n �
Lot No. i
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
e File No.
t� Sanitary No.
Do to ,�/�196 S
'Application is hereby made foperm,
a ry, Type
to be occupied only as
in a with pl t Plans an ecificaiion filed herewith.
Estimated Value Improvements
FEES I/� /J Plan Check $
i Owner 000
_SQA Address Q �/j � �� T
Contr. / �11&u� - Addresses�,��rY / eT/�sf^^'
-ifr S"�S39Phone State License
Approved
7�
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 .r GAS FEE $
PLUMBING FEE t p
Contr. 's'+ I� UAA a , Address-2 OeJ -/J i//'T/A1�.L /�.+"s'�•
Phone 6 7 145— State License ,
II` I'�
Approved &L�/v �/v
APPLICATION FOR APPLIANCE PERMIT
Date 196 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
FOUNDATION BUILDING
Do to Inspector'
UNDERFLOOR
Date Inspector
FRAME
Dote I ns pe c tot
LATH 8 PLASTER
Date Inspector
FINAL
Dote Insoector
ELECTRICAL
OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Dote Inspector
FIXTURES FINISH WIRING
Data Inspector
H.P. CHARGE FIXTURES
Date Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Data Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I La6TERIAL,
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Dote Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Dote Inspector
STORM DRAIN FEE MAIN DRAIN
Date Inspector
WATER SYSTEM FEE GAS PIPING
Date Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE 0202 MISC
ate nspector
TOTAL FEE � �► MISC
Date Inspector
APPLIANCE
TYPE OF APPLIANCE UNITS FEE TYPE OF APPLIANCE UNITS FEE
-" CIRCULATING HEATERS REGISTERS
BLOWER FURNACES COMBUSTION VENT
SUSPENDED UNIT MISC
GAS RANGE MISC
GAS DRYER PERMIT FEE
FLOOR FURNACE TOTAL FEE
INSPECTED
Date Ins pe c tar