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NO PERMIT NUMBER r a O X r I C:��C,Cc.,.� C(JiL s) Lot No. No. Str APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO File No. 9 fi L Sanitary No. Date / i 196 A plication ' rehy made r a 1 Mit to y, Type tolhe occupied only as in actor re with Plot Plan, Plans and ecification filed herewith, Estimated Value of Improvements $ FEEf 09 Plan Check $ Owner — Address Contr. f Address Phone `� I State License . , Approved APPLICATION FOR ELECTRICAL PERMIT o O J Date O 196 FEEf Contr. ��rr�� Address Phone _&LS- —/P IP State License 'J a `— Approved APPLICATION FOR PLUMBING & GAS PERMIT Date 196 GAS FEE f PLUMBING FEE $ Contr. Address Phone State License Approved 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 BUILDING FOUNDATION Dote Inspector UNDERFLOOR Date Inspector FRAME Date Inspector LATH & PLASTER Date Inspector FINAL Date Inseector ELECTRICAL ,OUTLETS 11, 34 SERVICE SIZE SWITCHES Z Ya UNDERGROUND Date Inspector RECEPTACLES' ROUGH WIRING Date Inspector FIXTURES L FINISH WIRING Date Inspector .P. CHARGEFIXTURES Date Inspector PERMIT FEE e Motors ' I — Dat IrIspector TO EES d s FINAL -t I sp ctor GAS.__ MAIN R IN SIZE MATERIAL STORM AIN SIZE MATERIAL WATER SYSTEM SIZE ITERIAL TOTAL FIXTURES UNDERGROUND FIXTURE FEE PARTIAL ROUGH Date Inspector MAIN DRAIN FEE ROUGH COMPLETE Date Inspector STORM DRAIN FEE MAIN DRAIN Date Inspector WATER SYSTEM FEE GAS PIPING Data Inspector GAS PIPING FEE FINAL Date Inspector PERMIT FEE MISC Date Inspector 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 Inspector