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511143 No. Street Lot No. APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO File No. 'X/115e / Sanitary No. Dora � � 196 �10� ^ Applica(iOn is hereby made for n permit to � y� yppe-- - sto aW% to he ccufled only as in accordance with Plot Plan, Plans and Specification filed herewith. Estimated Value of Improvements FEES Owner', ' Or r Contr. Atr-AW.a/ r Phone 2- 3— s 35y 6 = Plan Check f Address Address jO /–r/ „j'rsra•� "– State -State License r Approved 40 APPLICATION FOR ELECTRICAL PERMIT Date 196 FEES Contr. Phone Address State License Approved APPLICATION FOR PLUMBING & GAS PERMIT Date 196 GAS FEE $ PLUMBING FEE $ Contr. Phone Date Contr. Phone Addres State L Approv APPLICATION FOR APPLI 196 FEES Addros State L Approv Applicants agree not to violate any of the 91orkman's Compensation Laws of the State of California RECORD OF INSPECTION APPROVALS BUILDING FOUNDATION Date Inspector UNDERFLOOR Dot Inspector FRAME D o I Inspector LATH & PLASTER t ns actor FINAL to to Ins oe ctar ELECT CAL Dote Inspector PLUMBING & GAS MAIN DRAIN SIZE MATERIAL STORM DRAIN SIZE MATERIAL WATERS M iIZE SERVICE SIZE FEE ,OUTLETS UNITS UNDERGROUND SWITCHES FIXTURE FEE Date RECEPTACLES Inspector ROUGH WIRING FIXTURES Date Inspector CHARGEMIT Data ROUGH COMPLETE FEEAL E FINISH WIRING FEES Inspector STORM DRAIN FEE Dote Inspector PLUMBING & GAS MAIN DRAIN SIZE MATERIAL STORM DRAIN SIZE MATERIAL WATERS M iIZE SERVICE SIZE FEE UNDERGROUND UNITS UNDERGROUND CIRCULATING HEATERS FIXTURE FEE Date PARTIAL ROUGH Inspector ROUGH WIRING BLOWER FURNACES Date Inspector MAIN DRAIN FEE Data ROUGH COMPLETE Inspector FINISH WIRING Dots Inspector STORM DRAIN FEE Dote MAIN DRAIN Inspector FIXTURES Date Inspector WATER SYSTEM FEE Date GAS PIPING Inspector Motors Date Inspector GAS PIPING FEE Date FINAL Inspector FINAL Date Inspector Dote Inspector PLUMBING & GAS MAIN DRAIN SIZE MATERIAL STORM DRAIN SIZE MATERIAL WATERS M iIZE MATERIAL FEE TOTAL FIXTURES UNITS UNDERGROUND CIRCULATING HEATERS FIXTURE FEE PARTIAL ROUGH BLOWER FURNACES Date Inspector MAIN DRAIN FEE ROUGH COMPLETE SUSPENDED UNIT Dots Inspector STORM DRAIN FEE GAS RANGE MAIN DRAIN MISC Date Inspector WATER SYSTEM FEE GAS PIPING FLOOR FURNACE Date 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 Dote Ins po ctor /o/ tj 1T LOT NO, W FfAPNG( b ION POR BUILDING PERMIT r°CITY OF CUPERTINOo 9 1966 Sanitar} No. sU �,�` E _I.4.�,y gaup I^I 196 Permit No. v ��� o city lic�tl��i4k��t1{1 gip�le for a permit to a n/ i m a story, Type" i%J�d-[.[i1�- Building aW to be occupied only as in accordance with 0 'o Plans, Specifications and Plot -Plan filed herm,tth.ay. PI Ck Fee "; Estimated Value of Improvements, 0 Fee $ J O'` iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and * Z all other laws applicable to the construction, location, and use of buildings within the City of d 0 Cupertino will be complied wigi- 3:i t — W Owne Address Cl _V_ W Z / a n By Addres 0 au Phone Approved 2 Z S 2 PP BUILDING INSPECTOR Oct/ State Licens �/