NO PERMIT NUMBER 3i7 HG 67
l D lDD Lot No.
No. Street '
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No./V di/(� 2—
Sanitary No.
Data / � 196
Application is hereby made for a permit to
s' pe
to be accupi o
+,aaceardaace with plot Plan, gans and Specification filed herewith.
Estimated Value of Improvements $
FEES Plan Check $
n
Ower ".44*9 e
p
•
Contr. Q Address - � 3a /
Phone -s-.3� 7�� State License
Approved t/ �����
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Data 196 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
DATE INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH & PLASTER
DATE INSPECTOR
FINAL
DATE INSPECTOR '
ELECTRICAL
ELECT. SERVICE
DATE INSPECTOR
UNDERGROUND
DATE INSPECTOR
ROUGH WIRING
DATE INSPECTOR
FINISH WIRING
DATE INSPECTOR
FIXTURES
DATE INSPECTOR
MOTORS
DATE INSPECTOR
FINAL
DATE INSPECTOR
PLUMBING & GAS r� �
I
UNDERGROUND `ter' S ��
DATE I ♦(lid I OR
o S1
PARTIAL ROUGH 1A
DATE-fIA �C,My�... , INSPECTOR
ROUGH COMPLETE 1 T`•
, .ov `V� INSPECTOR
MAIN DRAIN DS o V
Ta.' S ' DALE INSPECTOR
GAS PIPING • 0
A 0
11 �raL DATE INSPECTOR
FINAL
I GATE INSPECTOR
MISC
DATE INSPECTOR
MISC
GATE INSPECTOR
APPLIANCE
INSPECTED
DATE INSPECTOR
MISC
DATE INSPECTOR
MISC
DATE INSPECTOR .
MISC DATE INSPECTOR
'