100008/vv( Lot No.
No. Street
APPLICATON FOR BUILDING PERMIT
CITY OF CUPERTINO p// "
File No( 06 �DO
Sanitary No.
Date 196
Application is hereby made for a permit to
a story, Type
to be occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEES Plan Check $
Owner Wit- rass
Contr. ddr ss
Phone State License
Approved
OC'�eLIW40 of i ELECTRICAL PERMIT
Date 1'p9/6 FEE$
Contr /v/j Address -Z/�• �1��- -�Q/� —
Phone �� D'/�� State License Cl o— 1,7<3 T 4
Approved WILLIAM D. GENEVIC:1-1
1
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
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
FOUNDATION BUILDING
Dote Inspector
UNDERFLOOR
Date Inspector
FRAME
Dote Inspector
- LATH 8 PLASTER
Date Inspector
FINAL
Date Insoector
ELECTRICAL
.OUTLETS SERVICE SIZE
SWITCHES / UNDERGROUND
RECEPTACLES ROUGH WIRING Date Inspector
Date Inspector
FIXTURES FINISH WIRING
Do to Inspector
H.P. CHARGE FIXTURES
PERMIT FEEMotors Date Inspector
!l4 DateInspector
TOTAL FEES a FINAL 10
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I L.,oTERIAL
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
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 Inspector