100,019/o,3a
No.
Date
Street 61 /!
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
196
Application is here hy`mddejfo'r a
to he occupied only as
Lot No.
File No. /OD
Sanitary
story, Type
cordance with Plot�lan, Plans and Specification filed herewitk
,. Estimated Value of Improvements $
FEES Plan Check $
Owner 1� G�A4-*"✓ulddress
Contr. Address
Phone
State License
Approved
fv419464 F R' ,LECTRICAL PERMIT
_
9 Z V-
6 FEE$ �{/(�/_�,_
Contr. +'�-� Dress /O 6 a � !- F
Phone 02sw State License, 744G J 7
Approved
Date
Contr.
Phone
APPLICATION FOR PLUMBING & GAS PERMIT
196 GAS FEE S
PLUMBING FEE $
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
Contr.
Phone
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State, of California
Address
State License
Approved _
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Date
UNDERFLOOR
Date
FRAME
Do to
LATH & PLASTER
Do to
PIMA[
Date
ELECTRICAL
Inspector
Inspector
Inspector
Inspector
Ins oector
SERVICE SIZE
I MATERIAL
,OUTLETS
STORM DRAIN
SIZE
SWITCHES
Date
RECEPTACLeS
Inspector
ROUGH WIRING
FIXTURES
FIXTURE FEE
H.P. CHARGE
Date
PERMIT FEE
/
tN
TOTAL FEES
o2O
ELECTRICAL
Inspector
Inspector
Inspector
Inspector
Ins oector
Date Inspect
PLUMBING & GAS
MAIN DRAIN
SERVICE SIZE
I MATERIAL
UNDERGROUND
STORM DRAIN
SIZE
L064TERIAL
Date
REGISTERS
Inspector
ROUGH WIRING
UNDERGROUND
FIXTURE FEE
COMBUSTION VENT
Date
Inspector
FINISH WIRING
. Date
Inspector
MAIN DRAIN FEE
Data
Spector
FIXTURES
Date
Inspector
STORM DRAIN FEE
Date
PERMIT FEE
sp or
Motors
Date
Inspector
WATER SYSTEM FEE
Dot
FINAL •ME
Date
fmoM
GAS PIPING FEE
Date Inspect
PLUMBING & GAS
MAIN DRAIN
SIZE
I MATERIAL
TYPE OF APPLIANCE
STORM DRAIN
SIZE
L064TERIAL
Data Inspector
APPLIANCE
TYPE OF APPLIANCE
UNITS
IlWWATER
TYPE OF APPLIANCE
UNITS
SYSTEM
SIZE
TERIAL
REGISTERS
TOTAL FIXTURES
UNDERGROUND
FIXTURE FEE
COMBUSTION VENT
PARTIAL ROUGH
SUSPENDED UNIT
. Date
Inspector
MAIN DRAIN FEE
ROUGH COMPLETE
MISC
Date
Inspector
STORM DRAIN FEE
MAIN DRAIN
PERMIT FEE
FLOOR FURNACE
Date
Inspector
WATER SYSTEM FEE
GAS PIPING
Date
Inspector
GAS PIPING FEE
FINAL
Date
Inspector
PERMIT FEE
MISC
Date
Inspoctor
TOTAL FEE
-MISC
Data 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
Data Inspector