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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