NO PERMIT NUMBER / , Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT'
CITY OF CUPERTINO
File No..] �
' Sanitary No.
Date 4
, 196
Application is hereby made for mpermit to
/orY. Type
to be up'
in accordance with Plot Un, Plans and Specification filed herewith,
Estimated Value of Improvements $
IitO
FEES J�• Plan Check $
Owner , Address /j07 7 ZL440 lflC�
Contr, Address
Phone State License
Approved WILLIAM D. DENEVICH
APPLICATION FOR ELECTRICAL PERMIT
Dote 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING 8 GAS PERMIT
Date 7��s•F 196 GAS FEE $
PLUMBING FEE $ �•
Cont,, Address I ■ ■ DUapJap,J YID
Phone. State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Dote 1% FEES
Contr. Address
Phone State License
� d
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 i Inspector
UNDERFLOOR
Date Inspector
FRAME
Data Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Ins De ctor
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
Date Inspector
H.P. CHARGE FIXTURES
Date Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE IATERIAL
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 I r
GAS PIPING FEE FINA
Dote Inspector
PERMIT FEE MISC
PC'
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
Date Inspector