File 51114Q_ I as-� Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
Sanitary No.
Date ' y fr 196 7z—
Application is hereby made ,foorr a permit to
V �" .story, Type
to be occupied only s
in accordance with plot Plan, Plans and Specification filed herewith,
Estimated Value o/ Improvements $
FEE$
Owner
IF or
Contr.
Phone
Plan Check $
Address
Address
State License
Approved _
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
Phone
State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data 196
Conte
Phone
GAS FEE $ —
PLUMBING FEE $
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date /V(, 1 6 FEES
Cwwr, • Address /002'4-
State License ��/
Approved /�T/CS---
Applicants agree not to violate any of the
Workman's Compensation Laws ofthe
State of California
RECORD OF INSPECTION APPROVALS
BUILDING
FOUNDATION
UNDERFLOOR
FRAME
DATE
DATE
ROUND
DATE
INSPECTOR
IRING
INSPECTOR
LATH & PLASTER
FINAL
DATE
DATE
DATE
INSPECTOR
S
INSPECTOR
INSPECTOR
DATE
INSPECTOR
INSPECTOR
ELECTRICAL
DATE
ELECT.
UNDERG
ROUGH V
FINISH M
FIXTURI
MOTORS
FINAL _
UND
PAR'
ROUT
MAIN
GAS
FINA
MISC
MISC
SERVICE
ROUND
DATE
INSPECTOR
IRING
DATE
INSPECTOR
IRING
DATE
INSPECTOR
S
DATE
INSPECTOR
L
DATE
INSPECTOR
DATE
INSPECTOR
DATE
PLUMBING & GAS
INSPECTOR
°RGROUND
PIAL ROUGH
DATE
INSPECTOR
iH COMPLETE
DATE
INSPECTOR
DRAIN
DATE
INSPECTOR
PIPING
DATE/
IN SPECTO
L
DATE
INSPECTOR
DATE
INSPECTOR
DATE
INSPECTOR
INSPECTED
MISC
MISC
MISC
DATE
DATE
DATE
DATE
APPLIANCE -
INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
TNO.
NO, sT am -y
APPLICATION FOR PLUMBING PERMIT
W a CITY OF CUPFRTINO
z
rrc
o Sanitary No.
LL
3 0 a Date 196L Permit No
Fee Su
0 Application is hereby made to the City of Cupertino for a permit to install plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i N and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all withheerr llaw_s ap/plicable thereto.
W `C.
LL Use of Premises
00
o a Owner _ Address
ZJ
o By Address sv
r CO/NTRACT AGENT
a.
wz
a o State License.
3 %yi�� Approved WILLIr^.;d u. G.:NEVICH
PLUMBING INSPECTOR
M
n
0
0
M
z
N
ro
r.+
O
z