NO PERMIT NUMBER r _
Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.Zao
/ Sanitary No.
Date/ 96 : `
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 Address
Contr, Address
Phone State'License
Approved
/APPLICATION FOR ELECTRICAL PERMIT
Date �O ��" 196 % FEES coz
Contr, Address + p/
Phone aZ s� —3State License
Approved w
APPLICATION FOR PLUMBING & GAS PERMIT
Data 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone ' ' State License
Approved
APPLICATIOWFOR 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
UNDERFLOOR Date Inspector
FRAME Date Inspector
LATH $ PLASTER Date, Inspector
FINAL Date Inspector
Date Insoector
ELECTRICAL
,OUTLETS '
SWITCHES UNDERGROUND SERVICE SIZE
RECEPTACLES ROUGH WIRING Date Inspector
FIXT ES 7 Date Inspector
FINISH WIRING
Dot Inspector
H.P. CHARGE
FIXTURES
Do Inspector
PERMIT F E Motors
?N,n a nspector
TOTAL FEIP FINA
to Inspec or
PLUMBINGI& GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I LeALATERIAL
WATER SYSTEM SIZE tATERIAL
TOTAL FIXTURES . UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
MAIN DRAIN FEE ROUGH COMPLETE Date Inspector
STORM DRAIN FEE MAIN DRAIN Data Inspector -
WATER SYSTEM FEE GAS PIPING Date Inspector
GAS PIPING FEE FINAL Data Inspector
Date Inspector
PERMIT FEE MISC
I
TOTAL FEE MISC Data nspector
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