NO PERMIT NUMBER /O A&— I of &i&Z Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.'-rl//g
s Sanitary No.
Data 196
Application is hereby a for a pe
a story, Type
to be occupied , n ^
V. ,o,%—'anKei rlot P ans� cificationfiled herewith,
Es mate Value os
FEE$ ' J� Plon Check $
Owrmr 4/ 'f�Ciy,wc.J (iiia-pc.�-�-y� Address
Contr, L/ Address
Phone State License
Approved'
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr, Address
Phone State License
Approved
ION FL NG & GAS PERMIT
q r/ A v
Data 1W6t ���» GAS FEE E / 3�
�] PLUMBING FEE $ f ^
Contr', '�`-y f' �� Address
Phone'
hone v State License
` �� ' Approved WILLIAM I1 RCNF't/ICl-1
'1OCT P1 1 W0 R APPLIANCE PERMIT ,ZS
FEES .
Contr. %�+'s�-�Nt/l,Q•{l�'6'� Address /L-) 3/-'jEz-Ls -'u� xv't-
Phoney State License
Approved WILLIAM In nFN[pt16•1f
Applicants agree not to violate any of the
Workman's Compensation Laws of the
Stale of California
RECORD OF INSPECTION APPROVALS
BUILDING
FOUNDATION
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Dote Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Inspector
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 I I MATERIAL
STORM DRAIN I SIZE I Lw4TERIAL
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 Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE MISC
Sia Data nspector
TOTAL FEE MISC
Date Inspector
APPLIANCE
TYPE OF APPLIANCE UNITS FEE TYPE OF APPLIANCE UNITS FEE
CIRCULATING HEATERS REGISTERS
BLOWER FURNACES COMBUSTION VENT Vie
SUSPENDED UNIT MISC
GAS RANGE MISC
GAS DRYER l a PERMIT FEE oZ Pw
FLOOR FURNACE TOTAL FEE '
INSPECTED r .
qu /. `1 STREET
LOT NO. I '
APPLICATION FOR APPLIANCE PERMIT
w z CITY OF CUPERTINO
f
Y0
0 j Date- � tom' ��' ' 196— Permit No.
3 a 1�
n Fee $
0 Application is hereby made to the City of Cupertino for a permit to
o F install gas appliances as listed on the reverse side hereof, and agrees to
<a install said appliances in accordance with thi; provisions of the Plumbing
w = Code of the City of Cope r I o, and all ther laws applicable thereto.
LL Use of Pre Wises
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0 Ownet` 0 Address
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Z By ` Address
CONT CTOR, AGENT
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Phone. Z S 3-
wz
w w c
o o State License Approve
_U PLUMBING INSPE
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IUY�/ r ESCS / C✓� `Lf_— Y LOT NO.
NO. STREET
CITY Of CUPERTINO CAP. VAL ��—
APPLICATION FOR BUILDING PERMIT FEE_/
Z Z 0 Building Per.No. e6 //6,
xO Data 79 Sanitary Per.No.
3 V Application is.her y made for a permit to
--iO- � �J
1 \\I-
u, u- �BB,Q GL93' I �vG S Structure
= O a slcry, Typ�
OUu to be o upl d,ly\as in accordance with
a 6
i , Plans,Specifications and Plot-Plan filed herewith.
au
F � Estimated Value of Improvements, $.�/�� r
a LL PI Ck Fee$
O O It is hereby agreed that the requirements of the
3 Cupertino Building and Zoning Ordinances and all Fee $
a other laws applicable to the construction,location,and Total Fee$
z use of buildings within the City of Cupertino will be
Z complied with.
ut Z OWNER PHONE ADDRESS
4 FOCONT .OR AGENT ADD0
_ u y
PHONE STATE LICENSE BUILDING INSPECTOR