NO PERMIT NUMBER Lot No.
No. Street -
CITY OF CUPERTINO
APPLICATION FOR BUILDING PERMIT
Sanitary No.
y / Fila No�a V•a.ro� .
Date �79 L�
Application is hereby made for a permit to
al� s tory, Typettg� �
to be occupied only as
a
in accordance with Plot Alan, Plans and Specification filed herewith„
Estimated Value of Improvements $
FEE$ 7 J.i Plan Check $
Owner - Address
Conte. Address
Phone - 02s *14 �- ` Z/ State License
Approved
.6L
APPLICATION FOR ELECTRICAL PERMIT
Date 19 FEES
Conte. Address
Prone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 19 GAS FEE $
PLUMBING FEE $
Conte. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 19 FEE$
ISI Conte. Address
Phone State License
Approved
Applicants agree not to violate any of the.
Workman's Compensation Laws of the
State of California
PD-1
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
PAD FINAL
FOUNDATION
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL_
FINAL BLDG.
ELECTRICAL
DATE INSPECTOR MISC.
UNDERGROUND ROUGH
ROUGH WIRING
FINISHED WIRING
FIXTURES
MOTORS -
FINAL
OTORS -FINAL
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC '
MISC
MISC