NO PERMIT NUMBER _ I !, -z -a. 6[Ysj Lot No.
r
No. Street '
APPLICATION FOR BUILDING PERMIT l
CITY OF CUPERTINO
Sanitary No.
File No. SII Ato. 3
Date 196 „
Application is hereby made for a permit to .
a story, Type
to be occupied only as ss
in accordance w4VPlot Plan, Plans and Specification filed herewith„
Estimated Value of Improvements $
FEES Plan Check ar1$
LT
Owner . .&-110,11 V%ASC) � 1 s 1 ' 1 rl
Address l�lp VY1.�
Contr. Address
Phone '3• Q�wZ� State License / 1e A (-7
Approved WILLIAM D. BENEVICH
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data 196 - GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
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
BUILDING
DATE INSPECTOR MISC.
PAD FINAL
FOUNDATION II
UNDERFLOOR 17
FRAME
LATH & PLASTER
GRADING FINAL
FINAL BLDG.
ELECTRICAL
DATE INSPECTOR MISC.
UNDERGROUND RO GH
ROUGH WIRING
FINISHED WIRING
FIXTURES
MOTORS
a
�✓
FINAL /j, •.
Y
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REQ.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
MISC