NO PERMIT NUMBER (2) Lot No.
No. Street
APPLICATION FOR BUILDING PER
CITY OF CUPERTINO
File No. t'0 Of��
Sanitary No.
I, Data 196
Applicato h ehy ade permit to
ma
story, Type
to he occupied only a
in accordance with Plot PIK, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEES Plan Check $
Owner Address
Cont,. Address
Phone State License
Approved
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APPLICATION FOR ELECTRICAL PERMIT
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Dara o 0 196 � ' FEES
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Phone v 7-5 /v`y 0 State License C"U 2s2 ' 9
Approved2L4� 4� - I
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Data 196 FEES
Contr. Address
Phone State License
APP and
Applicantsagree not to violate any of the
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
BUILDING
FOUNDATION
Dote Inspector
UNDERFLOOR
Date Inspector
FRAME
Dote Inspector
LATH & PLASTER
Data - Inspector
FINAL
Date Ins Do c for
ELECTRICAL
.OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Do to 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 MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Data Inspector
STORM DRAIN FEE MAIN DRAIN
Date Inspector
WATER SYSTEM FEE GAS PIPING
Dote Inspector
GAS PIPING FEE FINAL
Data Inspector
PERMIT FEE MISC
Date Inspector
TOTAL FEE MISC
Data 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 F�`E
FLOOR FURNACE--+-f-- TOTAL FEE
INSPECTED
nn to Inspector
ELECTRIC SERVICE NOTICE OFFICE COPy
BUILDING INSPECTOR'S OPFICE
n
CITY OF_ C U I LRTINO
19
You ar6-h'creby a th rized to con ec ele r' se Nnvice
enan .. ,
At _._..c.C..... - _..._.... . .
No. of Wires :.. 4)
... Size of W
Motor Load ires ." _ Size ofSwit
" `-
.......................... Voltage .........................
._.... Phase ,_......_.. -
Heating Load ............... .. ..............._.
K. \X. ......._............. ............Voltage
No. of Meters....................(Light...............
. Iln.... .. .. N Se tee...
.�.�..�.�.�.�.�.�.�.... Reconnnc
...
of Add. Meters............ Heat......'......... 2 ree it Move Service.................Power.......( .
r h e .. .......... M e Meter......... ...
. ................ .....
. . :............ _.....,
P.LECTRICAG INS ' " '
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Z m io h City of Cupertino for a permit to install electrical
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w x win r d/ ixt a t the reverse side hereof, and agrees to install said
o 'o wiring and/or fixtures in accordanrc with the provisions of the Electrical Code of the
> N City of Cupertino, and all er laws applicable thereto.
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By Address0 0 CONTRACTOR, ACGNTA rOVC—U 1'....npp rNSPECTOR
State License 6
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NO. STREET ,
CITY OF CUPERTINO
PPLICATION FOR ELECTRICAL PERMIT
Permit No.
Date iV I�D 19-? ' Fee$
Application is hereby mode to the City of Cupertino for a permit to install electrical
wiring .and/or fixtures as listed on the reverse side hereof, and agrees to install said.
wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino,and all other laws applicable thereto.
t
Use of Work To Be
Premises Performed �����
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Owner �
Phonei�6.
ByAddress
I Contractor,Apent
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State License Approved lJ/,
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I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S .
C' COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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