NO PERMIT NUMBER Lot No. 3
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. Sii7s
Sanitary No.
Date 196
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 Volae of Improvements S
FEES Plan Check $
n
Ower Address
Contr. Address
Phone State License
Approved -
APPLICATION FOR ELECTRICAL PERMIT
Date 196 T FEES '24
Canty. QQr Address 70
Phone tZ/O it T '�S� State License X70 99`r
Approved �
APPLICATION FOR PLUMBING & GAS PERMIT
Date '� 196 GAS FEE $
-- PLUMBING FEE R _
Contr. "��" ^ �C; Address �i
? A
Phone / 9f ?r/ Q State License �3 0�4
Approved -r�
APPLICATION FOR 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
BUILDING
FOUNDATION
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Do to I ns pector
LATH & PLASTER
Do to Inspector
FINAL
Date Ins Dec tar
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RE EPTACLES ROUGH WIRING
U"S Dote Inspector
FIXT ES FINISH WIRING
Dote Inspector
M.P. CHARGE FIXTURES
Date Inspector
PERMIT FEE Oo Motors
e ns pector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES J d3' UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Data Inspector
STORM DRAIN FEE MAIN DRAIN
Data Inspector
WATER SYSTEM FEE GAS PIPING `
/ Date n r
GAS PIPING FEE �'57 FINAL —47
Data spector
PERMIT FEE Y�� MISC
G Date Inspector
TOTAL FEE MISC
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
net. Inspector