NO PERMIT NUMBER Lot No.
No. Street
APPLICATION FOR„BUILDING PERMIT
CITY OF CUPERTINO <t
File No.
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 Value of Improvements S
FEES ,, Plan Check $
n1"
Owner IN "'" =jra Address
Contr, Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date L3,
196 FEES 3 47 '
Contr, /”�% Address -.77 /
p,9`r
�r
Phone fv —,W�`S State License 917 0!
Approved �+
v
APPLICATION FOR PLUMBING & GAS PERMIT
Date //(o 196 F GAS FEE $
A� PLUMBING FEE c PO
Contr, O Address 1?dQ-
p r
Phone .?77 - �1 4 �� State License 3
^cz0 '7s
Approved t9 2 S&I^ -
APPLICATION FOR APPLIANCE PERMIT
Data 1% 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
Data Inspector
LATH & PLASTER
Data Inspector
FINAL
Date Ins oe ctor
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
sv Date Inspector
FIX URE FINISH WIRING
Data Inspector
H.P. CHARGE FIXTURES 07
Data ns po ctar
PERMIT FEE Motora
—3 iot napactar
TOTAL FEES FINAL
Data Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES O'er 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
GAS PIPING FEE FINAL
Dote ns pector
PERMIT FEE �� MISC
Dote Inspector
TOTAL FEE G J--2, 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
De to Inspector