NO PERMIT NUMBER020 3
No.
/I
Street U
CITY OF CUPERTINO
APPLICATION FOR BUILDING PERMIT
Son itary
Dare /d y3 79 —?/
is hereby made for a permit to
a d
to be occupied only as
Lot No.
File No.'s
story, Type
in adcordance with Plot Plan, Plans and Specification filed herewith.
Estimated Value of Improvements $
FEES — , —?
-t ``�' Plan Check $
Owner / Address
Contr. 1'/ Address .;I°
Phone �- SJR— /� T `Z� State License
Approved
Contr.
Phone
Do to
Contr.
Phone
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
19 FEES
Address
State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State. of California
PD -1
APPLICATION FOR ELECTRICAL PERMIT
Date
19 FEE$
Contr.
Address
Phone
State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data
19 GAS FEE $
PLUMBING FEE $ —
Contr.
Phone
Do to
Contr.
Phone
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
19 FEES
Address
State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State. of California
PD -1
PAD FINAL_
FOUNDATION-
UNDERFLOOR
OUNDATION_UNDERFLOOR
FRAME
LATH 8 PLASTER
GRADING FINAL_
FINAL BLDG. -
UNDEF
ROUGI
FINISH
FIXTU
MOT 01
FINAL
RECORD OF INSPECTION APPROVALS
BUILDING
INSPECTOR
ELECTRICAL
nATF INSPECTOR MISC.
GROUND ROUGH
--
I WIRING
ED WIRING
RES
IS
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REQ.
SANITARY N0.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
Ile
No.
• n .
Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Do to 196
Application is
to he occupied only as
Lot
Fila No.
/ /a n itary
IN1\.91m
in cco nae with Plot Man, plans and Specification filed herewith,
Estimated Value of Improvements ` $
•i
FEE$ Plan Cheek $
Owner — Address
Contr.
Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196
Contr.
Phone
FEE$
Address
State License
A Approved
fLI AC TION FO LDNG & GAS PERMIT
NOV 1964 Lw•.
Data �� GAS FEE $
PLUMBING FEE t _�
Contr. ess
Phoney —J r v+ State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
Contr.
Phone
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
Address
State License
Approved
RECORD OF INSPECTION
APPROVALS
FEE
FOUNDATION
UNITS
BUILDING
SWITCHES
Date
Inspector
RECEPTACLES
ERIAL
FIXTURES
Dote
Inspector
N.P. CHARGE
Inspector
UNDERFLOOR
PERMIT FEE
Date
Inspector
TOTAL FEES
.Inspector
Date
FRAME
Inspector
Motors
GAS DRYER
Date
Inspector
FINAL
Inspector
LATH & PLASTER
Date
Inspector
Inspector
Date
FINAL
MAIN DRAIN FEE
ROUGH COMPLETE
Date
Data
InS ae ctor
STORM DRAIN FEE
ELECTRICAL
MAIN DRAIN
PLUMBING & GAS
MAIN DRAIN
SERVICE SIZE
FEE
,OUTLETS
UNITS
FEE
SWITCHES
Date
Inspector
RECEPTACLES
ERIAL
FIXTURES
Date
Inspector
N.P. CHARGE
ITERIAL
PERMIT FEE
Date
Inspector
TOTAL FEES
UNDERGROUND
PLUMBING & GAS
MAIN DRAIN
SERVICE SIZE
FEE
UNDERGROUND
UNITS
FEE
CIRCULATING HEATERS
Date
Inspector
ROUGH WIRING
ERIAL
BLOWER FURNACES
Date
Inspector
FINISH WIRING
ITERIAL
SUSPENDED UNIT
Date
Inspector
FIXTURES
UNDERGROUND
GAS RANGE
Date
Inspector
Motors
GAS DRYER
Date
Inspector
FINAL
PARTIAL ROUGH
Date
Inspector
PLUMBING & GAS
MAIN DRAIN
SIZE
FEE
MATERIAL
UNITS
FEE
CIRCULATING HEATERS
STORM DRAIN
SIZE
REGISTERS
ERIAL
BLOWER FURNACES
WATER SYSTEM
SIZE
ITERIAL
SUSPENDED UNIT
TOTAL FIXTURES
MISC
UNDERGROUND
GAS RANGE
MISC
GAS DRYER
FIXTURE FEE
PERMIT FEE
PARTIAL ROUGH
TOTAL FEE
Date
Inspector
MAIN DRAIN FEE
ROUGH COMPLETE
Data
Inspector
STORM DRAIN FEE
MAIN DRAIN
I
Date
Inspector
WATER SYSTEM FEE
�
GAS PIPING
D
or
GAS PIPING FEE
FINAL
�
Date
nspector
PERMIT FEE
MISC
ate
nspector
TOTAL FEE
i
MISC
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