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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