51113 /O3 ;K/I _^ Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
{_ Sanitary No.
Date •7 � 196 `�
A plication is hereby made for a permit to
a or-y, T"ie f 2!
to be occupied only as OL
in Fcordance with Plot Plan, Plans and Specification filed herewith.,
Estimated Value of Improvements $ J �Q
FEE$ J—elp Plan Check $
I
Owner s Address
Contr 617
fi Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date '196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
Contr. Address
Phone State tL icense
3
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVAIS'-
BUILDING
FOUNDATION
Data Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH & PLASTER
-. tom- actor
FINAL
Date Inspector
ELECTRICAL
OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date 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 I I MATERIAL
STORM DRAIN SIZE I IMUMTERIAL
WATER SYSTEM SIZE IATERIAL
TOTAL FIXTURES 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 Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE MISC
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 t TOTAL FEE
INSPECTED
n,a. - Ins Dector
wg
No. MEET
W a ® c APP i AT(�N FOR BUILDING PERMIT
t �11 Y
r ° OF CUPERTINO
5 a MAY 3 135Sanitary No.
O
_ ll:tte 196_ Permit No.
0
on� '(�1 a mit to . .
a � �
'z N a TYPe Building
w
to be occupied dance with
0 o Plans, Specifications nd Plot-Plan filed herewith s_ PI Ck Fee
r "; Estimated Value of Improvements, $ C Fee$
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* Z all other laws applicable to the construction, location, and use of buildings within the City of
d o Cupertino I be mplied t
; Q N Owner Address
W n By Address
a U Phone ryrL� 2,*1 Approve
State License--
a we tNSEecroa