NO PERMIT NUMBER v�T
10490 I GLENVIEW AVE. Lot No.
No. Street t
APPLICATION FOR BUI G PERMIT
CITY OFP INO
File No. 51118
Sanitary No.
Date 196
Application 4s h .6y made for •rmit to
a story, Type
to he occupied only
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEE$ Plan Check $
0,fief D. F. Bettisworth Address
C ontr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date / 196 1�1— GAS FEE $
/ PLUMBING FEE $
Contr.
w �Fvz rasa �7'J�.S—
Phone -.a'5Z 9� 7State License r0/9
Approved
APPLICATION FOR APPLIANCE PERMIT
Data 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
Data Inspector
LATH & PLASTER
Date Ins pe c tar
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 MATERIAL
STORM DRAIN SIZE TERIAL
WATER SYSTEM SIZE TERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE o_s PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date Inspector
STORM DRAIN FEE MAIN DRAIN
o-v Date Inspector
WA TE R'SYSTEM FEE GAS PIPING
Data n
GAS PIPING FEE FINAL
vo Date Anspector
PERMIT FEE MISC
Dote ns pector
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
Mt.. Inspector
loygo /
� J[� LOT NO.
PLI TI FOR PLUMBING PERMIT
a ,'JUL U �9 ( OP CUPERTINO
w Z
Y p Sanitary No.
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° a Dat 096— Permit No
3U Fee $ . QO
� ° Application is hereby made to the City of Cupertino for a permit to install plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said rices
rand/or fixtures in accordance with the provisions of the Plumbing Code of the City of
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Cupertino, and all oth )plicable thereto.
� w Use of Premises
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" D. r- 3 aT I , wow rte Address-
o < y4O G�PrI!// t°u>
. 3 Owner
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J By W/17 ER Address ��3s �ICRC��pS/S^�r•
3 0 s� CONTRACTOR,,.AAGENT S ANI/'QCL 'I
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W z �nj /
° O( / F '3 (� Approved WILLIAM D. BENEVICH
a o State License
—U PLUMBING INSPECTOR
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