NO PERMIT NUMBER (2) / I /C,jr Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
Sanitary No.
Date 796
Application is here by made for a permit to
a story, Type
to he occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements E
FEES Plan Check $
n
Ower Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Oo
Date 3 d 196p6 � FEES
Contr. �s�w_� �J 00-1—Ti�� Address �!� 0// `7
Phone 't,2- K3-7 State License
Approved
APPLICATION FOR.PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR.APPLIANCE PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
Slate of California
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Do to Inspector
UNDERFLOOR
Date Inspector
FRAME
Date i Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Ins Dector
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES / UNDERGROUND
RECEPTACLES/ � ROUGH WIRING Date Inspector
F XTURES � FINISH WIRING Date Inspector
Y rn Date Inspector
H.P. CHARGE FIXTURES
` Date Inspector
PERMIT FEE Motors
TOTAL FEES FINAL -h — ate Bator
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I low4TERIAL
WATER SYSTEM SIZE JATERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
STORM DRAIN FEE MAIN DRAIN Do to Inspector
WATER SYSTEM FEE GAS PIPING Date Inspector
GAS-PIPING FEE FINAL Dote Inspector
Date Inspector
PERMIT FEE MISC
Date Ins pactor
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
Date Inspector
LECTRIC SERVICE NOTICE OFFICE COPY
BUILDING INSPECTOR'S OFFICE
� �jrO
k\(4a CITY OF CUPERTINO
PQQ,,��� 3 - I I
t41 ............................................................. 1961c?
o
You are hereby autho tze to gunned e(cctcieal semce for
Owner or Tenant .................. . ' ' 2 s'� t
_ ........k
1 q� r61 1 Ze... Woo �. ... .
No. of Wires ..... ............. Size of Wires ...................... Size of Switch .........
JMotor Load .......................... Voltage ................................ Phase ..................................
HeatingLoad ........................ K. W. .................................. Voltage ................................
No. of Meters................. LighL............... 110_�Nm Service..._ Reconnect.............
. /
Hear................. 220..x..... reeYA
....... Move Service............
No.of Add. Mcters............
Power............... ee ....... Move Meter..............
......... .............
ets a