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NO PERMIT NUMBER Lot No. No. Street APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO File No.,.e-100.9 Sanitary No. Data 196 — / App[i cation is6tz de for a permit to a story, Type t � he occupied only ns in accordance with Plot Plan, Plans and Specification filed herewith, Estimated Value of Improvements $ FEE$ Plan Check $ Ow ner ) Address Contr. Address Phone State License Approved APPLICATION FOR ELECTRICAL PERMIT Dote � 196 6 FEE$ �(J � �.{/ Cont. J r Address,441 C/ /�_- c 4,s�t Phone State License 1r,,,,,I Q�_(0 Ate Approved E/''}}' ""^"�� APPLICATION FOR PLUMBING & GAS PERMIT v U 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 t Workman's Compensation Laws of the State of California RECORD OF INSPECTION APPROVALS FOUNDATION BUILDING Date Ins pe ctor UNDERFLOOR FRAME Date Inspector Date Inspector LATH 8 PLASTER Date Inspector FINAL Date Insoector ELECTRICAL .OUTLETS SERVICE SIZE SWITCHES UNDERGROUND RECEPTACLES ROUGH WIRING Date Inspector FIXTURES FINISH WIRING Date Inspector FIXTURES Date Inspector H• ERMIT FEEMotors Do a Inspector D Spector TOTAL FEES FINAL /1 i IS Inspector PLUMBING & GAS MAIN DRAIN SIZE MATERIAL STORM DRAIN I SIZE I 1.0mATERIAL—f WATER SYSTEM SIZE ITERIAL TOTAL FIXTURES UNDERGROUND FIXTURE FEE PARTIAL ROUGH Date Inspector MAIN DRAIN FEE ROUGH COMPLETE 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 Date Inspector TOTAL FEE � MISC Dote 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 i Inspector ELECTRIC SERVICE NOTICE OFFICE COPY BUILDING INSPECTOR'S OFFICE 145 ...... .......CITY OF CUP NO 5 f 19 . To You are hereby aut4tot a ric service fofOwner or Ten .... ........................ .. ....... ...... .. .... .......... ...At ................. .. ........................... ......... Siof Switch ....:............... No. of Wires ........................ Size of Wires*.I O ze MotorLoad .......................... Voltage ................................ Phase .................................. HeatingLoad ........................ K. W. ................ .............. Voltage ................................ No. of Meters...�............... Ltght............... 110....... .. New Service................ Reconnect.................. No.of Add. Meters............ Heat................ 220... ... .. T W' ................ Move Service............ Power............... P ve Meter.............. ................................. ........ .. ................. ar_ernuc INS ecroR