NO PERMIT NUMBER Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO p
File
Sanitary No.
Do to t 196
Applicat' n is h reby made for a permit to
a .story, Type
n be accupied only as
in accordance with Plot plan, Plans and Specification filed herewith.
Estimated Value of Improvemonts $
FEE$ Plan Check $
Owner J�Oj!!!��. Address
Cont'. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 -- FEE$
Cont' W,-,1 22-/ A&Zt," Address -T-,O'
0 '=10'
^4 J(.44.4
-
Phone eZ97-JP//P State License Irydfo3
Approved 9-2 -
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
Cont,. 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
FOUNDATION BUILDING
Date Inspector - '
UNDERFLOOR
FRAME Date , Inspector
Data 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
. H. CHARGE FIXTURES Date Inspector
Date Inspector
AM'IT FEE Motors
TOTAL FEES W FINAL vtt Spector ,
Dae Inspector ..
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN SIZE I LJL4 TERIAL
WATER SYSTEM SIZE 11TERIAL
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 Dote Inspector
GAS PIPING FEE FINAL Date Inspector
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 TOTAL FEE
INSPECTED
Data Inspector
OFFICE COPY
ELECTRIC SERVICE NOTICE
/BUILDING INSPECTOR'S OFFICE
-V•'•'•—f_� CITY OF CUPERT O /
�'../..�1... . ... .. , 19FA...
To
You are hereby au ori to Lo deet l service for
Owner or Tepant .f............. . . ...................... .......... .... .... .
`/ � (�� Z'
At ..................... :... ....................................................................... ........
No. of Wires .... ............ Size of Wires .1 ....... Size of Switch...........
MotorLoad .......................... Voltage ................................ Phase ..................................
HeatingLoad ........................ K. W. ............. .. ................. Voltage ................................
Light............... 110... ...... N rv' e................ Reconnect..................
No. of Meters...................
Heat................ 220 ....... . T e................ Move Service............
No,of Add. Meters............
Power............... ............... ve Meter..............
............................................ . ............... .............
ELECTRIC A INSPE OR