fILE 51009t
-J
rL//Lµti.L/ Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Dote let 196
Applicat(n is e6y ma for a permit to
a
n he me spied an Ly ns
File No.,.�00R
Sanitary
story, Type
in accordance with plot Plan, Plans and Specification filed herewith,
Estimated Valae of Improvements $
FEES Plan Check $
Owner Address
Con t,.
Phone
Address
State License
Approved _
APPLICATION FOR ELECTRICAL PERMIT
Date S/�1 ,196- FEE$ ')2
Centr. /"" ', Address -f-16)W,/auj
Phone State License AM0 y/7 3
"Approved ( /n..�16
APPLICATION FOR PLUMBING & GAS PERMIT
Dote .
Cont,.
Phone
Date
C ontr.
Phone
196 GAS FEE $ -
PLUMBING FEE $
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
196 FEE$
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
Address
State License
Approved
RECORD OF INSPECTION APPROVALS
SIZE
BUILDING
FOUNDATION
STORM DRAIN
Date
Date
ROUGH WIRING
UNDERFLOOR
RECEPTACLES
Inspector
FINISH WIRING
Date
FIXTURES Date
FRAME
HX. CHARGE
Inspector '
Motor
Do to
t e
LATH & PLASTER
TOTAL FEES J;N
ate
Date
PLUMBING & GAS
PIMA
-
Do to
Inspector
Inspector
Inspector
Inspector
Ins no ctor
ELECTRICAL
SIZE
SERVICE SIZE
,OUTLETS
STORM DRAIN
Date
SWITCHES
ROUGH WIRING
FIXTURE FEE
RECEPTACLES
Inspector
FINISH WIRING
FIXTURES
FIXTURES Date
/. Inspector
HX. CHARGE
Inspector '
Motor
PERMIT
t e
%�n.tru oactor
TOTAL FEES J;N
ate
Inspector
Inspector
Inspector
Inspector
Ins no ctor
ELECTRICAL
SIZE
SERVICE SIZE
UNDERGROUND
STORM DRAIN
Date
Inspector
ROUGH WIRING
FIXTURE FEE
Date
Inspector
FINISH WIRING
-
FIXTURES Date
/. Inspector
D to
Inspector '
Motor
ROUGH COMPLETE
t e
%�n.tru oactor
�D
FINAsL
ate
Inspector •-
PLUMBING & GAS
MAIN DRAIN
MAIN DRAIN
SIZE
I I MATERIAL
TYPE OF APPLIANCE
STORM DRAIN
I SIZE
TERIAL
WATER SYSTEM
SIZE
TERIAL
TYPE OF APPLIANCE
TOTAL FIXTURES
FEE
UNDERGROUND
FIXTURE FEE
REGISTERS
PARTIAL ROUGH
-
Date
Inspector
MAIN DRAIN FEE
ROUGH COMPLETE
'Dote
MISC
Inspector
STORM DRAIN FEE
MAIN DRAIN
-
Date
Inspector
WATER SYSTEM FEE
PERMIT FEE
GAS PIPING
FLOOR FURNACE
Date
Inspector
GAS PIPING FEE
FINAL
'
Date
Inspector
PERMIT FEE
MISC
DoteInspector
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
Do to
Inspector
V
To
You are hereby
Owner or Tenant ....
.T
ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
OFFICE COPY
CITY OF CUPERTINO /
............./-.......�.............I t9 .
At t a .'KtLJ.
No. of Wires ........................ Size of Wire!
Motor Load .......................... Voltage ........
Heating Load ........................ K. W...........
I.igtic............... tto...
No. of Meters ...................
Heat ................ 220...
No. of Add. Meters........:...
Power ...............
for
................................ .....-.:.......
...... Size of Switch .......
t- Io
................. Phase ..................................
................. Voltage ................................
ELECTRICAL
Reconnect ..................
Move Service............
Move Meter ..............