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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 ..............