NO PERMIT NUMBER (2) Ow/ Lot No.
No. Street
APPLICATION FOR UILDIN ERMIT
CITY OF CUPERTIN
File No.
Sanitary No.
Do to 196
Application is ere 6y m e r a permit to
a story, Type
if
to he occupied only as
in dance with Plot Plan, Plans and Specification filed herewith
Estimatedlue of Improvements f
FEES plan Check $
Owr'ar • Address
Contr. // Address
phone - o2 State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
A-J�TION FOR PLUMBING 8 GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. _ LAr AU4.4 Address —
Phone State License
•
Approved 04 o
APPLICATION FOR APPLIANCE PERMIT
Date 1% FEES
Contr. 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
BUILDING
FOUNDATION
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH & PLASTER
Do to Inspector
FINAL
Date Ins nectar
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Data Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
Date Inspector
H.P. CHARGE FIXTURES
Data Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I LOM.6TERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Dare Inspector
STORM DRAIN FEE MAIN DRAIN
D t I
WATER SYSTEM FEE GAS PIPING
Date Inspector
GAS PIPING FEE � Sa � FINAL
Date Inspector
PERMIT FEE MISC
Date napector
TOTAL FEE - MISC
Date Inspector
NONE.
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