NO PERMIT NUMBER (2) V
Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO /
File No-(20 0 f�
Sanitary No.
Date 196
Application is hereby ade for a p i
a story, Type
to be occupied only%s A-L
t i a dance lot Plan, Plans and Specification filed herewith.
Estimate lue of Imp ova ants $
FEE$ Plan Check $
Owner Address
Contr. Address
Phone ?t
' State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
Phone St o to Li n
Ftp
1P P U ING & GAS PERMIT
Dote —=«96 GAS FEE $
G ����////������,,���������� PLUMBING FEE $
Contr. o'er Address �� u./Ki�
Phone �S �`�•-�sTT�s� State License
r Approved
APPLICATION FOR APPLIANCE PERMIT
Data 196 FEE$
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
Data Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Ins asci or
ELECTRICAL
0UTI-E TS
SERVICE SIZE
SWITCHES UNDERGROUND
Dare Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
Date Inspector
H.P. CHARGE FIXTURES
Date Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I MATERIAL
STORM DRAIN SIZE L&ATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
♦E Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date
for
STORM DRAIN FEE MAIN DRAIN
Date rolnspector
WATER SYSTEM FEE GASP NG
Date Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE MISC
rL Date Inspector
TOTAL FEE r<� MISC
Date Ina pector
dm
A LIANCE
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 _
.._._ ice.....•,,.
flmg. Dep'L
-Xf.c- C-py
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
r-1 Sewer Connection Sa;'t Permit No.
.rer 0------------
P--flumbing Final PI W,45 it No. .........
Lot No.. ........._. ...................
Owner or Tenant .... .... . ...........................................
At -...------- .... .................................................
Tract -------------- ------------------------ -------------------------------
DateConnected ........................ TZ..........................................................
DateFinal ----------------- ...........................................................
............. �� R
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