FILE 100,078V, OSS
No.
I
Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUP,ERTINO y
File No. 0' 010/J-
Sanitary No. -34',-7
Do to 196
Application is herebyle for a permit to
to be occupied only as
FEE$
Owner _ O
Contr.
Phone
Date
Contr
Phone
Lot No.
a stogy, Type
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
Plan Check $
Address
Address
State License
Approved _
APPLICATION FOR ELECTRICAL PERMIT
196
FEE$ .
Address
State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 196 GAS FEE $
PLUMBING FEE $ -�-y - - —
Cont,. t/� /' Address /�` .7 N"`e'.0
Phone �'S �- State License/ 17 27T T r
Approved -
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
Contr. Address
Phone
Applicants agree not to violate any of the
Workman's Compensation Laws of the
Slate of California
State License
Approved
..
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Dote Inspector
LATH & PLASTER
Dote Inspector
FINAL
Date Inspector
ELECTRICAL
UNDERGROUND
ROUGH WIRING,
FINISH WIRING_
FIXTURES—
Motors
FINAL
PLUMBING & GAS
SERVICE SIZE
Date Inspector
Date Inspector
Date Inspector
Date
Date
Date
Inspector
Inspector
Inspector
MAIN DRAIN
SIZE
I I MATERIAL
,OUTLETS
STORM DRAIN
I SIZE I
SWITCHES
UNDERGROUND
RECEPTACLES
PARTIAL ROUGH
FIXTURES
H.P. CHARGE
Inspector
MAIN DRAIN FEE
PERMIT FEE
ROUGH COMPLETE
TOTAL FEES
_ qtb'
UNDERGROUND
ROUGH WIRING,
FINISH WIRING_
FIXTURES—
Motors
FINAL
PLUMBING & GAS
SERVICE SIZE
Date Inspector
Date Inspector
Date Inspector
Date
Date
Date
Inspector
Inspector
Inspector
MAIN DRAIN
SIZE
I I MATERIAL
TERIAL
STORM DRAIN
I SIZE I
LawaTERIAL
UNDERGROUND
SYSTEM
SIZE
IIWWATER
TERIAL
UNITS
TOTAL FIXTURES.
CIRCULATING HEATERS
UNDERGROUND
FIXTURE FEE
PARTIAL ROUGH
BLOWER FURNACES
Date
Inspector
MAIN DRAIN FEE
SUSPENDED UNIT
ROUGH COMPLETE
MISC
_ qtb'
to
STORM DRAIN FEE
MRIN DRAIN
GAS DRYER
�iate
Inspect
WATER SYSTEM FEE
`
AS PIPIms
TOTAL FEE
Date
Inspector
GAS PIPING FEE
I
. FINAL
Date
Inspector
PERMIT FEE
V�lMISC
Data
Inspector
TOTAL FEE
MISC -
Vote 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 i I
Data Inspector I
;4jpz
Bldg- Dept
Offi,.e Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Fj Sewer Connection Sanitary Permit No.
Plumbing Final Plumbing Permit No./Q01,0. 7f .....
Lot No..
Owner' -or Tenant .... ..........................
0
At...................
Tract
Date Connected .............. .... .......
Date Final .........................�.-15;
..........
M 7/63-1M
.........................
NG INSPECTOR
zoSGS KrRu:�N �.�
c
No. Street /1FAVY ro x,,,spac'7-
o —
E
of GtlAPPLICATION FOR PLUMBING PERMIT
+ CITY OF CUPERTINO
Hw, �`1� Sanitary No.
Lot No.
�arp (4— I �_ Permit Nod
3 Fee$ 3S6
x Application is hereby made to the City of Cupertino for a permit to install plumbing pipes
and/or fixtures listed on the reverse side hereof, and agrees to install said prices and/or fixtures
o in accordance with the provisions of the Plumbing Code of the City of Cupertino, and all other
laws applicable thereto.
0
m Use of Premises
fjE s
o w
Owner %3 027 O• K
—°� ayau
4, lie w 7
3 s ( Contractor, Agent
° Phone .L 7— S�/ L %
2 C (�
�7n a State License 3 � /
�C-Z3 lrrEuiv 4A,1-rlr
Address
Address 5r6 /�EQ2Y/t c•'•'7 Au,
Approved_C
Plumbing Inspector
3