NO PERMIT NUMBER Lot No.
No. St et
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
File No.
a�yyu/
Date r 196
Application is hereby made for a permit to
a story, Type
to be occupied only as
in accordance with Plo an, Plans and Specification filed herewith,
Estimated Value of Improvements s J. 7 7 7 tf�o
FEE$ 6 Plan Check $ 3
Owner 14 - Address 2 A,
Jd
Contr. Address /
Phone ZI State License/
Approved W //
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
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 O� INSPECTION APPROVALS
BUILDING d ,
V DATE INSPECTOR MISC. --
PAD FINAL
FOUNDATION C 6��.....
FRAME
LATH & PLASTER
GRADING FINAL
FINAL BLDG.
ELECTRICAL
DATE INSPECTOR MISC.
UNDERGROUND ROUGH
ROUGH WIRING
FINISHED WIRING
FIXTURES
MOTORS
FINAL
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REQ.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
MISC `
5
w '
fl
JA
kr
TI
C
o COOD
no
n �.
LA
---I W
n � T
SN
CD
`cyT p�
ti � zr r, CMID
CD as