NO PERMIT NUMBER ray
Lot No.
No. 5treet
r APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
Sanitary No.
Date 196
Applica do hereby made for a permit to
a story, Type
to be occupied only s
in accords 20with Plot Plan, P ns and Specification filed herewith.
I Estimated Value of Improvements $
FEES Plan Check $
Owner Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Canty. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data Z 196 GAS FEE E
�(y�/�" PLUM0ING FEE c/'� � •
Contr. /�/ �•[ ' � Address 14/// /�4/-4 /
Phone 04'rv yz 00 7 0 State License e .3 �' J- ` d
Approved CAL 4
APPLICATION FOR APPLIANC PERMIT
Data 196 FEES
Cont, _ 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
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Dote - Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Ins De c tar
ELECTRICAL
.OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
RECEPTACLES ROUGH WIRING Date Inspector
FIXTURES FINISH WIRING Date Inspector
H.P. CHARGE FIXTURES Date Inspector
Dote Inspector
PERMIT FEE Motors
TOTAL FEES FINAL Date Inspector
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I MATERIAL
WATER SYSTEM SIZE ITERIAL -
TOTAL FIXTURES UNDERGROUND /
FIXTURE FEE PARTIAL ROUGH T)— —6
Data Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date Inspector
STORM DRAIN FEE MAIN DRAIN
WATER SYSTEM FEE GAS PIPING Date Inspector
GAS PIPING FEE FINAL Date Inspector
Date Inspector
PERMIT FEE MISC
Date Inspector
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
Date Inspector .