NO PERMIT NUMBER �//6 I �j6r�•�yy�,,,st/ �/Ls„V.,.�/ Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. QJ
•/ Sanitary No.
Do to 7 L 196 1
Application is hereby made for a permit to
story, Pyne
to be occupied only as `20-w "K/
in accordjWce with Plot Plan, Plans and Specification filed herewith„
Estimated Volvo of Improvements $ 7d d
FEES Z d`• Plan Check $
Owner Doe Address
Address /'
Contr. /�-•+�atl 9 IA�Wfs�.r.-e Address 4'f—d /�+a�
Phone A—P` 'EYS State License "'� O
Approved L
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 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 8 PLASTER
J DATE IN SPE
FINAL J
DATE INSPECTOR
ELECTRICAL
ELECT. SERVICE
DATE INSPECTOR
UNDERGROUND
DATE INSPECTOR
ROUGH WIRING
DATE - INSPECTOR
FINISH WIRING
DATE INSPECTOR
FIXTURES
DATE INSPECTOR
MOTORS
DATE INSPECTOR
FINAL
DATE INSPECTOR
PLUMBING & GAS .
UNDERGROUND
DATE INSPECTOR
PARTIAL ROUGH
DATE INSPECTOR
ROUGH COMPLETE
DATE INSPECTOR
MAIN DRAIN
DATE INSPECTOR
GAS PIPING
DATE INSPECTOR
FINAL
DATE INSPECTOR
MISC
DATE INSPECTOR
MISC
DATE INSPECTOR
APPLIANCE
INSPECTED
DATE INSPECTOR
MISC
DATE INSPECTOR
MISC ' /?
DATE INSPECTOR
MISC
DATE INSPECTOR
11164 La Paloma Drive LOT NO.
NO. STREET
CITY G CU.- CITY r CITY OF CUPERTINO
PLICATION FOR APPLIANCE PERMIT
SFP 9 19715
Permit No.
)ate l5e3kt'1 ID
,q 76 Fee$
—�'
Applicol on� hirel? made to the City of Cupertino for a permit to install gas,
appliances as_fisted on the reverse side hereof, and agrees to install said appliances in:
accordance with the provisions of the Plumbing Code of the City of Cupertino, and all,
other laws applicable thereto.
ase of Work To Be Replacement Furnace
sremises Residence Performed
owner nalri r] ThgmnS; Address 11164 La Paloma Drive
'hone 446-1040
aY Valley Heating Address63' N. 13th St. San Jose
2 n 4ontya�c�tor,2 gent
phone 7 b 7Q��
itate License 2 58 540 Approved •"'���- 4,
Plumbi ctor
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
1 COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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