NO PERMIT NUMBER Lot No.
No.k ;Street
APPLICATION R. UI -G PERMIT
CITY OF COPE 0
t /' /
File ..No. /V a/ODfe
t
Sanitary No.
Date 196
Applic tion is hereby madefa p 't to
n story, Type
to be oc ied a n.
EstJoIn ac rdanae, with Plot Plan, Plans and Specification filed herewith,
tted Value of Improvements b
FEES Plan Check $
Owner Address
Contr. Address
Phone State License
Approved
i
�l
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
® Approved
la&TrH- P NG & GAS PERMIT
Data. VV 11196 GAS FEE $
Cyt Y OF Ir-rs.r�ltet� PLUMBING FEE $ �t
Cont,. /(X•,ISVTI"[T/1--ZD �pYw i ��.-�i tNAddress�S�7✓l
Phone `j`r" — 1� — 7t��7/State License
4 Approved WLL'AM, D. EIENEVIGF•t
APPLICATION FOR APPLIANCE PERMIT
Data 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 .APPROVAL
FOUNDATION BUIL
Dare Inspector'
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH & PLASTER
FINAL Date Inspector
Date Ins oe ctor
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
RECEPTACLES ROUGH WIRING Date Inspector
FIXTURES FINISH WIRING Dare Inspector
H.P. CHARGE FIXTURES Date Inspector
PERMIT FEE Motors Dare Inspector
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
SP<<
WA Se ITEM SIZE MATERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
pa
MAIN DRAIN FEE '� ROUGH COMPL T Date Inspector
STORM DRAIN FEE NAI l y is Inspector
MAIN DRAIN
Date Inspector
WATER SYSTEM FEE GAS PIPING
Date Inspector
GAS PIPING FEE � FINAL '
�i
PERMIT FEE MISC Date Inspector
yip Dare Inspector
L
TOTAFEE - / —
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 r
GAS DRYER PERMIT FEE
FLOOR FURNACE TAL FEE ! iJ
INSPECTED �I
Date ALInspector 11
Z O G LOT NO.
NO. STREET pb
10 CITY OF CU RTINO CAP, v EE-!!6 --
f _'APPLICATION FOR BUILDING PERMIT FEE •S D
w Z L'• Building Per.No.� CJV 3 7 0
F Data kri 19�-tC� ,19 T-1 .
>< Q P unitary Per.No.
3 v AP�licotion is h�re�j made for a permit to re- rp7
w a-0'story, Type Structure
= O
5�D
. to be occupied only as in accordance with
O a
i w Plans,Specifications and Plot-Plan filed herewith.
as
Estimated Value of Improvements,$ 'r_t'
a PI Ck Fee$
p O It is hereby agreed that the requirements of the 22
> w Cupertino Building and Zoning Ordinances and all Fee$
d P-
O < applicable to the construction,
other laws a ilocation,ana g
d 41-6$ '
Z � use of buildings within the City of Cupertino will be Total Fee
Z complied with.
S in ' _ 10 510. Darr wa of
- a ab b �'
w w OWNER PHONE ADDRES )15
skarb�k 12na�i "rt a5 �. Suak
Q 0 CONTR.OR AGENT DD ['dn'71f7k°t
_ ou 37y-/053/ 345 4�9
PHONE STATE LICENSE BUILDING INSPECTOR�Q
p LA