NO PERMIT NUMBER Lot No.
No. Street
APPLICATION FOR BUILDING P RMIT
CITY OF C/UPERTI
I / File No. /
Sanitary No.
Date ' 1^, 1966,,r�
App is teon is here ad for a permit to
b rs story, Type
to he occupied only as d
in accordance with plot plan, Plans and Specification filed herewith,
';,Estimated Value of Improvements $
FEES Plan Check $
Owner ��t f^l'J�"-r-��+% Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEES
Contr. Address
Phone State License
® Approved
A 68tC CA FdkkU : & GAS PERMIT
Data 6 GAS FEE $
C PERT C PLUMBING FEE $
Conte r Address ���� /d(
Phone �� �— �a State License�'3�—��
r
/ Approved
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 APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Dote Inspector
FRAME
Date I ns pe c for
LATH &•PLASTER
FINAL Date Inspector
Date InSDectar
ELECTRICAL
,OUTLETS SERVICE SIZE
SWITCHES UNDERGROUND
RECEPTACLES ROUGH WIRING Date Inspector
FIXTURES FINISH WIRING Dote Inspector
' -H.P. CHARGE FI%TURES Date Inspector
Date Inspector
PERMIT FEE Motors
Dote Ins pastor
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN I SIZE I LLATERIAL
WATER SYSTEM SIZE tTERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE �`y/ PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
STORM DRAIN FEE MAIN DRAIN Date Inspector
WATER SYSTEM FEE �'� GAS PIPING Date Inspector
GAS PIPING FEE FINAL Date Inspector
Date Inspector
PERMIT FEE r�' MISC
[,cEp 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