51009 /0 3 3/ I y'& eY' Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO !
File Nod/ !/d40/y
Sanitary No.
Date 196
p Application is er y made
for a permit to
a story, Type
to be occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith.
Estimated Value of Improvements E
FEES Pion Cheek E
Owner/��� AIIA ' ' 'yam Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
4�
Date r1.41 196 FEES
Cantr. Address / p
Phone 7 .Q��� State License
Approved �• �
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE b
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 CompensationLaws of the
State of California
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR '
FRAME Date Inspector
Date Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Insaector
ELECTRICAL
,OUTLETS
SWITCHES UNDERGROUND ' SERVICE SIZE
Data Inspector
RECEPTACLES ROUGH WIRING
.FIXTURES FINISH WIRING Date Inspector
FIXTURES Date Inspector
F(E MotorsD to Inspector
PERMIT
o a Inspector
TOTAL FEES FINAL
ate Spector
lWolosillill
PLUMBING & GAS -
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE I ATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date -Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date Inspector
STORM DRAIN FEE MAIN DRAIN
Date Inspector
WATER SYSTEM FEE GAS PIPING
Data Inspector
GAS PIPING FEEFINAL
Date Inspector
PERMIT FEE - MISC -
Date Inspector
TOTAL FEE � 'MISC
Date Inspector
APPLIANCE
TYPE OF APPLIANCE UNITS FEE TYPE OF APPLIANCE UNITS7 FEE
CIRCULATING HEATERS REGISTERS
BLOWER FURNACES COMBUSTION VENT
SUSPENDED UNIT MISC
GAS RANGE MISC
GAS DRYER PERMIT FEE
FLOOR FURNACE TOTAL FEE
INSPECTED
Dote Inspector _ r
OFFICE COPY
ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CU TING _
To
You are hereby autizedo ical service for
Owneror Tenant .......... ........................................At ...........�.o.s .l ............................. .:.... ......................................
... ...
No. of Wires ....... Size of Wires�..t.V....... Size of Switch�............
MotorLoad .......................... Voltage ................................ Phase ..................................
HeatingLoad ........................ K. W. .................................. Voltage ................................
Light............... 110... ..... N Service................ Reconnect..................
No. of Meters....................
Heat................ 220... ...... re............... Move Service............
No.of Add. Meters............
Power............... ............... M ve Meter..............
.... ............ .............. . . .
ELECTRICAL SP OR