NO PERMIT NUMBER Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.`v /oO
Sanitary No.
`Dd"te 196 —
Application is reh r ade for a permit to . .
a story, Type
a he occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith.
Estimated Value of Improvements S
FEES ��� Plan Check $
Ow ne rlL^�^�irLF Address
Cont,, Address
Phone State License
Approved
- -- APPLICATION FOR ELECTRICAL PERMIT
Date 196- FEES r ��
Contr. r Address - 10 cd
Phone 02�7� k1l State License �s �Dc-1
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data 196 GAS FEE $
PLUMBING FEE E
Contr. Address
Phone State License
Approved f
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
Contr.
Address
Phone State License
Approved
Applicants agree not to violate anyof the
Workman's Compensation Laws ofthe
State of California ... - -
.r
p•..y.a. r .. ..
RECORD OF INSPECTION APPROVALS z-
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Ins as ctor
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
RECEPTACLES ROUGH WIRING Date Inspector
FIXTURES FINISH WIRING
Date Inspector
Date Inspector
H CHARG FIXTURES
Dat Inspector
MIT FEE Motors
at pector
TOTAL FEES FINAL
D to Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE . MATERIAL
WATER SYSTEM SIZE I.- TERIAL
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 PIP NG
Date Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE MISC
Date Inspector
TOTAL FEE M ISC
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 7
k
FLOOR FURNACE - TOTAL FEE . I.
INSPECTED ' I
Data Inspector
OFFICE COPY _
ELECTRIC SEI�Yli f NOTICE
BUILDING INSPECTOR'S OFFICE.
CITY OF CUPERTIN
To
You are herebyt rued t connect ical service for
Owner or Tenant .... ............. ... ............. ............. .. ..
( cv 3 / ......................... .. ... ..-............... ........
.. .............
No. of Wires ........ .............. Size of Wires ... :�. .._ Size of SwltcP...... 1 .........
MotorLoad .......................... Voltage ................................ Phase ............... ................
Heating Load ........................ K. W. ............e:" ............... Voltage ................................
Light............... t10..../e. New Service................ Reconnect..................
No. of Meters......�...........
Heat................ 220...:.. .. Three Wire................ Move Service............
No.of Add.Meters............
Power............... Phase............. Move Meter..............
............ . .... ..: . . ...................
BLE L INSPB -