51009 Lot No.
No. -Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
Sanitary No.
Date 196
Application is hereby made for a permit to
a story, Type
' to he occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEE$ Plan Cheek $
Owner Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Data. 196 FEE$ T�
Cont'. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $ _
PLUMBING FEE $
Contr. Address
Phone State License
i
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$ _
C ontr. Address
Phone t State License
' rte' Approved
Applicants agree not to violate anylofthe ,
Workman's Compensation Laws of the
State of California '
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Inspector
ELECTRICAL
.OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
RECEPTACLES ROUGH WIRING Date Inspector
Date Inspector
FIXTURES FINISH WIRING
Date Inspector
H.P. CHARGE FIXTURES
Oat Inspector
PERMIT FEE I I Motors
Inspector
TOTAL FEES FINAL
Dat Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE 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 MISC
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 FEH
FLOOR FURNACE TOTAL FEE
INSPECTED _ / /
Date / Inspector
lZ4 C7� LOT NO.
NO STREET
/t� 3 �✓ Lc� : < C
CITY OF CUPERTINO
c;APPLICATION FOR PLUMBING PERMIT
1.
1, 191t� Sanitary No.
Date ,19Permh No. S:Z�
�
N.4
Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said pipes
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Work To Be
Premises Performed
Owner C � -'��• Address l G�s—d �J� 4�
e7
Phone
By Address
Con'tr/actor,Agent
Phone ��7 �Z 7•} / ' I
State License Approved /L
t,i Plumbing Inspector
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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OFFICE COPY
ELECTRIC SERVICE"NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
To
You are hereby author' a to conned.eled i ` ervice for
r,.
Owner or Tenant ..............
_ s b"�
No. of Wires ........................ Size of Wires �..�d... Size of Switc ....QTS ....
..............
MotorLoad ............... ......... Voltage ............... Phase ..................................
HeatingLoad ........................ K. W. ................-................. Voltage .......................-........
1 Light..._.-........ 11 New Service_.............. Reconnect..-...............
No. of Meters...................
Heat................. 220......... . Thm ire................ Move Service............
No.of Add. Meters..........-.
Power............... h e................ ve Meter..............
... ........ . .............. . ...
s�ectwcnL SP CTOR