NO PERMIT NUMBER (3)(t&4 -t °V-,&/
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Date
_196
Application is hereby made for a permit to
a
to be occupied only ns
Lot No.
File No.
Sanitary No.
story, Type
in accordance with Plot plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEE$ Plan Check $
Owner 4 A ,O Address
Cont,. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Conte. p p Address ttr149 K/. Ad-,r.M"2, wa
Phone 2� �� O��Q State License �s�0
Approved If\sM s
APPLICATION FOR PLUMBING & GAS PERMIT
Do to 196 GAS FEE $
PLUMBING FEE $
Cont,.
Phone
Date
Contr.
Phone
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
196 FEE$
Address
State License
Approved
Applicants agree not to vinlate any,of the
Workrnan's Compensation Laws of the
State, of California
RECORD OF INSPECTION APPROVALS
SIZE
TERIAL
BUILDING
TOTAL FIXTURES
FOUNDATION
UNDERGROUND
FIXTURE FEE
Date
PARTIAL ROUGH
Inspector
UNDERFLOOR
Date
Inspector
MAIN DRAIN FEE
Date
ROUGH COMPLETE
Inspector
FRAME
MISC
Date
Inspector
STORM DRAIN FEE
Date
MAIN DRAIN
Inspector
LATH & PLASTER
Date
Inspector
WATER SYSTEM FEE
Date
GAS PIPING
Inspector
FINAL
Date
Inspector
GAS PIPING FEE
Date
Insoector
ELECTRICAL
WATER SYSTEM
SIZE
TERIAL
TYPE OF APPLIANCE
TOTAL FIXTURES
FEE
UNDERGROUND
FIXTURE FEE
REGISTERS
PARTIAL ROUGH
BLOWER FURNACES
Date
Inspector
MAIN DRAIN FEE
ROUGH COMPLETE
MISC
Date
Inspector
STORM DRAIN FEE
MAIN DRAIN
MISC
Date
Inspector
WATER SYSTEM FEE
PERMIT FEE"..
GAS PIPING
FLOOR FURNACE
Date
Inspector
GAS PIPING FEE
FINAL
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 FEE"..
FLOOR FURNACE
i
TOTAL FEE .
INSPECTED
Data Ins
OFFICE COPY
Mm
ELECTRIC SERVICE NOTICE
BUILDING INSPkgOR'S OFFICE
CITY OF CUPERTIINO
You are hereby authof ze j to
for%
Owner or Tenant ............. IV. -........ ... ....
At- ..
�.. (U'
No. of Wires ................ Size of Wires .........:............ Size of Switch..:.....
MotorLoad .......................... Voltage ................................ Phase ..................................
HeatingLoad ........................ K. W. ......... .... ........ ............. Voltage ................................
Light ............... 110............ ew Service................ Reconnect..................
No. of Meters ....................
Heat ................ 220........... Three ire. ............ Move Service............
No. of Add. Meters............
Power ............... f . ........... Mov Meter..............
ELECTarCA1