NO PERMIT NUMBER (3)/o
No.
Date
Lot No.
Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
_196
Application is hereby made far a permit to
a
to be occupied only as
File No.!
Sanitary No.
,story, Type
in accordance with Plot Plan, Plans and Specification filed herewith.
APPLICATION FOR ELECTRICAL PERMIT
✓
Data 196 FEE$ Tw
Contr. �j A d d r a s s."rya
Phone ���,7� ell O State License is o 6 3
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Do to 196 GAS FEE $
PLUMBING FEE $
Cont,.
Estimated Value o4 Improvements $ —
FEES
Plan Check $
1
/�
Owner (L
0%0%A-dIL� Address _
Contr.
Address
Phone
State License
Contr. N
Approved
APPLICATION FOR ELECTRICAL PERMIT
✓
Data 196 FEE$ Tw
Contr. �j A d d r a s s."rya
Phone ���,7� ell O State License is o 6 3
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Do to 196 GAS FEE $
PLUMBING FEE $
Cont,.
Address
Phone
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196
FEE$
Contr. N
Address
Phone
State License
4-
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws`pf the
State of California s
RECORD OF INSPECTION
APPROVALS
MATERIAL
FOUNDATION
TOTAL FIXTURES
BUILDING
UNDERGROUND
Date
REGISTERS
PARTIAL ROUGH
Inspector
UNDERFLOOR
Date
Inspector
MAIN DRAIN FEE
Date
' -
Inspector
FRAME
Inspector
STORM DRAIN FEE
MAIN DRAIN
Date
Inspector
WATER SYSTEM FEE
Dote
GAS PIPING
Inspector
LATH 8 PLASTER
Date
Inspector
GAS PIPING FEE
FLOOR FURNACE
FINAL
Inspector
Date
FINAL
Date
Inspector
PERMIT FEE
MISC
Date
Data
TOTAL FEE
Ins oe c for
MISC
ELECTRICAL
.OUTLETS
SWITCHES
RECEPTACLES
FIXTURES
H.P. CHARGE
FEE
TOTAL FEES
UNDERGROUND
ROUGH WIRING,
FINISH WIRING_
FIXTURES
Motors
FINAL
V
SERVICE SIZE
Date
Date
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
Adilk
Inspector
Inspector
Inspector
Inspector
Inspector
WATER SYSTEM
SIZE
MATERIAL
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
Date
Inspector
WATER SYSTEM FEE
MISC
GAS PIPING
GAS DRYER
Date
Inspector
GAS PIPING FEE
FLOOR FURNACE
FINAL
I
TOTAL FEE '
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
I �
'PERMIT FEE j J
FLOOR FURNACE
I
TOTAL FEE '
INSPECTED
Data Inspector
OFFICE COPY
ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
C
CITY 01" CUPEItTIN
< ........ ....... 14..
To
You are hereby atyfi , ized to 2&� c
or
_le
'gji5al service for
Owner or Tenant ........ . ..... ...... on:!!7w ..................... ..
At.............. .. .................... ........
.......
-0--W
No. of Wires ................. Size of Wires ------- . .... Size of Switch
MotorLoad .......................... Voltage ................................ Phase ..................................
HeatingLoad ............ K. W . .................................. Voltage ................................
No. of Meters ....................
Light ............... 110............ Service................ Reconnect..................
Heat ................ 220............ hree e ................ Move Service............
No. of Add, Meters............ Power ............... . ............. N
'�Yve Meter..............
tA -j
................. . .. .... ......
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