NO PERMIT NUMBER/o37o I Lot No:
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
v a 9File No..L/
Sanitary No.
Data 196
Application is hereby made for a permit to
a story, Type
to be occupied only ns
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEE$ Plan Check $
Owner ll � Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date & 196A FEES
' 1 A y e
Contr. �J� r Address `�I'Gt/
Phone et 7- t1l r State License
Approved � �
t7/_
APPLICATION FOR PLUMBING & GAS PERMIT /
Date 196 GAS FEE $
PLUMBING FEE $
Cont,. 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 Compensation Laws of the
State of California
RECORD OF INSPECTION APPRCPVALS
FOUNDATION BUILDING
Dote Inspector
UNDERFLOOR
Date Inspector
FRAME
Date I ns pe c for
LATH & PLASTER _
Dote Inspector
FINAL
Date Ins De c for
ELECTRICAL
.OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Dote Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
Dote Inspector
.P. CHARGE FIXTURES
ate , Inspector
PERMIT E Motors
�1to Spector
TOTAL FEES FINAL 0.
ate
Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERI I AL
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
Date Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE MISC
' Dote 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 F"EE
w
FLOOR FURNACE TOTAL FEE
INSPECTED , I
Date Inspector
r
OFFICE COPY
ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
41� ........... —/..... I. ..... . ... 3=
To
You are hereby autho z to conaW_el I service.
Owneror Tenant ............. . . . . ..... .. ......... ......................................
At .................... . . ... ......... .......... .-- - ---------- -
f W,
No. of Wires .. ............... Size Of res ---------f-.0..... Size of Switch
MotorLoad .......................... Voltage ................................ Phase ..................................
Heating Load ..... K.
W ..... ................ Volt'age ................................
Lightlio....... .. New Service................ Reconnect..................
No. of Mete,.................... ig
No.of Add. Metef' Hear- 220..... ..... Th Wire................
7 ire............. Move Service............
Power............... T
e**
.... .......
aLECTRIC INS ACTOR