NO PERMIT NUMBER (2) /0j7/I 4¢ cx Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. I00
Sanitary No.
Date 196
Applieation is hereby rack for a permit to
a story, Type
to be occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Valae of Improvements $
FEES Plan Check $
Ownert/--- w —_OA�� Address
Cont'. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date `tom/// 196r FEE$ r 6
Cant- Address �r�O ��� —
Phone .27 nap ll k State License
Approved � 10'a�
APPLICATION FOR PLUMBING & GAS PERMIT
Do to 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Data 196 FEES
Contr. Address
Phone State License
Approved
Applicants agree not to violate any of the.
Workman's Compensation Laws ofthe
State of California
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILD-'NG
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Date I ns pe c for
LATH 8 PLASTER
Date Inspector
FINAL
Date Inspector
_ ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
H.h CHARGE FIXTURES D to Inspector
to Inspector
ERMIT FEE Motors
r
TOTAL FEES FINAL pector
•ate Inspector
PLUMBING 8 GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Dote 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
Dote 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 PERM!T,FEE
Ii
FLOOR FURNACE . , .TOTAL FEE
INSPECTED
Date Inspector
Al
OFFICE COPY
ELECTRIC IIRVICINOTICI
BUILDING INSPECTORS OFFICE
CITY 017 CUPERTINO
4;.......... .....--...... ..........
TO
You are hereby au or—ed to ned I al service for'
Owner or Tentnt .......3.....z..... .. . ....... . ... cl";� ......... ......................
in. ---— . . ..........
At ...................!d.......n �>. ..
.... ...... .. ........ .............................3... ...
.41. F (� S
Wires .................... 1z
No. of Wires ...........:....1:...... ............
MotorLoad .......................... Voltage ................................ Phase ..................................
HeatingLoad ........................ K. W. ................... .... ........ Volt'age ................................
Light 'I io........... m Service................ Rmnnect...............
No. of Meters.......
No.of Add. 220...... ... Three wire................ Move Service............
Power............... T Phase................ Move eter..............
...............................:............... . .. ............
ELECTRICAL I�rPl OR