NO PERMIT NUMBER (2) _ t•i
AQ 73G I off..-rc. 1��e�. .� .
Lot No. 7-
No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
Sanitary No.-
Do te
o.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 Check $
Owner .. Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FFOR'PLUMBING & GAS PERMIT
Date y/� ` 196 GAS FEE $
,/Q_ - _ �y L+' PLUMBING FEF $ -i
Contr. 46 +ry1 �/ tl,"�/• Address / -7 7��• //t/—`/
Phone �! ` ' 0'7( (rs State Licensee-' A 3is�.s—o
Approved -
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
Contr. Address
Phone State License
Approved
Applicants agree not to violate any of the
Workman's Compedsation Laws of the
State of California-
RECORD OF INSPECTION APPROVALS
FOUNDATION i BUILDING
Date Inspector
UNDERFLOOR
FRAME Date Inspector
Date Inspector
LATH 8 PLASTER
Date Inspector
FINAL
Date Insoector
ELECTRICAL
.OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
RECEPTACLES ROUGH WIRING Date Inspector
FIXTURES FINISH WIRING Date Inspector
H.P'. CHARGE FIXTURES Date Inspector
PERMIT FEE Motors Data Inspector
Dote
Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN' I SIZE I LAL4TERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES /0'0 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
ate r
GAS PIPING FEE FINAL —o�� S p
Date Inspector
PERMIT FEE MISC
Date Inspector
TOTAL FEE � T � �M_ ISC
-• 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 TOTAL FEE
INSPECTED
Date Inspector