NO PERMIT NUMBER (2) /0 7J-7 I s� �! / /VKAAe/� Lot No. I
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF C_UPERTINO
File No.S/to y7
y Sanitary No.
Date 196
Application is hereby made for a permit to
a story, Type
to be occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith.
Estimated Value of Improvements $
FEE$ /r�� Plan Check $
Owner !q!! Address
or r
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
Phone State License
Approved
�,,�A�PPLICATION FOR PLUMBING & GAS PERMIT
Do to 196 GAS FEE $
PLUMBING FEE t dL
Con r. e`er"" W���' Address 's �jV
Phone .2 - d 8.3 State License C/� /'gp3� �«y�L—
Approvedp�
/s(
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
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 APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date .Inspector
FRAME
Dote 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
Date Inspector
H.P. CHARGE FIXTURES
'PERMIT FEE Motors Date Inspector
Inspector ,
TOTAL FEES FINAL Date
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I LOTERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES . UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
STORM DRAIN FEE MAIN DRAIN Date Inspector
Date Inspector
WATER SYSTEM FEE / .�.► GAS PIPING
GAS PIPING FEE FINAL Date Inspector
Date Inspector
PERMIT FEE �� MISC
vu 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 TOTAL FEE
INSPECTED
Date Inspector