NO PERMIT NUMBER oty,,,� y Lot No.
No. Street
APPLICATION FOR BUILDINQ WRMIT
CITY OF CUPERTINO
File No. /Ow?
Sanitary No.
DateAoccapied
6 00-� r'
i a i e .b made for a p rmit to
story, Type
to
in accords .e ith Piot Pla , Plans and Specification filed herewith,
Estimated Va lee of Improvements $
FEE$ Plan Check $
Owr.er Address
Cont,. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date ` ,.196 FEE$'
Contr. Address
Phone State License
yppJq 1. Approved
A LRERI1ofv;tFNAL ',G & GAS PERMIT
Date 196 GAS FEE $
CITY .0 _PLUMBING FEE $
Con". _SC_`�� ess
Of 7
s X
Phone d,2j�. yur State License Z
Approved WILLIAM G r+_._C•7IGF�
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 APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Dote Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Inspector
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Do to Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
H.P, CHARGE FIXTURES Data Inspector
Date Inspector
PERMIT FEE Motors
TOTAL FEES FINAL Date Inspector
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
Data Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date Inspector
STORM DRAIN FEE MAIN DRAIN
(�I Data Inspector
WATER SYSTEM FEE GAS PIPING
Date Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE 3 MISC
Date Inspector
TOTAL FEE 0% MISC
.00
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