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NO PERMIT NUMBER 2 Z 0'.9,41 l Lot No, f 7 No. Street APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO �.—� G File No 6 Q 7 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$ '` /� Plan Check $ Owner �is/fta,&g lIY' �rass Contr. Address Phone State License Approved APPLICATION FOR ELECTRICAL PERMIT Date 196 FEES Contr. Address Phone Stare License Approved APPLICATION FOR PLUMBING & GAS PERMIT l Dote 196 GAS FEE $ PLUMBING FEE $ Contr. / W Address / )07/.7/' 9 X 'Jr Phone �Z S Q Q State Lice nsa ��L Approved APPLICATION FOR APPLIANCE ERMIT 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 Data Inspector FRAME Date I ns pe c for LATH B PLASTER Date Inspector FINAL Date InS ae ctor 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 Date Inspector TOTAL FEES FINAL Date Inspector Date Inspector PLUMBING & GAS MAIN DRAIN SIZE I I MATERIAL STORM DRAIN I SIZE I LwATERIAL WATER SYSTEM SIZE ITERIAL TOTAL FIXTURES . UNDERGROUND FIXTURE FEE PARTIAL ROUGH Date Inspector MAIN DRAIN FEE ROUGH COMPLETE Dare Inspector STORM DRAIN FEE MAIN DRAIN Date Inspector WATER SYSTEM FEE GAS PIPING — D to ns c GAS PIPING FEE FINAL Datens pe ttor PERMIT FEE MISC 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