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51046 a .WA-4.v / r• 0 G 3 No. Sere APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO File No. -J_/* xb L. Sanitary No. Do to L 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 $ FEES Plan Check $ Owner GSA:✓'K� 4" Address Address Contr. Address Phone State License Approved APPLICATION FOR ELECTRICAL PERMIT Data 196 FEE$ Contr. Address Phone State License Approved APPLICATION FOR PLUMBING 8, GAS PERMIT Date I/2=9gr 196 7 GAS FEE $ PLUMBING FEE $ Cont'. &Zn2&e Address OZ 01. Phone « T/- .33 7 o State License Approved APPLICATION FOR APPLIANCE PERMIT Date 196 FEES Contr. Address Phone 'State License Approved Applicants agree not to violate any of the Norkman's,Compensation Laws of the State of California - _ RECORD OF INSPECTION APPROVALS BUILDING FOUNDATION DATE INSPECTOR UNDERFLOOR DATE INSPECTOR FRAME DATE INSPECTOR LATH & PLASTER DATE INSPECTOR FINAL DATE INSPECTOR ELECTRICAL ELECT, SERVICE DATE INSPECTOR UNDERGROUND DATE INSPECTOR ROUGH WIRING DATE INSPECTOR FINISH WIRING DATE INSPECTOR FIXTURES DATE INSPECTOR MOTORS DATE INSPECTOR FINAL DATE INSPECTOR PLUMBING & GAS UNDERGROUND DATE INSPECTOR PARTIAL ROUGH DATE INSPECTOR ROUGH COMPLETE DATE INSPECTOR MAIN DRAIN DATE INSPECTOR GAS PIPING DATE INSPECTOR FINAL DATE INSPECTOR MISC DATE INSPECTOR MISC DATE INSPECTOR APPLIANCE INSPECTED DATE INSPECTOR MISC DATE INSPECTOR MISC DATE INSPECTOR MISC DATE INSPECTOR Lot No. No. Str t APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO / File No. 0 Sanitary No. Date ot196 _y�_ Application is hereby made fora permit to r VC-4 , story, Type to be occupied only as in accordance with Plot Plan, flans and Specification filed herewith. Estimated Value of Improvements $ FEES Plan Check $ Owner Address Contr. Address Phone State License Approved APPLICATION FOR ELECTRICAL PERMIT Date 196 FEES Contr. Address Phone State License Approved APPLICATION FOR PLUMBING & GAS PERMIT Date � 196 7 GAS FEE E Nn PLUMBING FEE $ } C Contr. 91=22� Address Phone T��`�3 70 State License Approved APPLICATION FOR APPLIANCE PERMIT f Date 196 FEES Coot'. Address Phone State License Approved Applicants agree not to violate any of the Workman's Compensation Laws of the State of California I RECORD OF INSPECTION APPROVALS ` BUILDING FOUNDATION DATE INSPECTOR UNDERFLOOR DATE INSPECTOR FRAME DATE INSPECTOR LATH & PLASTER DATE INSPECTOR FINAL DATE INSPECTOR ELECTRICAL ELECT. SERVICE DATE INSPECTOR UNDERGROUND DATE INSPECTOR ROUGH WIRING ' DATE INSPECTOR FINISH WIRING DATE INSPECTOR FIXTURES DATE INSPECTOR MOTORS DATE INSPECTOR FINAL DATE INSPECTOR PLUMBING & GAS UNDERGROUND DATE INSPECTOR PARTIAL ROUGH DATE INSPECTOR ROUGH COMPLETE DATE INSPECTOR MAIN DRAIN DATE INSPECTOR GAS PIPING DATE PECTOR FINAL DATE INSPECTOR MISC DATE INSPECTOR MISC DATE INSPECTOR APPLIANCE INSPECTED DATE INSPECTOR MISC DATE INSPECTOR MISC DATE :NSPECTOR MISC DATE INSPECTOR