100,081 Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO CC
File NOIA9 11
Sanitary No.
Date 196
Application is hereby made for a permit to
n 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 Y Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEES
Contr. Address
Phone State License
Approved
APPLICATIONFOR PLUMBING & GAS PERMIT
Dare r
1966
v GAS FEE $
PLUMBING FEE $
.G.Nr. / cl Address
Phone I -tam T 7 State LicensJ
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
Applicants agree not to violate any of'thet
Workman's Compensation Laws of the '.`
State of California
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Date Inspector '
UNDERFLOOR
FRAME Date _ Inspector
Date Inspector
LATH & PLASTER
FINAL Date Inspector
Date Ins De c ter
ELECTRICAL
,OUTLETS SERVICE S17_E
SWITCHES UNDERGROUND
Data Inspector
RECEPTACLES ROUGH WIRING
FIXTURES FINISH WIRING Date Inspector
H.P. CHARGE FIXTURES Date Inspector'
PERMIT FEE Motors Date Inspector
,
TOTAL FEES FINAL DateInspector.
Dote Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN SIZE I Lw6TERIAL
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
Date r
GAS PIPING FEE FINAL _ _
Date Spector
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
Dote Inspector