NO PERMIT NUMBER Lot N..'116
No. - t Street -
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO ` Q
File No. + IIy '
�7�/�� Sanitary No.
Date -. [-196
Application is hereby made for a permit to
a story, Type
= sr
to be occupied only as
in accordance with Plot Plan, Plans and Specifics file herewith„
.E t* Value of lmprove'ants' $922 r♦
FEES IT 'Plan Check $
Owner Address
Contr. �/ Address
Phone Qe.2 2193,0
State
ApprLieansa
ove
z
d
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEES o2."'r�"�
Contr, _ (N6—r�- .t_._J Address
Phone 7 State License -/L{G]- L
WILLIAM D. BENCVICH
' Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data 196 GAS FEE S J
PLUMBING FFF t.�A ,
Contr. _�LSs-�1M1/ �s^^-^ Q Address I4R,%q /t.•�C �^y�
Phone -c'1�5 �a3a�3 State License `-+ 79
Approved WILLIAM D. BENEVICH
AP541CATION FOR APPLIANCE FERMI 7 J
Date � � L 1% FEES r
Contr../(, Address /
Phone .3-7 f - 0 /`P 3 State License L" L
_t
Approved V'JILLIA:l1 D. CEidiiVlChS
Applicants agree not to violate any of the i
Workman's Compensation Laws of the r
State of California
9',
RECORD OF INSPECTION APPROVALS
APPROVALS
FOUNDATION _09 BUILDING
ajo Ins pec r
UNDERFLOOR b
6 Inepeat
FRAME
�P In, ata
LATH PLASTER
t for
FINAL
Date Inspector
ELECTRICAL
,OUTLETS
SERVICE SIZ
SWITCHES UNDERGROUND
D nsp'ctor
,RECEPTACLES ROUGH_ WIRING �
nspector
FIXTURES FINISH WIRING
— to Inspector
M.P. CHARGE FIXTURES
ate-- Inspector
'PERMIT FEE Motors'
— atavactor
TOTAL FEES FINAL ak
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND /�
FIXTURE FEE PARTIAL ROUGH — &1 J
Date y or
MAIN DRAIN FEE ROUGH COMPLET -C/
D 19. I or
STORM DRAIN FEE MAIN DRAIN
Wpet.rr WATER SYSTEM FEE GAS PI NG
DafeGAS PIPING FEE FINAL '� Date
PERMIT FEE MISC
Date napector
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 — �6 _
Date Inspector
\ } /
$ � 2 j . •
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} % . $ 2 �
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Bldg. Dept
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
F-1 Sewer Connection Sanitary Permit No
. ..................................
EJ—Plumbing Final Plumbing Permit No. .......
Lot NO.
........................
Owner or Tenant .......A6,W ......................................................
At .....................................................
Tract .......... . -
.....I--- --✓-e--.,�-,—nle,
....................................../
DateConnected -----------------------------�. ............................................................ 19.--41V—.
DateFinal .................................I./ ................... ..................................... 19 el
...........
4-TL.UM�Bl.N.G---INSPECTOR-. - - - -------------------
111 7/63-IM
File No. J�1/-k 7
Date /- 7-6'9_
Location_
Subject
Notes
Approved40� 7-49�f
Date Ins c or'