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51003 /Q J V7 T I �/L•A.I••tl/ Lot No. No. Street - CITY OF CUPERTINO APPLICATION FOR BUILDING PERMIT Sanitary No. File No. 4220ed Date 19 Application is hereby made for a permit to story, Type to be occupied only as in act ante wit lot Plan, Plans and Specification filed herewith, Estimated Value of Improvements $ FEE$ �^ _ n Plan Check $ Owner �o � - Address Contr. ��"�"� �s+.�e✓ /�� C�e Address Phone eZ A-..2 - .233 {• State License ��j`r��Qr���- Approved �1 APPLICATION FOR ELECTRICAL PERMIT Date 19 FEE$ Contr. Address Phone State License Approved APPLICATION FOR PLUMBING & GAS PERMIT ro Dare yor 79 �� GAS FEE $ � 1� PLUMBING FEE $ Contr. � Address Phone .2 1—,2 .2-3 a to State License 9 so.Z' Approved APPLICATION FOR APPLIANC PERMIT Date 19 FEES Contr. Address 5 Phone State License r Approved Applicants agree not to violate any of the Workman's Compensation Laws of the State of California PD-1 . V A RECORD OF INSPECTION APPROVALS BUILDING DATE INSPECTOR MISC. PAD FINAL FOUNDATION UNDERFLOOR FRAME LATH S PLASTER GRADING FINAL FINAL BLDG. ELECTRICAL DATE INSPECTOR MISC. UNDERGROUND ROUGH ROUGH WIRING FINISHED WIRING FIXTURES MOTORS FINAL PLUMBING, GAS 8 APPLIANCE DATE INSPECTOR MISC. BACK FLOW REQ. SANITARY NO. UNDERGROUND ROUGH PARTIAL ROUGH ROUGH COMPLETE MAIN DRAIN FINAL PLBG. FINAL GAS FINAL APPLIANCE DATE INSPECTOR MISC. MISC MISC MISC 1 0�I. LOT NO. � EET WATER DEPT. 04 Vqq�� CITY OF CUPERTINO NOV 4 APPLICATION FOR APPLIANCE PERMIT " x Oi 0 <Date fA D�_ 19� Permit No. d� U W W Fee-$,�� . ° Application is hereby mat-de to the City of Cupertino for a permit to o F install gas appliances as listed on the reverse side hereof, and agrees to 4z LO initall said appliances in accordance with the provisions of the Plumbing ` x Code of the City of Cupertino, and all other laws applicable thereto. 3 Use of Premises Se. Lr o c (/ /�,( - 1-- � ;" ()wnera 4 L / •A/P�Anr!' SR. Address ../C `/ U�A/{P11%! 4, 04 zBy "! ON i7C l�/S/y , A( Address 2 CONTRACTOR,AGENT 3 < PhoneS 233 — _ mz W'W ao State License 3 9'5'1—_ Approved - 0 11 PLUMBING INSPECTOR L a+ Z� E a a F :n c = o ULLL i ro U 3 U Ii U 3 rn '.] U 2 li 0 � 3 !0 GAS SERVICE NOTICE OFFICE BUILDING INSPECTOR'S. OFFICE . COPY CITY OF.CUPERTINO a, ' ..........if/. // /.. I To 1 You are herebyauthorized to the,G , ✓�} AS service for. . Owner or Tenant ......: ... . . . . Ai Y1 ... .................. I' New Service v . No. ofAMetersR ..:.... nned -/........... y eco .. :. Mav e-Service ......... ............. No. of Add. Meters ...........:.. . . - Move Metet .....:.:............... ., - .............. ....... ................................. PLUMBING INSPECTOR