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FILE 51167i I ___, , ! . No. 'Street .G+. .. APPLICATION FOR:BUILDING PERMIT ;CITY OF,CUPERTINO Do to ._� 196. Application is: hereby made for a permit to to be occupied only as :File 'No. Sanitary .story, Type /a i r in accordance with Plot Plan, Plans .. and Specification filed herewith Estimated Value of.lmprovements s .t•s s t%• FEES _. .3. Or7 Plan Check $ Owner %.VQ/AA, _A..Z/: iLr Address "'oto Contr. IOJ'199��' p,rQA,aw[i Address . Phone ds IO a� State License /�/ Approved I W JLQ• tC7dntp ekr.K•� 1 APPLICATION FOR ELECTRICAL PERMIT Date 196 FEES Contr. Address Phone State License Approved APPLICATION FOR PLUMBING & GAS PERMIT Date 196 GAS FEE $ PLUMBING FEE $ Contr. Address Phone State License ' 'Approved APPLICATION FOR APPLIANCE PERMIT Data 196 FEES Contr. Address Phone Stu to "License' Approved " Applicants agree not to violate any of the Workman'sCompensation Laws of the . State of California -� , RECORD OF INSPECTION APPROVALS ' 'BUILDING FOUNDATION ' _I UNDERFLOOR FRAME LATH 8 PLASTER FINAL INSPECTOR ' ELECTRICAL ' ELECT. UNDERG ROUGH FINISH W FIXTURE MOTORS FINAL SERVICE WIRING 3, .. _� .. .., DATE DATE INSPECTOR ROUND ... _,... _ . ,, . ...... ..... DATE 'DATE INSPECTOR :H COMPLETE ... �"' ATE DATE ....INSPECTOR .. IRING DATE A INSPECTOR ' ELECTRICAL ' ELECT. UNDERG ROUGH FINISH W FIXTURE MOTORS FINAL SERVICE WIRING 3, .. _� .. .., INSPECTOR ' DATE INSPECTOR ROUND ... _,... _ . ,, . ...... ..... "- DATE 'DATE '� INSPECTOR :H COMPLETE ... �"' . DATE - INSPECTOR , IRING DATE DATE INSPECTOR S -- . • ........ DATE ... .. ... INSPECTOR n DATE INSPECTOR .. .,, .. ', DATE INSPECTOR PLUMBING-..& ,GAS;,.::'..'I ERGROUND ... DATE .. _� .. .., INSPECTOR ' DATE ... INSPECTOR ' f IAL ROUGH ..... ... _,... _ . ,, . ...... ..... "- DATE - DATE INSPECTOR :H COMPLETE ... �"' DATE INSPECTOR DRAIN DATE DATE INSPECTOR PIPING -- DATE INSPECTOR ,. .. . 'DATE INSPECTOR „DATE INSPECTOR , .. .. DATE .... ... INSPECTOR ' INSPECTED APPLIANCE - - -' MISC "- DATE ....INSPECTOR MISC DATE INSPECTOR MISC DATE INSPECTOR DATE INSPECTOR