NO PERMIT NUMBER 11,42- .31 �AZIE �..V VZ . Lot No.
No. Street `+`
APPLICATION;FOR,BUILDING RERMIT
CITY`OF CUP/EERTIN
• File No.
Sanitary No.
No.
Do to 196
Appli -ti n s hereby m de for pe t to
a story, Type
to he occupied only as
iri accordance with Plot.Plan, Plans and Specification filed herewith„
Estimated Value of ImproJements $
FEE$ � Qf _ Plan Check $
Ownerj
/'s�t a /�t�s�/� Address
Contr. Address
Phone State License
. ..f v
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
qqqqqq �Waa� h Approved
j�
N8(�TION jo jeL l',BING & GAS, PERMIT
Date
491-18V
1196( ' .GAS FEE $
PLUMBING FEE Eerg
Q0,►
Contr. Y fess 7 ('( LC�
Phone
l / S `; State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$'
Contr. Address
Phone State License
a Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California 7
RECORD OF INSPECTION ,APPROVALS
FOUNDATION BUILDING
Date Inspector '
UNDERFLOOR
Date '
FRAME Inspector
LATH & PLASTER Date Inspector '
'
Date
_FINAL Inspector v
Date Insoector
ELECTRICAL
,OUTLETS "
SERVICE SIZE
_ SWITCHES UNDERGROUND
Dote Inspector
RECEPTACLES - ROUGH WIRING
FIXTURES FINISH WIRING Date Inspector'
Do to Inspector'
H.P. CHARGE FIXTURES
PERMIT FEE Motors Date Inspector
I-H Dote Inspector
TOTAL FEES FINAL
Data Inspector
PLUMBING & GAS "
MAIN DRAIN SIZE MATERIAL
STORM DRAIN I SIZE TERIAL
WATER SYSTEM SIZE TERIAL
TOTAL FIXTURES . UNDERGROUND
FIXTURE FEE �
PARTIAL ROUGH
Date 'Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date Inspector
STORM DRAIN FEE MAIN DRAIN
WATER SYSTEM FEE � IGAS PIPING Date Inspector'
Date
FINAL
GAS PIPING FEE / r
Date nspector
PERMIT FEE AX—' MISC .
Bate Ina pec for
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
_. Date Inspector