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NO PERMIT NUMBERLot Street APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO Do to 196 Applicat" is'herA to he occupied on File No. 5—/04/ Sanitary to a story, Type in accordance with plot Plan, Plans and Specification filed herewith, Estimated Value of Improvements $ FEE$ Plan Check $ Owner / Cont,. Address Phone State License Approved APPLICATION FOR ELECTRICAL PERMIT Date 1 Contr. Phone Do to FEES Address State License Approved APPLICATION FOR PLUMBING & GAS PERMIT 196 GAS FEE $ PLUMBING FEE $ Contr. Address Phone State License Approved APPLICATION FOR APPLIANCE PERMIT d� Date ! 196 es FEE$ Contr: Address Phone` X " State License r/O r A pproved l� / Applicants agree not to violate any of the Workman's Compensation Laws of the State of California RECORD OF INSPECTION. APPROVALS FOUNDATION BUILDING Dote UNDERFLOOR Date FRAME Do to LATH 8 PLASTER Do to FINAL Do to ELECTRICAL Inspector Inspector Inspector Inspector Ins oe ctor SERVICE SIZE UNDERGROUND SIZE FEE ,OUTLETS Date Inspector SWITCHES ' RECEPTACLES Date Inspector FIXTURES UNDERGROUND H.P. CHARGE Date Inspector PERMIT FEE MAIN DRAIN FEE TOTAL FEES Date Inspector ELECTRICAL Inspector Inspector Inspector Inspector Ins oe ctor SERVICE SIZE UNDERGROUND SIZE FEE MATERIAL Date Inspector ROUGH WIRING ' REGISTERS Date Inspector FINISH WIRING UNDERGROUND COMBUST ON VENT Date Inspector FIXTURES MAIN DRAIN FEE MISC Date Inspector Motors MAIN DRAIN Date Inspector Data Inspector FINAL Inspector ' GAS PIPING FEE Date Inspector PLUMBING & GAS MAIN DRAIN SIZE FEE MATERIAL UNITS STORM DRAIN SIZE TERIAL REGISTERS WATER SYSTEM SIZE ITERIAL TOTAL FIXTURES. UNDERGROUND COMBUST ON VENT FIXTURE FEE PARTIAL ROUGH MAIN DRAIN FEE MISC Dote ROUGH COMPLETE 'Inspector STORM DRAIN FEE MAIN DRAIN Date Inspector WATER SYSTEM FEE GAS PI Date NG Inspector ' GAS PIPING FEE PERMI E FINAL Date Inspector _PERMIT FEE � Date MISC Inspector TOTAL FEE � Date -MISC Inspector Date Inspector APPLIANCE TYPE OF APPLIANCE UNITS FEE TYPE OF APPLIANCE UNITS FEE .CIRCULATING HEATERS REGISTERS BLOWER FURNACES COMBUST ON VENT SUSPENDED UNIT MISC GAS RANGE MISC ' GAS DRYER PERMI E pLE►- FLOOR FURNACE TOT O V INSPECTED ( 4e .r �— K7fo Date Inspector