NO PERMIT NUMBERLot No.
No.I Street v.
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO r
File No. v zd G
Sanitary No.
Date �L_ 196 /�
is
o story, Type
to be occupied on y ns
in accordance with plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEES y Plari Check $
Owner ( 4
Contr. Address
I Phone
I Date
I Contr.
State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
FEE$
Address
Phone State License
I Date
I Contr.
I Phone
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
196 GAS FEE $
PLUMBING FEE $
Address
State License
Approved
S APP ICA TION FOR APPLIANCE PERMIT j p e
Date 196 FEE$
Contr. nn �" Address V.
Phone 7.X G-16 71 O . , 'State License ' C-2
Approved
Applicantsagree not to violate any of the -
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION. APPROVALS
FOUNDATION BUILDING
. Date Inspector
UNDERFLOOR
FRAME Dote Inspector
Do to
LATH &'PLASTER
Do to
FINAL
Date
Inspector
Inspector
Insoector
ELECTRICAL'
I SIZE
.OUTLETS
I MATERIAL
SWITCHES
STORM DRAIN
RECEPTACLES
I
FIXTURES
REGISTERS
H.P. CHARGE
Date
PERMIT FEE
Inspector
TOTAL FEES
COMBUSTION VENT
Inspector
Inspector
Insoector
ELECTRICAL'
I SIZE
I
I MATERIAL
SERVICE SIZE'
STORM DRAIN
UNDERGROUND
I
LowTERIAL
REGISTERS
WATER SYSTEM SIZE
Date
TOTAL FIXTURES.
Inspector
ROUGH WIRING
COMBUSTION VENT
FIXTURE FEE
PARTIAL ROUGH
Date
MAIN DRAIN FEE
Inspector
FINISH WIRING
Inspector
STORM DRAIN FEE
Do t6
MAIN DRAIN
Date
WATER SYSTEM FEE
Inspector
FIXTURES
Inspector
GAS PIPING FEE
PERMITAE
FINAL Date
Date
PERMIT FEE
Inspector
Motors
Inspector
-TOTAL FEE �
Date
MISC
Date
.Inspector ,
FINAL'
PLUMBING & GAS
Date Inspector
MAIN DRAIN
I SIZE
I
I MATERIAL
UNITS
STORM DRAIN
I SIZE
I
LowTERIAL
REGISTERS
WATER SYSTEM SIZE
ITE RIAL
TOTAL FIXTURES.
UNDERGROUND
COMBUSTION VENT
FIXTURE FEE
PARTIAL ROUGH
MAIN DRAIN FEE
MISC
Date
ROUGH COMPLETE
Inspector
STORM DRAIN FEE
Do t6
MAIN DRAIN
Inspector
WATER SYSTEM FEE
GAS PIPING Date
Inspector
GAS PIPING FEE
PERMITAE
FINAL Date
Inspector
PERMIT FEE
Date
MISC I.
Inspector
-TOTAL FEE �
Date
MISC
Inspector
uote 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
PERMITAE
FLOOR FURNACE
I TOTAL
INSPECTED l 0` N 1- 1010
Data Inspector