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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