NO PERMIT NUMBER /0//0 Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO S
File No.`s /0
9 G Sanitary No.
Data 196 �fL�
Application is her 6y e for¢ permit to
story, Type
to he o toted only as
in accordance with Plot Plan, Plans and Specification filed herewith.. .
.Estimated Value of Improvements $
FEES Plan Check $
Owner Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data T 196 GAS FEE $
PLUMBING FEE $
Contr. /lig W `
Phone (/���`� �� State License C'-/31 ^' a-v�-�/
Approved �/s/ "�'�'�'`�"'� Le
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
C ontr. Address
Phone State License
Approved
Applicants agree not to violate any of the "
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Do to Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH 8 PLASTER
Date Inspector
FINAL
Date Inaoector
ELECTRICAL
,OUTLETS SERVICE SIZE
SWITCHES UNDERGROUND
RECEPTACLES ROUGH WIRING Date Inspector
FIXTURES FINISH WIRING Date Inspector
H,P. CHARGE FIXTURES Date Inspector
PERMIT FEE Motors Date Inspector
D
TOTAL FEES FINAL ate ! Inspector
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE TERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Data Inspector
STORM DRAIN FEE MAIN DRAT
Date Inspector
WATER SYSTEM FEE Of GAS PIPING
Datefor
GAS PIPING FEE FINAL - i
Date nspector
PERMIT FEE � MISC
TOTAL FEE �� MISC ate Inspector
Date Inspector
APPLIANCE
TYPE OF APPLIANCE UNITS FEE TYPE OF APPLIANCE UNITS FEE
CIRCULATING HEATERS REGISTERS
BLOWER FUR14ACES COMBUSTION VENT
SUSPENDED UNIT MISC
GAS RANGE MISC
GAS DRYER PERMIT FEE :d
FLOOR FURNACE TOTAL FEE
INSPECTED
Date Ina pe c for