NO PERMIT NUMBER Iat ,
Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
\- File No. ir;'or06
Sanitary No.
Date 196
Applicationis enGym'-.adLe far¢ permit -
"^-'�` story, Type
to he occupied 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 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date _�.A:4 196 GAS FEE $
PLUMBING FEE $
//'I 0/'92.� J
Contr. 4 1 Address '�3
Phone - ! 4 7 '<_1S� State License
Approved 16�1
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
Contr. 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
BUILDING
FOUNDATION
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Data Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Insoector
sssssssss
ELECTRICAL
,OUTLETS SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING .
Data Inspector
FIXTURES FINISH WIRING
Date Inspector ,
H.P. CHARGE FIXTURES
Date Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE . MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES /dr—v UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date Inspector -
STORM DRAIN FEE MAIN DRAIN
e„o —�=Dote= ns actor'
WATER SYSTEM FEE � '� GASP HL
Dote e r
GAS PIPING FEE FINAL
D spector
PERMIT FEE oa GY MISC
✓ ate Inspector
TOTAL FEE Tw 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
Onto Inspector