51118 Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File N
Sanitary No.
Data 196
Application is hereby made for a permit to
a story, Type
to be occupied only as
in accordance with Plot Plan, Plans and Specification filed hereto"
Estimated Value of Improvements S
FEES ' Plan Check $
Owner Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEES
Contr. Address
Phone C 10 State License
GJ AUG 12 9964 Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date : lQ 1 CUKRTINO GAS FEE $
PLUMBING FENS
v 'J / n
Can G Lt Address L ,!" .
J /
Ph na / 3'0 State Ll Aense o�r.. ApprovedAPPLICATION FOR APPLIAT
Data 196 FEES
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
Dote Inspector
FRAME
Date Inspector
LATH & PLASTER
Dote Inspector
FINAL
Date Insoector
ELECTRICAL
,OUTLETS SERVICE SIZE
S ES UNDERGROUND
Date Inspector
TACLE$ ROUGH WIRING
Date 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 SIZEMATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE MATERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE . 00 PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date Inspector
STORM DRAIN FEE MAIN DRAIN
' Date Inspector
WATER SYSTEM FEE .U 0 GAS PIPING
Date Inspector
GAS PIPING FEE FINAL
Date Inspector
-
PERMIT FEE 7,00 MISC
Date Inspector
FEE D 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