51118Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO p
File No.,yy2z/
Sanitary No.
Date 196
Application is hereby made fora permit to.
a
to be occupied only as (f0 -0,.e
in accordance with Plot Plr lawns and Specification filed herewith„
Estimated Value of Improvements j1A e)d
FEES ./,f -
Plan Check $
OwnerII-f-� L(/6
Contr.
Address
/ Address
li phone -Z ( State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
6� % CAA'
Date • �196 v FEES
Contr. �/i�J�.K Address
Phone OZ
State License
l.J
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date ` 196 GAS FEE $
PLUMBING FEF $ 1
Cewtr. i7M.� U/rtLL4.�/
Phone
Date
Contr.
Phone
Address
State License
�—
Approved ZC)0);
APPLICATION FOR APPLIANCE PERMIT
196 FEES
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
Address
State License
Approved
RECPRD/yF IN_VECTION
U`
AP OV LS
ANw1 m
PouWtSXtl6r+
Date
,OUTLETS
Date
ROUGH WIRING
Inspector
UNDERFLOOR
Inspector
FIXTURES /
Data
Inspector
FRAME
Date
PERMIT FEE
Do ��
Ins pacto� s
LATH & PLASTER
IN
Motors
Date
ROUGH COMPLETE
Inspector
FINAL
FINAL
Do to
Date
Inspector
ELECTRICAL
SERVICE SIZE
UNDERGROUND
I SIZE
I I MATERIAL
,OUTLETS
Date
ROUGH WIRING
SWITCHES L
RECEPTACLES
Inspector
FIXTURES /
FINISH WIRING
P. CHAR
Inspector
Date
PERMIT FEE
TOTAL FEES
IN
Motors
ELECTRICAL
SERVICE SIZE
UNDERGROUND
I SIZE
I I MATERIAL
Inspector
Date
ROUGH WIRING
LMATERIAL
Inspector
Date
FINISH WIRING
FIXTURE FEE
Inspector
Date
FIXTURES
Inspector
Date
Motors
MISC
ROUGH COMPLETE
Inspector
Date
FINAL
Do to
Inspector
Date Inspector
PLUMBING & GAS
MAIN DRAIN
I SIZE
I I MATERIAL
TYPE OF APPLIANCE
STORM DRAIN
I SIZE I
LMATERIAL
WATER SYSTEM
SIZE
TERIAL
TYPE OF APPLIANCE
UNITS
FEE
CIRCULATING HEATERS
TOTAL FIXTURES
T r
UNDERGROUND
FIXTURE FEE
PARTIAL ROUGH
COMBUSTION VENT
Date
Inspector
MAIN DRAIN FEE
MISC
ROUGH COMPLETE
GAS RANGE
Do to
Inspector
STORM DRAIN FEE
MAIN DRAIN
PERMIT FEE
Date
Inspector
WATER. SYSTEM FEE
GAS P NG
Date
Inspector
GAS PIPING FEE
FINAL
�
Date
Inspector
PERMIT FEE
MISC
dy
Date
ns pe ctor
TOTAL FEE
4
MISC
vara Ins pe cror
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
n,.m Ina nnrtnr
TRENCHING PERMIT
SIDEWALK PERMIT
DRIVEWAY APPROACH PERMIT
CITY OF CUPERTINO
Fee --------- -------------- Date --- 1966
...... . ............
Permission Is Granted
....... .... . .................
. .......... . .
Location .............. . .........
Purpose .............................................
Contractor----------------- ------------------------- .......... ...................................................... ............
NOTE: All work shall comply to all conditions con
-ained in Ordinance 130.
Issued by ................ _I, To ........ ... .......
BUILDING IN F&'(W•
RECORD OF INSPECTION
.............. ................... ...... ............................. ............. ----- ---- I .......................
DATE TIME INSPECTOR
...... .... AT17...... 1 M 1:DTINSPECTOR
... ............ ..... -------------------------- ......... ............................ I .................
DATE TIME INSPECTOR
.......... ................... ............................... .... ....................................... ........
DATE TIME INSPECTOR
NOTE: Inspector must be given 24 hours notice on each Inspection. 115 9/60-500