NO PERMIT NUMBER Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
File-No.
Date 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 herewith„
Estimated Value of Improvements $
FEE$ Pion Check $
Owner Address
Conir. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
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
Slate of Califnrnia
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
PAD FINAL
FOUNDATION
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL
FINAL BLDG.
ELECTRICAL
DATE IN MISC.
UNDERGROUND ROUGH
ROUGH WIRING
FINISHED WIRI If
FI%TURES 1w ff
MOT ORS
FINAL
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS -
FINAL APPLIANCE
DATE INSPECTOR MISC.,
MISC
MISC
MISC
ir7�3� m `T.9� vs
y, Q NO. STn Lor NO.
¢ 1 FOR ELECTRICAL PERMIT
Y °
Oa 91Q CITY OF CUPERTINO
° Date 19 Permit No, —
o a ` Vpce ti
<m Applicati,,,o111n �erR •made to the City of Cupertino for a permit to install electrical
W r wiring ciFl7Ur fixtures as listed on the reverse side hereof, and agrees to install said
0 o wiring 443''/�or fixtures in accordance with the provisions of the Electrical Code of the
5 City of Cupertino, and all other laws applicable thereto.
z -1 Use of Premises f
J Z
3 < Owner (Ze—AlS.C/� Address 105/ 4
w zBy r "ti Address
O CONTRACTOR, AGENT Approved WILCIAIVI D' B nt>nrtr+l..l
—<) Phoned .2� — 57 ELECTRICAL INSPEL706t
j.L State License:
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LOT NO. %L►•
NO. STREET ^
APPLICATION FOR APPLIANCE PERMIT
d zCITY OF CUPERTINO
i CITY G2 CUr: X
.SO
3 < Dae / C 19, Permit No.
U '7/ 'o
W n Fee•$
„ o
P pptc,- n is hereby made to the City-of Cupertino for a permit to
°o a install gas appliances as listed on the reverse side hereof, and agrees to.
m install said appliances in accordance with the provisions of the Plumbing
W = Code of the City of Cupertino, and all other laws applicable thereto.
F �
5L Use of Premises,
o_ o
M ; OwneFh/ _FA il Address � ? 4ed &W-
?z By U ilk 639' N, I� c�.'Tos/
Address i9^ 3os—`
J'e C NTRACTOR, AGENT
3 m Phone
o o ate License Z Approved • '
U PLUMBING INSPECTOR
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