51118 Cf Lot No.
No. Street
APPLICATION FOR BUILDING P RMIT
/UP�ER, X/
File No.
is
y No.
Do to 196
Applica 'V�Iser ype
to he occ pi o ly
in accord tnce with P14,
l P1 , plans and Specification filed herewith„
s imated Value of Improvements $
FEES Plan Check $
Owner � �YNr-�� O Address
Contr. Address
r
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data a /5� 196 GAS FEE $
PLUMBINGFEE $
/ y/
Contr. 1? Address 02
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT \
Date 196 FEES
Conir. Address
Phone State License A
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
Date Ins pector
LATH & PLASTER
Date Inspector
FINAL
Dote Insoector
ELECTRICAL
,OUTLETS SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES 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 SIZE I I MATERIAL
STORM DRAIN SIZE I Lli,6TERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Do td Inspector
STORM DRAIN FEE MAIN DRAIN
Date Inspector
WATER SYSTEM FEE GAS PIPING
Date Inspector
GAS PIPING FEE FINAL
I ctor
PERMIT FEE MISC 1 i
l ate nspector
TOTAL FEE - 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
n..•� Insoeeter
l .O�.1/ t LOT NO. ;
S .P.
A1 FOR PLUMBING PERMIT
= Z
FEB 15 1965 OF CUPERTINO
s o Sanitary No.
LL
30
U l�I a I)ato �^111 wr 0196`5 Permit No
Pee $
w
0 Application is hereby made to the City of Cupertino for a permit to install plumbing
`o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said rices
i H and/ fixtures in-accordance with the provisions of the Plumbing Code of the Cary of
a n Cupertino, and all lei Inws applicab t reto.
w I
r
Use of Pre
s
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PLUMBING INSPECTOR
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