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NO PERMIT NUMBER /0/00 I �,�/ /Cyr Lot No. No. Street APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO File No. Sanitary No. Data 196 Application is hereby made for a per"". o a ry, Type to be occupied only as in accordance with Plot Plan, Plans and Specification filed herewith, Estimated Value of Improvements $ FEES T —��^�-�s�/I e_ Plan Check $ Owr,er —$ �G�.A Contr. Address Phone State License Approved APPLICATION FOR ELECTRICAL PERMIT Date 196—L . FEES J7MI �y•v Contr. Address 1*441 Phone t�s JIL— /OV O State License Approved `�'�,1�V Approved ` I� •"�^'� APPLICATION FOR PLUMBING & GAS PERMIT Date 196 GAS FEE $ PLUMBING FEE $ Contr. Address Phone State License Approved APPLICATION FOR APPLIANCE PERMIT Date 196 FEES Cont,. 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 FOUNDATION BUILDING Date Inspector UNDERFLOOR Date Ins pe bt or FRAME Data Inspector LATH & PLASTER Date Inspector FINAL Dote Ins oe c for ELECTRICAL ,OUTLETS SERVICE SIZE SWITCHES UNDERGROUND Date Inspector RECEPTACLES ROUGH WIRING Date Inspector FIX,TURES FINISH WIRING Date Inspector H.P HARGE FIXTURES Data Inspector PERMIT FEE 40 Motors 2 Da c r TOTAL FEES L' FINAL ' Dote Inspector PLUMBING & GAS MAIN DRAIN SIZE MATERIAL STORM DRAIN SIZE MATERIAL WATER SYSTEM SIZE ITERIAL TOTAL FIXTURES UNDERGROUND FIXTURE FEE PARTIAL ROUGH Dote Inspector " MAIN DRAIN FEE ROUGH COMPLETE Dote Inspector STORM DRAIN FEE MAIN DRAIN Date Inspector WATER SYSTEM FEE GAS PIPING Date Inspector GAS PIPING FEE FINAL Date Inspector PERMIT FEE MISC Date 'Inspector TOTAL FEE MISC Dote 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 Data Inspector